*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| J121 - Respiratory syncytial virus pneumonia - as a primary diagnosis code | J121 - Respiratory syncytial virus pneumonia - as a primary or secondary diagnosis code | |
|---|---|---|
| OUTCOMES | ||
| Avg. LOS | 8.13 | |
| Readmission Rate (%) | 20.18 | |
| Unplanned Readmission Rate (%) | 11.31 | |
| Mortality Rate (%) | ||
| SNF Discharge Rate (%) | ||
| Home Discharge Rate (%) | ||
| PAYMENTS AND CHARGES | ||
| Total Medicare Payments | ||
| Payment Per Day | ||
| Payment Per Hospitalization | ||
| Total Medicare Charges | ||
| Avg. Charges | ||
| MARKET SIZING & INCIDENCE RATES | ||
| Total National Projected Hospitalizations - Annualized (Present on Admission - All) | ||
| Total Medicare Hospitalizations - Oct 2015 to Sep 2018 (Present on Admission - All) | ||
| Total National Projected Hospitalizations - Annualized (Present on Admission - Yes) | ||
| Total Medicare Hospitalizations - Oct 2015 to Sep 2018 (Present on Admission - Yes) | ||
| Total National Projected Hospitalizations - Annualized (Present on Admission - Not Y) | ||
| Total Medicare Hospitalizations - Oct 2015 to Sep 2018 (Present on Admission - Not Y) | ||
| Total Medicare Hospitalizations after Exclusion | ||
*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| DRG 193: SIMPLE PNEUMONIA AND PLEURISY WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 194: SIMPLE PNEUMONIA AND PLEURISY WITH COMPLICATION OR COMORBIDITY (CC) | DRG 195: SIMPLE PNEUMONIA AND PLEURISY WITHOUT COMPLICATION OR COMORBIDITY (CC)/MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 208: RESPIRATORY SYSTEM DIAGNOSIS W VENTILATOR SUPPORT <=96 HOURS | DRG 166: OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 443,386 | ||||
| Total Hospitalizations with ICD J121 - Respiratory syncytial virus pneumonia | 2,784 | ||||
| DRG Share of Total Hospitalizations | 1.35 | ||||
| % of Total ICD J121 - Respiratory syncytial virus pneumonia in DRG | 54.78 | ||||
| Avg LOS at DRG | 5.27 | ||||
| Avg LOS with ICD J121 - Respiratory syncytial virus pneumonia | 6.29 | ||||
| Readmission Rate at DRG | 21.6 | ||||
| Readmission Rate with ICD J121 - Respiratory syncytial virus pneumonia | 17.85 | ||||
| Unplanned Readmission Rate at DRG | 15.91 | ||||
| Unplanned Readmission Rate with ICD J121 - Respiratory syncytial virus pneumonia | 12.84 | ||||
| Total Medicare payments at DRG | $3,812,834,208 | ||||
| Total Medicare payments with ICD J121 - Respiratory syncytial virus pneumonia | $26,760,214 | ||||
| Total Medicare payment per Day at DRG | $1,632 | ||||
| Total Medicare payment per Day with ICD J121 - Respiratory syncytial virus pneumonia | $1,529 | ||||
| Total Medicare payment per Hospitalization at DRG | $8,599 | ||||
| Total Medicare payment per Hospitalization with ICD J121 - Respiratory syncytial virus pneumonia | $9,612 | ||||
| Total Medicare Charges at DRG | $18,110,468,211 | ||||
| Total Medicare Charges with ICD J121 - Respiratory syncytial virus pneumonia | $154,010,110 | ||||
| Avg Charges at DRG | $40,846 | ||||
| Avg Charges with ICD J121 - Respiratory syncytial virus pneumonia | $55,320 | ||||
| Mortality Rate at DRG | 3.59 | ||||
| Mortality Rate with ICD J121 - Respiratory syncytial virus pneumonia | 3.16 | ||||
| SNF Discharge Rate at DRG | 22.57 | ||||
| SNF Discharge Rate with ICD J121 - Respiratory syncytial virus pneumonia | 21.98 | ||||
| Home Discharge Rate at DRG | 40.95 | ||||
| Home Discharge Rate with ICD J121 - Respiratory syncytial virus pneumonia | 41.81 |
*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| DRG 207: RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT >96 HOURS | DRG 981: EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 167: OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITH COMPLICATION OR COMORBIDITY (CC) | |
|---|---|---|---|
| Total Hospitalizations at DRG | 99,136 | ||
| Total Hospitalizations with ICD J121 - Respiratory syncytial virus pneumonia | 53 | ||
