*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| Z8701 - Personal history of pneumonia (recurrent) - as a primary or secondary diagnosis code | ||
|---|---|---|
| OUTCOMES | ||
| Avg. LOS | ||
| Readmission Rate (%) | ||
| Unplanned Readmission Rate (%) | 17.59 | |
| 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 190: CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 291: HEART FAILURE AND SHOCK WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 189: PULMONARY EDEMA AND RESPIRATORY FAILURE | DRG 193: SIMPLE PNEUMONIA AND PLEURISY WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 1,808,415 | ||||
| Total Hospitalizations with ICD Z8701 - Personal history of pneumonia (recurrent) | 33,804 | ||||
| DRG Share of Total Hospitalizations | 5.5 | ||||
| % of Total ICD Z8701 - Personal history of pneumonia (recurrent) in DRG | 9.32 | ||||
| Avg LOS at DRG | 6.34 | ||||
| Avg LOS with ICD Z8701 - Personal history of pneumonia (recurrent) | 5.59 | ||||
| Readmission Rate at DRG | 24.2 | ||||
| Readmission Rate with ICD Z8701 - Personal history of pneumonia (recurrent) | 24.45 | ||||
| Unplanned Readmission Rate at DRG | 16.78 | ||||
| Unplanned Readmission Rate with ICD Z8701 - Personal history of pneumonia (recurrent) | 18.59 | ||||
| Total Medicare payments at DRG | $21,288,214,047 | ||||
| Total Medicare payments with ICD Z8701 - Personal history of pneumonia (recurrent) | $384,025,342 | ||||
| Total Medicare payment per Day at DRG | $1,857 | ||||
| Total Medicare payment per Day with ICD Z8701 - Personal history of pneumonia (recurrent) | $2,032 | ||||
| Total Medicare payment per Hospitalization at DRG | $11,772 | ||||
| Total Medicare payment per Hospitalization with ICD Z8701 - Personal history of pneumonia (recurrent) | $11,360 | ||||
| Total Medicare Charges at DRG | $107,155,481,388 | ||||
| Total Medicare Charges with ICD Z8701 - Personal history of pneumonia (recurrent) | $1,704,071,310 | ||||
| Avg Charges at DRG | $59,254 | ||||
| Avg Charges with ICD Z8701 - Personal history of pneumonia (recurrent) | $50,410 | ||||
| Mortality Rate at DRG | 12.11 | ||||
| Mortality Rate with ICD Z8701 - Personal history of pneumonia (recurrent) | 8.58 | ||||
| SNF Discharge Rate at DRG | 27.18 | ||||
| SNF Discharge Rate with ICD Z8701 - Personal history of pneumonia (recurrent) | 24.63 | ||||
| Home Discharge Rate at DRG | 25.81 | ||||
| Home Discharge Rate with ICD Z8701 - Personal history of pneumonia (recurrent) | 31.91 |
*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 177: RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 191: CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH COMPLICATION OR COMORBIDITY (CC) | DRG 470: MAJOR JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 292: HEART FAILURE AND SHOCK WITH COMPLICATION OR COMORBIDITY (CC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 417,755 | ||||
| Total Hospitalizations with ICD Z8701 - Personal history of pneumonia (recurrent) | 9,972 | ||||
| DRG Share of Total Hospitalizations | 1.27 | ||||
| % of Total ICD Z8701 - Personal history of pneumonia (recurrent) in DRG | 2.75 | ||||
| Avg LOS at DRG | 3.9 | ||||
| Avg LOS with ICD Z8701 - Personal history of pneumonia (recurrent) | 3.93 | ||||
| Readmission Rate at DRG | 16.53 | ||||
| Readmission Rate with ICD Z8701 - Personal history of pneumonia (recurrent) | 17.56 | ||||
| Unplanned Readmission Rate at DRG | 11.52 | ||||
| Unplanned Readmission Rate with ICD Z8701 - Personal history of pneumonia (recurrent) | 12.93 | ||||
