EDICARE EE FOR ERVICE OSPITAL EADMISSIONS QUARTER …...Hospital Readmission Reduction Program or on...
29
Region 6: San Luis Obispo Readmission Report 1 MEDICARE FEE-FOR-SERVICE (FFS) HOSPITAL READMISSIONS: QUARTER 3 (Q3) 2012–Q2 2013 STATE OF CALIFORNIA REGION 6: SAN LUIS OBISPO Executive Summary The Centers for Medicare & Medicaid Services (CMS) has tasked Health Services Advisory Group of California, Inc. (HSAG of California), with assisting communities, hospitals, and post-acute providers with improving the quality of care for Medicare beneficiaries who transition among care settings. This document provides information regarding the all-cause, acute myocardial infarction (AMI), heart failure, pneumonia, chronic obstructive pulmonary disease (COPD), and total hip/knee replacement (THA/TKA) 30-day readmissions for Region 6: San Luis Obispo. Readmission results are limited to Medicare FFS Part-A data for discharges from July 1, 2012, through June 30, 2013. 1 Readmissions were identified from July 1, 2012, through July 30, 2013. Readmission rates in this report are not calculated using the 30-day risk standardized methodology for the CMS Hospital Readmission Reduction Program or on hospitalcompare.hhs.gov. This report is arranged with comparison readmission rates to the nation and state of California. Data are broken out into seven different sections: All-Cause Readmission Rates AMI Readmission Rates Heart Failure Readmission Rates Pneumonia Readmission Rates COPD Readmission Rates THA/TKA Readmission Rates Emergency Department (ED) Visits and Observation Stays Details for All-Cause Readmissions: All-cause readmission rates are calculated as the percentage of hospital admissions that occurred within 30 days of an index admission for any condition. Each hospital admission within 30 days following an index admission is considered a readmission (e.g., a beneficiary with four readmissions in the measurement period counts as four separate readmissions). Any beneficiary who dies in the hospital is excluded from the calculation. Details for Condition-Specific Readmissions: When calculating disease-specific readmission rates, an admission is included if the principal diagnosis code for the admission specifies that disease (i.e., AMI, heart failure, pneumonia, COPD, and THA/TKA readmission rates). Condition-specific readmissions include all-cause admissions that occur within 30 days of an index admission for the specific condition (e.g., a beneficiary with an index admission of AMI and is readmitted for a urinary tract infection [UTI] is considered an AMI readmission). Any beneficiary who dies in the hospital is excluded from the calculation. For questions on the results, please contact Chad Vargas at 818-265-4688, [email protected] or Michelle Pastrano at 818-265-4648, [email protected]. 1 The ASAT data file was used for this analysis. The ASAT data file is provided to HSAG by CMS. The ASAT data file includes Part-A claims for Fee-for-Service (FFS) beneficiaries.
Transcript of EDICARE EE FOR ERVICE OSPITAL EADMISSIONS QUARTER …...Hospital Readmission Reduction Program or on...
Region 6: San Luis Obispo Readmission Report 1
MEDICARE FEE-FOR-SERVICE (FFS) HOSPITAL READMISSIONS: QUARTER 3 (Q3) 2012–Q2 2013 STATE OF CALIFORNIA
REGION 6: SAN LUIS OBISPO
Executive Summary
The Centers for Medicare & Medicaid Services (CMS) has tasked Health Services Advisory Group of California, Inc. (HSAG of California), with assisting communities, hospitals, and post-acute providers with improving the quality of care for Medicare beneficiaries who transition among care settings. This document provides information regarding the all-cause, acute myocardial infarction (AMI), heart failure, pneumonia, chronic obstructive pulmonary disease (COPD), and total hip/knee replacement (THA/TKA) 30-day readmissions for Region 6: San Luis Obispo. Readmission results are limited to Medicare FFS Part-A data for discharges from July 1, 2012, through June 30, 2013.1 Readmissions were identified from July 1, 2012, through July 30, 2013. Readmission rates in this report are not calculated using the 30-day risk standardized methodology for the CMS Hospital Readmission Reduction Program or on hospitalcompare.hhs.gov.
This report is arranged with comparison readmission rates to the nation and state of California. Data are broken out into seven different sections:
All-Cause Readmission Rates AMI Readmission Rates Heart Failure Readmission Rates Pneumonia Readmission Rates COPD Readmission Rates THA/TKA Readmission Rates Emergency Department (ED) Visits and Observation Stays
Details for All-Cause Readmissions:
All-cause readmission rates are calculated as the percentage of hospital admissions that occurred within 30 days of an index admission for any condition. Each hospital admission within 30 days following an index admission is considered a readmission (e.g., a beneficiary with four readmissions in the measurement period counts as four separate readmissions). Any beneficiary who dies in the hospital is excluded from the calculation.
Details for Condition-Specific Readmissions:
When calculating disease-specific readmission rates, an admission is included if the principal diagnosis code for the admission specifies that disease (i.e., AMI, heart failure, pneumonia, COPD, and THA/TKA readmission rates). Condition-specific readmissions include all-cause admissions that occur within 30 days of an index admission for the specific condition (e.g., a beneficiary with an index admission of AMI and is readmitted for a urinary tract infection [UTI] is considered an AMI readmission). Any beneficiary who dies in the hospital is excluded from the calculation.
For questions on the results, please contact Chad Vargas at 818-265-4688, [email protected] or Michelle Pastrano at 818-265-4648, [email protected].
1 The ASAT data file was used for this analysis. The ASAT data file is provided to HSAG by CMS. The ASAT data file
includes Part-A claims for Fee-for-Service (FFS) beneficiaries.
Region 6: San Luis Obispo Readmission Report 2
Region-Level Map The figure below displays the location of each region in the state of California. The table below displays the average readmission rate for each region from the best rate to the worst rate. In addition, a crosswalk of the counties located in each region has been provided.
Region Avg Rate
Region and County Crosswalk
8 8.3% Region Counties
6 13.2% Region 1 San Diego/Imperial
20 14.0% Region 2 Riverside/San Bernardino
19 14.0% Region 3 Orange
13 15.1% Region 4 Los Angeles/Antelope Valley
10 15.1% Region 5 Santa Barbara/Ventura
5 15.7% Region 6 San Luis Obispo
17 16.4% Region 7 Kern
16 17.2% Region 8 Inyo/Mono
12 17.4% Region 9 Madera/Fresno/Kings/Tulare
15 17.9% Region 10 Monterey/San Benito
3 18.1% Region 11 Stanislaus/Merced/Mariposa
1 18.1% Region 12 Santa Clara
11 18.3% Region 13 San Mateo/Santa Cruz
9 18.4% Region 14 San Francisco
2 18.9% Region 15 Solano/Contra Costa/Alameda
18 18.9% Region 16 San Joaquin/Amador/Calaveras/Tuolumne/Alpine
14 19.1% Region 17 Yolo/Sacramento/Nevada/Placer/El Dorado
7 20.8% Region 18 Sutter/Yuba/Sierra/Plumas/Tehama/Glenn/Colusa/Butte
4 21.1% Region 19 Marin/Napa/Sonoma/Lake/Mendocino/Humboldt/Del Norte
Region 20 Siskiyou/Modoc/Trinity/Shasta/Lassen
Region 6: San Luis Obispo Readmission Report 3
All-Cause Readmission Rates
Table 1 depicts the all-cause 30-day readmission rates by discharge setting for Q3 2012 through Q2 2013 for Region 6 and the state of California.
