Manager's reports of variation in coding accuracy across U.S. oncology centers.

Advances in high-speed data processing capabilities, and the increasing reliance on information systems in comparative data assessment, are creating greater dependence on information systems, with a related need for more timely assessment of coding quality. Assessing the accuracy of coded and classified data becomes critical as the implementation of government compliance management requirements, along with the growing adoption of evidence-based medicine in error detection, serve to challenge healthcare researchers to consider the quality of coded data in management assessments. The implementation of larger, faster and more comprehensive databases in healthcare delivery settings is one response to this changing environment, but at a national level there will need to be some degree of uniformity in their utilization and management, if researchers are expected to rely on comparative benchmarks to fully assess organizational performance. In a nationwide survey of health information managers we found about 81 percent of respondents reported that significant coding errors existed in 5 percent or less of the records in their institutions. About 11 percent of respondents, however, reported that the coding errors existed in six to ten percent of their records. Regional and practice setting variation in reported coding error ranged widely, occurring across organizations as well as area locations. Related impact on comparative data-driven management assessment is discussed.