By: Jeffrey Maser  Mar. 26, 2018
A Dexur study of inpatient Medicare claims data from CMS indicates that Dr. Margaret Laughlin Winkler of North Oaks Medical Center in Hammond accounted for 28 discharges with pneumonia in 2016, the most of any physician in Louisiana. Furthermore, Dr. Winkler accounted for 106 pneumonia discharges between 2013-2016, ranking 4th. In 2016, the 2nd highest volume physician was Dr. Kirit Patel of Willis - Knighton Medical Center in Shreveport with 27 discharges followed by Dr. Wen Liu, who also practices at Willis - Knighton, with 26 discharges. Dr. Cesar Ramirez-Astacio ranked 4th with 25 discharges, while splitting time between Iberia Medical Center in New Iberia and AMG Specialty Hospital - Lafayette. Five physicians had 22 discharges to tied for 5th in the rankings with three of these physicians practicing at Terrebonne General Medical Center in Houma.
Physicians were included in the rankings if they accounted for 11 or more pneumonia discharges between January - December 2016. Pneumonia is divided into three diagnosis related groups (DRG-193, DRG-194, and DRG-195) where DRG-193 and DRG-194 each accounted for nearly triple the national inpatient volume compared to DRG-195 in 2016. However, in the state of Louisiana, the discharges for DRG-193 and DRG-194 were only about double the volume of DRG-195 during this same year.
Pneumonia Discharge Volume by Diagnosis Related Group for the Nation and Louisiana Medicare Enrollees over Two Time Periods | |||||
---|---|---|---|---|---|
DRG Code | DRG Description | National Discharge Volume in 2016 | National Discharge Volume between 2013 - 2016 | Louisiana Discharge Volume in 2016 | Louisiana Discharge Volume between 2013 - 2016 |
194 | Simple Pneumonia And Pleurisy With Complication or Comorbidity | 142,542 | 676,279 | 2,855 | 13,643 |
193 | Simple Pneumonia And Pleurisy With Major Complication or Comorbidity | 145,763 | 594,119 | 2,299 | 9,974 |
195 | Simple Pneumonia And Pleurisy Without Complication or Comorbidity/Major Complication or Comorbidity | 52,644 | 271,548 | 1,259 | 6,471 |
Along with ranking first in volume for all pneumonia discharges, Dr. Winkler was one of only six physicians in the state to report 11 or more discharges for DRG-194 (Simple Pneumonia And Pleurisy With Complication Or Comorbidity), with 13 discharges to rank 4th in volume. The three physicians ahead of Dr. Winkler in this ranking were Dr. Fadi Abou-Issa with 17 discharges, Dr. Russell Henry with 16 and Dr. Wen Liu with 14. Dr. Abou-Issa practices at Terrebonne General Medical Center while Dr. Henry splits his time between Terrebonne General and AMG Specialty Hospital - Houma in Houma.