*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| R69 - Illness, unspecified - as a primary diagnosis code | R69 - Illness, unspecified - as a primary or secondary diagnosis code | |
|---|---|---|
| OUTCOMES | ||
| Avg. LOS | 16.89 | |
| Readmission Rate (%) | 19.24 | |
| Unplanned Readmission Rate (%) | 7.76 | |
| 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 951: OTHER FACTORS INFLUENCING HEALTH STATUS | |
|---|---|
| Total Hospitalizations at DRG | 4,475 |
| Total Hospitalizations with ICD R69 - Illness, unspecified | 685 |
| DRG Share of Total Hospitalizations | 0.01 |
| % of Total ICD R69 - Illness, unspecified in DRG | 100.0 |
| Avg LOS at DRG | 6.46 |
| Avg LOS with ICD R69 - Illness, unspecified | 23.15 |
| Readmission Rate at DRG | 21.75 |
| Readmission Rate with ICD R69 - Illness, unspecified | 13.97 |
| Unplanned Readmission Rate at DRG | 13.67 |
| Unplanned Readmission Rate with ICD R69 - Illness, unspecified | 7.76 |
| Total Medicare payments at DRG | $24,331,342 |
| Total Medicare payments with ICD R69 - Illness, unspecified | $3,174,326 |
| Total Medicare payment per Day at DRG | $842 |
| Total Medicare payment per Day with ICD R69 - Illness, unspecified | $200 |
| Total Medicare payment per Hospitalization at DRG | $5,437 |
| Total Medicare payment per Hospitalization with ICD R69 - Illness, unspecified | $4,634 |
| Total Medicare Charges at DRG | $86,404,017 |
| Total Medicare Charges with ICD R69 - Illness, unspecified | $5,948,234 |
| Avg Charges at DRG | $19,308 |
| Avg Charges with ICD R69 - Illness, unspecified | $8,684 |
| Mortality Rate at DRG | 26.77 |
| Mortality Rate with ICD R69 - Illness, unspecified | 29.05 |
| SNF Discharge Rate at DRG | 8.09 |
| SNF Discharge Rate with ICD R69 - Illness, unspecified | NA |
| Home Discharge Rate at DRG | 40.13 |
| Home Discharge Rate with ICD R69 - Illness, unspecified | 49.78 |
| Hospital Name | Address | City | State | Zip Code | Total Hospitalizations ( Oct 2015 to Sep 2018 ) |
|---|---|---|---|---|---|
| ARDEN WOOD | 445 WAWONA STREET | SAN FRANCISCO | CA | 94116 | 112 |
| CHESTNUT HILL BENEVOLENT ASSOCIATION | 910 BOYLSTON ST | CHESTNUT HILL | MA | 02467 | 74 |
| PEACE HAVEN ASSOCIATION | 12630 ROTT RD | SAINT LOUIS | MO | 63127 | 71 |
| Physician Name | Address | City | State | Zip Code | Total Hospitalizations ( Oct 2015 to Sep 2018 ) |
|---|---|---|---|---|---|
| Dr. LESLEAH L DE FRISCO | 445 WAWONA ST | SAN FRANCISCO | CA | 94116 | 112 |
| Dr. KATHLEEN GLOVER | 910 BOYLSTON ST | CHESTNUT HILL | MA | 02467 | 73 |
| Dr. CATHERINE FARRELL | 12630 ROTT RD | SAINT LOUIS | MO | 63127 | 71 |
*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 951: OTHER FACTORS INFLUENCING HEALTH STATUS | DRG 897: ALCOHOL, DRUG ABUSE OR DEPENDENCE WITHOUT REHABILITATION THERAPY WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 884: ORGANIC DISTURBANCES AND INTELLECTUAL DISABILITY | DRG 057: DEGENERATIVE NERVOUS SYSTEM DISORDERS WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 1,100,860 | ||||
| Total Hospitalizations with ICD R69 - Illness, unspecified | 2,215 | ||||
| DRG Share of Total Hospitalizations | 3.35 | ||||
| % of Total ICD R69 - Illness, unspecified in DRG | 43.54 | ||||
| Avg LOS at DRG | 11.86 | ||||
| Avg LOS with ICD R69 - Illness, unspecified | 20.67 | ||||
| Readmission Rate at DRG | 27.58 | ||||
| Readmission Rate with ICD R69 - Illness, unspecified | 18.29 | ||||
| Unplanned Readmission Rate at DRG | 13.34 | ||||
| Unplanned Readmission Rate with ICD R69 - Illness, unspecified | 6.86 | ||||
| Total Medicare payments at DRG | $9,312,828,663 | ||||
| Total Medicare payments with ICD R69 - Illness, unspecified | $25,605,702 | ||||
| Total Medicare payment per Day at DRG | $713 | ||||
| Total Medicare payment per Day with ICD R69 - Illness, unspecified | $559 | ||||
| Total Medicare payment per Hospitalization at DRG | $8,460 | ||||
