Palliative care coding practices in Canada since the introduction of guidelines and the HSMR indicator.
Bottom Line: National HSMR declined by 22% during the study period, compared with a 17% decline in HSMR-PC.Provincial results for HSMR-PC are not significantly different from regular HSMR calculation.Aside from PC coding practices, we note numerous independent drivers of improving HSMR results, notably, a significant reduction of in-hospital mortality, and increase in admissions accompanied by a greater number of coded comorbidities.
Affiliation: Canadian Institute for Health Information, Toronto, Ontario, Canada.Show MeSH
Related in: MedlinePlus
Mentions: At the national level, HSMR-PC declined by 17.2% (from 111 in 2006–2007 to 92 in 2012–2013), compared to a 22% decline in regular HSMR (from 114 in 2006–2007 to 89 in 2012–2013). Adjustment for PC cases resulted in an increase of 2.6 points in national HSMR for 2012–2013. We observe no significant differences when comparing provincial results of HSMR and HSMR-PC (see figure 4). Analysing eight provinces over seven data years, we note four instances (7%) of non-overlapping CIs between HSMR and HSMR-PC results. A linear regression test shows that regular HSMR and HSMR-PC provincial trends are not significantly different for all provinces.
Affiliation: Canadian Institute for Health Information, Toronto, Ontario, Canada.