Discharge status of the patient: Evaluating hospital data quality with a focus on long-term and palliative care patient data

Health administrative data, as found in hospital morbidity datasets are valuable data sources that inform epidemiological studies such as the Global Burden of Disease study (GBD 2019 Diseases and Injuries Collaborators, 2020), and can be used to achieve many aims in relation to health services research and management. Furthermore, Diagnosis Related Group (DRG) systems rely on administrative data, namely diagnosis/procedure codes, age, sex, and discharge destination (Averill et al., 2003) and inmany countries are used for hospital reimbursement purposes (Geissler et al., 2011; Mathauer and Wittenbecher, 2013). In this context, the quality of health records, which constitutes the basis for the construction of administrative datasets through clinical coding (Alonso et al., 2020), is paramount. Clinical coding quality issues have been widely discussed (Cheng et al., 2009; Dafny, 2005; O'Malley et al., 2005; Pongpirul and Robinson, 2013; Southern et al., 2015), but little attention has been paid to issues associated with some administrative variables, such as discharge destination, despite their potential impact on the financial reimbursements received by hospitals, as previously mentioned in the case of Medicare (Centers for Medicare and Medicaid Services, 2018). Presented in this letter is our analysis of the quality of this variable, which is essential for DRG grouping and can also be reused for many other purposes.