*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| M351 - Other overlap syndromes - as a primary diagnosis code | M351 - Other overlap syndromes - as a primary or secondary diagnosis code | |
|---|---|---|
| OUTCOMES | ||
| Avg. LOS | 6.96 | |
| Readmission Rate (%) | 25.79 | |
| Unplanned Readmission Rate (%) | 18.5 | |
| 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 546: CONNECTIVE TISSUE DISORDERS WITH COMPLICATION OR COMORBIDITY (CC) | DRG 545: CONNECTIVE TISSUE DISORDERS WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 547: CONNECTIVE TISSUE DISORDERS WITHOUT COMPLICATION OR COMORBIDITY (CC)/MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|---|
| Total Hospitalizations at DRG | 14,526 | ||
| Total Hospitalizations with ICD M351 - Other overlap syndromes | 88 | ||
| DRG Share of Total Hospitalizations | 0.04 | ||
| % of Total ICD M351 - Other overlap syndromes in DRG | 41.9 | ||
| Avg LOS at DRG | 5.12 | ||
| Avg LOS with ICD M351 - Other overlap syndromes | 5.43 | ||
| Readmission Rate at DRG | 23.17 | ||
| Readmission Rate with ICD M351 - Other overlap syndromes | 19.77 | ||
| Unplanned Readmission Rate at DRG | 15.83 | ||
| Unplanned Readmission Rate with ICD M351 - Other overlap syndromes | 15.12 | ||
| Total Medicare payments at DRG | $123,348,417 | ||
| Total Medicare payments with ICD M351 - Other overlap syndromes | $743,714 | ||
| Total Medicare payment per Day at DRG | $1,658 | ||
| Total Medicare payment per Day with ICD M351 - Other overlap syndromes | $1,556 | ||
| Total Medicare payment per Hospitalization at DRG | $8,492 | ||
| Total Medicare payment per Hospitalization with ICD M351 - Other overlap syndromes | $8,451 | ||
| Total Medicare Charges at DRG | $565,151,481 | ||
| Total Medicare Charges with ICD M351 - Other overlap syndromes | $4,022,948 | ||
| Avg Charges at DRG | $38,906 | ||
| Avg Charges with ICD M351 - Other overlap syndromes | $45,715 | ||
| Mortality Rate at DRG | 0.34 | ||
| Mortality Rate with ICD M351 - Other overlap syndromes | NA | ||
| SNF Discharge Rate at DRG | 16.01 | ||
| SNF Discharge Rate with ICD M351 - Other overlap syndromes | NA | ||
| Home Discharge Rate at DRG | 53.61 | ||
| Home Discharge Rate with ICD M351 - Other overlap syndromes | 63.64 |
*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 189: PULMONARY EDEMA AND RESPIRATORY FAILURE | DRG 291: HEART FAILURE AND SHOCK WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 190: CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 470: MAJOR JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 1,808,415 | ||||
| Total Hospitalizations with ICD M351 - Other overlap syndromes | 749 | ||||
| DRG Share of Total Hospitalizations | 5.5 | ||||
| % of Total ICD M351 - Other overlap syndromes in DRG | 6.86 | ||||
| Avg LOS at DRG | 6.34 | ||||
| Avg LOS with ICD M351 - Other overlap syndromes | 7.34 | ||||
| Readmission Rate at DRG | 24.2 | ||||
| Readmission Rate with ICD M351 - Other overlap syndromes | 29.36 | ||||
| Unplanned Readmission Rate at DRG | 16.78 | ||||
| Unplanned Readmission Rate with ICD M351 - Other overlap syndromes | 22.29 | ||||
| Total Medicare payments at DRG | $21,288,214,047 | ||||
| Total Medicare payments with ICD M351 - Other overlap syndromes | $9,634,971 | ||||
| Total Medicare payment per Day at DRG | $1,857 | ||||
| Total Medicare payment per Day with ICD M351 - Other overlap syndromes | $1,752 | ||||
| Total Medicare payment per Hospitalization at DRG | $11,772 | ||||
| Total Medicare payment per Hospitalization with ICD M351 - Other overlap syndromes | $12,864 | ||||
| Total Medicare Charges at DRG | $107,155,481,388 | ||||
