*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| J158 - Pneumonia due to other specified bacteria - as a primary diagnosis code | J158 - Pneumonia due to other specified bacteria - as a primary or secondary diagnosis code | |
|---|---|---|
| OUTCOMES | ||
| Avg. LOS | 14.78 | |
| Readmission Rate (%) | 33.88 | |
| Unplanned Readmission Rate (%) | 15.92 | |
| 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 177: RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 178: RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH COMPLICATION OR COMORBIDITY (CC) | DRG 179: RESPIRATORY INFECTIONS AND INFLAMMATIONS WITHOUT COMPLICATION OR COMORBIDITY (CC)/MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 166: OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 208: RESPIRATORY SYSTEM DIAGNOSIS W VENTILATOR SUPPORT <=96 HOURS | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 231,410 | ||||
| Total Hospitalizations with ICD J158 - Pneumonia due to other specified bacteria | 1,788 | ||||
| DRG Share of Total Hospitalizations | 0.7 | ||||
| % of Total ICD J158 - Pneumonia due to other specified bacteria in DRG | 47.08 | ||||
| Avg LOS at DRG | 7.29 | ||||
| Avg LOS with ICD J158 - Pneumonia due to other specified bacteria | 7.64 | ||||
| Readmission Rate at DRG | 25.54 | ||||
| Readmission Rate with ICD J158 - Pneumonia due to other specified bacteria | 27.6 | ||||
| Unplanned Readmission Rate at DRG | 18.36 | ||||
| Unplanned Readmission Rate with ICD J158 - Pneumonia due to other specified bacteria | 19.25 | ||||
| Total Medicare payments at DRG | $2,801,759,007 | ||||
| Total Medicare payments with ICD J158 - Pneumonia due to other specified bacteria | $23,179,099 | ||||
| Total Medicare payment per Day at DRG | $1,661 | ||||
| Total Medicare payment per Day with ICD J158 - Pneumonia due to other specified bacteria | $1,696 | ||||
| Total Medicare payment per Hospitalization at DRG | $12,107 | ||||
| Total Medicare payment per Hospitalization with ICD J158 - Pneumonia due to other specified bacteria | $12,964 | ||||
| Total Medicare Charges at DRG | $13,366,030,360 | ||||
| Total Medicare Charges with ICD J158 - Pneumonia due to other specified bacteria | $103,114,423 | ||||
| Avg Charges at DRG | $57,759 | ||||
| Avg Charges with ICD J158 - Pneumonia due to other specified bacteria | $57,670 | ||||
| Mortality Rate at DRG | 7.21 | ||||
| Mortality Rate with ICD J158 - Pneumonia due to other specified bacteria | 5.43 | ||||
| SNF Discharge Rate at DRG | 32.47 | ||||
| SNF Discharge Rate with ICD J158 - Pneumonia due to other specified bacteria | 23.88 | ||||
| Home Discharge Rate at DRG | 20.84 | ||||
| Home Discharge Rate with ICD J158 - Pneumonia due to other specified bacteria | 33.17 |
*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 167: OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITH COMPLICATION OR COMORBIDITY (CC) | DRG 163: MAJOR CHEST PROCEDURES WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 981: EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|---|---|
| Total Hospitalizations at DRG | 99,136 | |||
| Total Hospitalizations with ICD J158 - Pneumonia due to other specified bacteria | 91 | |||
| DRG Share of Total Hospitalizations | 0.3 | |||
| % of Total ICD J158 - Pneumonia due to other specified bacteria in DRG | 2.4 | |||
| Avg LOS at DRG | 22.0 | |||
| Avg LOS with ICD J158 - Pneumonia due to other specified bacteria | 14.33 | |||
| Readmission Rate at DRG | 40.67 | |||
| Readmission Rate with ICD J158 - Pneumonia due to other specified bacteria | 52.54 | |||
| Unplanned Readmission Rate at DRG | 20.54 | |||
| Unplanned Readmission Rate with ICD J158 - Pneumonia due to other specified bacteria | 25.42 | |||
| Total Medicare payments at DRG | $4,616,563,352 | |||
| Total Medicare payments with ICD J158 - Pneumonia due to other specified bacteria | $3,250,411 | |||