Table 1: All-Cause 30-Day Readmission Rates—July 1, 2012–June 30, 2013
Group Setting Discharged To Number of Discharges
Number of Discharges Readmitted
within 30 Days
30-Day Readmit
Rate
Number of 30-Day
Readmits to the same
hospital
Percentage of 30-Day Readmits
to the same hospital
Number of 30-Day
Readmits to another
hospital
Percentage of 30-Day Readmits
to another hospital
Home 2,868 347 12.1% 253 72.9% 94 27.1% Nursing Home 1,652 255 15.4% 190 74.5% 65 25.5%
Region 6 Home Health 1,395 191 13.7% 155 81.2% 36 18.8% Hospice 179 3 1.7% 2 66.7% 1 33.3% Other 239 39 16.3% 21 53.8% 18 46.2% All 6,333 835 13.2% 621 74.4% 214 25.6% Home 372,838 64,244 17.2% 46,834 72.9% 17,410 27.1% Nursing Home 171,600 36,478 21.3% 26,407 72.4% 10,071 27.6%
California Home Health 124,407 24,510 19.7% 19,207 78.4% 5,303 21.6% Hospice 16,155 522 3.2% 353 67.6% 169 32.4% Other 54,564 11,137 20.4% 6,491 58.3% 4,646 41.7% All 739,564 136,891 18.5% 99,292 72.5% 37,599 27.5%
Table 2 depicts the number of days from discharge to readmission for each discharge setting for Region 6 and the state of California.
Table 2: Number of Days from Discharge to Readmission—July 1, 2012–June 30, 2013 Setting Number of 1–3 Days 4–7 Days 8–14 Days 15–21 Days 22–30 Days
Group Discharged To Readmissions N % N % N % N % N % Home 347 69 19.9% 64 18.4% 84 24.2% 70 20.2% 60 17.3% Nursing Home 255 49 19.2% 54 21.2% 60 23.5% 47 18.4% 45 17.6%
Region 6 Home Health 191 33 17.3% 35 18.3% 40 20.9% 41 21.5% 42 22.0%
Hospice 3 0 0.0% 1 33.3% 1 33.3% 0 0.0% 1 33.3% Other 39 14 35.9% 2 5.1% 10 25.6% 8 20.5% 5 12.8%
All 835 165 19.8% 156 18.7% 195 23.4% 166 19.9% 153 18.3% Home 64,244 11,009 17.1% 12,241 19.1% 16,022 24.9% 12,541 19.5% 12,431 19.3% Nursing Home 36,478 5,185 14.2% 6,634 18.2% 9,531 26.1% 7,508 20.6% 7,620 20.9%
California Home Health 24,510 4,044 16.5% 4,865 19.8% 6,355 25.9% 4,692 19.1% 4,554 18.6% Hospice 522 123 23.6% 108 20.7% 122 23.4% 96 18.4% 73 14.0% Other 11,137 2,452 22.0% 1,804 16.2% 2,458 22.1% 2,047 18.4% 2,376 21.3%
All 136,891 22,813 16.7% 25,652 18.7% 34,488 25.2% 26,884 19.6% 27,054 19.8%
Region 6: San Luis Obispo Readmission Report 4
Table 3 provides a comparison of the age breakouts for those cases that were readmitted for all causes versus those that were not readmitted for Region 6.2
Table 3: Age Breakout by Readmission Category—July 1, 2012–June 30, 2013
Age Readmitted Cases Non-Readmitted Cases Total Discharges
% of Total Discharges
Readmitted N % N % N %
<18 0 0.0% 0 0.0% 0 0.0% 18–24 5 0.6% 7 0.1% 12 41.7% 25–34 3 0.4% 53 1.0% 56 5.4% 35–44 23 2.8% 88 1.6% 111 20.7% 45–54 54 6.5% 226 4.1% 280 19.3% 55–64 57 6.8% 372 6.8% 429 13.3% 65–74 231 27.7% 1,736 31.6% 1,967 11.7% 75–84 250 29.9% 1,667 30.3% 1,917 13.0%
85+ 212 25.4% 1,349 24.5% 1,561 13.6% Total 835 100.0% 5,498 100.0% 6,333 13.2%
Table 4 provides a comparison of the all-cause 30-day readmission rates by gender for Q3 2012 through Q2 2013 for Region 6.
Table 4: Gender Breakout by Readmission Category—July 1, 2012–June 30, 2013
Gender Readmitted Cases Non-Readmitted Cases Total Discharges
% of Total Discharges
Readmitted N % N % N %
Female 423 50.7% 3,025 55.0% 3,448 12.3% Male 412 49.3% 2,473 45.0% 2,885 14.3% Total 835 100.0% 5,498 100.0% 6,333 13.2%
2 The counts in the following tables may not equal the total readmit and discharge counts, due to the receipt of incomplete
data in some claims.
Region 6: San Luis Obispo Readmission Report 5
Table 5 depicts the all-cause 30-day readmission rates by race for Q3 2012 through Q2 2013 for Region 6.3
Table 5: All-Cause 30-Day Readmission Rates by Race/Ethnicity—July 1, 2012–June 30, 2013
Race Readmitted Cases Non-Readmitted Cases Total Discharges
% of Total Discharges
Readmitted Categories N % N % N %
White 792 94.9% 5,212 94.8% 6,004 13.2% Black 11 1.3% 58 1.1% 69 15.9% Asian 5 0.6% 47 0.9% 52 9.6%
Hispanic 11 1.3% 97 1.8% 108 10.2% Native American 1 0.1% 19 0.3% 20 5.0%
Other 15 1.8% 65 1.2% 80 18.8% Total 835 100.0% 5,498 100.0% 6,333 13.2%
Table 6 depicts the all-cause 30-day readmission rates by discharge setting for calendar year (CY) 2010 (i.e., baseline period4), CY 2011, and CY 2012 for Region 6.
Table 6: All-Cause 30-Day Readmission Rates by Year
Group Setting Discharged To Number of Discharges
Number of Discharges Readmitted
within 30 Days
30-Day Readmit
Rate
Number of 30-Day
Readmits to the same
hospital
Percentage of 30-Day Readmits
to the same hospital
Number of 30-Day
Readmits to another
hospital
Percentage of 30-Day Readmits
to another hospital
Home 3,788 516 13.6% 404 78.3% 112 21.7% Nursing Home 1,762 295 16.7% 233 79.0% 62 21.0%
Region 6 Home Health 1,535 257 16.7% 213 82.9% 44 17.1% Calendar Year Hospice 176 5 2.8% 3 60.0% 2 40.0%
2010 Other 172 39 22.7% 24 61.5% 15 38.5% All 7,433 1,112 15.0% 877 78.9% 235 21.1% Home 3,816 507 13.3% 383 75.5% 124 24.5% Nursing Home 1,743 272 15.6% 202 74.3% 70 25.7%
Region 6 Home Health 1,425 196 13.8% 157 80.1% 39 19.9% Calendar Year Hospice 196 3 1.5% 3 100.0% 0 0.0%
2011 Other 215 41 19.1% 24 58.5% 17 41.5% All 7,395 1,019 13.8% 769 75.5% 250 24.5% Home 3,414 417 12.2% 318 76.3% 99 23.7% Nursing Home 1,814 285 15.7% 205 71.9% 80 28.1%
Region 6 Home Health 1,464 194 13.3% 156 80.4% 38 19.6% Calendar Year Hospice 207 4 1.9% 2 50.0% 2 50.0%
2012 Other 290 41 14.1% 22 53.7% 19 46.3% All 7,189 941 13.1% 703 74.7% 238 25.3%
3 Caution should be exercised when evaluating readmission rates for races with a low number of discharges/readmissions. 4 Note: Due to the receipt of incomplete data, the baseline period data may have been underreported in the previous report.
Region 6: San Luis Obispo Readmission Report 6
Figure 1 displays the all-cause 30-day readmission rates for home, nursing home, home health, hospice, other, and all settings for CY 2010 (i.e., baseline period5), CY 2011, and CY 2012 for Region 6.
