Voltar
Artigo Produção Nacional Revisado por pares
BIBTEX RIS

Upcoding in a National Health Service: the evidence from Portugal

2016; Wiley; Volume: 26; Issue: 5 Linguagem: Inglês

10.1002/hec.3335

ISSN

1099-1050

Autores

Pedro Pita Barros, Gisele Braun,

Tópico(s)

Pharmaceutical industry and healthcare

Resumo

Health EconomicsVolume 26, Issue 5 p. 600-618 Research Article Upcoding in a National Health Service: the evidence from Portugal Pedro Barros, Pedro Barros Nova School of Business and Economics, Lisbon, PortugalSearch for more papers by this authorGisele Braun, Corresponding Author Gisele Braun gbraun@novasbe.pt Department of Economics, Universidade Federal de Pelotas, Pelotas, Brazil Correspondence to: Department of Economics, Universidade Federal de Pelotas, Brazil, E-mail: gbraun@novasbe.ptSearch for more papers by this author Pedro Barros, Pedro Barros Nova School of Business and Economics, Lisbon, PortugalSearch for more papers by this authorGisele Braun, Corresponding Author Gisele Braun gbraun@novasbe.pt Department of Economics, Universidade Federal de Pelotas, Pelotas, Brazil Correspondence to: Department of Economics, Universidade Federal de Pelotas, Brazil, E-mail: gbraun@novasbe.ptSearch for more papers by this author First published: 14 March 2016 https://doi.org/10.1002/hec.3335Citations: 27Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat Abstract For many years, evidence from the USA has pointed out to the existence of upcoding in management practices. Upcoding is defined as classifying patients in diagnosis-related groups codes associated with larger payments. The incentive for upcoding is not restricted to private providers of care. Conceptually, any patient classification system that is used for payment purposes may be vulnerable to this sort of strategic behaviour by providers. We document here that upcoding occurs in a National Health Service where public hospitals have their payment (budget) tied to the classification of treatment episodes. Using diagnosis-related groups data from Portugal, we found that the practice of upcoding has been used in the hospitals in a way leading to larger budgets (age of patients plays a key role). The effect is quantitatively small. Copyright © 2016 John Wiley & Sons, Ltd. Citing Literature Volume26, Issue5May 2017Pages 600-618 RelatedInformation

Referência(s)