| Total Medicare payment per Day at DRG | $2,116 | |||
| Total Medicare payment per Day with ICD J158 - Pneumonia due to other specified bacteria | $2,493 | |||
| Total Medicare payment per Hospitalization at DRG | $46,568 | |||
| Total Medicare payment per Hospitalization with ICD J158 - Pneumonia due to other specified bacteria | $35,719 | |||
| Total Medicare Charges at DRG | $21,375,486,291 | |||
| Total Medicare Charges with ICD J158 - Pneumonia due to other specified bacteria | $18,116,823 | |||
| Avg Charges at DRG | $215,618 | |||
| Avg Charges with ICD J158 - Pneumonia due to other specified bacteria | $199,086 | |||
| Mortality Rate at DRG | 28.16 | |||
| Mortality Rate with ICD J158 - Pneumonia due to other specified bacteria | 32.97 | |||
| SNF Discharge Rate at DRG | 30.65 | |||
| SNF Discharge Rate with ICD J158 - Pneumonia due to other specified bacteria | 30.77 | |||
| Home Discharge Rate at DRG | 5.17 | |||
| Home Discharge Rate with ICD J158 - Pneumonia due to other specified bacteria | 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 | 40 |
| GEARY COMMUNITY HOSPITAL | 1102 SAINT MARYS RD | JUNCTION CITY | KS | 66441 | 38 |
| MISSISSIPPI BAPTIST MEDICAL CENTER | 1225 N STATE ST | JACKSON | MS | 39202 | 23 |
| Physician Name | Address | City | State | Zip Code | Total Hospitalizations ( Oct 2015 to Sep 2018 ) |
|---|---|---|---|---|---|
| Dr. JIMMY W JENKINS | 1110 SAINT MARYS RD | JUNCTION CITY | KS | 66441 | 22 |
*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 177: RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 178: RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH COMPLICATION OR COMORBIDITY (CC) | DRG 207: RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT >96 HOURS | DRG 870: SEPTICEMIA OR SEVERE SEPSIS WITH MV >96 HOURS | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 1,808,415 | ||||
| Total Hospitalizations with ICD J158 - Pneumonia due to other specified bacteria | 3,415 | ||||
| DRG Share of Total Hospitalizations | 5.5 | ||||
| % of Total ICD J158 - Pneumonia due to other specified bacteria in DRG | 17.83 | ||||
| Avg LOS at DRG | 6.34 | ||||
| Avg LOS with ICD J158 - Pneumonia due to other specified bacteria | 8.36 | ||||
| Readmission Rate at DRG | 24.2 | ||||
| Readmission Rate with ICD J158 - Pneumonia due to other specified bacteria | 27.59 | ||||
| Unplanned Readmission Rate at DRG | 16.78 | ||||
| Unplanned Readmission Rate with ICD J158 - Pneumonia due to other specified bacteria | 19.0 | ||||
| Total Medicare payments at DRG | $21,288,214,047 | ||||
| Total Medicare payments with ICD J158 - Pneumonia due to other specified bacteria | $44,656,838 | ||||
| Total Medicare payment per Day at DRG | $1,857 | ||||
| Total Medicare payment per Day with ICD J158 - Pneumonia due to other specified bacteria | $1,564 | ||||
| Total Medicare payment per Hospitalization at DRG | $11,772 | ||||
| Total Medicare payment per Hospitalization with ICD J158 - Pneumonia due to other specified bacteria | $13,077 | ||||
| Total Medicare Charges at DRG | $107,155,481,388 | ||||
| Total Medicare Charges with ICD J158 - Pneumonia due to other specified bacteria | $256,381,946 | ||||
| Avg Charges at DRG | $59,254 | ||||
| Avg Charges with ICD J158 - Pneumonia due to other specified bacteria | $75,075 | ||||
| Mortality Rate at DRG | 12.11 | ||||
| Mortality Rate with ICD J158 - Pneumonia due to other specified bacteria | 12.06 | ||||
| SNF Discharge Rate at DRG | 27.18 | ||||
| SNF Discharge Rate with ICD J158 - Pneumonia due to other specified bacteria | 27.73 | ||||
| Home Discharge Rate at DRG | 25.81 | ||||
| Home Discharge Rate with ICD J158 - Pneumonia due to other specified bacteria | 25.83 |
