2019
DOI: 10.1136/bmjopen-2019-030454
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Temporal variation in the diagnosis of resolved atrial fibrillation and the influence of performance targets on clinical coding: cohort study

Abstract: ObjectivesTo investigate whether the introduction of performance targets for anticoagulation in atrial fibrillation (AF) was associated with a change in use of the ‘resolved AF’ code.DesignRetrospective cohort studies.SettingData from The Health Improvement Network, a UK database of electronic patient records, from 2000 to 2016.Participants250 788 adult patients aged ≥18 years with a diagnosis of AF, including 14 757 with an incident diagnosis of ‘resolved AF’.Main outcome measuresAnnual and monthly incidence … Show more

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Cited by 4 publications
(3 citation statements)
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“…All but one (aortic aneurysms) of the CRM conditions are included in QOF, which financially incentivises practices to have accurate disease coding, whilst eating disorders and PTSD are not included in QOF [18]. Longitudinal analysis of atrial fibrillation coding in UK EHRs suggests that the introduction of QOF did lead to practices refining the diagnostic coding for this condition [55].…”
Section: Comparisons With Other Literaturementioning
confidence: 99%
“…All but one (aortic aneurysms) of the CRM conditions are included in QOF, which financially incentivises practices to have accurate disease coding, whilst eating disorders and PTSD are not included in QOF [18]. Longitudinal analysis of atrial fibrillation coding in UK EHRs suggests that the introduction of QOF did lead to practices refining the diagnostic coding for this condition [55].…”
Section: Comparisons With Other Literaturementioning
confidence: 99%
“…Approval for this analysis was obtained from the Scientific Review Committee (for the use of IMRD data) in March 2020 (SRC reference No: 20SRC019). 13…”
Section: Ethicsmentioning
confidence: 99%
“…12 At the time of being coded as resolved AF, most were not receiving anticoagulants (82.6%; 95% CI = 81.9% to 83.3%) and most had never been prescribed anticoagulants (62.3%; 95% CI = 61.4 to 63.2). 13 Their removal from the register therefore increased the proportion on the register prescribed anticoagulants. This suggests introduction of a financial incentive led to an increase in coding of AF as resolved (that is, a diagnosis of resolved AF).…”
Section: Introductionmentioning
confidence: 99%