1. 1 Overview of Organization & Comparative Quality Data Ron Spingarn, Deputy Director Healthcare Information Division Email: rspingar@oshpd.ca.gov Phone: (916) 326-3801 University of California at Davis June 18, 2010

2. 2 OSHPD Facilities Development Workforce Development Administration Cal-Mortgage Loan Insurance Healthcare Information Technical Advisory Committee Health Data Transparency & Effectiveness Committee CA Health Policy & Data Advisory Commission (Coronary) Clinical Advisory Panel Health Professions Education Foundation

3. 3 Data Flow from Facilities Inpatient Facilities (443): - Acute Care Hosp. (386) - Chemical Dependency Hosp. (6) - Acute Psych. Hosp. (30) - Psych. Facilities (21) Emergency Department (322) Ambulatory Surgery (574): - Acute Care (375) - Surgical Clinic (hosp.) (115) - Surgical Clinic (non-hosp.) (84) Utilization Data (4,715): - Skilled Nursing (1,144) - Hospices (281) - Community & Free Clinics (983) - Dialysis Clinics (401) - Surgical Clinics (209) -Home Health (1,215) - Hospitals (510) Financial Data: Inpatient Facilities (447) Healthcare Information Division Clinical Data & Research Patient Discharge Data Data Products Aggregate Financial & Utilization Data Coronary Artery Bypass Graft Surgery Hosp. (121) Cardiac Surgeons (284)

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5. 5 Requests for OSHPD Data Peter McNair, and Hal Luft, UCSF : Readmissions That are the Sequelae of Hospital Acquired Conditions; Realigning Hospital Incentives by Bundling Readmissions and Outlier Costs into Prospective Payments and Engaging Insurers Craig Newgard, MD, MPH, Oregon Health & Science University: Improving Pre Hospital Trauma Triage: Generating a Cost-Effective and Resource- Efficient Mechanism for the Field Triage of Injured Persons Ashish Jha, MD, MPH, Harvard : Postpartum Readmission: Reasons, Risk Factors & Regional Variation Andrew D. Racine, M.D., Albert Einstein College of Medicine: The Impact of Palivizumab on Hospitalization Rates for Bronchiolitis in California Mitchell Berman, M.D., Columbia University: Outcome After Treatment of Cerebrovascular Disease, Outcome of Patients with Parkinson's Disease Following General Anesthesia Examples: Data Use Agreement Information - Contact: Jonathan Teague, Email: jteague@oshpd.ca.gov Phone: (916) 326-3805

6. 6 Quality Measures’ Reporting Levels by OSHPD Area-Level Inpatient Utilization Prevention Quality Hospital-Level Inpatient Mortality Inpatient Volume & Utilization Pediatric Quality Patient Safety Coronary Artery Bypass Graft Surgery Maternal Outcomes* Hip Fracture Repair Mortality* Surgeon-Level Coronary Artery Bypass Graft Surgery *not yet released OSHPD measures in red AHRQ measures in blue

7. 7 AHRQ Quality Indicators Reported by OSHPD Mortality Inpatient (15 available measures) 2006 – 2007: 8 reported 2008: 4 new (12 total) Volume and Utilization Inpatient (13 available measures) 2005 – 2008: 11 reported Area-Level Utilization Inpatient (4 available measures) 2005 – 2008: all reported Area-Level Patient Safety (7 available measures) 2005 – 2008: 4 reported Area-Level Prevention Quality (14 available measures) 2005 – 2008: all reported Area-Level Pediatric (5 available measures) 2005 - 2008: all reported

8. 8 7 Measures of Conditions Available through OSHPD 8 Measures of Procedures Available through OSHPD 2006-2007 data reported: Acute Stroke Gastrointestinal Hemorrhage Hip Fracture Beginning in 2008: Acute Myocardial Infarction (AMI) Pneumonia Congestive Heart Failure Release not planned: AMI without transfer cases 2006-2007 data reported: Esophageal Resection Pancreatic Resection Craniotomy Carotid Endarterectomy Percutaneous Transluminal Coronary Angioplasty Beginning in 2008: Abdominal Aortic Aneurysm Repair Release not planned: Hip Replacement Coronary Artery Bypass Graft Surgery AHRQ Inpatient Mortality Indicators

9. 9 AHRQ Inpatient Volume & Utilization Indicators Volume Indicators: All measures reported by OSHPD, since 2005 Esophageal Resection Pancreatic Resection Abdominal Aortic Aneurysm Repair Carotid Endarterectomy Coronary Artery Bypass Graft Surgery Percutaneous Transluminal Coronary Angioplasty Utilization Indicators: 7 available; 5 reported by OSHPD since 2005 Cesarean Delivery Rate Cesarean Delivery Rate – Primary Vaginal Birth After Cesarean (VBAC) Rate, All Vaginal Birth After Cesarean (VBAC) Rate, Uncomplicated Laparoscopic Cholecystectomy Under Consideration: Bi-lateral cardiac catheterization & Incidental appendectomy in elderly

10. 10 AHRQ Prevention Quality Indicators (Area-Level Measures) Diabetes Short-term Complications Perforated Appendix Diabetes Long-term Complications Chronic Obstructive Pulmonary Disease (COPD) Hypertension Congestive Heart Failure (CHF) Low Birth Weight Dehydration Bacterial Pneumonia Urinary Tract Infections Angina without Procedure Uncontrolled Diabetes Adult Asthma Lower-extremity Amputations among Patients with Diabetes All 14 available measures reported by OSHPD since 2005:

11. 11 AHRQ Pediatric Quality Indicator (Area-Level Measures) All 5 available area-level rates reported by OHSPD since 2005: Asthma Admission Rate Diabetes Short-Term Complication Rate Gastroenteritis Admission Rate Perforated Appendix Admission Rate Urinary Tract Infection Admission Rate AHRQ Utilization Rates All 4 available area-level rates reported by OSHPD since 2005: Coronary Artery Bypass Graft Surgery Percutaneous Transluminal Coronary Angioplasty Hysterectomy Laminectomy or Spinal Fusion

12. 12 Patient Safety Indicators, Area-Level Rates (7 available) 4 reported by OSHPD beginning with 2005 data: Iatrogenic Pneumothorax, Secondary Diagnosis Field Selected Infections due to Medical Care, Secondary Diagnosis Field Postoperative Wound Dehiscence Postoperative Hemorrhage or Hematoma No plans/undecided about Accidental Puncture/Laceration, Foreign Object Left in Body & Transfusion Reaction