*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| DRG 853: INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURE WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 189: PULMONARY EDEMA AND RESPIRATORY FAILURE | DRG 190: CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 003: ECMO OR TRACHEOSTOMY WITH MV >96 HOURS OR PDX EXCEPT FACE, MOUTH AND NECK WITH MAJOR O.R. PROCEDURE | DRG 166: OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 269,064 | ||||
| Total Hospitalizations with ICD J158 - Pneumonia due to other specified bacteria | 773 | ||||
| DRG Share of Total Hospitalizations | 0.82 | ||||
| % of Total ICD J158 - Pneumonia due to other specified bacteria in DRG | 4.04 | ||||
| Avg LOS at DRG | 13.18 | ||||
| Avg LOS with ICD J158 - Pneumonia due to other specified bacteria | 20.83 | ||||
| Readmission Rate at DRG | 37.51 | ||||
| Readmission Rate with ICD J158 - Pneumonia due to other specified bacteria | 45.79 | ||||
| Unplanned Readmission Rate at DRG | 18.15 | ||||
| Unplanned Readmission Rate with ICD J158 - Pneumonia due to other specified bacteria | 21.61 | ||||
| Total Medicare payments at DRG | $9,344,186,034 | ||||
| Total Medicare payments with ICD J158 - Pneumonia due to other specified bacteria | $35,587,070 | ||||
| Total Medicare payment per Day at DRG | $2,635 | ||||
| Total Medicare payment per Day with ICD J158 - Pneumonia due to other specified bacteria | $2,210 | ||||
| Total Medicare payment per Hospitalization at DRG | $34,728 | ||||
| Total Medicare payment per Hospitalization with ICD J158 - Pneumonia due to other specified bacteria | $46,038 | ||||
| Total Medicare Charges at DRG | $44,371,117,432 | ||||
| Total Medicare Charges with ICD J158 - Pneumonia due to other specified bacteria | $220,167,191 | ||||
| Avg Charges at DRG | $164,909 | ||||
| Avg Charges with ICD J158 - Pneumonia due to other specified bacteria | $284,822 | ||||
| Mortality Rate at DRG | 14.37 | ||||
| Mortality Rate with ICD J158 - Pneumonia due to other specified bacteria | 25.61 | ||||
| SNF Discharge Rate at DRG | 31.8 | ||||
| SNF Discharge Rate with ICD J158 - Pneumonia due to other specified bacteria | 27.94 | ||||
| Home Discharge Rate at DRG | 14.61 | ||||
| Home Discharge Rate with ICD J158 - Pneumonia due to other specified bacteria | 10.09 |
*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| DRG 208: RESPIRATORY SYSTEM DIAGNOSIS W VENTILATOR SUPPORT <=96 HOURS | DRG 004: TRACHEOSTOMY WITH MV >96 HOURS OR PDX EXCEPT FACE, MOUTH AND NECK WITHOUT MAJOR O.R. PROCEDURE | DRG 291: HEART FAILURE AND SHOCK WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 179: RESPIRATORY INFECTIONS AND INFLAMMATIONS WITHOUT COMPLICATION OR COMORBIDITY (CC)/MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 981: EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 181,637 | ||||
| Total Hospitalizations with ICD J158 - Pneumonia due to other specified bacteria | 547 | ||||
| DRG Share of Total Hospitalizations | 0.55 | ||||
| % of Total ICD J158 - Pneumonia due to other specified bacteria in DRG | 2.86 | ||||
| Avg LOS at DRG | 7.0 | ||||
| Avg LOS with ICD J158 - Pneumonia due to other specified bacteria | 11.01 | ||||
| Readmission Rate at DRG | 32.53 | ||||
| Readmission Rate with ICD J158 - Pneumonia due to other specified bacteria | 38.74 | ||||
| Unplanned Readmission Rate at DRG | 19.84 | ||||
| Unplanned Readmission Rate with ICD J158 - Pneumonia due to other specified bacteria | 19.13 | ||||
| Total Medicare payments at DRG | $2,845,609,163 | ||||
| Total Medicare payments with ICD J158 - Pneumonia due to other specified bacteria | $10,164,448 | ||||
| Total Medicare payment per Day at DRG | $2,237 | ||||
| Total Medicare payment per Day with ICD J158 - Pneumonia due to other specified bacteria | $1,688 | ||||
| Total Medicare payment per Hospitalization at DRG | $15,666 | ||||
| Total Medicare payment per Hospitalization with ICD J158 - Pneumonia due to other specified bacteria | $18,582 | ||||
| Total Medicare Charges at DRG | $14,794,146,746 | ||||
