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Why use these indicators/measures?

 

APR-DRGs

Measures for average charges are All Patient Refined Diagnosis Related Groups (APR-DRGs) for similar, though not identical, hip and knee procedures and conditions in this report’s quality of care section. APR-DRG software, widely used in health care research, organizes about 20,000 clinical diagnoses and procedures into about 300 groups. Each APR-DRG has four severity of illness levels. This report uses APR-DRG version 20.0, because the Agency for Healthcare Research and Quality (AHRQ) uses it for expected rate and risk-adjusted rate in the Inpatient Quality Indicators (IQIs).

Note that other Utah Department of Health reports that include average charge information use APR-DRG Version 15.0 for data from 2004 and earlier. Read more…

Specifically, the Utah Hospital Comparison Report for Selected Hip and Knee Surgeries and Conditions, 2002-2004, reports average hospital charge for Hip Joint Replacement (APR-DRG 301), Hip and Femur Procedures for Trauma Except Joint Replacement (APR-DRG 308) and Fracture of Femur (APR-DRG 340) because the AHRQ Inpatient Quality Indicators use them for hip replacement and hip fracture expected death rates. The report also includes average hospital charge for Knee Joint Replacement (APR-DRG 302).

Hip Joint Replacement (APR-DRG 301) includes total hip joint replacement, partial hip joint replacement and revision of hip joint replacement.

Knee Joint Replacement (APR-DRG 302) includes total knee joint replacement and revision of knee joint replacement.

Hip and Femur Procedures for Trauma (APR-DRG 308) includes procedures for fractures of the pelvic bones and femur for trauma except those included in APR-DRGs 301 and 340.

Fracture of Femur (APR-DRG 340) includes fractures anywhere along the length of the femur (thigh bone), including the femur head and neck (top), shaft and lower end that meets the bones in the knee. Hip fractures include fractures of the femur head.

AHRQ Inpatient Quality Indicators

The Agency for Health Care Research and Quality (AHRQ), a federal agency in charge of quality of care, developed the Inpatient Quality Indicators (IQIs) for in-hospital deaths used in this report. The IQIs allow comparison among Utah hospitals and other U.S. hospitals that treated similar patients based on the State Inpatient Databases 2003. These databases represent about 90% of all inpatients in the U.S. from 38 participating states in 2003. The Health Care Cost and Utilization Project (HCUP) collects these data every year. Read more…
The AHRQ IQIs are nationally recognized indicators, in compliance with the mandates of Senate Bill 132, the Health Care Consumer’s Report Bill passed in 2005.

Specifically, the Utah Hospital Comparison Report for Selected Hip and Knee Surgeries and Conditions, 2002-2004, includes IQIs for a serious condition (hip fracture) and for a major surgery (hip joint replacement). Currently there is no IQI for knee joint replacement. Read more …

Hip Replacement Death Rate (IQI 14) includes total hip joint replacement, partial hip joint replacement and revision of hip joint replacement.

AHRQ IQIs and APR-DRGs do not distinguish between patients with a single knee joint replacement and patients with bilateral knee joint replacement (both knees replaced during the same hospital stay) or between patients with a single hip joint replacement and patients with bilateral hip joint replacement. However, this report’s Key Findings section includes additional information on bilateral knee replacement and bilateral hip replacement.

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Last updated: November 13, 2008 1:37 PM