| DRG Share of Total Hospitalizations | 0.3 | ||
| % of Total ICD J121 - Respiratory syncytial virus pneumonia in DRG | 1.04 | ||
| Avg LOS at DRG | 22.0 | ||
| Avg LOS with ICD J121 - Respiratory syncytial virus pneumonia | 16.66 | ||
| Readmission Rate at DRG | 40.67 | ||
| Readmission Rate with ICD J121 - Respiratory syncytial virus pneumonia | NA | ||
| Unplanned Readmission Rate at DRG | 20.54 | ||
| Unplanned Readmission Rate with ICD J121 - Respiratory syncytial virus pneumonia | NA | ||
| Total Medicare payments at DRG | $4,616,563,352 | ||
| Total Medicare payments with ICD J121 - Respiratory syncytial virus pneumonia | $2,343,568 | ||
| Total Medicare payment per Day at DRG | $2,116 | ||
| Total Medicare payment per Day with ICD J121 - Respiratory syncytial virus pneumonia | $2,654 | ||
| Total Medicare payment per Hospitalization at DRG | $46,568 | ||
| Total Medicare payment per Hospitalization with ICD J121 - Respiratory syncytial virus pneumonia | $44,218 | ||
| Total Medicare Charges at DRG | $21,375,486,291 | ||
| Total Medicare Charges with ICD J121 - Respiratory syncytial virus pneumonia | $12,025,947 | ||
| Avg Charges at DRG | $215,618 | ||
| Avg Charges with ICD J121 - Respiratory syncytial virus pneumonia | $226,905 | ||
| Mortality Rate at DRG | 28.16 | ||
| Mortality Rate with ICD J121 - Respiratory syncytial virus pneumonia | 37.74 | ||
| SNF Discharge Rate at DRG | 30.65 | ||
| SNF Discharge Rate with ICD J121 - Respiratory syncytial virus pneumonia | NA | ||
| Home Discharge Rate at DRG | 5.17 | ||
| Home Discharge Rate with ICD J121 - Respiratory syncytial virus pneumonia | NA |
| Hospital Name | Address | City | State | Zip Code | Total Hospitalizations ( Oct 2015 to Sep 2018 ) |
|---|---|---|---|---|---|
| UNIVERSITY OF TEXAS MD ANDERSON CANCER CENTER | 1515 HOLCOMBE BLVD | HOUSTON | TX | 77030 | 55 |
| CHRISTIANA CARE WILMINGTON HOSPITAL | 501 W 14TH ST | WILMINGTON | DE | 19801 | 42 |
| NORTHSHORE UNIVERSITY HEALTHSYSTEM EVANSTON HOSPITAL | 2650 RIDGE AVE | EVANSTON | IL | 60201 | 38 |
| Physician Name | Address | City | State | Zip Code | Total Hospitalizations ( Oct 2015 to Sep 2018 ) |
|---|---|---|---|---|---|
| Dr. ANTHONY D LUNA | 222 MAIN STREET | MINNEOLA | KS | 67865 | 11 |
*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| DRG 871: SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 193: SIMPLE PNEUMONIA AND PLEURISY WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 194: SIMPLE PNEUMONIA AND PLEURISY WITH COMPLICATION OR COMORBIDITY (CC) | DRG 190: CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 291: HEART FAILURE AND SHOCK WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 1,808,415 | ||||
| Total Hospitalizations with ICD J121 - Respiratory syncytial virus pneumonia | 3,016 | ||||
| DRG Share of Total Hospitalizations | 5.5 | ||||
| % of Total ICD J121 - Respiratory syncytial virus pneumonia in DRG | 21.73 | ||||
| Avg LOS at DRG | 6.34 | ||||
| Avg LOS with ICD J121 - Respiratory syncytial virus pneumonia | 6.98 | ||||
| Readmission Rate at DRG | 24.2 | ||||
| Readmission Rate with ICD J121 - Respiratory syncytial virus pneumonia | 17.91 | ||||
| Unplanned Readmission Rate at DRG | 16.78 | ||||
| Unplanned Readmission Rate with ICD J121 - Respiratory syncytial virus pneumonia | 12.76 | ||||
| Total Medicare payments at DRG | $21,288,214,047 | ||||
| Total Medicare payments with ICD J121 - Respiratory syncytial virus pneumonia | $39,541,988 | ||||
| Total Medicare payment per Day at DRG | $1,857 | ||||
| Total Medicare payment per Day with ICD J121 - Respiratory syncytial virus pneumonia | $1,880 | ||||
| Total Medicare payment per Hospitalization at DRG | $11,772 | ||||
| Total Medicare payment per Hospitalization with ICD J121 - Respiratory syncytial virus pneumonia | $13,111 | ||||
| Total Medicare Charges at DRG | $107,155,481,388 | ||||
| Total Medicare Charges with ICD J121 - Respiratory syncytial virus pneumonia | $217,277,417 | ||||