Figure 1: 30-Day Readmission Rates by Discharge Setting
Table 7 depicts the all-cause 30-day readmissions and admissions per 1,000 beneficiaries by discharge setting for CY 2010 (i.e., baseline period6), CY 2011, and CY 2012 for Region 6.
Table 7: All-Cause 30-Day Readmission Rates per 1,000 Beneficiaries by Year
Group FFS Beneficiaries
All-Cause Readmissions
Readmissions per 1,000
Beneficiaries
All-Cause Admissions
Admissions per 1,000
Beneficiaries Region 6
Calendar Year 2010
39,492 1,112 28.2 7,433 188.2
Region 6 Calendar Year
2011 40,758 1,019 25.0 7,395 181.4
Region 6 Calendar Year
2012 44,609 941 21.1 7,189 161.2
5 Note: Due to the receipt of incomplete data, the baseline period data may have been underreported in the previous report. 6 Note: Due to the receipt of incomplete data, the baseline period data may have been underreported in the previous report.
Read
miss
ion
Rate
0.0%
5.0%
10.0%
15.0%
20.0%
25.0%
30.0%
Time Period
CY 2010 CY 2011 CY 2012
Home Skilled Nursing Facility
Home Health Agency Hospice
Other All
Region 6: San Luis Obispo Readmission Report 7
Table 8 depicts the all-cause 30-day readmission rates for patients discharged to home for Q3 2012 through Q2 2013 for Region 6.
Table 8: All-Cause 30-Day Readmission Rates by Quarter for Patients Discharged to Home—July 1, 2012–June 30, 2013
Setting Discharged
To Quarter Number of
Discharges
Number of Discharges Readmitted
within 30 Days
30-Day Readmit Rate
Number of 30-Day
Readmits to the same hospital
Percentage of 30-Day
Readmits to the same hospital
Number of 30-Day
Readmits to another hospital
Percentage of 30-Day
Readmits to another hospital
Q3 2012 797 85 10.7% 64 75.3% 21 24.7% Q4 2012 770 103 13.4% 73 70.9% 30 29.1%
Home Q1 2013 681 81 11.9% 59 72.8% 22 27.2% Q2 2013 620 78 12.6% 57 73.1% 21 26.9% All 2,868 347 12.1% 253 72.9% 94 27.1%
Figure 2 displays the all-cause 30-day readmission rates for patients discharged to home for Q3 2012 through Q2 2013 for Region 6. The readmission rate for each quarter is displayed above the bar.
Figure 2: Readmission Rate by Quarter for Patients Discharged to Home
11.9%12.6%
10.7%
13.4%
Read
miss
ion
Rate
0.0%
5.0%
10.0%
15.0%
20.0%
Q3 2012
Q4 2012
Q1 2013
Q2 2013
Region 6: San Luis Obispo Readmission Report 8
Table 9 depicts the all-cause 30-day readmission rates for patients discharged to home for each month in Q3 2012 through Q2 2013 for Region 6.
Table 9: All-Cause 30-Day Readmission Rates by Month for Patients Discharged to Home—July 1, 2012–June 30, 2013
Setting Discharged
To Month Number of
Discharges
Number of Discharges Readmitted
within 30 Days
30-Day Readmit
Rate
Number of 30-Day
Readmits to the same
hospital
Percentage of 30-Day
Readmits to the same hospital
Number of 30-Day
Readmits to another hospital
Percentage of 30-Day
Readmits to another hospital
July 2012 290 29 10.0% 22 75.9% 7 24.1% August 2012 254 22 8.7% 18 81.8% 4 18.2% September 2012 253 34 13.4% 24 70.6% 10 29.4% October 2012 250 31 12.4% 22 71.0% 9 29.0% November 2012 253 34 13.4% 26 76.5% 8 23.5% December 2012 267 38 14.2% 25 65.8% 13 34.2%
Home January 2013 235 29 12.3% 20 69.0% 9 31.0% February 2013 205 26 12.7% 22 84.6% 4 15.4% March 2013 241 26 10.8% 17 65.4% 9 34.6% April 2013 205 31 15.1% 24 77.4% 7 22.6% May 2013 225 23 10.2% 17 73.9% 6 26.1% June 2013 190 24 12.6% 16 66.7% 8 33.3% All 2,868 347 12.1% 253 72.9% 94 27.1%
Figure 3 displays the all-cause 30-day readmission rates for patients discharged to home for each month in Q3 2012 through Q2 2013 for Region 6. The readmission rate for each month is displayed above the bar.
Figure 3: Readmission Rate by Month for Patients Discharged to Home
15.1%
8.7%
14.2%
12.7%12.3%
10.0%
12.6%
10.8% 10.2%
13.4%12.4%
13.4%
Read
miss
ion
Rate
0.0%
5.0%
10.0%
15.0%
20.0%
Jul-12
Aug-12
Sep-12
Oct-12
Nov-12
Dec-12
Jan-13
Feb-13
Mar-13
Apr-13
May-13
Jun-13
Region 6: San Luis Obispo Readmission Report 9
Table 10 depicts the all-cause 30-day readmission rates for patients discharged to a nursing home for Q3 2012 through Q2 2013 for Region 6.
Table 10: All-Cause 30-Day Readmission Rates by Quarter for Patients Discharged to Nursing Home— July 1, 2012–June 30, 2013
Setting Discharged
To Quarter Number of
Discharges
Number of Discharges Readmitted
within 30 Days
30-Day Readmit Rate
Number of 30-Day
Readmits to the same hospital
Percentage of 30-Day
Readmits to the same hospital
Number of 30-Day
Readmits to another hospital
Percentage of 30-Day
Readmits to another hospital
Q3 2012 429 67 15.6% 49 73.1% 18 26.9% Q4 2012 450 58 12.9% 37 63.8% 21 36.2%
Nursing Home Q1 2013 417 71 17.0% 59 83.1% 12 16.9% Q2 2013 356 59 16.6% 45 76.3% 14 23.7% All 1,652 255 15.4% 190 74.5% 65 25.5%
Figure 4 displays the all-cause 30-day readmission rates for patients discharged to a nursing home for Q3 2012 through Q2 2013 for Region 6. The readmission rate for each quarter is displayed above the bar.
Figure 4: Readmission Rate by Quarter for Patients Discharged to a Nursing Home
17.0% 16.6%15.6%
12.9%
Read
miss
ion
Rate
0.0%
5.0%
10.0%
15.0%
20.0%
Q3 2012
Q4 2012
Q1 2013
Q2 2013
Region 6: San Luis Obispo Readmission Report 10
Table 11 depicts the all-cause 30-day readmission rates for patients discharged to a nursing home for each month in Q3 2012 through Q2 2013 for Region 6.
Table 11: All-Cause 30-Day Readmission Rates by Month for Patients Discharged to Nursing Home— July 1, 2012–June 30, 2013
Setting Discharged
To Month Number of
Discharges
Number of Discharges Readmitted
within 30 Days
30-Day Readmit
Rate
Number of 30-Day
Readmits to the same
hospital
Percentage of 30-Day
Readmits to the same hospital
Number of 30-Day
Readmits to another hospital
Percentage of 30-Day
Readmits to another hospital
July 2012 140 23 16.4% 17 73.9% 6 26.1% August 2012 151 23 15.2% 15 65.2% 8 34.8% September 2012 138 21 15.2% 17 81.0% 4 19.0% October 2012 153 12 7.8% 8 66.7% 4 33.3% November 2012 146 19 13.0% 9 47.4% 10 52.6% December 2012 151 27 17.9% 20 74.1% 7 25.9%
Nursing Home January 2013 139 17 12.2% 16 94.1% 1 5.9% February 2013 132 22 16.7% 18 81.8% 4 18.2% March 2013 146 32 21.9% 25 78.1% 7 21.9% April 2013 135 19 14.1% 13 68.4% 6 31.6% May 2013 109 18 16.5% 15 83.3% 3 16.7% June 2013 112 22 19.6% 17 77.3% 5 22.7% All 1,652 255 15.4% 190 74.5% 65 25.5%
Figure 5 displays the all-cause 30-day readmission rates for patients discharged to a nursing home for each month in Q3 2012 through Q2 2013 for Region 6. The readmission rate for each month is displayed above the bar.
