*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| R091 - Pleurisy - as a primary diagnosis code | R091 - Pleurisy - as a primary or secondary diagnosis code | |
|---|---|---|
| OUTCOMES | ||
| Avg. LOS | 4.41 | |
| Readmission Rate (%) | 19.28 | |
| Unplanned Readmission Rate (%) | 12.5 | |
| 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 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 193: SIMPLE PNEUMONIA AND PLEURISY WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 167: OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITH COMPLICATION OR COMORBIDITY (CC) | DRG 166: OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 417,755 | ||||
| Total Hospitalizations with ICD R091 - Pleurisy | 795 | ||||
| DRG Share of Total Hospitalizations | 1.27 | ||||
| % of Total ICD R091 - Pleurisy in DRG | 51.52 | ||||
| Avg LOS at DRG | 3.9 | ||||
| Avg LOS with ICD R091 - Pleurisy | 2.44 | ||||
| Readmission Rate at DRG | 16.53 | ||||
| Readmission Rate with ICD R091 - Pleurisy | 15.23 | ||||
| Unplanned Readmission Rate at DRG | 11.52 | ||||
| Unplanned Readmission Rate with ICD R091 - Pleurisy | 11.33 | ||||
| Total Medicare payments at DRG | $2,493,587,688 | ||||
| Total Medicare payments with ICD R091 - Pleurisy | $4,041,063 | ||||
| Total Medicare payment per Day at DRG | $1,529 | ||||
| Total Medicare payment per Day with ICD R091 - Pleurisy | $2,087 | ||||
| Total Medicare payment per Hospitalization at DRG | $5,969 | ||||
| Total Medicare payment per Hospitalization with ICD R091 - Pleurisy | $5,083 | ||||
| Total Medicare Charges at DRG | $11,318,800,289 | ||||
| Total Medicare Charges with ICD R091 - Pleurisy | $22,064,725 | ||||
| Avg Charges at DRG | $27,094 | ||||
| Avg Charges with ICD R091 - Pleurisy | $27,754 | ||||
| Mortality Rate at DRG | 0.87 | ||||
| Mortality Rate with ICD R091 - Pleurisy | NA | ||||
| SNF Discharge Rate at DRG | 17.03 | ||||
| SNF Discharge Rate with ICD R091 - Pleurisy | 5.91 | ||||
| Home Discharge Rate at DRG | 53.31 | ||||
| Home Discharge Rate with ICD R091 - Pleurisy | 77.36 |
| Hospital Name | Address | City | State | Zip Code | Total Hospitalizations ( Oct 2015 to Sep 2018 ) |
|---|---|---|---|---|---|
| ADVENTHEALTH ORLANDO | 601 E ROLLINS ST | ORLANDO | FL | 32803 | 20 |
| SHERMAN OAKS HOSPITAL | 4929 VAN NUYS BLVD. | SHERMAN OAKS | CA | 91403 | 12 |
*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| 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 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 190: CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 417,755 | ||||
| Total Hospitalizations with ICD R091 - Pleurisy | 2,016 | ||||
| DRG Share of Total Hospitalizations | 1.27 | ||||
| % of Total ICD R091 - Pleurisy in DRG | 16.03 | ||||
| Avg LOS at DRG | 3.9 | ||||
| Avg LOS with ICD R091 - Pleurisy | 3.16 | ||||
| Readmission Rate at DRG | 16.53 | ||||
| Readmission Rate with ICD R091 - Pleurisy | 15.75 | ||||
| Unplanned Readmission Rate at DRG | 11.52 | ||||
| Unplanned Readmission Rate with ICD R091 - Pleurisy | 11.21 | ||||
| Total Medicare payments at DRG | $2,493,587,688 | ||||
| Total Medicare payments with ICD R091 - Pleurisy | $10,523,668 | ||||
| Total Medicare payment per Day at DRG | $1,529 | ||||
| Total Medicare payment per Day with ICD R091 - Pleurisy | $1,653 | ||||
| Total Medicare payment per Hospitalization at DRG | $5,969 | ||||
| Total Medicare payment per Hospitalization with ICD R091 - Pleurisy | $5,220 | ||||
