*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| R52 - Pain, unspecified - as a primary diagnosis code | R52 - Pain, unspecified - as a primary or secondary diagnosis code | |
|---|---|---|
| OUTCOMES | ||
| Avg. LOS | 10.66 | |
| Readmission Rate (%) | 21.46 | |
| Unplanned Readmission Rate (%) | 15.94 | |
| 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 948: SIGNS AND SYMPTOMS WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 947: SIGNS AND SYMPTOMS WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|
| Total Hospitalizations at DRG | 160,950 | |
| Total Hospitalizations with ICD R52 - Pain, unspecified | 509 | |
| DRG Share of Total Hospitalizations | 0.49 | |
| % of Total ICD R52 - Pain, unspecified in DRG | 76.08 | |
| Avg LOS at DRG | 4.98 | |
| Avg LOS with ICD R52 - Pain, unspecified | 3.47 | |
| Readmission Rate at DRG | 20.85 | |
| Readmission Rate with ICD R52 - Pain, unspecified | 22.59 | |
| Unplanned Readmission Rate at DRG | 13.4 | |
| Unplanned Readmission Rate with ICD R52 - Pain, unspecified | 14.47 | |
| Total Medicare payments at DRG | $1,184,949,733 | |
| Total Medicare payments with ICD R52 - Pain, unspecified | $2,701,491 | |
| Total Medicare payment per Day at DRG | $1,477 | |
| Total Medicare payment per Day with ICD R52 - Pain, unspecified | $1,530 | |
| Total Medicare payment per Hospitalization at DRG | $7,362 | |
| Total Medicare payment per Hospitalization with ICD R52 - Pain, unspecified | $5,307 | |
| Total Medicare Charges at DRG | $4,222,078,897 | |
| Total Medicare Charges with ICD R52 - Pain, unspecified | $11,456,293 | |
| Avg Charges at DRG | $26,232 | |
| Avg Charges with ICD R52 - Pain, unspecified | $22,507 | |
| Mortality Rate at DRG | 0.67 | |
| Mortality Rate with ICD R52 - Pain, unspecified | 2.75 | |
| SNF Discharge Rate at DRG | 22.29 | |
| SNF Discharge Rate with ICD R52 - Pain, unspecified | 21.22 | |
| Home Discharge Rate at DRG | 35.46 | |
| Home Discharge Rate with ICD R52 - Pain, unspecified | 41.85 |
*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| DRG 885: PSYCHOSES | DRG 560: AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH COMPLICATION OR COMORBIDITY (CC) | DRG 057: DEGENERATIVE NERVOUS SYSTEM DISORDERS WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 949: AFTERCARE WITH COMPLICATION OR COMORBIDITY (CC)/MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 897: ALCOHOL, DRUG ABUSE OR DEPENDENCE WITHOUT REHABILITATION THERAPY WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 1,100,860 | ||||
| Total Hospitalizations with ICD R52 - Pain, unspecified | 5,956 | ||||
| DRG Share of Total Hospitalizations | 3.35 | ||||
| % of Total ICD R52 - Pain, unspecified in DRG | 13.2 | ||||
| Avg LOS at DRG | 11.86 | ||||
| Avg LOS with ICD R52 - Pain, unspecified | 13.03 | ||||
| Readmission Rate at DRG | 27.58 | ||||
| Readmission Rate with ICD R52 - Pain, unspecified | 28.9 | ||||
| Unplanned Readmission Rate at DRG | 13.34 | ||||
| Unplanned Readmission Rate with ICD R52 - Pain, unspecified | 12.27 | ||||
| Total Medicare payments at DRG | $9,312,828,663 | ||||
| Total Medicare payments with ICD R52 - Pain, unspecified | $54,298,502 | ||||
| Total Medicare payment per Day at DRG | $713 | ||||
| Total Medicare payment per Day with ICD R52 - Pain, unspecified | $699 | ||||
| Total Medicare payment per Hospitalization at DRG | $8,460 | ||||
| Total Medicare payment per Hospitalization with ICD R52 - Pain, unspecified | $9,117 | ||||
| Total Medicare Charges at DRG | $32,341,464,302 | ||||
| Total Medicare Charges with ICD R52 - Pain, unspecified | $151,520,803 | ||||
| Avg Charges at DRG | $29,378 | ||||
| Avg Charges with ICD R52 - Pain, unspecified | $25,440 | ||||
| Mortality Rate at DRG | 0.04 | ||||
| Mortality Rate with ICD R52 - Pain, unspecified | NA | ||||
