The potential lost hospital income from miscoded emergency department boarders in Ireland

Ir J Med Sci. 2014 Jun;183(2):215-7. doi: 10.1007/s11845-013-0992-0. Epub 2013 Aug 15.

Abstract

Background: Emergency department (ED) boarders, namely patients who have been admitted under an in-patient service but remain on a trolley in the ED, have long been a problem in the Irish healthcare system.

Methods: We conducted a retrospective analysis of all ED boarders in Cork University Hospital (CUH) for a 6-month period from January to July 2011. Data were obtained from the Hospital In-Patient Enquiry Office (HIPE). The income generated by the hospital for a subset of these patients (January and February attendances) was obtained from the Finance Office in the hospital, based on diagnoses as recorded on the HIPE system. A convenience sample of two-thirds of the 39 acute hospitals nationally was surveyed to ascertain whether ED boarders were coded by individual HIPE offices as hospital in-patients or as ED attendees.

Results: A total of 806 patients were admitted to an in-patient service from January to July 2011 in CUH and subsequently discharged, having completed their entire stay in the ED. The income generated by a sub-sample of 228 patients (January and February ED boarders) was determined. The hospital was remunerated by <euro>685,111 for these patients, i.e. an average income of <euro>3,098 per patient. Only 8 hospitals of the 27 surveyed hospitals coded overnight ED Boarders as in-patients and were thus able to request income for these patients appropriately.

Conclusion: Discrepancies in coding of ED boarders may result in significant revenue losses for certain hospitals.

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Clinical Coding*
  • Economics, Hospital*
  • Emergencies / classification*
  • Emergencies / economics*
  • Emergency Service, Hospital / economics*
  • Emergency Service, Hospital / statistics & numerical data
  • Female
  • Hospitalization
  • Hospitals, University
  • Humans
  • Income*
  • Ireland
  • Male
  • Middle Aged
  • Patient Admission / economics*
  • Patient Admission / statistics & numerical data
  • Patient Discharge / statistics & numerical data
  • Retrospective Studies