Figure 5: Readmission Rate by Month for Patients Discharged to a Nursing Home
14.1%15.2%
17.9%16.7%
12.2%
16.4%
19.6%
21.9%
16.5%
13.0%
7.8%
15.2%
Read
miss
ion
Rate
0.0%
5.0%
10.0%
15.0%
20.0%
25.0%
30.0%
Jul-12
Aug-12
Sep-12
Oct-12
Nov-12
Dec-12
Jan-13
Feb-13
Mar-13
Apr-13
May-13
Jun-13
Region 6: San Luis Obispo Readmission Report 11
Table 12 depicts the all-cause 30-day readmission rates for patients discharged to home health for Q3 2012 through Q2 2013 for Region 6.
Table 12: All-Cause 30-Day Readmission Rates by Quarter for Patients Discharged to Home Health— July 1, 2012–June 30, 2013
Setting Discharged
To Quarter Number of
Discharges
Number of Discharges Readmitted
within 30 Days
30-Day Readmit Rate
Number of 30-Day
Readmits to the same hospital
Percentage of 30-Day
Readmits to the same hospital
Number of 30-Day
Readmits to another hospital
Percentage of 30-Day
Readmits to another hospital
Q3 2012 338 55 16.3% 46 83.6% 9 16.4% Q4 2012 389 49 12.6% 38 77.6% 11 22.4%
Home Health Q1 2013 366 49 13.4% 36 73.5% 13 26.5% Q2 2013 302 38 12.6% 35 92.1% 3 7.9% All 1,395 191 13.7% 155 81.2% 36 18.8%
Figure 6 displays the all-cause 30-day readmission rates for patients discharged to home health for Q3 2012 through Q2 2013 for Region 6. The readmission rate for each quarter is displayed above the bar.
Figure 6: Readmission Rate by Quarter for Patients Discharged to Home Health
13.4%12.6%
16.3%
12.6%
Read
miss
ion
Rate
0.0%
5.0%
10.0%
15.0%
20.0%
Q3 2012
Q4 2012
Q1 2013
Q2 2013
Region 6: San Luis Obispo Readmission Report 12
Table 13 depicts the all-cause 30-day readmission rates for patients discharged to home health for each month in Q3 2012 through Q2 2013 for Region 6.
Table 13: All-Cause 30-Day Readmission Rates by Month for Patients Discharged to Home Health— July 1, 2012–June 30, 2013
Setting Discharged
To Month Number of
Discharges
Number of Discharges Readmitted
within 30 Days
30-Day Readmit
Rate
Number of 30-Day
Readmits to the same
hospital
Percentage of 30-Day
Readmits to the same hospital
Number of 30-Day
Readmits to another hospital
Percentage of 30-Day
Readmits to another hospital
July 2012 121 13 10.7% 8 61.5% 5 38.5% August 2012 107 20 18.7% 19 95.0% 1 5.0% September 2012 110 22 20.0% 19 86.4% 3 13.6% October 2012 133 17 12.8% 10 58.8% 7 41.2% November 2012 135 18 13.3% 15 83.3% 3 16.7% December 2012 121 14 11.6% 13 92.9% 1 7.1%
Home Health January 2013 162 20 12.3% 12 60.0% 8 40.0% February 2013 93 12 12.9% 9 75.0% 3 25.0% March 2013 111 17 15.3% 15 88.2% 2 11.8% April 2013 107 8 7.5% 8 100.0% 0 0.0% May 2013 93 8 8.6% 8 100.0% 0 0.0% June 2013 102 22 21.6% 19 86.4% 3 13.6% All 1,395 191 13.7% 155 81.2% 36 18.8%
Figure 7 displays the all-cause 30-day readmission rates for patients discharged to home health for each month in Q3 2012 through Q2 2013 for Region 6. The readmission rate for each month is displayed above the bar.
Figure 7: Readmission Rate by Month for Patients Discharged to Home Health
7.5%
18.7%
11.6%12.9%12.3%
10.7%
21.6%
15.3%
8.6%
13.3%12.8%
20.0%
Read
miss
ion
Rate
0.0%
5.0%
10.0%
15.0%
20.0%
25.0%
30.0%
Jul-12
Aug-12
Sep-12
Oct-12
Nov-12
Dec-12
Jan-13
Feb-13
Mar-13
Apr-13
May-13
Jun-13
Region 6: San Luis Obispo Readmission Report 13
Table 14 depicts the all-cause 30-day readmission rates for patients discharged to all settings for Q3 2012 through Q2 2013 for Region 6.
Table 14: All-Cause 30-Day Readmission Rates by Quarter for Patients Discharged to All Settings— July 1, 2012–June 30, 2013
Setting Discharged
To Quarter Number of
Discharges
Number of Discharges Readmitted
within 30 Days
30-Day Readmit Rate
Number of 30-Day
Readmits to the same hospital
Percentage of 30-Day
Readmits to the same hospital
Number of 30-Day
Readmits to another hospital
Percentage of 30-Day
Readmits to another hospital
Q3 2012 1,681 219 13.0% 166 75.8% 53 24.2% Q4 2012 1,748 226 12.9% 157 69.5% 69 30.5%
All Settings Q1 2013 1,567 209 13.3% 158 75.6% 51 24.4% Q2 2013 1,337 181 13.5% 140 77.3% 41 22.7% All 6,333 835 13.2% 621 74.4% 214 25.6%
Figure 8 displays the all-cause 30-day readmission rates for patients discharged to all settings for Q3 2012 through Q2 2013 for Region 6. The readmission rate for each quarter is displayed above the bar.
Figure 8: Readmission Rate by Quarter for Patients Discharged to All Settings
13.3% 13.5%13.0% 12.9%
Read
miss
ion
Rate
0.0%
5.0%
10.0%
15.0%
20.0%
Q3 2012
Q4 2012
Q1 2013
Q2 2013
Region 6: San Luis Obispo Readmission Report 14
Table 15 depicts the all-cause 30-day readmission rates for patients discharged to all settings for each month in Q3 2012 through Q2 2013 for Region 6.
Table 15: All-Cause 30-Day Readmission Rates by Month for Patients Discharged to All Settings— July 1, 2012–June 30, 2013
Setting Discharged
To Month Number of
Discharges
Number of Discharges Readmitted
within 30 Days
30-Day Readmit
Rate
Number of 30-Day
Readmits to the same
hospital
Percentage of 30-Day
Readmits to the same hospital
Number of 30-Day
Readmits to another hospital
Percentage of 30-Day
Readmits to another hospital
July 2012 591 67 11.3% 47 70.1% 20 29.9% August 2012 551 71 12.9% 57 80.3% 14 19.7% September 2012 539 81 15.0% 62 76.5% 19 23.5% October 2012 591 64 10.8% 43 67.2% 21 32.8% November 2012 580 81 14.0% 55 67.9% 26 32.1% December 2012 577 81 14.0% 59 72.8% 22 27.2%
All Settings January 2013 576 71 12.3% 50 70.4% 21 29.6% February 2013 464 63 13.6% 51 81.0% 12 19.0% March 2013 527 75 14.2% 57 76.0% 18 24.0% April 2013 470 60 12.8% 46 76.7% 14 23.3% May 2013 445 52 11.7% 41 78.8% 11 21.2% June 2013 422 69 16.4% 53 76.8% 16 23.2% All 6,333 835 13.2% 621 74.4% 214 25.6%
Figure 9 displays the all-cause 30-day readmission rates for patients discharged to all settings for each month in Q3 2012 through Q2 2013 for Region 6. The readmission rate for each month is displayed above the bar.
