Table 2. Improved pneumonia 30-day mortality and hospital readmission rates when hospitals above the 50th percentile recoded patients to a primary diagnosis of sepsis or respiratory failure.
| When 100 hospitals with mortality rates above the 50th percentile recoded patients | After half of eligible patients recoded | After all eligible patients recoded |
|---|---|---|
| Average percent decrease in mortality rate among the hospitals (95% CI) | 0.54 (0.42-0.66) | 1.09 (0.94-1.28) |
| Number who improved out of 100 hospitals (95% CI) | 81 (73-88) | 90 (84-95) |
| Number who dropped below the 50th percentile out of 100 hospitals (95% CI) | 22 (15-29) | 41 (33-52) |
| Number of patient's recoded per hospital (median, IQR) | 9 (5-16) | 18 (9-31) |
| When 100 hospitals with readmission rates above the 50th percentile recoded patients | After recoding half of eligible patients | After recoding all eligible patients |
| Average percent decrease in readmission rate among the hospitals (95% CI) | 0.16 (0.09-0.25) | 0.34 (0.19-0.45) |
| Number who improved out of 100 hospitals (95% CI) | 61 (51-70) | 66 (54-75) |
| Number who dropped below the 50th percentile out of 100 hospitals (95% CI) | 10 (4-16) | 15 (9-22) |
| Number of patient's recoded per hospital (median, IQR) | 9 (4-16) | 17 (9-32) |
Results are means and 95% confidence interval estimates from Monte-Carlo simulations unless otherwise stated. Confidence intervals are percentiles of the simulated results. In each simulation: (1) 100 hospitals are selected to recode patients (2) among selected hospitals, 50% or 100% of patients with pneumonia and organ failure are dropped (recoded) and the mortality or readmission rate is re-calculated. Patients eligible for recoding are those with a primary ICD-9-CM code for pneumonia and ICD-9-CM procedure code for mechanical ventilation or secondary code for acute organ failure