ArticlePharmacoepidemiology and drug safety2014
Observation stays in administrative claims databases: underestimation of hospitalized cases.
Article in Pharmacoepidemiology and drug safety, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
7 citing papers in PubMed.
- Effect of Electronic Reminders, Financial Incentives, and Social Support on Outcomes After Myocardial Infarction: The HeartStrong Randomized Clinical Trial.JAMA internal medicine · 2017Trial
- Associations between hospital admission frequency and household financial outcomes in Korea.International journal for equity in health · 2026Article
- Early Follow-up After Colorectal Surgery Reduces Postdischarge Emergency Department Visits.Diseases of the colon and rectum · 2020Article
- Increasing Trends in the Use of Hospital Observation Services for Older Medicare Advantage and Privately Insured Patients.Medical care research and review : MCRR · 2019Article
- Identifying Observation Stays In Medicare Data: Policy Implications of a Definition.Journal of hospital medicine · 2019Article
- Observation management of pulmonary embolism and agreement with claims-based and clinical risk stratification criteria in United States patients: a retrospective analysis.BMC pulmonary medicine · 2017Article
- DXA Utilization Between 2006 and 2012 in Commercially Insured Younger Postmenopausal Women.Journal of clinical densitometry : the official journal of the International Society for Clinical DensitometryArticle
Corrections and comments
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Authors and funding
5 authors.
Funding
Abstract
purposeRecent policy changes in the USA have led to an increasing number of patients being placed into observation units rather than admitted directly to the hospital. Studies of administrative data that use inpatient diagnosis codes to identify cohorts, outcomes, or covariates may be affected by this change in practice. To understand the potential impact of observation stays on research using administrative healthcare data, we examine the trends of observation stays, short (≤2 days) inpatient admissions, and all inpatient admissions.
methodsWe examined a large administrative claims database of commercially insured individuals in the USA between 2002 and 2011. Observation stays were defined on the basis of the procedure codes reimbursable by Medicare or commercial insurers. We report monthly rates of observation stays and short inpatient admissions overall and by patient demographics.
resultsWe identified 5 355 752 observation stays from 2002 to 2011. Over the course of study, the rate of observation stays increased, whereas the rate of short inpatient stays declined. The most common reason for observation stays was nonspecific chest pain, also the third most common reason for short inpatient stays. The increasing trend of observation stays related to circulatory diseases mirrors the decreasing trend of short inpatient stays.
conclusionsThe use of observation stays has increased in patients with commercial insurance. Failure to account for observation stays may lead to an under-ascertainment of hospitalizations in contemporary administrative healthcare data from the USA.
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