| Avg Charges at DRG | $59,254 | ||||
| Avg Charges with ICD J121 - Respiratory syncytial virus pneumonia | $72,042 | ||||
| Mortality Rate at DRG | 12.11 | ||||
| Mortality Rate with ICD J121 - Respiratory syncytial virus pneumonia | 8.59 | ||||
| SNF Discharge Rate at DRG | 27.18 | ||||
| SNF Discharge Rate with ICD J121 - Respiratory syncytial virus pneumonia | 26.59 | ||||
| Home Discharge Rate at DRG | 25.81 | ||||
| Home Discharge Rate with ICD J121 - Respiratory syncytial virus pneumonia | 33.62 |
*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| DRG 189: PULMONARY EDEMA AND RESPIRATORY FAILURE | DRG 195: SIMPLE PNEUMONIA AND PLEURISY WITHOUT COMPLICATION OR COMORBIDITY (CC)/MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 208: RESPIRATORY SYSTEM DIAGNOSIS W VENTILATOR SUPPORT <=96 HOURS | DRG 870: SEPTICEMIA OR SEVERE SEPSIS WITH MV >96 HOURS | DRG 853: INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURE WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 539,642 | ||||
| Total Hospitalizations with ICD J121 - Respiratory syncytial virus pneumonia | 570 | ||||
| DRG Share of Total Hospitalizations | 1.64 | ||||
| % of Total ICD J121 - Respiratory syncytial virus pneumonia in DRG | 4.11 | ||||
| Avg LOS at DRG | 6.42 | ||||
| Avg LOS with ICD J121 - Respiratory syncytial virus pneumonia | 8.57 | ||||
| Readmission Rate at DRG | 26.55 | ||||
| Readmission Rate with ICD J121 - Respiratory syncytial virus pneumonia | 23.89 | ||||
| Unplanned Readmission Rate at DRG | 20.01 | ||||
| Unplanned Readmission Rate with ICD J121 - Respiratory syncytial virus pneumonia | 15.99 | ||||
| Total Medicare payments at DRG | $5,267,842,463 | ||||
| Total Medicare payments with ICD J121 - Respiratory syncytial virus pneumonia | $6,502,202 | ||||
| Total Medicare payment per Day at DRG | $1,520 | ||||
| Total Medicare payment per Day with ICD J121 - Respiratory syncytial virus pneumonia | $1,331 | ||||
| Total Medicare payment per Hospitalization at DRG | $9,762 | ||||
| Total Medicare payment per Hospitalization with ICD J121 - Respiratory syncytial virus pneumonia | $11,407 | ||||
| Total Medicare Charges at DRG | $25,503,568,329 | ||||
| Total Medicare Charges with ICD J121 - Respiratory syncytial virus pneumonia | $38,609,367 | ||||
| Avg Charges at DRG | $47,260 | ||||
| Avg Charges with ICD J121 - Respiratory syncytial virus pneumonia | $67,736 | ||||
| Mortality Rate at DRG | 5.62 | ||||
| Mortality Rate with ICD J121 - Respiratory syncytial virus pneumonia | 7.02 | ||||
| SNF Discharge Rate at DRG | 19.26 | ||||
| SNF Discharge Rate with ICD J121 - Respiratory syncytial virus pneumonia | 27.37 | ||||
| Home Discharge Rate at DRG | 39.65 | ||||
| Home Discharge Rate with ICD J121 - Respiratory syncytial virus pneumonia | 31.75 |
*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| DRG 207: RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT >96 HOURS | DRG 177: RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 166: OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 280: ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 004: TRACHEOSTOMY WITH MV >96 HOURS OR PDX EXCEPT FACE, MOUTH AND NECK WITHOUT MAJOR O.R. PROCEDURE | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 99,136 | ||||
| Total Hospitalizations with ICD J121 - Respiratory syncytial virus pneumonia | 237 | ||||
| DRG Share of Total Hospitalizations | 0.3 | ||||
| % of Total ICD J121 - Respiratory syncytial virus pneumonia in DRG | 1.71 | ||||
| Avg LOS at DRG | 22.0 | ||||
| Avg LOS with ICD J121 - Respiratory syncytial virus pneumonia | 19.39 | ||||
| Readmission Rate at DRG | 40.67 | ||||
| Readmission Rate with ICD J121 - Respiratory syncytial virus pneumonia | 34.12 | ||||
| Unplanned Readmission Rate at DRG | 20.54 | ||||
| Unplanned Readmission Rate with ICD J121 - Respiratory syncytial virus pneumonia | 10.59 | ||||
| Total Medicare payments at DRG | $4,616,563,352 | ||||
| Total Medicare payments with ICD J121 - Respiratory syncytial virus pneumonia | $11,144,350 | ||||