| SNF Discharge Rate at DRG | 5.83 | ||||
| SNF Discharge Rate with ICD R52 - Pain, unspecified | 11.38 | ||||
| Home Discharge Rate at DRG | 79.47 | ||||
| Home Discharge Rate with ICD R52 - Pain, unspecified | 78.61 |
*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| DRG 561: AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT COMPLICATION OR COMORBIDITY (CC)/MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 948: SIGNS AND SYMPTOMS WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 895: ALCOHOL, DRUG ABUSE OR DEPENDENCE WITH REHABILITATION THERAPY | DRG 871: SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 552: MEDICAL BACK PROBLEMS WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 95,335 | ||||
| Total Hospitalizations with ICD R52 - Pain, unspecified | 1,396 | ||||
| DRG Share of Total Hospitalizations | 0.29 | ||||
| % of Total ICD R52 - Pain, unspecified in DRG | 3.09 | ||||
| Avg LOS at DRG | 10.22 | ||||
| Avg LOS with ICD R52 - Pain, unspecified | 11.06 | ||||
| Readmission Rate at DRG | 9.28 | ||||
| Readmission Rate with ICD R52 - Pain, unspecified | 7.56 | ||||
| Unplanned Readmission Rate at DRG | 5.52 | ||||
| Unplanned Readmission Rate with ICD R52 - Pain, unspecified | 4.63 | ||||
| Total Medicare payments at DRG | $1,423,955,801 | ||||
| Total Medicare payments with ICD R52 - Pain, unspecified | $22,465,279 | ||||
| Total Medicare payment per Day at DRG | $1,462 | ||||
| Total Medicare payment per Day with ICD R52 - Pain, unspecified | $1,454 | ||||
| Total Medicare payment per Hospitalization at DRG | $14,936 | ||||
| Total Medicare payment per Hospitalization with ICD R52 - Pain, unspecified | $16,093 | ||||
| Total Medicare Charges at DRG | $2,977,958,847 | ||||
| Total Medicare Charges with ICD R52 - Pain, unspecified | $48,886,837 | ||||
| Avg Charges at DRG | $31,237 | ||||
| Avg Charges with ICD R52 - Pain, unspecified | $35,019 | ||||
| Mortality Rate at DRG | 0.08 | ||||
| Mortality Rate with ICD R52 - Pain, unspecified | NA | ||||
| SNF Discharge Rate at DRG | 15.14 | ||||
| SNF Discharge Rate with ICD R52 - Pain, unspecified | 12.82 | ||||
| Home Discharge Rate at DRG | 25.42 | ||||
| Home Discharge Rate with ICD R52 - Pain, unspecified | 25.64 |
*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| DRG 559: AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 092: OTHER DISORDERS OF NERVOUS SYSTEM WITH COMPLICATION OR COMORBIDITY (CC) | DRG 884: ORGANIC DISTURBANCES AND INTELLECTUAL DISABILITY | DRG 091: OTHER DISORDERS OF NERVOUS SYSTEM WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 536: FRACTURES OF HIP AND PELVIS WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 65,966 | ||||
| Total Hospitalizations with ICD R52 - Pain, unspecified | 802 | ||||
| DRG Share of Total Hospitalizations | 0.2 | ||||
| % of Total ICD R52 - Pain, unspecified in DRG | 1.78 | ||||
| Avg LOS at DRG | 13.11 | ||||
| Avg LOS with ICD R52 - Pain, unspecified | 13.97 | ||||
| Readmission Rate at DRG | 21.08 | ||||
| Readmission Rate with ICD R52 - Pain, unspecified | 20.38 | ||||
| Unplanned Readmission Rate at DRG | 14.13 | ||||
| Unplanned Readmission Rate with ICD R52 - Pain, unspecified | 13.15 | ||||
| Total Medicare payments at DRG | $1,323,430,782 | ||||
| Total Medicare payments with ICD R52 - Pain, unspecified | $16,934,401 | ||||
| Total Medicare payment per Day at DRG | $1,530 | ||||
| Total Medicare payment per Day with ICD R52 - Pain, unspecified | $1,511 | ||||
| Total Medicare payment per Hospitalization at DRG | $20,062 | ||||
| Total Medicare payment per Hospitalization with ICD R52 - Pain, unspecified | $21,115 | ||||
| Total Medicare Charges at DRG | $3,810,466,828 | ||||
| Total Medicare Charges with ICD R52 - Pain, unspecified | $46,000,653 | ||||
| Avg Charges at DRG | $57,764 | ||||
