2 new studies show hospitalization rates of kids in 2 CA hospitals overestimated by at least 40% Why? "incidental diagnosis" eg, child at hosp for fracture, gets routine covid test, is (+) but asymptomatic. Incorrectly counted as hospitalized *for* covidhttps://nymag.com/intelligencer/2021/05/study-number-of-kids-hospitalized-for-covid-is-overcounted.html …
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Replying to @zeynep @j_g_allen
Zenyep, does your "eek" mean you didn't already know this was happening in large quantities for all ages ever since funding started being provided to hospitals for COVID diagnoses or just that you are acknowledging it's an unfortunate situation that has yet to be rectified?
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Replying to @Hold2LLC @j_g_allen
Hospitalized kids are a very small group and I’d have expected more precision. (No, it’s not the same in adults.)
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I’ll bet it is. If you screen every hospital admission for SarsCoV2 nasopharyngeal carriage by pcr you will inevitably overcount hospitalizations+deaths. Unless the driver was severe pneumonia, ARDS, or pulmonary embolism, then the default should be hospitalized “with” not “for”
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Copy of response to Berenson because he, as usual, misrepresented so it's here: "Adults are a much larger and diverse category compared to children. That’s how they’re different—harder to sort through due to sheer size if nothing else."
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Replying to @zeynep @rfsquared and
Hospital codes are messy but can be sorted through. (Your list would limit to severe/advanced cases, there's dyspnea, fever etc.) Plus the guideline, of course, has ways to distinguish primary diagnoses. (I'm not asserting anything about the practice). https://www.aha.org/system/files/media/file/2020/04/ICD10CMCodingforCOVID19FINALHandoutsandCE_1.pdf …
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Absent irrational panic, only “severe/advanced cases” should be hospitalized!
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You defined it too narrowly, otherwise high-risk patients with dyspnea fever etc. have been admitted. I'm not a hospital coding expert, but there is clearly instructions/methods on how to distinguish primary diagnoses from incidental positives.
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Now if the claim is that hospitals all ignored these instructions, or that the numbers/analyses all ignored this etc? That's the kind of thing that can be studied and demonstrated. I don't doubt tons of researchers would be happy to do this, and we'd all read an actual paper.
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Yes there were perverse incentives around billing. Direct chart review with formal adjudication of cause specific hospitalization is a better way. tldr- if a 68 yr old man is admitted for typical acute MI and happens to have a few strands of SarsCov2 RNA in throat that’s “with”
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