| Total Medicare Charges with ICD M351 - Other overlap syndromes | $54,715,600 | ||||
| Avg Charges at DRG | $59,254 | ||||
| Avg Charges with ICD M351 - Other overlap syndromes | $73,052 | ||||
| Mortality Rate at DRG | 12.11 | ||||
| Mortality Rate with ICD M351 - Other overlap syndromes | 9.61 | ||||
| SNF Discharge Rate at DRG | 27.18 | ||||
| SNF Discharge Rate with ICD M351 - Other overlap syndromes | 20.03 | ||||
| Home Discharge Rate at DRG | 25.81 | ||||
| Home Discharge Rate with ICD M351 - Other overlap syndromes | 38.72 |
*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| DRG 191: CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH COMPLICATION OR COMORBIDITY (CC) | DRG 546: CONNECTIVE TISSUE DISORDERS WITH COMPLICATION OR COMORBIDITY (CC) | DRG 193: SIMPLE PNEUMONIA AND PLEURISY WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 392: ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 194: SIMPLE PNEUMONIA AND PLEURISY WITH COMPLICATION OR COMORBIDITY (CC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 286,456 | ||||
| Total Hospitalizations with ICD M351 - Other overlap syndromes | 261 | ||||
| DRG Share of Total Hospitalizations | 0.87 | ||||
| % of Total ICD M351 - Other overlap syndromes in DRG | 2.39 | ||||
| Avg LOS at DRG | 3.75 | ||||
| Avg LOS with ICD M351 - Other overlap syndromes | 4.21 | ||||
| Readmission Rate at DRG | 22.9 | ||||
| Readmission Rate with ICD M351 - Other overlap syndromes | 19.35 | ||||
| Unplanned Readmission Rate at DRG | 18.29 | ||||
| Unplanned Readmission Rate with ICD M351 - Other overlap syndromes | 14.92 | ||||
| Total Medicare payments at DRG | $1,641,467,496 | ||||
| Total Medicare payments with ICD M351 - Other overlap syndromes | $1,535,810 | ||||
| Total Medicare payment per Day at DRG | $1,526 | ||||
| Total Medicare payment per Day with ICD M351 - Other overlap syndromes | $1,399 | ||||
| Total Medicare payment per Hospitalization at DRG | $5,730 | ||||
| Total Medicare payment per Hospitalization with ICD M351 - Other overlap syndromes | $5,884 | ||||
| Total Medicare Charges at DRG | $8,050,963,680 | ||||
| Total Medicare Charges with ICD M351 - Other overlap syndromes | $9,105,268 | ||||
| Avg Charges at DRG | $28,105 | ||||
| Avg Charges with ICD M351 - Other overlap syndromes | $34,886 | ||||
| Mortality Rate at DRG | 0.24 | ||||
| Mortality Rate with ICD M351 - Other overlap syndromes | NA | ||||
| SNF Discharge Rate at DRG | 10.84 | ||||
| SNF Discharge Rate with ICD M351 - Other overlap syndromes | 6.13 | ||||
| Home Discharge Rate at DRG | 59.73 | ||||
| Home Discharge Rate with ICD M351 - Other overlap syndromes | 67.82 |
*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| DRG 872: SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 853: INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURE WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 292: HEART FAILURE AND SHOCK WITH COMPLICATION OR COMORBIDITY (CC) | DRG 545: CONNECTIVE TISSUE DISORDERS WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 603: CELLULITIS WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 499,133 | ||||
| Total Hospitalizations with ICD M351 - Other overlap syndromes | 163 | ||||
| DRG Share of Total Hospitalizations | 1.52 | ||||
| % of Total ICD M351 - Other overlap syndromes in DRG | 1.49 | ||||
| Avg LOS at DRG | 4.34 | ||||
| Avg LOS with ICD M351 - Other overlap syndromes | 4.56 | ||||
| Readmission Rate at DRG | 17.57 | ||||
| Readmission Rate with ICD M351 - Other overlap syndromes | 22.36 | ||||
| Unplanned Readmission Rate at DRG | 12.56 | ||||
| Unplanned Readmission Rate with ICD M351 - Other overlap syndromes | 16.77 | ||||
| Total Medicare payments at DRG | $3,254,711,780 | ||||
