Las Vegas Sun

August 30, 2014

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About the report:

Reporting is the first of its kind in Nevada

The Sun’s reporting on patients being harmed while hospitalized is based on the newspaper’s analysis of Nevada hospital data collected in 2008 and 2009.

Nevada law requires that the data, which are based on hospital billing records, be collected for analysis. Nevada is one of at least 40 states that collect similar data.

The 560,000 records do not contain patient names, birth dates or addresses, nor do they identify admission dates. These records are not the same as medical records, so they lack clinical details such as nurse and doctor notes, diagnostic tests and medical histories.

The data include detailed information on diagnoses, procedures and billed charges for each admission — essentially a summary of what was wrong with the patient and what was done. They also indicate the patients’ length of stay and whether they were sent home or to another facility, or died.

The Sun obtained the data through a public records request.

The newspaper followed guidelines used by the federal Centers for Medicare & Medicaid Services to identify patients who experienced 10 types of preventable, high-cost complications that are — or have the potential to become — substantial injuries or illnesses. Medicare no longer reimburses hospitals for these “hospital-acquired conditions” and has published detailed methods for finding them based on standard codes in billing records.

The Sun’s analysis, and Medicare’s, largely hinge on billing codes that indicate whether a medical condition was “present on admission.” Such codes have been required since 2008. This allowed the Sun and Medicare to single out problems that began after the patient entered the hospital.

The Sun’s reporting is unique because up to this point, no information on hospital-acquired patient harm — by any definition — has been reported in Nevada on a facility-by-facility basis.

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