| Total Medicare Charges with ICD J158 - Pneumonia due to other specified bacteria | $60,796,298 | ||||
| Avg Charges at DRG | $81,449 | ||||
| Avg Charges with ICD J158 - Pneumonia due to other specified bacteria | $111,145 | ||||
| Mortality Rate at DRG | 25.14 | ||||
| Mortality Rate with ICD J158 - Pneumonia due to other specified bacteria | 18.65 | ||||
| SNF Discharge Rate at DRG | 19.06 | ||||
| SNF Discharge Rate with ICD J158 - Pneumonia due to other specified bacteria | 26.51 | ||||
| Home Discharge Rate at DRG | 20.69 | ||||
| Home Discharge Rate with ICD J158 - Pneumonia due to other specified bacteria | 16.82 |
*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| DRG 163: MAJOR CHEST PROCEDURES WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 682: RENAL FAILURE WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 091: OTHER DISORDERS OF NERVOUS SYSTEM WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 280: ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 193: SIMPLE PNEUMONIA AND PLEURISY WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 37,276 | ||||
| Total Hospitalizations with ICD J158 - Pneumonia due to other specified bacteria | 174 | ||||
| DRG Share of Total Hospitalizations | 0.11 | ||||
| % of Total ICD J158 - Pneumonia due to other specified bacteria in DRG | 0.91 | ||||
| Avg LOS at DRG | 12.15 | ||||
| Avg LOS with ICD J158 - Pneumonia due to other specified bacteria | 19.49 | ||||
| Readmission Rate at DRG | 27.64 | ||||
| Readmission Rate with ICD J158 - Pneumonia due to other specified bacteria | 35.37 | ||||
| Unplanned Readmission Rate at DRG | 14.04 | ||||
| Unplanned Readmission Rate with ICD J158 - Pneumonia due to other specified bacteria | 13.61 | ||||
| Total Medicare payments at DRG | $1,238,611,931 | ||||
| Total Medicare payments with ICD J158 - Pneumonia due to other specified bacteria | $7,218,030 | ||||
| Total Medicare payment per Day at DRG | $2,735 | ||||
| Total Medicare payment per Day with ICD J158 - Pneumonia due to other specified bacteria | $2,129 | ||||
| Total Medicare payment per Hospitalization at DRG | $33,228 | ||||
| Total Medicare payment per Hospitalization with ICD J158 - Pneumonia due to other specified bacteria | $41,483 | ||||
| Total Medicare Charges at DRG | $5,969,079,351 | ||||
| Total Medicare Charges with ICD J158 - Pneumonia due to other specified bacteria | $39,585,547 | ||||
| Avg Charges at DRG | $160,132 | ||||
| Avg Charges with ICD J158 - Pneumonia due to other specified bacteria | $227,503 | ||||
| Mortality Rate at DRG | 8.94 | ||||
| Mortality Rate with ICD J158 - Pneumonia due to other specified bacteria | 11.49 | ||||
| SNF Discharge Rate at DRG | 17.97 | ||||
| SNF Discharge Rate with ICD J158 - Pneumonia due to other specified bacteria | 23.56 | ||||
| Home Discharge Rate at DRG | 31.66 | ||||
| Home Discharge Rate with ICD J158 - Pneumonia due to other specified bacteria | 20.11 |
| 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 | 151 |
| MONROVIA MEMORIAL HOSPITAL | 323 S HELIOTROPE AVE | MONROVIA | CA | 91016 | 87 |
| OSF SAINT FRANCIS MEDICAL CENTER | 530 NE GLEN OAK AVE | PEORIA | IL | 61637 | 81 |
| Physician Name | Address | City | State | Zip Code | Total Hospitalizations ( Oct 2015 to Sep 2018 ) |
|---|---|---|---|---|---|
| Dr. IBRAHIM A SULTAN-ALI | 8066 WALNUT RUN ROAD | CORDOVA | TN | 38018 | 18 |
| Dr. NGO C. PHAN | 330 S GARFIELD AVE | ALHAMBRA | CA | 91801 | 14 |
| Dr. DAVID GU | 723 S GARFIELD AVE | ALHAMBRA | CA | 91801 | 14 |
| Physician Name | Address | City | State | Zip Code | Total Hospitalizations ( Oct 2015 to Sep 2018 ) |
|---|---|---|---|---|---|
| Dr. JIMMY W JENKINS | 1110 SAINT MARYS RD | JUNCTION CITY | KS | 66441 | 41 |
| Dr. FAISAL WASI | 905 NW 5TH ST | STIGLER | OK | 74462 | 32 |
| Dr. NGO C. PHAN | 330 S GARFIELD AVE | ALHAMBRA | CA | 91801 | 24 |