Figure 9: Readmission Rate by Month for Patients Discharged to All Settings
12.8%12.9%14.0% 13.6%
12.3%11.3%
16.4%
14.2%
11.7%
14.0%
10.8%
15.0%
Read
miss
ion
Rate
0.0%
5.0%
10.0%
15.0%
20.0%
Jul-12
Aug-12
Sep-12
Oct-12
Nov-12
Dec-12
Jan-13
Feb-13
Mar-13
Apr-13
May-13
Jun-13
Region 6: San Luis Obispo Readmission Report 15
Figure 10 displays the all-cause 30-day readmission rate for Region 6, the state of California, and the nation for CY 2010 (i.e., baseline period7), CY 2011, CY 2012, Q1 2013, and Q2 2013.
Figure 10: All-Cause 30-Day Readmission Rates
All-Cause 30-Day Mortality Rates
Table 16 depicts the all-cause 30-day mortality rates from admission for each quarter during Q3 2012 through Q2 2013 for Region 6 and the state of California.8
Table 16: All-Cause 30-Day Mortality Rates Quarter Region 6 Statewide Q3 2012 5.5% 3.9% Q4 2012 5.8% 4.2% Q1 2013 6.0% 4.6% Q2 2013 5.3% 4.0%
7 Note: Due to the receipt of incomplete data, the baseline period data may have been underreported in the previous report. 8 The 30-day mortality rates are not risk adjusted.
Read
miss
ion
Rate
0.0%
5.0%
10.0%
15.0%
20.0%
Time Period
CY 2010 CY 2011 CY 2012 Q1 2013 Q2 2013
Region Rate State Rate
National Rate
Region 6: San Luis Obispo Readmission Report 16
Top 10 Diagnosis Related Groups (DRGs) for Region 6
Tables 17 and 18 depict the top 10 DRGs associated with all discharges for Q3–Q4 2012 and Q1–Q2 2013 for Region 6.
Table 17: Region 6 Top 10 DRGs Associated with Discharges for Q3–Q4 2012 DRG Code Description N %
470 MAJOR JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY W/O MCC 325 10.1%
871 SEPTICEMIA OR SEVERE SEPSIS W/O MV 96+ HOURS W MCC 131 4.1% 872 SEPTICEMIA OR SEVERE SEPSIS W/O MV 96+ HOURS W/O MCC 111 3.4% 194 SIMPLE PNEUMONIA & PLEURISY W CC 65 2.0% 378 G.I. HEMORRHAGE W CC 65 2.0% 392 ESOPHAGITIS, GASTROENT & MISC DIGEST DISORDERS W/O MCC 65 2.0% 189 PULMONARY EDEMA & RESPIRATORY FAILURE 59 1.8% 690 KIDNEY & URINARY TRACT INFECTIONS W/O MCC 58 1.8% 641 NUTRITIONAL & MISC METABOLIC DISORDERS W/O MCC 55 1.7% 065 INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION W CC 52 1.6%
Table 18: Region 6 Top 10 DRGs Associated with Discharges for Q1–Q2 2013 DRG Code Description N %
470 MAJOR JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY W/O MCC 283 10.0%
871 SEPTICEMIA OR SEVERE SEPSIS W/O MV 96+ HOURS W MCC 98 3.5% 194 SIMPLE PNEUMONIA & PLEURISY W CC 94 3.3% 189 PULMONARY EDEMA & RESPIRATORY FAILURE 76 2.7% 872 SEPTICEMIA OR SEVERE SEPSIS W/O MV 96+ HOURS W/O MCC 76 2.7% 247 PERC CARDIOVASC PROC W DRUG-ELUTING STENT W/O MCC 68 2.4% 378 G.I. HEMORRHAGE W CC 51 1.8% 392 ESOPHAGITIS, GASTROENT & MISC DIGEST DISORDERS W/O MCC 45 1.6% 065 INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION W CC 44 1.6% 641 NUTRITIONAL & MISC METABOLIC DISORDERS W/O MCC 41 1.4%
Region 6: San Luis Obispo Readmission Report 17
Tables 19 and 20 depict the top 10 DRGs associated with all-cause readmissions for Q3–Q4 2012 and Q1–Q2 2013 for Region 6.
Table 19: Region 6 Top 10 DRGs Associated with Readmissions for Q3–Q4 2012 DRG Code Description N %
871 SEPTICEMIA OR SEVERE SEPSIS W/O MV 96+ HOURS W MCC 35 8.2% 189 PULMONARY EDEMA & RESPIRATORY FAILURE 19 4.5% 872 SEPTICEMIA OR SEVERE SEPSIS W/O MV 96+ HOURS W/O MCC 16 3.8% 378 G.I. HEMORRHAGE W CC 12 2.8% 292 HEART FAILURE & SHOCK W CC 10 2.3% 641 NUTRITIONAL & MISC METABOLIC DISORDERS W/O MCC 9 2.1% 193 SIMPLE PNEUMONIA & PLEURISY W MCC 8 1.9% 291 HEART FAILURE & SHOCK W MCC 8 1.9% 194 SIMPLE PNEUMONIA & PLEURISY W CC 7 1.6% 309 CARDIAC ARRHYTHMIA & CONDUCTION DISORDERS W CC 6 1.4%
Table 20: Region 6 Top 10 DRGs Associated with Readmissions for Q1–Q2 2013 DRG Code Description N %
871 SEPTICEMIA OR SEVERE SEPSIS W/O MV 96+ HOURS W MCC 25 6.5% 194 SIMPLE PNEUMONIA & PLEURISY W CC 17 4.4% 189 PULMONARY EDEMA & RESPIRATORY FAILURE 15 3.9% 872 SEPTICEMIA OR SEVERE SEPSIS W/O MV 96+ HOURS W/O MCC 15 3.9% 291 HEART FAILURE & SHOCK W MCC 10 2.6% 292 HEART FAILURE & SHOCK W CC 10 2.6% 178 RESPIRATORY INFECTIONS & INFLAMMATIONS W CC 7 1.8% 193 SIMPLE PNEUMONIA & PLEURISY W MCC 7 1.8% 176 PULMONARY EMBOLISM W/O MCC 6 1.6% 308 CARDIAC ARRHYTHMIA & CONDUCTION DISORDERS W MCC 5 1.3%
Region 6: San Luis Obispo Readmission Report 18
AMI Readmission Rates
Table 21 depicts the AMI 30-day readmission rates by discharge setting for Q3 2012 through Q2 2013 for Region 6 and the state of California.
Table 21: AMI 30-Day Readmission Rates—July 1, 2012–June 30, 2013
Group Setting Discharged To Number of Discharges
Number of Discharges Readmitted
within 30 Days
30-Day Readmit
Rate
Number of 30-Day
Readmits to the same
hospital
Percentage of 30-Day Readmits
to the same hospital
Number of 30-Day
Readmits to another
hospital
Percentage of 30-Day Readmits
to another hospital
Home 113 17 15.0% 11 64.7% 6 35.3% Nursing Home 29 4 13.8% 2 50.0% 2 50.0%
Region 6 Home Health 27 4 14.8% 2 50.0% 2 50.0% Hospice 5 0 0.0% 0 0.0% 0 0.0% Other 1 0 0.0% 0 0.0% 0 0.0% All 175 25 14.3% 15 60.0% 10 40.0% Home 8,820 1,485 16.8% 1,047 70.5% 438 29.5% Nursing Home 2,511 690 27.5% 495 71.7% 195 28.3%
California Home Health 2,357 547 23.2% 405 74.0% 142 26.0% Hospice 384 14 3.6% 10 71.4% 4 28.6% Other 1,098 277 25.2% 150 54.2% 127 45.8% All 15,170 3,013 19.9% 2,107 69.9% 906 30.1%
Table 22 depicts the number of days from discharge to readmission by discharge setting for AMI for Region 6 and the state of California.