| Total Medicare payment per Hospitalization with ICD R69 - Illness, unspecified | $11,560 | ||||
| Total Medicare Charges at DRG | $32,341,464,302 | ||||
| Total Medicare Charges with ICD R69 - Illness, unspecified | $81,041,645 | ||||
| Avg Charges at DRG | $29,378 | ||||
| Avg Charges with ICD R69 - Illness, unspecified | $36,588 | ||||
| Mortality Rate at DRG | 0.04 | ||||
| Mortality Rate with ICD R69 - Illness, unspecified | NA | ||||
| SNF Discharge Rate at DRG | 5.83 | ||||
| SNF Discharge Rate with ICD R69 - Illness, unspecified | 0.95 | ||||
| Home Discharge Rate at DRG | 79.47 | ||||
| Home Discharge Rate with ICD R69 - Illness, unspecified | 84.51 |
*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| DRG 881: DEPRESSIVE NEUROSES | DRG 882: NEUROSES EXCEPT DEPRESSIVE | DRG 871: SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 091: OTHER DISORDERS OF NERVOUS SYSTEM WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 092: OTHER DISORDERS OF NERVOUS SYSTEM WITH COMPLICATION OR COMORBIDITY (CC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 61,417 | ||||
| Total Hospitalizations with ICD R69 - Illness, unspecified | 181 | ||||
| DRG Share of Total Hospitalizations | 0.19 | ||||
| % of Total ICD R69 - Illness, unspecified in DRG | 3.56 | ||||
| Avg LOS at DRG | 7.49 | ||||
| Avg LOS with ICD R69 - Illness, unspecified | 13.5 | ||||
| Readmission Rate at DRG | 25.08 | ||||
| Readmission Rate with ICD R69 - Illness, unspecified | 19.77 | ||||
| Unplanned Readmission Rate at DRG | 13.22 | ||||
| Unplanned Readmission Rate with ICD R69 - Illness, unspecified | 8.14 | ||||
| Total Medicare payments at DRG | $347,280,742 | ||||
| Total Medicare payments with ICD R69 - Illness, unspecified | $2,031,871 | ||||
| Total Medicare payment per Day at DRG | $755 | ||||
| Total Medicare payment per Day with ICD R69 - Illness, unspecified | $832 | ||||
| Total Medicare payment per Hospitalization at DRG | $5,654 | ||||
| Total Medicare payment per Hospitalization with ICD R69 - Illness, unspecified | $11,226 | ||||
| Total Medicare Charges at DRG | $1,287,801,202 | ||||
| Total Medicare Charges with ICD R69 - Illness, unspecified | $7,576,428 | ||||
| Avg Charges at DRG | $20,968 | ||||
| Avg Charges with ICD R69 - Illness, unspecified | $41,859 | ||||
| Mortality Rate at DRG | 0.07 | ||||
| Mortality Rate with ICD R69 - Illness, unspecified | NA | ||||
| SNF Discharge Rate at DRG | 5.44 | ||||
| SNF Discharge Rate with ICD R69 - Illness, unspecified | NA | ||||
| Home Discharge Rate at DRG | 79.31 | ||||
| Home Discharge Rate with ICD R69 - Illness, unspecified | 93.92 |
*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| DRG 880: ACUTE ADJUSTMENT REACTION AND PSYCHOSOCIAL DYSFUNCTION | DRG 056: DEGENERATIVE NERVOUS SYSTEM DISORDERS WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 872: SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 189: PULMONARY EDEMA AND RESPIRATORY FAILURE | DRG 560: AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH COMPLICATION OR COMORBIDITY (CC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 34,840 | ||||
| Total Hospitalizations with ICD R69 - Illness, unspecified | 42 | ||||
| DRG Share of Total Hospitalizations | 0.11 | ||||
| % of Total ICD R69 - Illness, unspecified in DRG | 0.83 | ||||
| Avg LOS at DRG | 5.38 | ||||
| Avg LOS with ICD R69 - Illness, unspecified | 18.05 | ||||
| Readmission Rate at DRG | 22.47 | ||||
| Readmission Rate with ICD R69 - Illness, unspecified | NA | ||||
| Unplanned Readmission Rate at DRG | 12.18 | ||||
| Unplanned Readmission Rate with ICD R69 - Illness, unspecified | NA | ||||
| Total Medicare payments at DRG | $193,767,073 | ||||
| Total Medicare payments with ICD R69 - Illness, unspecified | $648,726 | ||||
| Total Medicare payment per Day at DRG | $1,033 | ||||
| Total Medicare payment per Day with ICD R69 - Illness, unspecified | $856 | ||||
| Total Medicare payment per Hospitalization at DRG | $5,562 | ||||