| Total Medicare payment per Day at DRG | $2,116 | ||||
| Total Medicare payment per Day with ICD J121 - Respiratory syncytial virus pneumonia | $2,425 | ||||
| Total Medicare payment per Hospitalization at DRG | $46,568 | ||||
| Total Medicare payment per Hospitalization with ICD J121 - Respiratory syncytial virus pneumonia | $47,023 | ||||
| Total Medicare Charges at DRG | $21,375,486,291 | ||||
| Total Medicare Charges with ICD J121 - Respiratory syncytial virus pneumonia | $55,297,446 | ||||
| Avg Charges at DRG | $215,618 | ||||
| Avg Charges with ICD J121 - Respiratory syncytial virus pneumonia | $233,323 | ||||
| Mortality Rate at DRG | 28.16 | ||||
| Mortality Rate with ICD J121 - Respiratory syncytial virus pneumonia | 26.58 | ||||
| SNF Discharge Rate at DRG | 30.65 | ||||
| SNF Discharge Rate with ICD J121 - Respiratory syncytial virus pneumonia | 27.0 | ||||
| Home Discharge Rate at DRG | 5.17 | ||||
| Home Discharge Rate with ICD J121 - Respiratory syncytial virus pneumonia | 9.28 |
*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| DRG 205: OTHER RESPIRATORY SYSTEM DIAGNOSES WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 202: BRONCHITIS AND ASTHMA WITH COMPLICATION OR COMORBIDITY (CC)/MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 682: RENAL FAILURE WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 178: RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH COMPLICATION OR COMORBIDITY (CC) | DRG 308: CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 25,762 | ||||
| Total Hospitalizations with ICD J121 - Respiratory syncytial virus pneumonia | 93 | ||||
| DRG Share of Total Hospitalizations | 0.08 | ||||
| % of Total ICD J121 - Respiratory syncytial virus pneumonia in DRG | 0.67 | ||||
| Avg LOS at DRG | 5.4 | ||||
| Avg LOS with ICD J121 - Respiratory syncytial virus pneumonia | 7.05 | ||||
| Readmission Rate at DRG | 26.53 | ||||
| Readmission Rate with ICD J121 - Respiratory syncytial virus pneumonia | 30.77 | ||||
| Unplanned Readmission Rate at DRG | 17.68 | ||||
| Unplanned Readmission Rate with ICD J121 - Respiratory syncytial virus pneumonia | 15.38 | ||||
| Total Medicare payments at DRG | $258,625,689 | ||||
| Total Medicare payments with ICD J121 - Respiratory syncytial virus pneumonia | $2,924,594 | ||||
| Total Medicare payment per Day at DRG | $1,859 | ||||
| Total Medicare payment per Day with ICD J121 - Respiratory syncytial virus pneumonia | $4,458 | ||||
| Total Medicare payment per Hospitalization at DRG | $10,039 | ||||
| Total Medicare payment per Hospitalization with ICD J121 - Respiratory syncytial virus pneumonia | $31,447 | ||||
| Total Medicare Charges at DRG | $1,285,891,031 | ||||
| Total Medicare Charges with ICD J121 - Respiratory syncytial virus pneumonia | $17,700,937 | ||||
| Avg Charges at DRG | $49,914 | ||||
| Avg Charges with ICD J121 - Respiratory syncytial virus pneumonia | $190,333 | ||||
| Mortality Rate at DRG | 3.49 | ||||
| Mortality Rate with ICD J121 - Respiratory syncytial virus pneumonia | NA | ||||
| SNF Discharge Rate at DRG | 21.29 | ||||
| SNF Discharge Rate with ICD J121 - Respiratory syncytial virus pneumonia | NA | ||||
| Home Discharge Rate at DRG | 40.23 | ||||
| Home Discharge Rate with ICD J121 - Respiratory syncytial virus pneumonia | 70.97 |
| Hospital Name | Address | City | State | Zip Code | Total Hospitalizations ( Oct 2015 to Sep 2018 ) |
|---|---|---|---|---|---|
| CEDARS-SINAI MEDICAL CENTER | 8700 BEVERLY BLVD | LOS ANGELES | CA | 90048 | 104 |
| ADVENTHEALTH ORLANDO | 601 E ROLLINS ST | ORLANDO | FL | 32803 | 100 |
| CHRISTIANA CARE WILMINGTON HOSPITAL | 501 W 14TH ST | WILMINGTON | DE | 19801 | 97 |
| Physician Name | Address | City | State | Zip Code | Total Hospitalizations ( Oct 2015 to Sep 2018 ) |
|---|---|---|---|---|---|
| Dr. MICHAEL MULLOWNEY | 4300 B ST | ANCHORAGE | AK | 99503 | 14 |
| Dr. ANTHONY D LUNA | 222 MAIN STREET | MINNEOLA | KS | 67865 | 12 |