Table 22: Number of Days from AMI Discharge to Readmission—July 1, 2012–June 30, 2013 Setting Number of 1–3 Days 4–7 Days 8–14 Days 15–21 Days 22–30 Days
Group Discharged To Readmissions N % N % N % N % N % Home 17 4 23.5% 1 5.9% 4 23.5% 3 17.6% 5 29.4% Nursing Home 4 3 75.0% 1 25.0% 0 0.0% 0 0.0% 0 0.0%
Region 6 Home Health 4 1 25.0% 2 50.0% 0 0.0% 0 0.0% 1 25.0%
Hospice 0 0 0.0% 0 0.0% 0 0.0% 0 0.0% 0 0.0% Other 0 0 0.0% 0 0.0% 0 0.0% 0 0.0% 0 0.0%
All 25 8 32.0% 4 16.0% 4 16.0% 3 12.0% 6 24.0% Home 1,485 312 21.0% 301 20.3% 379 25.5% 227 15.3% 266 17.9% Nursing Home 690 132 19.1% 153 22.2% 178 25.8% 107 15.5% 120 17.4%
California Home Health 547 108 19.7% 111 20.3% 141 25.8% 91 16.6% 96 17.6% Hospice 14 2 14.3% 0 0.0% 8 57.1% 3 21.4% 1 7.1% Other 277 84 30.3% 44 15.9% 48 17.3% 49 17.7% 52 18.8%
All 3,013 638 21.2% 609 20.2% 754 25.0% 477 15.8% 535 17.8%
Region 6: San Luis Obispo Readmission Report 19
Figure 11 displays the AMI 30-day readmission rate for Region 6, the state of California, and the nation for CY 2010 (i.e., baseline period9), CY 2011, CY 2012, Q1 2013, and Q2 2013.
Figure 11: AMI 30-Day Readmission Rates
AMI 30-Day Mortality Rates
Table 23 depicts the AMI 30-day mortality rates from admission for Q3 2012 through Q2 2013 for Region 6 and the state of California.10
Table 23: AMI 30-Day Mortality Rates Quarter Region 6 Statewide Q3 2012 0.0% 5.0% Q4 2012 6.1% 5.4% Q1 2013 12.3% 6.0% Q2 2013 6.3% 4.9%
9 Note: Due to the receipt of incomplete data, the baseline period data may have been underreported in the previous report. 10 The 30-day mortality rates are not risk adjusted.
Read
miss
ion
Rate
0.0%
5.0%
10.0%
15.0%
20.0%
25.0%
Time Period
CY 2010 CY 2011 CY 2012 Q1 2013 Q2 2013
Region Rate State Rate
National Rate
Region 6: San Luis Obispo Readmission Report 20
Heart Failure Readmission Rates
Table 24 depicts the heart failure 30-day readmission rates by discharge setting for Q3 2012 through Q2 2013 for Region 6 and the state of California.
Table 24: Heart Failure 30-Day Readmission Rates—July 1, 2012–June 30, 2013
Group Setting Discharged To Number of Discharges
Number of Discharges Readmitted
within 30 Days
30-Day Readmit
Rate
Number of 30-Day
Readmits to the same
hospital
Percentage of 30-Day Readmits
to the same hospital
Number of 30-Day
Readmits to another
hospital
Percentage of 30-Day Readmits
to another hospital
Home 115 19 16.5% 18 94.7% 1 5.3% Nursing Home 53 13 24.5% 10 76.9% 3 23.1%
Region 6 Home Health 67 13 19.4% 9 69.2% 4 30.8% Hospice 12 1 8.3% 0 0.0% 1 100.0% Other 7 4 57.1% 3 75.0% 1 25.0% All 254 50 19.7% 40 80.0% 10 20.0% Home 18,192 4,566 25.1% 3,394 74.3% 1,172 25.7% Nursing Home 6,758 1,917 28.4% 1,428 74.5% 489 25.5%
California Home Health 7,594 2,124 28.0% 1,691 79.6% 433 20.4% Hospice 1,044 38 3.6% 29 76.3% 9 23.7% Other 1,890 596 31.5% 352 59.1% 244 40.9% All 35,478 9,241 26.0% 6,894 74.6% 2,347 25.4%
Table 25 depicts the number of days from discharge to readmission by discharge setting for heart failure for Region 6 and the state of California.
Table 25: Number of Days from Heart Failure Discharge to Readmission—July 1, 2012–June 30, 2013 Setting Number of 1–3 Days 4–7 Days 8–14 Days 15–21 Days 22–30 Days
Group Discharged To Readmissions N % N % N % N % N % Home 19 4 21.1% 6 31.6% 3 15.8% 3 15.8% 3 15.8% Nursing Home 13 2 15.4% 2 15.4% 3 23.1% 3 23.1% 3 23.1%
Region 6 Home Health 13 0 0.0% 2 15.4% 2 15.4% 3 23.1% 6 46.2%
Hospice 1 0 0.0% 0 0.0% 0 0.0% 0 0.0% 1 100.0% Other 4 1 25.0% 1 25.0% 0 0.0% 1 25.0% 1 25.0%
All 50 7 14.0% 11 22.0% 8 16.0% 10 20.0% 14 28.0% Home 4,566 615 13.5% 820 18.0% 1,214 26.6% 952 20.8% 965 21.1% Nursing Home 1,917 243 12.7% 327 17.1% 521 27.2% 412 21.5% 414 21.6%
California Home Health 2,124 307 14.5% 395 18.6% 541 25.5% 445 21.0% 436 20.5% Hospice 38 7 18.4% 7 18.4% 12 31.6% 6 15.8% 6 15.8% Other 596 118 19.8% 107 18.0% 132 22.1% 99 16.6% 140 23.5%
All 9,241 1,290 14.0% 1,656 17.9% 2,420 26.2% 1,914 20.7% 1,961 21.2%
Region 6: San Luis Obispo Readmission Report 21
Figure 12 displays the heart failure 30-day readmission rate for Region 6, the state of California, and the nation for CY 2010 (i.e., baseline period11), CY 2011, CY 2012, Q1 2013, and Q2 2013.
Figure 12: Heart Failure 30-Day Readmission Rates
Heart Failure 30-Day Mortality Rates
Table 26 depicts the heart failure 30-day mortality rates from admission for Q3 2012 through Q2 2013 for Region 6 and the state of California.12
Table 26: Heart Failure 30-Day Mortality Rates
Quarter Region 6 Statewide Q3 2012 4.5% 6.0% Q4 2012 4.0% 6.2% Q1 2013 10.9% 7.3% Q2 2013 10.5% 6.2%
11 Note: Due to the receipt of incomplete data, the baseline period data may have been underreported in the previous report. 12
The 30-day mortality rates are not risk adjusted.
Read
miss
ion
Rate
0.0%
5.0%
10.0%
15.0%
20.0%
25.0%
30.0%
Time Period
CY 2010 CY 2011 CY 2012 Q1 2013 Q2 2013
Region Rate State Rate
National Rate
Region 6: San Luis Obispo Readmission Report 22
Pneumonia Readmission Rates
Table 27 depicts the pneumonia 30-day readmission rates by discharge setting for Q3 2012 through Q2 2013 for Region 6 and the state of California.
