For the COPD reviews, across all of the phases of care and overall care, for both conditions, there were statistically significant differences between the types of comments made by the three types of staff for COPD, with the medical staff using the highest level codes across all phases of care and overall care (Table 11). There is therefore some evidence to suggest that doctors are more likely to use explicit codes than the other staff groups. Table 11: Types of comment made by different staff types for COPD (“highest comment per review) level” Admission Initial management Pre-discharge Overall or (nurse or or or Coding bands audit Doctor other) audit Doctor audit Doctor audit Codes 1-5 (Little or no comment 5% 14% 41% 1% 12% 38% 4% 13% 47% 4% 16% 47% about care and little of no judgement) Codes 6-8 (Limited comment 15% 32% 56% 15% 36% 48% 27% 53% 48% 4% 15% 7% about care and implied judgement) Code 9-13 (explicit judgement of care [9] or more 81% 54% 4% 84% 52% 13% 68% 34% 6% 93% 69% 46% sophisticated comments about care with explicit judgements and views) Number of 258 357 271 355 352 reviews (and 273 (6) 356 (8) 271 (7) 273 (6) 271 (7) 273 (6) 267 (7) (6) (8) (7) (8) (8) reviewers): Chi-square: 338.0 (p < 0.001) 306.2 (p < 0.001) 313.1 (p < 0.001) 190.3 (p < 0.001) For heart failure reviews, while there are still statistically significant differences between the three groups, the differences between the groups are less strong, with similarities the doctors and nurses for phases of care and little difference between the groups for overall care (Table 12).
For the COPD reviews, across all of the phases of care and overall care, for both conditions, there were statistically significant differences between the types of comments made by the three types of staff for COPD, with the medical staff using the highest level codes across all phases of care and overall care (Table 11). There is therefore some evidence to suggest that doctors are more likely to use explicit codes than the other staff groups. Table 11: Types of comment made by different staff types for COPD (“highest level” comment per review) Admission Initial management Pre-discharge Overall Coding bands or audit Doctor (nurse or other) audit Doctor or audit Doctor or audit Codes 1-5 (Little or no comment about care and little of no judgement) 5% 14% 41% 1% 12% 38% 4% 13% 47% 4% 16% 47% Codes 6-8 (Limited comment about care and implied judgement) 15% 32% 56% 15% 36% 48% 27% 53% 48% 4% 15% 7% Code 9-13 (explicit judgement of care [9] or more sophisticated comments about care with explicit judgements and views) 81% 54% 4% 84% 52% 13% 68% 34% 6% 93% 69% 46% Number of reviews (and reviewers): 258 (6) 357 (8) 271 (7) 273 (6) 356 (8) 271 (7) 273 (6) 355 (8) 271 (7) 273 (6) 352 (8) 267 (7) Chi-square: 338.0 (p < 0.001) 306.2 (p < 0.001) 313.1 (p < 0.001) 190.3 (p < 0.001) For heart failure reviews, while there are still statistically significant differences between the three groups, the differences between the groups are less strong, with similarities the doctors and nurses for phases of care and little difference between the groups for overall care (Table 12).
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