| Total Medicare payment per Hospitalization with ICD R69 - Illness, unspecified | $15,446 | ||||
| Total Medicare Charges at DRG | $895,692,673 | ||||
| Total Medicare Charges with ICD R69 - Illness, unspecified | $1,969,833 | ||||
| Avg Charges at DRG | $25,709 | ||||
| Avg Charges with ICD R69 - Illness, unspecified | $46,901 | ||||
| Mortality Rate at DRG | 0.21 | ||||
| Mortality Rate with ICD R69 - Illness, unspecified | NA | ||||
| SNF Discharge Rate at DRG | 12.88 | ||||
| SNF Discharge Rate with ICD R69 - Illness, unspecified | NA | ||||
| Home Discharge Rate at DRG | 62.18 | ||||
| Home Discharge Rate with ICD R69 - Illness, unspecified | 85.71 |
*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 561: AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT COMPLICATION OR COMORBIDITY (CC)/MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 690: KIDNEY AND URINARY TRACT INFECTIONS WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 683: RENAL FAILURE WITH COMPLICATION OR COMORBIDITY (CC) | DRG 193: SIMPLE PNEUMONIA AND PLEURISY WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 65,966 | ||||
| Total Hospitalizations with ICD R69 - Illness, unspecified | 20 | ||||
| DRG Share of Total Hospitalizations | 0.2 | ||||
| % of Total ICD R69 - Illness, unspecified in DRG | 0.39 | ||||
| Avg LOS at DRG | 13.11 | ||||
| Avg LOS with ICD R69 - Illness, unspecified | 9.45 | ||||
| Readmission Rate at DRG | 21.08 | ||||
| Readmission Rate with ICD R69 - Illness, unspecified | NA | ||||
| Unplanned Readmission Rate at DRG | 14.13 | ||||
| Unplanned Readmission Rate with ICD R69 - Illness, unspecified | NA | ||||
| Total Medicare payments at DRG | $1,323,430,782 | ||||
| Total Medicare payments with ICD R69 - Illness, unspecified | $205,005 | ||||
| Total Medicare payment per Day at DRG | $1,530 | ||||
| Total Medicare payment per Day with ICD R69 - Illness, unspecified | $1,085 | ||||
| Total Medicare payment per Hospitalization at DRG | $20,062 | ||||
| Total Medicare payment per Hospitalization with ICD R69 - Illness, unspecified | $10,250 | ||||
| Total Medicare Charges at DRG | $3,810,466,828 | ||||
| Total Medicare Charges with ICD R69 - Illness, unspecified | $679,290 | ||||
| Avg Charges at DRG | $57,764 | ||||
| Avg Charges with ICD R69 - Illness, unspecified | $33,965 | ||||
| Mortality Rate at DRG | 1.49 | ||||
| Mortality Rate with ICD R69 - Illness, unspecified | NA | ||||
| SNF Discharge Rate at DRG | 24.48 | ||||
| SNF Discharge Rate with ICD R69 - Illness, unspecified | NA | ||||
| Home Discharge Rate at DRG | 12.66 | ||||
| Home Discharge Rate with ICD R69 - Illness, unspecified | NA |
| Hospital Name | Address | City | State | Zip Code | Total Hospitalizations ( Oct 2015 to Sep 2018 ) |
|---|---|---|---|---|---|
| MCLEAN HOSPITAL | 115 MILL ST | BELMONT | MA | 02478 | 1,755 |
| ENCOMPASS HEALTH REHABILITATION HOSPITAL OF MORGANTOWN | 1160 VAN VOORHIS RD | MORGANTOWN | WV | 26505 | 232 |
| INSPIRA BEHAVIORAL CARE | CALLE GUADALUPE NUM 184 | PONCE | PR | 00733 | 176 |
| Physician Name | Address | City | State | Zip Code | Total Hospitalizations ( Oct 2015 to Sep 2018 ) |
|---|---|---|---|---|---|
| Dr. CHARLES ALFRED WELCH | 56 SHEPARD ST | CAMBRIDGE | MA | 02138 | 47 |
| Dr. ROBERT C MEISNER | 1 DEACONESS RD | BOSTON | MA | 02215 | 47 |
| Dr. JOHN B ROSEMAN | 115 MILL ST | BELMONT | MA | 02478 | 41 |
| Physician Name | Address | City | State | Zip Code | Total Hospitalizations ( Oct 2015 to Sep 2018 ) |
|---|---|---|---|---|---|
| Dr. MAUREEN A MALIN | MCLEAN CENTER AT FERNSIDE | PRINCETON | MA | 01541 | 177 |
| Dr. ARKADIY STOLYAR | 115 MILL ST | BELMONT | MA | 02478 | 143 |
| Dr. MOINUDDIN HUDALLIL MUTTAKIN | 115 MILL ST | BELMONT | MA | 02478 | 135 |
| No | ICD Diagnosis Code | Description |
|---|---|---|
| 1 | Z531 | Procedure and treatment not carried out because of patient's decision for reasons of belief and group pressure |