| Total Medicare Charges at DRG | $11,318,800,289 | ||||
| Total Medicare Charges with ICD R091 - Pleurisy | $55,808,173 | ||||
| Avg Charges at DRG | $27,094 | ||||
| Avg Charges with ICD R091 - Pleurisy | $27,683 | ||||
| Mortality Rate at DRG | 0.87 | ||||
| Mortality Rate with ICD R091 - Pleurisy | NA | ||||
| SNF Discharge Rate at DRG | 17.03 | ||||
| SNF Discharge Rate with ICD R091 - Pleurisy | 7.34 | ||||
| Home Discharge Rate at DRG | 53.31 | ||||
| Home Discharge Rate with ICD R091 - Pleurisy | 73.51 |
*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| DRG 176: PULMONARY EMBOLISM WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 191: CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH COMPLICATION OR COMORBIDITY (CC) | DRG 192: CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITHOUT COMPLICATION OR COMORBIDITY (CC)/MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 202: BRONCHITIS AND ASTHMA WITH COMPLICATION OR COMORBIDITY (CC)/MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 291: HEART FAILURE AND SHOCK WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 103,915 | ||||
| Total Hospitalizations with ICD R091 - Pleurisy | 431 | ||||
| DRG Share of Total Hospitalizations | 0.32 | ||||
| % of Total ICD R091 - Pleurisy in DRG | 3.43 | ||||
| Avg LOS at DRG | 3.34 | ||||
| Avg LOS with ICD R091 - Pleurisy | 3.26 | ||||
| Readmission Rate at DRG | 13.92 | ||||
| Readmission Rate with ICD R091 - Pleurisy | 12.08 | ||||
| Unplanned Readmission Rate at DRG | 10.02 | ||||
| Unplanned Readmission Rate with ICD R091 - Pleurisy | 8.45 | ||||
| Total Medicare payments at DRG | $565,714,520 | ||||
| Total Medicare payments with ICD R091 - Pleurisy | $2,182,931 | ||||
| Total Medicare payment per Day at DRG | $1,632 | ||||
| Total Medicare payment per Day with ICD R091 - Pleurisy | $1,553 | ||||
| Total Medicare payment per Hospitalization at DRG | $5,444 | ||||
| Total Medicare payment per Hospitalization with ICD R091 - Pleurisy | $5,065 | ||||
| Total Medicare Charges at DRG | $3,040,468,542 | ||||
| Total Medicare Charges with ICD R091 - Pleurisy | $11,895,473 | ||||
| Avg Charges at DRG | $29,259 | ||||
| Avg Charges with ICD R091 - Pleurisy | $27,600 | ||||
| Mortality Rate at DRG | 0.51 | ||||
| Mortality Rate with ICD R091 - Pleurisy | NA | ||||
| SNF Discharge Rate at DRG | 10.78 | ||||
| SNF Discharge Rate with ICD R091 - Pleurisy | 5.8 | ||||
| Home Discharge Rate at DRG | 64.62 | ||||
| Home Discharge Rate with ICD R091 - Pleurisy | 79.12 |
*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| DRG 313: CHEST PAIN | DRG 189: PULMONARY EDEMA AND RESPIRATORY FAILURE | DRG 175: PULMONARY EMBOLISM WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 178: RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH COMPLICATION OR COMORBIDITY (CC) | DRG 177: RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 180,138 | ||||
| Total Hospitalizations with ICD R091 - Pleurisy | 225 | ||||
| DRG Share of Total Hospitalizations | 0.55 | ||||
| % of Total ICD R091 - Pleurisy in DRG | 1.79 | ||||
| Avg LOS at DRG | 1.91 | ||||
| Avg LOS with ICD R091 - Pleurisy | 2.09 | ||||
| Readmission Rate at DRG | 16.98 | ||||
| Readmission Rate with ICD R091 - Pleurisy | 21.23 | ||||
| Unplanned Readmission Rate at DRG | 12.86 | ||||
| Unplanned Readmission Rate with ICD R091 - Pleurisy | 16.51 | ||||
| Total Medicare payments at DRG | $645,443,207 | ||||
| Total Medicare payments with ICD R091 - Pleurisy | $753,291 | ||||