Table 27: Pneumonia 30-Day Readmission Rates—July 1, 2012–June 30, 2013
Group Setting Discharged To Number of Discharges
Number of Discharges Readmitted
within 30 Days
30-Day Readmit
Rate
Number of 30-Day
Readmits to the same
hospital
Percentage of 30-Day Readmits
to the same hospital
Number of 30-Day
Readmits to another
hospital
Percentage of 30-Day Readmits
to another hospital
Home 107 10 9.3% 7 70.0% 3 30.0% Nursing Home 77 16 20.8% 11 68.8% 5 31.3%
Region 6 Home Health 84 16 19.0% 13 81.3% 3 18.8% Hospice 6 0 0.0% 0 0.0% 0 0.0% Other 7 1 14.3% 1 100.0% 0 0.0% All 281 43 15.3% 32 74.4% 11 25.6% Home 13,856 2,215 16.0% 1,703 76.9% 512 23.1% Nursing Home 7,239 1,629 22.5% 1,172 71.9% 457 28.1%
California Home Health 5,022 1,006 20.0% 828 82.3% 178 17.7% Hospice 716 15 2.1% 13 86.7% 2 13.3% Other 1,903 346 18.2% 233 67.3% 113 32.7% All 28,736 5,211 18.1% 3,949 75.8% 1,262 24.2%
Table 28 depicts the number of days from discharge to readmission by discharge setting for pneumonia for Region 6 and the state of California.
Table 28: Number of Days from Pneumonia Discharge to Readmission—July 1, 2012–June 30, 2013 Setting Number of 1–3 Days 4–7 Days 8–14 Days 15–21 Days 22–30 Days
Group Discharged To Readmissions N % N % N % N % N % Home 10 1 10.0% 2 20.0% 2 20.0% 2 20.0% 3 30.0% Nursing Home 16 1 6.3% 7 43.8% 2 12.5% 4 25.0% 2 12.5%
Region 6 Home Health 16 3 18.8% 2 12.5% 1 6.3% 4 25.0% 6 37.5%
Hospice 0 0 0.0% 0 0.0% 0 0.0% 0 0.0% 0 0.0% Other 1 0 0.0% 0 0.0% 0 0.0% 1 100.0% 0 0.0%
All 43 5 11.6% 11 25.6% 5 11.6% 11 25.6% 11 25.6% Home 2,215 368 16.6% 380 17.2% 593 26.8% 410 18.5% 464 20.9% Nursing Home 1,629 229 14.1% 303 18.6% 393 24.1% 355 21.8% 349 21.4%
California Home Health 1,006 173 17.2% 192 19.1% 268 26.6% 188 18.7% 185 18.4% Hospice 15 5 33.3% 2 13.3% 4 26.7% 1 6.7% 3 20.0% Other 346 67 19.4% 47 13.6% 74 21.4% 63 18.2% 95 27.5%
All 5,211 842 16.2% 924 17.7% 1,332 25.6% 1,017 19.5% 1,096 21.0%
Region 6: San Luis Obispo Readmission Report 23
Figure 13 displays the pneumonia 30-day readmission rate for Region 6, the state of California, and the nation for CY 2010 (i.e., baseline period13), CY 2011, CY 2012, Q1 2013, and Q2 2013.
Figure 13: Pneumonia 30-Day Readmission Rates
Pneumonia 30-Day Mortality Rates
Table 29 depicts the pneumonia 30-day mortality rates from admission for Q3 2012 through Q2 2013 for Region 6 and the state of California.14
Table 29: Pneumonia 30-Day Mortality Rates
Quarter Region 6 Statewide Q3 2012 6.8% 6.1% Q4 2012 8.2% 7.0% Q1 2013 8.6% 6.3% Q2 2013 1.5% 5.5%
13 Note: Due to the receipt of incomplete data, the baseline period data may have been underreported in the previous report. 14 The 30-day mortality rates are not risk adjusted.
Read
miss
ion
Rate
0.0%
5.0%
10.0%
15.0%
20.0%
25.0%
30.0%
Time Period
CY 2010 CY 2011 CY 2012 Q1 2013 Q2 2013
Region Rate State Rate
National Rate
Region 6: San Luis Obispo Readmission Report 24
COPD Readmission Rates
Table 30 depicts the COPD 30-day readmission rates by discharge setting for Q3 2012 through Q2 2013 for Region 6 and the state of California.
Table 30: COPD 30-Day Readmission Rates—July 1, 2012–June 30, 2013
Group Setting Discharged To Number of Discharges
Number of Discharges Readmitted
within 30 Days
30-Day Readmit
Rate
Number of 30-Day
Readmits to the same
hospital
Percentage of 30-Day Readmits
to the same hospital
Number of 30-Day
Readmits to another
hospital
Percentage of 30-Day Readmits
to another hospital
Home 65 12 18.5% 10 83.3% 2 16.7% Nursing Home 29 4 13.8% 4 100.0% 0 0.0%
Region 6 Home Health 34 7 20.6% 7 100.0% 0 0.0% Hospice 5 1 20.0% 1 100.0% 0 0.0% Other 3 0 0.0% 0 0.0% 0 0.0% All 136 24 17.6% 22 91.7% 2 8.3% Home 10,765 2,369 22.0% 1,861 78.6% 508 21.4% Nursing Home 3,433 862 25.1% 633 73.4% 229 26.6%
California Home Health 3,195 776 24.3% 626 80.7% 150 19.3% Hospice 288 15 5.2% 12 80.0% 3 20.0% Other 1,130 303 26.8% 195 64.4% 108 35.6% All 18,811 4,325 23.0% 3,327 76.9% 998 23.1%
Table 31 depicts the number of days from discharge to readmission by discharge setting for COPD for Region 6 and the state of California.
Table 31: Number of Days from COPD Discharge to Readmission—July 1, 2012–June 30, 2013 Setting Number of 1–3 Days 4–7 Days 8–14 Days 15–21 Days 22–30 Days
Group Discharged To Readmissions N % N % N % N % N % Home 12 3 25.0% 2 16.7% 3 25.0% 3 25.0% 1 8.3% Nursing Home 4 0 0.0% 1 25.0% 0 0.0% 1 25.0% 2 50.0%
Region 6 Home Health 7 3 42.9% 0 0.0% 1 14.3% 2 28.6% 1 14.3%
Hospice 1 0 0.0% 0 0.0% 1 100.0% 0 0.0% 0 0.0% Other 0 0 0.0% 0 0.0% 0 0.0% 0 0.0% 0 0.0%
All 24 6 25.0% 3 12.5% 5 20.8% 6 25.0% 4 16.7% Home 2,369 415 17.5% 387 16.3% 552 23.3% 508 21.4% 507 21.4% Nursing Home 862 99 11.5% 160 18.6% 214 24.8% 183 21.2% 206 23.9%
California Home Health 776 116 14.9% 131 16.9% 217 28.0% 161 20.7% 151 19.5% Hospice 15 3 20.0% 2 13.3% 6 40.0% 2 13.3% 2 13.3% Other 303 60 19.8% 45 14.9% 70 23.1% 68 22.4% 60 19.8%
All 4,325 693 16.0% 725 16.8% 1,059 24.5% 922 21.3% 926 21.4%
Region 6: San Luis Obispo Readmission Report 25
Figure 14 displays the COPD 30-day readmission rate for Region 6, the state of California, and the nation for CY 2010 (i.e., baseline period15), CY 2011, CY 2012, Q1 2013, and Q2 2013.