| Total Medicare payments at DRG | $2,493,587,688 | ||||
| Total Medicare payments with ICD Z8701 - Personal history of pneumonia (recurrent) | $59,891,785 | ||||
| Total Medicare payment per Day at DRG | $1,529 | ||||
| Total Medicare payment per Day with ICD Z8701 - Personal history of pneumonia (recurrent) | $1,529 | ||||
| Total Medicare payment per Hospitalization at DRG | $5,969 | ||||
| Total Medicare payment per Hospitalization with ICD Z8701 - Personal history of pneumonia (recurrent) | $6,006 | ||||
| Total Medicare Charges at DRG | $11,318,800,289 | ||||
| Total Medicare Charges with ICD Z8701 - Personal history of pneumonia (recurrent) | $282,326,939 | ||||
| Avg Charges at DRG | $27,094 | ||||
| Avg Charges with ICD Z8701 - Personal history of pneumonia (recurrent) | $28,312 | ||||
| Mortality Rate at DRG | 0.87 | ||||
| Mortality Rate with ICD Z8701 - Personal history of pneumonia (recurrent) | 0.64 | ||||
| SNF Discharge Rate at DRG | 17.03 | ||||
| SNF Discharge Rate with ICD Z8701 - Personal history of pneumonia (recurrent) | 14.82 | ||||
| Home Discharge Rate at DRG | 53.31 | ||||
| Home Discharge Rate with ICD Z8701 - Personal history of pneumonia (recurrent) | 56.98 |
*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 178: RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH COMPLICATION OR COMORBIDITY (CC) | DRG 392: ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITHOUT 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) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 499,133 | ||||
| Total Hospitalizations with ICD Z8701 - Personal history of pneumonia (recurrent) | 5,275 | ||||
| DRG Share of Total Hospitalizations | 1.52 | ||||
| % of Total ICD Z8701 - Personal history of pneumonia (recurrent) in DRG | 1.45 | ||||
| Avg LOS at DRG | 4.34 | ||||
| Avg LOS with ICD Z8701 - Personal history of pneumonia (recurrent) | 4.23 | ||||
| Readmission Rate at DRG | 17.57 | ||||
| Readmission Rate with ICD Z8701 - Personal history of pneumonia (recurrent) | 21.3 | ||||
| Unplanned Readmission Rate at DRG | 12.56 | ||||
| Unplanned Readmission Rate with ICD Z8701 - Personal history of pneumonia (recurrent) | 16.59 | ||||
| Total Medicare payments at DRG | $3,254,711,780 | ||||
| Total Medicare payments with ICD Z8701 - Personal history of pneumonia (recurrent) | $34,985,586 | ||||
| Total Medicare payment per Day at DRG | $1,504 | ||||
| Total Medicare payment per Day with ICD Z8701 - Personal history of pneumonia (recurrent) | $1,566 | ||||
| Total Medicare payment per Hospitalization at DRG | $6,521 | ||||
| Total Medicare payment per Hospitalization with ICD Z8701 - Personal history of pneumonia (recurrent) | $6,632 | ||||
| Total Medicare Charges at DRG | $16,863,396,143 | ||||
| Total Medicare Charges with ICD Z8701 - Personal history of pneumonia (recurrent) | $179,015,860 | ||||
| Avg Charges at DRG | $33,785 | ||||
| Avg Charges with ICD Z8701 - Personal history of pneumonia (recurrent) | $33,937 | ||||
| Mortality Rate at DRG | 1.33 | ||||
| Mortality Rate with ICD Z8701 - Personal history of pneumonia (recurrent) | 1.48 | ||||
| SNF Discharge Rate at DRG | 19.89 | ||||
| SNF Discharge Rate with ICD Z8701 - Personal history of pneumonia (recurrent) | 23.17 | ||||
| Home Discharge Rate at DRG | 49.27 | ||||
| Home Discharge Rate with ICD Z8701 - Personal history of pneumonia (recurrent) | 43.34 |
