Claims Data Underreports Pressure Ulcers

John Commins, October 17, 2013

Rates of hospital-acquired pressure ulcers vary widely in hospitals based on how the data is collected, researchers say. In one study, surveillance data identified 10 times more pressure ulcers than billing data.

Hospitals that rely on claims data to measure hospital-acquired pressure ulcers are likely under-reporting the problem and creating an inaccurate comparison with competitors for the public. A far more accurate measure uses surveillance reports by trained clinicians inside the hospital, a new study shows.

A University of Michigan School of Medicine study, which appears this week in the Annals of Internal Medicine, found that HAPU rates varied wildly in hospitals based on how the data was collected, inaccurately making some hospitals appear to be better or worse than peer institutions.

The UM study examined two million all-payer administrative records from 448 California hospitals and quarterly hospital surveillance data from 213 hospitals in that state that were publicly reported on CalHospitalCompare in 2009. The researchers winnowed the sample to 196 acute care hospitals with at least six months of claims data and surveillance data.

Jennifer A. Meddings, MD, an internist and pediatrician at UM and the leader author of the study, says researchers "looked at the same hospitals in the state of California in the same year and mapped criteria looking at the same patients as much as possible and the same severity of ulcers."

John Commins

John Commins is a senior editor at HealthLeaders Media.


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