Figure 14: COPD 30-Day Readmission Rates
COPD 30-Day Mortality Rates
Table 32 depicts the COPD 30-day mortality rates from admission for Q3 2012 through Q2 2013 for Region 6 and the state of California.16
Table 32: COPD 30-Day Mortality Rates
Quarter Region 6 Statewide Q3 2012 8.1% 4.3% Q4 2012 8.8% 4.4% Q1 2013 6.8% 4.6% Q2 2013 4.8% 4.0%
15 Note: Due to the receipt of incomplete data, the baseline period data may have been underreported in the previous report. 16 The 30-day mortality rates are not risk adjusted.
Read
miss
ion
Rate
0.0%
5.0%
10.0%
15.0%
20.0%
25.0%
Time Period
CY 2010 CY 2011 CY 2012 Q1 2013 Q2 2013
Region Rate State Rate
National Rate
Region 6: San Luis Obispo Readmission Report 26
THA/TKA Readmission Rates
Table 33 depicts the THA/TKA 30-day readmission rates by discharge setting for Q3 2012 through Q2 2013 for Region 6 and the state of California.
Table 33: Hip/Knee Replacement 30-Day Readmission Rates—July 1, 2012–June 30, 2013
Group Setting Discharged To Number of Discharges
Number of Discharges Readmitted
within 30 Days
30-Day Readmit
Rate
Number of 30-Day
Readmits to the same
hospital
Percentage of 30-Day Readmits
to the same hospital
Number of 30-Day
Readmits to another
hospital
Percentage of 30-Day Readmits
to another hospital
Home 62 1 1.6% 0 0.0% 1 100.0% Nursing Home 158 9 5.7% 9 100.0% 0 0.0%
Region 6 Home Health 315 11 3.5% 8 72.7% 3 27.3% Hospice 0 0 0.0% 0 0.0% 0 0.0% Other 15 1 6.7% 1 100.0% 0 0.0% All 550 22 4.0% 18 81.8% 4 18.2% Home 5,727 177 3.1% 123 69.5% 54 30.5% Nursing Home 8,863 532 6.0% 383 72.0% 149 28.0%
California Home Health 12,781 448 3.5% 294 65.6% 154 34.4% Hospice 5 0 0.0% 0 0.0% 0 0.0% Other 1,784 133 7.5% 91 68.4% 42 31.6% All 29,160 1,290 4.4% 891 69.1% 399 30.9%
Table 34 depicts the number of days from discharge to readmission by discharge setting for THA/TKA for Region 6 and the state of California.
Table 34: Number of Days from Hip/Knee Replacement Discharge to Readmission—July 1, 2012–June 30, 2013 Setting Number of 1–3 Days 4–7 Days 8–14 Days 15–21 Days 22–30 Days
Group Discharged To Readmissions N % N % N % N % N % Home 1 0 0.0% 0 0.0% 0 0.0% 0 0.0% 1 100.0% Nursing Home 9 4 44.4% 1 11.1% 2 22.2% 1 11.1% 1 11.1%
Region 6 Home Health 11 3 27.3% 3 27.3% 3 27.3% 0 0.0% 2 18.2%
Hospice 0 0 0.0% 0 0.0% 0 0.0% 0 0.0% 0 0.0% Other 1 0 0.0% 0 0.0% 1 100.0% 0 0.0% 0 0.0%
All 22 7 31.8% 4 18.2% 6 27.3% 1 4.5% 4 18.2% Home 177 51 28.8% 21 11.9% 48 27.1% 28 15.8% 29 16.4% Nursing Home 532 95 17.9% 101 19.0% 135 25.4% 107 20.1% 94 17.7%
California Home Health 448 91 20.3% 97 21.7% 116 25.9% 72 16.1% 72 16.1% Hospice 0 0 0.0% 0 0.0% 0 0.0% 0 0.0% 0 0.0% Other 133 25 18.8% 19 14.3% 28 21.1% 30 22.6% 31 23.3%
All 1,290 262 20.3% 238 18.4% 327 25.3% 237 18.4% 226 17.5%
Region 6: San Luis Obispo Readmission Report 27
Figure 15 displays the THA/TKA 30-day readmission rate for Region 6 and the state of California for CY 2010 (i.e., baseline period17), CY 2011, CY 2012, Q1 2013 and Q2 2013.
Figure 15: THA/TKA 30-Day Readmission Rates18
THA/TKA 30-Day Mortality Rates
Table 35 depicts the THA/TKA 30-day mortality rates from admission for Q3 2012 through Q2 2013 for Region 6 and the state of California.19
Table 35: Hip/Knee Replacement 30-Day Mortality Rates Quarter Region 6 Statewide Q3 2012 0.7% 0.1% Q4 2012 0.7% 0.1% Q1 2013 0.0% 0.1% Q2 2013 0.0% 0.1%
17 Note: Due to the receipt of incomplete data, the baseline period data may have been underreported in the previous report. 18 Note: If there is no data point for your hospital for a given time period, no data were reported for that time period. 19 The 30-day mortality rates are not risk adjusted.
Read
miss
ion
Rate
0.0%
5.0%
10.0%
Time Period
CY 2010 CY 2011 CY 2012 Q1 2013 Q2 2013
Region Rate State Rate
Region 6: San Luis Obispo Readmission Report 28
ED Visits and Observation Stays
Table 36 depicts the number of ED visits for Region 6 and the state of California for Q3 2012 through Q2 2013.20
Table 36: Number of Emergency Department Visits Quarter Region 6 Statewide Q3 2012 4,350 272,352 Q4 2012 4,419 265,591 Q1 2013 3,449 269,611 Q2 2013 3,359 258,243
Table 37 depicts the number of observation stays for Region 6 and the state of California for Q3 2012 through Q2 2013.21
Table 37: Number of Observation Stays Quarter Region 6 Statewide Q3 2012 291 25,958 Q4 2012 298 26,093 Q1 2013 231 25,529 Q2 2013 238 24,193
20 Note: Emergency department visits resulting in an inpatient stay are not included in this number. 21 Note: Observation stays resulting in an inpatient stay are not included in this number.
A-1
Appendix
Settings Included in the “Other” Category
The “Other” category in the tables throughout the report includes discharges to the following settings:
Psychiatric hospital
Long-term care hospital
Rehabilitation facility
Federal government-operated healthcare facility
Intermediate care facility
Short-term general hospital
Critical access hospital
Left against medical advice
Other institutions
Diagnosis Code List for Disease-Specific Discharges
The following table lists the diagnosis codes used to identify the discharges for AMI, heart failure, pneumonia, and COPD.
Disease Diagnosis Codes
AMI 410.00, 410.01, 410.10, 410.11, 410.20, 410.21, 410.30, 410.31, 410.40, 410.41, 410.50, 410.51, 410.60, 410.61, 410.70, 410.71, 410.80, 410.81, 410.90, 410.91
Heart Failure 402.01, 402.11, 402.91, 404.01, 404.03, 404.11, 404.13, 404.91, 404.93, 428
Pneumonia 480.0, 480.1, 480.2, 480.3, 480.8, 480.9, 482.0, 482.1, 482.2, 482.9, 483.0, 483.1, 483.8,
487.0, 481, 485, 486, 482.30, 482.31, 482.32, 482.39, 482.40, 482.41, 482.49, 482.81, 482.82, 482.83, 482.84, 482.89
COPD 491, 492, 496
Procedural Code List for Disease-Specific Discharges
The following table lists the procedural codes used to identify the discharges for THA/TKA.
Procedure Procedural Codes
THA/TKA 81.51, 81.54
This material was prepared by Health Services Advisory Group of California, Inc., the Medicare Quality Improvement Organization for California, under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services. The contents presented do not necessarily reflect CMS policy. Publication No. CA-10SOW-8.0-012414-06.