| Total Medicare payments with ICD M351 - Other overlap syndromes | $1,118,711 | ||||
| Total Medicare payment per Day at DRG | $1,504 | ||||
| Total Medicare payment per Day with ICD M351 - Other overlap syndromes | $1,506 | ||||
| Total Medicare payment per Hospitalization at DRG | $6,521 | ||||
| Total Medicare payment per Hospitalization with ICD M351 - Other overlap syndromes | $6,863 | ||||
| Total Medicare Charges at DRG | $16,863,396,143 | ||||
| Total Medicare Charges with ICD M351 - Other overlap syndromes | $6,558,216 | ||||
| Avg Charges at DRG | $33,785 | ||||
| Avg Charges with ICD M351 - Other overlap syndromes | $40,234 | ||||
| Mortality Rate at DRG | 1.33 | ||||
| Mortality Rate with ICD M351 - Other overlap syndromes | NA | ||||
| SNF Discharge Rate at DRG | 19.89 | ||||
| SNF Discharge Rate with ICD M351 - Other overlap syndromes | 10.43 | ||||
| Home Discharge Rate at DRG | 49.27 | ||||
| Home Discharge Rate with ICD M351 - Other overlap syndromes | 63.8 |
*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| DRG 683: RENAL FAILURE WITH COMPLICATION OR COMORBIDITY (CC) | DRG 314: OTHER CIRCULATORY SYSTEM DIAGNOSES WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 208: RESPIRATORY SYSTEM DIAGNOSIS W VENTILATOR SUPPORT <=96 HOURS | DRG 309: CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH COMPLICATION OR COMORBIDITY (CC) | DRG 690: KIDNEY AND URINARY TRACT INFECTIONS WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 434,264 | ||||
| Total Hospitalizations with ICD M351 - Other overlap syndromes | 126 | ||||
| DRG Share of Total Hospitalizations | 1.32 | ||||
| % of Total ICD M351 - Other overlap syndromes in DRG | 1.15 | ||||
| Avg LOS at DRG | 3.94 | ||||
| Avg LOS with ICD M351 - Other overlap syndromes | 4.02 | ||||
| Readmission Rate at DRG | 22.76 | ||||
| Readmission Rate with ICD M351 - Other overlap syndromes | 26.67 | ||||
| Unplanned Readmission Rate at DRG | 16.46 | ||||
| Unplanned Readmission Rate with ICD M351 - Other overlap syndromes | 21.67 | ||||
| Total Medicare payments at DRG | $2,472,138,198 | ||||
| Total Medicare payments with ICD M351 - Other overlap syndromes | $816,533 | ||||
| Total Medicare payment per Day at DRG | $1,444 | ||||
| Total Medicare payment per Day with ICD M351 - Other overlap syndromes | $1,611 | ||||
| Total Medicare payment per Hospitalization at DRG | $5,693 | ||||
| Total Medicare payment per Hospitalization with ICD M351 - Other overlap syndromes | $6,480 | ||||
| Total Medicare Charges at DRG | $12,478,361,060 | ||||
| Total Medicare Charges with ICD M351 - Other overlap syndromes | $4,075,103 | ||||
| Avg Charges at DRG | $28,735 | ||||
| Avg Charges with ICD M351 - Other overlap syndromes | $32,342 | ||||
| Mortality Rate at DRG | 0.91 | ||||
| Mortality Rate with ICD M351 - Other overlap syndromes | NA | ||||
| SNF Discharge Rate at DRG | 22.02 | ||||
| SNF Discharge Rate with ICD M351 - Other overlap syndromes | 12.7 | ||||
| Home Discharge Rate at DRG | 46.68 | ||||
| Home Discharge Rate with ICD M351 - Other overlap syndromes | 61.11 |
| Hospital Name | Address | City | State | Zip Code | Total Hospitalizations ( Oct 2015 to Sep 2018 ) |
|---|---|---|---|---|---|
| UNIVERSITY OF MICHIGAN HEALTH SYSTEM | 1500 EAST MEDICAL CENTER DRIVE | ANN ARBOR | MI | 48109 | 81 |
| NORTHWESTERN MEMORIAL HOSPITAL | 251 E HURON ST | CHICAGO | IL | 60611 | 78 |
| UT SOUTHWESTERN MEDICAL CENTER | 6201 HARRY HINES BLVD | DALLAS | TX | 75390 | 71 |
| Physician Name | Address | City | State | Zip Code | Total Hospitalizations ( Oct 2015 to Sep 2018 ) |
|---|---|---|---|---|---|
| Dr. MUSHTAQ AHMED | 3551 Q STREET | BAKERSFIELD | CA | 93301 | 20 |