*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| T394X5A - Adverse effect of antirheumatics, not elsewhere classified, initial encounter - as a primary or secondary diagnosis code | ||
|---|---|---|
| OUTCOMES | ||
| Avg. LOS | ||
| Readmission Rate (%) | ||
| Unplanned Readmission Rate (%) | 14.17 | |
| 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 871: SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS 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) | DRG 872: SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 378: G.I. HEMORRHAGE WITH COMPLICATION OR COMORBIDITY (CC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 1,808,415 | ||||
| Total Hospitalizations with ICD T394X5A - Adverse effect of antirheumatics, not elsewhere classified, initial encounter | 78 | ||||
| DRG Share of Total Hospitalizations | 5.5 | ||||
| % of Total ICD T394X5A - Adverse effect of antirheumatics, not elsewhere classified, initial encounter in DRG | 7.22 | ||||
| Avg LOS at DRG | 6.34 | ||||
| Avg LOS with ICD T394X5A - Adverse effect of antirheumatics, not elsewhere classified, initial encounter | 7.26 | ||||
| Readmission Rate at DRG | 24.2 | ||||
| Readmission Rate with ICD T394X5A - Adverse effect of antirheumatics, not elsewhere classified, initial encounter | 27.27 | ||||
| Unplanned Readmission Rate at DRG | 16.78 | ||||
| Unplanned Readmission Rate with ICD T394X5A - Adverse effect of antirheumatics, not elsewhere classified, initial encounter | 19.7 | ||||
| Total Medicare payments at DRG | $21,288,214,047 | ||||
| Total Medicare payments with ICD T394X5A - Adverse effect of antirheumatics, not elsewhere classified, initial encounter | $922,170 | ||||
| Total Medicare payment per Day at DRG | $1,857 | ||||
| Total Medicare payment per Day with ICD T394X5A - Adverse effect of antirheumatics, not elsewhere classified, initial encounter | $1,629 | ||||
| Total Medicare payment per Hospitalization at DRG | $11,772 | ||||
| Total Medicare payment per Hospitalization with ICD T394X5A - Adverse effect of antirheumatics, not elsewhere classified, initial encounter | $11,823 | ||||
| Total Medicare Charges at DRG | $107,155,481,388 | ||||
| Total Medicare Charges with ICD T394X5A - Adverse effect of antirheumatics, not elsewhere classified, initial encounter | $4,735,189 | ||||
| Avg Charges at DRG | $59,254 | ||||
| Avg Charges with ICD T394X5A - Adverse effect of antirheumatics, not elsewhere classified, initial encounter | $60,708 | ||||
| Mortality Rate at DRG | 12.11 | ||||
| Mortality Rate with ICD T394X5A - Adverse effect of antirheumatics, not elsewhere classified, initial encounter | NA | ||||
| SNF Discharge Rate at DRG | 27.18 | ||||
| SNF Discharge Rate with ICD T394X5A - Adverse effect of antirheumatics, not elsewhere classified, initial encounter | 15.38 | ||||
| Home Discharge Rate at DRG | 25.81 | ||||
| Home Discharge Rate with ICD T394X5A - Adverse effect of antirheumatics, not elsewhere classified, initial encounter | 47.44 |
*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| DRG 603: CELLULITIS WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 193: SIMPLE PNEUMONIA AND PLEURISY WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 683: RENAL FAILURE WITH COMPLICATION OR COMORBIDITY (CC) | DRG 607: MINOR SKIN DISORDERS WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 291: HEART FAILURE AND SHOCK WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 364,421 | ||||
| Total Hospitalizations with ICD T394X5A - Adverse effect of antirheumatics, not elsewhere classified, initial encounter | 21 | ||||
| DRG Share of Total Hospitalizations | 1.11 | ||||
| % of Total ICD T394X5A - Adverse effect of antirheumatics, not elsewhere classified, initial encounter in DRG | 1.94 | ||||
