Comparison of ICD Classification Schemes in a Home Health Care Setting

• Activity Number: 443
• Type: Contributed
• Date/Time: Tuesday, August 6, 2013 : 2:00 PM to 3:50 PM
• Sponsor: Health Policy Statistics Section
• Author(s): Carlin Brickner*+ and Timothy Peng
• Companies: Visiting Nurse Service of New York and The Visiting Nurse Service of New York
• Keywords: Model Comparison ; Bayesian Information Criteria ; ICD

Abstract

The International Classification of Diseases (ICD) is a classification system of diagnostic codes used as a standard for clinical, epidemiological, and quality functions. ICD codes often are under reported since health care providers are incentivized to document diagnoses for reimbursement purposes. Classification schemes are necessary to synthesize the information gathered from thousands of unique diagnosis codes. As a result, many additional classification schemes have been developed to group ICD codes together using a variety of similarity criteria. This study compares the performance of several diagnosis classification schemes commonly used in the home health care setting by comparing the performance of each scheme in a series of multivariate regression analyses of a national study of Medicare claims from 26 not-for-profit, home health care agencies. A comparison of performance is made for several types of outcome measures: cost, hospitalization, service utilization, and improvement measures. Schemes are compared using the Bayesian Information Criteria.