Hospitals, SNFs don't agree on wounds

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Hospitals and nursing homes agreed on the existence of a pressure wound just over one-third of the time, according to a new study, a finding that calls treatment into question.

In research published online in BMJ Quality and Safety, investigators in California explored the reliability of claims data for hospital-acquired pressure injuries and stage reporting by evaluating codes during facility transfers.

They used the 2012 Provider and Analysis Review file, looking for patients who were discharged with an ICD code for a pressure injury and admitted to two different hospitals within one day.

Among transfers with a pressure injury present at hospital admission, only 34% had been previously diagnosed at the transferring facility. Even when both facilities agreed on an ulcer's presence, they documented a different stage one-fourth of the time.

“Coding discrepancy among transfers between SNFs and acute inpatient hospitals raises important questions regarding the role of staffing/coding capacity versus different coding motivations between facility types,” wrote lead author Lee Squitieri, M.D., with the University of Southern California.