| Avg LOS at DRG | 3.97 | ||||
| Avg LOS with ICD T394X5A - Adverse effect of antirheumatics, not elsewhere classified, initial encounter | 3.95 | ||||
| Readmission Rate at DRG | 16.14 | ||||
| Readmission Rate with ICD T394X5A - Adverse effect of antirheumatics, not elsewhere classified, initial encounter | NA | ||||
| Unplanned Readmission Rate at DRG | 10.98 | ||||
| Unplanned Readmission Rate with ICD T394X5A - Adverse effect of antirheumatics, not elsewhere classified, initial encounter | NA | ||||
| Total Medicare payments at DRG | $1,924,528,848 | ||||
| Total Medicare payments with ICD T394X5A - Adverse effect of antirheumatics, not elsewhere classified, initial encounter | $101,332 | ||||
| Total Medicare payment per Day at DRG | $1,332 | ||||
| Total Medicare payment per Day with ICD T394X5A - Adverse effect of antirheumatics, not elsewhere classified, initial encounter | $1,221 | ||||
| Total Medicare payment per Hospitalization at DRG | $5,281 | ||||
| Total Medicare payment per Hospitalization with ICD T394X5A - Adverse effect of antirheumatics, not elsewhere classified, initial encounter | $4,825 | ||||
| Total Medicare Charges at DRG | $8,912,106,420 | ||||
| Total Medicare Charges with ICD T394X5A - Adverse effect of antirheumatics, not elsewhere classified, initial encounter | $475,206 | ||||
| Avg Charges at DRG | $24,456 | ||||
| Avg Charges with ICD T394X5A - Adverse effect of antirheumatics, not elsewhere classified, initial encounter | $22,629 | ||||
| Mortality Rate at DRG | 0.09 | ||||
| Mortality Rate with ICD T394X5A - Adverse effect of antirheumatics, not elsewhere classified, initial encounter | NA | ||||
| SNF Discharge Rate at DRG | 15.72 | ||||
| SNF Discharge Rate with ICD T394X5A - Adverse effect of antirheumatics, not elsewhere classified, initial encounter | NA | ||||
| Home Discharge Rate at DRG | 53.33 | ||||
| Home Discharge Rate with ICD T394X5A - Adverse effect of antirheumatics, not elsewhere classified, initial encounter | 76.19 |
*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| DRG 809: MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITH COMPLICATION OR COMORBIDITY (CC) | DRG 853: INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURE WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 682: RENAL FAILURE WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 812: RED BLOOD CELL DISORDERS WITHOUT 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 | 45,432 | ||||
| Total Hospitalizations with ICD T394X5A - Adverse effect of antirheumatics, not elsewhere classified, initial encounter | 18 | ||||
| DRG Share of Total Hospitalizations | 0.14 | ||||
| % of Total ICD T394X5A - Adverse effect of antirheumatics, not elsewhere classified, initial encounter in DRG | 1.67 | ||||
| Avg LOS at DRG | 4.42 | ||||
| Avg LOS with ICD T394X5A - Adverse effect of antirheumatics, not elsewhere classified, initial encounter | 4.28 | ||||
| Readmission Rate at DRG | 30.74 | ||||
| Readmission Rate with ICD T394X5A - Adverse effect of antirheumatics, not elsewhere classified, initial encounter | NA | ||||
| Unplanned Readmission Rate at DRG | 18.94 | ||||
| Unplanned Readmission Rate with ICD T394X5A - Adverse effect of antirheumatics, not elsewhere classified, initial encounter | NA | ||||
| Total Medicare payments at DRG | $376,347,273 | ||||
| Total Medicare payments with ICD T394X5A - Adverse effect of antirheumatics, not elsewhere classified, initial encounter | $137,197 | ||||
| Total Medicare payment per Day at DRG | $1,873 | ||||
| Total Medicare payment per Day with ICD T394X5A - Adverse effect of antirheumatics, not elsewhere classified, initial encounter | $1,782 | ||||
| Total Medicare payment per Hospitalization at DRG | $8,284 | ||||