| Total Medicare payment per Day at DRG | $1,876 | ||||
| Total Medicare payment per Day with ICD R091 - Pleurisy | $1,603 | ||||
| Total Medicare payment per Hospitalization at DRG | $3,583 | ||||
| Total Medicare payment per Hospitalization with ICD R091 - Pleurisy | $3,348 | ||||
| Total Medicare Charges at DRG | $4,502,159,305 | ||||
| Total Medicare Charges with ICD R091 - Pleurisy | $5,539,492 | ||||
| Avg Charges at DRG | $24,993 | ||||
| Avg Charges with ICD R091 - Pleurisy | $24,620 | ||||
| Mortality Rate at DRG | 0.13 | ||||
| Mortality Rate with ICD R091 - Pleurisy | NA | ||||
| SNF Discharge Rate at DRG | 7.73 | ||||
| SNF Discharge Rate with ICD R091 - Pleurisy | 8.0 | ||||
| Home Discharge Rate at DRG | 72.82 | ||||
| Home Discharge Rate with ICD R091 - Pleurisy | 76.44 |
*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| DRG 292: HEART FAILURE AND SHOCK WITH COMPLICATION OR COMORBIDITY (CC) | DRG 203: BRONCHITIS AND ASTHMA WITHOUT COMPLICATION OR COMORBIDITY (CC)/MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 314: OTHER CIRCULATORY SYSTEM DIAGNOSES WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 167: OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITH COMPLICATION OR COMORBIDITY (CC) | DRG 206: OTHER RESPIRATORY SYSTEM DIAGNOSES WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 422,757 | ||||
| Total Hospitalizations with ICD R091 - Pleurisy | 107 | ||||
| DRG Share of Total Hospitalizations | 1.29 | ||||
| % of Total ICD R091 - Pleurisy in DRG | 0.85 | ||||
| Avg LOS at DRG | 4.14 | ||||
| Avg LOS with ICD R091 - Pleurisy | 4.03 | ||||
| Readmission Rate at DRG | 24.43 | ||||
| Readmission Rate with ICD R091 - Pleurisy | 31.37 | ||||
| Unplanned Readmission Rate at DRG | 18.48 | ||||
| Unplanned Readmission Rate with ICD R091 - Pleurisy | 27.45 | ||||
| Total Medicare payments at DRG | $2,636,135,714 | ||||
| Total Medicare payments with ICD R091 - Pleurisy | $648,961 | ||||
| Total Medicare payment per Day at DRG | $1,507 | ||||
| Total Medicare payment per Day with ICD R091 - Pleurisy | $1,506 | ||||
| Total Medicare payment per Hospitalization at DRG | $6,236 | ||||
| Total Medicare payment per Hospitalization with ICD R091 - Pleurisy | $6,065 | ||||
| Total Medicare Charges at DRG | $11,980,955,733 | ||||
| Total Medicare Charges with ICD R091 - Pleurisy | $2,938,515 | ||||
| Avg Charges at DRG | $28,340 | ||||
| Avg Charges with ICD R091 - Pleurisy | $27,463 | ||||
| Mortality Rate at DRG | 1.01 | ||||
| Mortality Rate with ICD R091 - Pleurisy | NA | ||||
| SNF Discharge Rate at DRG | 16.05 | ||||
| SNF Discharge Rate with ICD R091 - Pleurisy | 14.02 | ||||
| Home Discharge Rate at DRG | 47.18 | ||||
| Home Discharge Rate with ICD R091 - Pleurisy | 60.75 |
| Hospital Name | Address | City | State | Zip Code | Total Hospitalizations ( Oct 2015 to Sep 2018 ) |
|---|---|---|---|---|---|
| EVERGREEN MEDICAL CENTER | 101 CRESTVIEW AVE | EVERGREEN | AL | 36401 | 184 |
| MEMORIAL SLOAN KETTERING CANCER CENTER | 1275 YORK AVE | NEW YORK | NY | 10065 | 52 |
| ADVENTHEALTH ORLANDO | 601 E ROLLINS ST | ORLANDO | FL | 32803 | 52 |
| Physician Name | Address | City | State | Zip Code | Total Hospitalizations ( Oct 2015 to Sep 2018 ) |
|---|---|---|---|---|---|
| Dr. MARK A ROBERTS | 106 EDWINA STREET | EVERGREEN | AL | 36401 | 168 |
| Dr. MATT HAI PHAM | 500 N RAINBOW BLVD | LAS VEGAS | NV | 89107 | 24 |
| Dr. ELIZABETH ELIACIN | 3950 AUSTELL RD | AUSTELL | GA | 30106 | 19 |