*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| DRG 682: RENAL FAILURE WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 192: CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITHOUT COMPLICATION OR COMORBIDITY (CC)/MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 378: G.I. HEMORRHAGE WITH COMPLICATION OR COMORBIDITY (CC) | DRG 208: RESPIRATORY SYSTEM DIAGNOSIS W VENTILATOR SUPPORT <=96 HOURS | DRG 202: BRONCHITIS AND ASTHMA WITH COMPLICATION OR COMORBIDITY (CC)/MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 365,119 | ||||
| Total Hospitalizations with ICD Z8701 - Personal history of pneumonia (recurrent) | 3,723 | ||||
| DRG Share of Total Hospitalizations | 1.11 | ||||
| % of Total ICD Z8701 - Personal history of pneumonia (recurrent) in DRG | 1.03 | ||||
| Avg LOS at DRG | 5.91 | ||||
| Avg LOS with ICD Z8701 - Personal history of pneumonia (recurrent) | 5.18 | ||||
| Readmission Rate at DRG | 27.73 | ||||
| Readmission Rate with ICD Z8701 - Personal history of pneumonia (recurrent) | 28.32 | ||||
| Unplanned Readmission Rate at DRG | 20.3 | ||||
| Unplanned Readmission Rate with ICD Z8701 - Personal history of pneumonia (recurrent) | 21.47 | ||||
| Total Medicare payments at DRG | $3,552,910,533 | ||||
| Total Medicare payments with ICD Z8701 - Personal history of pneumonia (recurrent) | $35,192,024 | ||||
| Total Medicare payment per Day at DRG | $1,646 | ||||
| Total Medicare payment per Day with ICD Z8701 - Personal history of pneumonia (recurrent) | $1,826 | ||||
| Total Medicare payment per Hospitalization at DRG | $9,731 | ||||
| Total Medicare payment per Hospitalization with ICD Z8701 - Personal history of pneumonia (recurrent) | $9,453 | ||||
| Total Medicare Charges at DRG | $16,860,985,198 | ||||
| Total Medicare Charges with ICD Z8701 - Personal history of pneumonia (recurrent) | $153,470,497 | ||||
| Avg Charges at DRG | $46,179 | ||||
| Avg Charges with ICD Z8701 - Personal history of pneumonia (recurrent) | $41,222 | ||||
| Mortality Rate at DRG | 5.06 | ||||
| Mortality Rate with ICD Z8701 - Personal history of pneumonia (recurrent) | 4.32 | ||||
| SNF Discharge Rate at DRG | 28.7 | ||||
| SNF Discharge Rate with ICD Z8701 - Personal history of pneumonia (recurrent) | 28.34 | ||||
| Home Discharge Rate at DRG | 32.16 | ||||
| Home Discharge Rate with ICD Z8701 - Personal history of pneumonia (recurrent) | 32.29 |
| Hospital Name | Address | City | State | Zip Code | Total Hospitalizations ( Oct 2015 to Sep 2018 ) |
|---|---|---|---|---|---|
| TEXAS HEALTH HARRIS METHODIST HOSPITAL FORT WORTH | 1301 PENNSYLVANIA AVE | FORT WORTH | TX | 76104 | 2,462 |
| NCH BAKER HOSPITAL DOWNTOWN | 350 7TH ST N | NAPLES | FL | 34102 | 1,645 |
| TEXAS HEALTH PRESBYTERIAN HOSPITAL DALLAS | 8200 WALNUT HILL LANE | DALLAS | TX | 75231 | 1,337 |
| Physician Name | Address | City | State | Zip Code | Total Hospitalizations ( Oct 2015 to Sep 2018 ) |
|---|---|---|---|---|---|
| Dr. AAMIR HASHMAT | 2024 15TH ST FL 2 | MERIDIAN | MS | 39301 | 87 |
| Dr. EZINNE UGOCHI NWOTITE | 1925 PACIFIC AVE | ATLANTIC CITY | NJ | 08401 | 78 |
| Dr. FRANK A MORELLO | 21214 NORTHWEST FWY | CYPRESS | TX | 77429 | 62 |
| Physician Name | Address | City | State | Zip Code | Total Hospitalizations ( Oct 2015 to Sep 2018 ) |
|---|---|---|---|---|---|
| Dr. NOE ZAMORA | 800 TOWN AND COUNTRY BLVD STE 300 | HOUSTON | TX | 77024 | 176 |
| Dr. PONON DILEEP KUMAR | 1217 KEARNEY ST | PORT HURON | MI | 48060 | 165 |
| Dr. ROBERT SIEW | 301 W HUNTINGTON DR | ARCADIA | CA | 91007 | 159 |