| Total Medicare payment per Hospitalization with ICD T394X5A - Adverse effect of antirheumatics, not elsewhere classified, initial encounter | $7,622 | ||||
| Total Medicare Charges at DRG | $1,794,383,177 | ||||
| Total Medicare Charges with ICD T394X5A - Adverse effect of antirheumatics, not elsewhere classified, initial encounter | $629,358 | ||||
| Avg Charges at DRG | $39,496 | ||||
| Avg Charges with ICD T394X5A - Adverse effect of antirheumatics, not elsewhere classified, initial encounter | $34,964 | ||||
| Mortality Rate at DRG | 0.61 | ||||
| Mortality Rate with ICD T394X5A - Adverse effect of antirheumatics, not elsewhere classified, initial encounter | NA | ||||
| SNF Discharge Rate at DRG | 7.48 | ||||
| SNF Discharge Rate with ICD T394X5A - Adverse effect of antirheumatics, not elsewhere classified, initial encounter | NA | ||||
| Home Discharge Rate at DRG | 67.79 | ||||
| Home Discharge Rate with ICD T394X5A - Adverse effect of antirheumatics, not elsewhere classified, initial encounter | 61.11 |
*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| DRG 394: OTHER DIGESTIVE SYSTEM DIAGNOSES WITH COMPLICATION OR COMORBIDITY (CC) | DRG 808: MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 864: FEVER | DRG 810: MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITHOUT COMPLICATION OR COMORBIDITY (CC)/MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 189: PULMONARY EDEMA AND RESPIRATORY FAILURE | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 130,303 | ||||
| Total Hospitalizations with ICD T394X5A - Adverse effect of antirheumatics, not elsewhere classified, initial encounter | 16 | ||||
| DRG Share of Total Hospitalizations | 0.4 | ||||
| % of Total ICD T394X5A - Adverse effect of antirheumatics, not elsewhere classified, initial encounter in DRG | 1.48 | ||||
| Avg LOS at DRG | 3.94 | ||||
| Avg LOS with ICD T394X5A - Adverse effect of antirheumatics, not elsewhere classified, initial encounter | 2.94 | ||||
| Readmission Rate at DRG | 20.31 | ||||
| Readmission Rate with ICD T394X5A - Adverse effect of antirheumatics, not elsewhere classified, initial encounter | NA | ||||
| Unplanned Readmission Rate at DRG | 14.61 | ||||
| Unplanned Readmission Rate with ICD T394X5A - Adverse effect of antirheumatics, not elsewhere classified, initial encounter | NA | ||||
| Total Medicare payments at DRG | $778,992,768 | ||||
| Total Medicare payments with ICD T394X5A - Adverse effect of antirheumatics, not elsewhere classified, initial encounter | $91,161 | ||||
| Total Medicare payment per Day at DRG | $1,517 | ||||
| Total Medicare payment per Day with ICD T394X5A - Adverse effect of antirheumatics, not elsewhere classified, initial encounter | $1,940 | ||||
| Total Medicare payment per Hospitalization at DRG | $5,978 | ||||
| Total Medicare payment per Hospitalization with ICD T394X5A - Adverse effect of antirheumatics, not elsewhere classified, initial encounter | $5,698 | ||||
| Total Medicare Charges at DRG | $4,222,655,144 | ||||
| Total Medicare Charges with ICD T394X5A - Adverse effect of antirheumatics, not elsewhere classified, initial encounter | $389,708 | ||||
| Avg Charges at DRG | $32,406 | ||||
| Avg Charges with ICD T394X5A - Adverse effect of antirheumatics, not elsewhere classified, initial encounter | $24,357 | ||||
| Mortality Rate at DRG | 0.93 | ||||
| Mortality Rate with ICD T394X5A - Adverse effect of antirheumatics, not elsewhere classified, initial encounter | NA | ||||
| SNF Discharge Rate at DRG | 14.17 | ||||
| SNF Discharge Rate with ICD T394X5A - Adverse effect of antirheumatics, not elsewhere classified, initial encounter | NA | ||||
| Home Discharge Rate at DRG | 60.3 | ||||
| Home Discharge Rate with ICD T394X5A - Adverse effect of antirheumatics, not elsewhere classified, initial encounter | 81.25 |