Bias due to re-used databases: Coding in hospital for extremely vulnerable patients

Carine Milcent

PSE-Ecole d'économie de Paris (Postprint) from HAL

Abstract: Electronic health records (EHRs) are intended to reduce healthcare costs and improve the quality of care. Nevertheless, usability issues common to EHRs have been identified. In this paper, we investigate these usability issues for social vulnerability codes. Using the acute care EHR and the rehabilitation care EHR databases, hospital stays of 800'000 patients are studied. This article highlights the differences in coding processes between public and private institutions observed when there are different incentives to code. Furthermore, it shows that the differences in coding are not random but depend on the coding strategy. This article emphasises that the reuse of data leads to biases in interpretation. Using the example of social vulnerability alerts policymakers to the need to consider these differences in coding processes when decisions are based on EHR information. Otherwise, this process of coding differences in social vulnerability may exacerbate social inequalities rather than reduce them.

Keywords: Database; Hospitals; quality; efficiency; ownership; social vulnerability; inequity (search for similar items in EconPapers)
Date: 2024
New Economics Papers: this item is included in nep-hea
Note: View the original document on HAL open archive server: https://hal.science/hal-03960584v1
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Published in Health Policy and Technology, 2024, ⟨10.1016/j.hlpt.2024.100851⟩

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Working Paper: Bias due to re-used databases: Coding in hospital for extremely vulnerable patients (2024)
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Persistent link: https://EconPapers.repec.org/RePEc:hal:pseptp:hal-03960584

DOI: 10.1016/j.hlpt.2024.100851

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