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Health and Wellness for all Arizonans Bureau of Public Health Statistics Khaleel S. Hussaini Ph.D. Chief, Public Health Statistics

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Presentation on theme: "Health and Wellness for all Arizonans Bureau of Public Health Statistics Khaleel S. Hussaini Ph.D. Chief, Public Health Statistics"— Presentation transcript:

1 Health and Wellness for all Arizonans Bureau of Public Health Statistics Khaleel S. Hussaini Ph.D. Chief, Public Health Statistics khaleel.hussaini@azdhs.gov

2 Health and Wellness for all Arizonans Hospital Discharge Data 2008-2013 16,543,849 inpatient and emergency department records during 2008-2013. Cases with a discharge status as ‘dead’ and/or newborns were excluded. Utilized standard DRGs and ICD 9 CM codes. Prevention Quality Indicators (PQI) as well as top 20 DRGs and top 20 ICD (i.e. Principal Dx) were analyzed for inpatient hospitalization. Analyzed length of stay (LOS) and total charges.

3 Health and Wellness for all Arizonans Prevention Quality Indicators 1.Bacterial Pneumonia 2.Dehydration 3.Congestive Heart Failure (CHF) 4.Hypertension 5.Adult Asthma Admission (AAA) 6.Chronic Obstructive Pulmonary Disorder (COPD) 7.Uncontrolled Diabetes 8.Diabetes Short-term Complications

4 Health and Wellness for all Arizonans Prevention Quality Indicators

5 Inpatient Hospitalizations 2008-2013 #Top 20 DRGs (Diagnostic Related Groups) 2008-2013CountsPercent 1Vaginal Delivery W/O Complicating Diagnoses 310,6317.68 2Major Joint Replacement Or Reattachment Of Lower Extremity W/O Mcc 123,9353.06 3Psychoses 111,0332.74 4Esophagitis, Gastroent & Misc Digest Disorders W/O Mcc 103,5622.56 5Cesarean Section W/O Cc/Mcc 92,4262.28 6Cellulitis W/O Mcc 64,0971.58 7Septicemia or Severe Sepsis W/O Mv 96+ Hours W Mcc 57,0481.41 8Cesarean Section W Cc/Mcc 56,0961.39 9Kidney & Urinary Tract Infections W/O Mcc 49,8561.23 10Simple Pneumonia & Pleurisy W Cc 47,3541.17 11Vaginal Delivery W Complicating Diagnoses 46,7721.16 12Chest Pain 46,3451.15 13Perc Cardiovasc Proc W Drug-Eluting Stent W/O Mcc 43,6011.08 14Misc Disorders Of Nutrition,Metabolism,Fluids/Electrolytes W/O Mcc 41,1281.02 15Uterine & Adnexa Proc For Non-Malignancy W/O Cc/Mcc 37,5750.93 16Bronchitis & Asthma W/O Cc/Mcc 37,2990.92 17Circulatory Disorders Except Ami, W Card Cath W/O Mcc 35,6370.88 18Renal Failure W Cc 32,3930.8 19Laparoscopic Cholecystectomy W/O C.D.E. W/O Cc/Mcc 31,9520.79 20Alcohol/Drug Abuse Or Dependence W/O Rehabilitation Therapy W/O Mcc 31,5640.78

6 Inpatient Hospitalizations 2008-2013 #Top 20 Principal Diagnoses (ICD9-CM codes) 2008-2013CountsPercent 1Pneumonia, organism unspecified 90,7512.21 2Care involving other specified rehabilitation procedure 80,7671.97 3Coronary atherosclerosis of native coronary artery 68,4261.67 4Unspecified septicemia 67,0481.63 5Osteoarthrosis, localized, not specified whether primary or secondary, lower leg 63,9921.56 6Previous cesarean delivery, delivered, with or without mention of antepartum condition 63,2671.54 7Atrial fibrillation 51,5951.26 8Acute kidney failure, unspecified 50,9201.24 9Other chest pain 47,0451.15 10Obstructive chronic bronchitis with (acute) exacerbation 45,8161.12 11Second-degree perineal laceration, delivered, with or without mention of antepartum condition 45,6081.11 12Subendocardial infarction, initial episode of care 41,4251.01 13Urinary tract infection, site not specified 40,9921 14First-degree perineal laceration, delivered, with or without mention of antepartum condition 37,1030.9 15Acute pancreatitis 36,4140.89 16Post term pregnancy, delivered, with or without mention of antepartum condition 34,9360.85 17Cellulitis and abscess of leg, except foot 34,8360.85 18Cerebral artery occlusion, unspecified with cerebral infarction 33,0930.81 19Normal delivery 32,1340.78 20Acute appendicitis without mention of peritonitis 29,8120.73

7 Length of Stay and Charges TOPDRGN ObsVariableMeanStd DevMedianQuartile RangeMinimumMaximum 1 310,631 LOS 2 1 210 81 CHARGES 10,373 5,042 9,66141640 332,831 2 123,935 LOS 3 1 310 45 CHARGES 52,466 18,208 49,240186380 485,818 3 111,033 LOS 10 12 770 473 CHARGES 22,048 27,396 14,473164330 959,173 4 103,562 LOS 3 2 220 74 CHARGES 20,307 13,317 17,700130160 366,091 5 92,426 LOS 3 1 310 73 CHARGES 18,234 6,982 16,9527413252 226,014 6 64,097 LOS 3 2 320 104 CHARGES 18,480 13,878 15,10312796585 496,257 7 57,048 LOS 6 5 550 282 CHARGES 54,122 44,497 42,663405501136 2,149,489 8 56,096 LOS 5 5 410 112 CHARGES 25,914 21,521 21,170108740 751,715 9 49,856 LOS 3 2 320 102 CHARGES 18,781 12,134 16,167119770 288,705 10 47,354 LOS 4 3 330 45 CHARGES 24,540 17,822 20,328173130 406,275 11 46,772 LOS 3 3 210 89 CHARGES 14,050 10,087 11,82162911320 491,447 12 46,345 LOS 2 1 110 61 CHARGES 18,483 10,302 16,826114900 307,137 13 43,601 LOS 2 1 220 69 CHARGES 70,908 27,393 65,849295300 463,342 14 41,128 LOS 3 3 220 109 CHARGES 17,450 14,205 14,417131970 828,947 15 37,575 LOS 2 1 210 23 CHARGES 28,690 13,760 25,5171582937 225,943 16 37,299 LOS 2 2 220 29 CHARGES 12,133 9,164 9,67189070 165,041 17 35,637 LOS 2 2 220 57 CHARGES 37,518 17,724 33,962175730 440,804 18 32,393 LOS 4 3 330 100 CHARGES 27,183 20,312 22,012179541050 863,310 19 31,952 LOS 2 1 220 17 CHARGES 32,914 14,286 29,600159661154 204,130 20 31,564 LOS 4 4 430 314 CHARGES 15,874 13,428 12,0581142886 478,736

8 Charges by Payer type

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18 Health and Wellness for all Arizonans So what…? Are the top DRGs and Principal Diagnosis cases consistent with reality? What data elements can comprise of hospital price transparency? Who champions this cause and what resources are needed?


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