week 4 case study
6
Case study 1 charts
Identifying Hospitals that Upcode
|
|
Average Upcoding Rate |
Average Downcoding Rate |
|
OIG Experimental sample - hospitals with a high predicted rate of upcoding (n=50) |
11.4% |
5.1% |
|
OIG Control sample - hospitals without a high predicted rate of upcoding (n=20) |
5.2% |
3.9% |
Three Highly Vulnerable DRGs
|
|
OIG Experimental Sample |
OIG Control Sample |
CDAC Sample |
|||
|
|
Up-coded |
Down-coded |
Up-codedg |
Down-coded |
Up-coded |
Down-coded |
|
DRG 79: Respiratory Infections |
37.7% (n=60) |
0.0% (n=0) |
18.5% (n=5) |
0.0% (n=0) |
11.0% (n=48) |
0.7% (n=3) |
|
DRG 416: Septicemia |
21.2% (n=14) |
0.0% (n=0) |
16.7% (n=3) |
0.0% (n=0) |
13.3% (n=49) |
1.1% (n=4) |
|
DRG 14: Specific Cerebrovascular Disorders |
10.1% (n=10) |
0.0% (n=0) |
6.7% (n=2) |
0.0% (n=0) |
3.5% (n=24) |
0.4% (n=3) |