Abstract Number: Esoc2026ot169 Recurrent Coding of Acute Stroke

Abstract Background and aims Reliable stroke epidemiology and sustainable hospital financing depend on accurate clinical coding. In Kyrgyzstan, patients with acute cerebrovascular accident (ACVA) may be hospitalized repeatedly within one year at different levels of care, while continuing to be coded as a new acute stroke case according to ICD rules. This practice may lead to overestimation of national stroke incidence and inefficient allocation of financial resources. Methods To quantify the magnitude of recurrent coding of acute stroke hospitalizations within a 12-month period in Kyrgyzstan and to evaluate its impact on national stroke incidence statistics and case-based hospital reimbursement mechanisms. Results A retrospective multicenter review of medical records was conducted for the year 2022 in five inpatient facilities providing stroke care in Kyrgyzstan, including national, city, regional, and district hospitals. Medical charts were reviewed using standardized tables developed in collaboration with the Mandatory Health Insurance Fund (MHIF). The primary objective was to identify repeated hospitalizations of the same patient within one year that were continuously coded as new acute stroke episodes. Conclusions A total of 5,600 medical records were reviewed, including 2,725 cases coded as acute stroke. The analysis demonstrated that a substantial proportion of these cases represented repeated hospitalizations of the same patients within a one-year period, all registered as new acute stroke events. The rate of recurrent coding varied across institutions and reached up to 16%, indicating significant overreporting of acute stroke incidence. This misclassification directly affected national statistics and case-based hospital reimbursement. Conflict of interest