| Avg Charges with ICD R52 - Pain, unspecified | $57,357 | ||||
| Mortality Rate at DRG | 1.49 | ||||
| Mortality Rate with ICD R52 - Pain, unspecified | NA | ||||
| SNF Discharge Rate at DRG | 24.48 | ||||
| SNF Discharge Rate with ICD R52 - Pain, unspecified | 24.19 | ||||
| Home Discharge Rate at DRG | 12.66 | ||||
| Home Discharge Rate with ICD R52 - Pain, unspecified | 12.34 |
*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| DRG 945: REHABILITATION WITH COMPLICATION OR COMORBIDITY (CC)/MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 189: PULMONARY EDEMA AND RESPIRATORY FAILURE | DRG 056: DEGENERATIVE NERVOUS SYSTEM DISORDERS WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 554: BONE DISEASES AND ARTHROPATHIES WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 812: RED BLOOD CELL DISORDERS WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 38,773 | ||||
| Total Hospitalizations with ICD R52 - Pain, unspecified | 515 | ||||
| DRG Share of Total Hospitalizations | 0.12 | ||||
| % of Total ICD R52 - Pain, unspecified in DRG | 1.14 | ||||
| Avg LOS at DRG | 11.96 | ||||
| Avg LOS with ICD R52 - Pain, unspecified | 12.79 | ||||
| Readmission Rate at DRG | 18.12 | ||||
| Readmission Rate with ICD R52 - Pain, unspecified | 16.03 | ||||
| Unplanned Readmission Rate at DRG | 14.28 | ||||
| Unplanned Readmission Rate with ICD R52 - Pain, unspecified | 12.87 | ||||
| Total Medicare payments at DRG | $739,082,714 | ||||
| Total Medicare payments with ICD R52 - Pain, unspecified | $10,513,847 | ||||
| Total Medicare payment per Day at DRG | $1,594 | ||||
| Total Medicare payment per Day with ICD R52 - Pain, unspecified | $1,596 | ||||
| Total Medicare payment per Hospitalization at DRG | $19,062 | ||||
| Total Medicare payment per Hospitalization with ICD R52 - Pain, unspecified | $20,415 | ||||
| Total Medicare Charges at DRG | $2,416,011,805 | ||||
| Total Medicare Charges with ICD R52 - Pain, unspecified | $39,686,132 | ||||
| Avg Charges at DRG | $62,312 | ||||
| Avg Charges with ICD R52 - Pain, unspecified | $77,060 | ||||
| Mortality Rate at DRG | 0.2 | ||||
| Mortality Rate with ICD R52 - Pain, unspecified | NA | ||||
| SNF Discharge Rate at DRG | 17.34 | ||||
| SNF Discharge Rate with ICD R52 - Pain, unspecified | 18.25 | ||||
| Home Discharge Rate at DRG | 21.02 | ||||
| Home Discharge Rate with ICD R52 - Pain, unspecified | 18.25 |
| Hospital Name | Address | City | State | Zip Code | Total Hospitalizations ( Oct 2015 to Sep 2018 ) |
|---|---|---|---|---|---|
| ADCARE HOSPITAL OF WORCESTER | 107 LINCOLN ST | WORCESTER | MA | 01605 | 1,792 |
| KESSLER INSTITUTE FOR REHABILITATION | 1199 PLEASANT VALLEY WAY | WEST ORANGE | NJ | 07052 | 1,729 |
| EINSTEIN MEDICAL CENTER PHILADELPHIA | 5501 OLD YORK RD | PHILA | PA | 19141 | 906 |
| Physician Name | Address | City | State | Zip Code | Total Hospitalizations ( Oct 2015 to Sep 2018 ) |
|---|---|---|---|---|---|
| Dr. RONALD F. PIKE | 107 LINCOLN ST | WORCESTER | MA | 01605 | 687 |
| Dr. WOJCIECH POLUHA | 107 LINCOLN ST | WORCESTER | MA | 01605 | 597 |
| Dr. KAREN S GUADAGNINI | 102 NORTH ST | BRISTOL | CT | 06010 | 373 |
| Physician Name | Address | City | State | Zip Code | Total Hospitalizations ( Oct 2015 to Sep 2018 ) |
|---|---|---|---|---|---|
| Dr. RONALD F. PIKE | 107 LINCOLN ST | WORCESTER | MA | 01605 | 763 |
| Dr. WOJCIECH POLUHA | 107 LINCOLN ST | WORCESTER | MA | 01605 | 603 |
| Dr. POONAM MEHTA MANASA | 3568 SHORELINE CIR | PALM HARBOR | FL | 34684 | 495 |
| No | ICD Diagnosis Code | Description |
|---|---|---|
| 1 | R531 | Weakness |
| 2 | Z66 | Do not resuscitate |
| 3 | M1990 | Unspecified osteoarthritis, unspecified site |
| 4 | J449 | Chronic obstructive pulmonary disease, unspecified |
| 5 | F419 | Anxiety disorder, unspecified |
| 6 | F329 | Major depressive disorder, single episode, unspecified |