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Overview of Organization & Comparative Quality Data

Overview of Organization & Comparative Quality Data. Ron Spingarn, Deputy Director Healthcare Information Division Email: rspingar@oshpd.ca.gov Phone: (916) 326-3801. University of California at Davis June 18, 2010. Facilities Development. Workforce Development. Health

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Overview of Organization & Comparative Quality Data

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  1. Overview of Organization & Comparative Quality Data Ron Spingarn, Deputy DirectorHealthcare Information Division Email: rspingar@oshpd.ca.gov Phone: (916) 326-3801 University of California at Davis June 18, 2010

  2. Facilities Development WorkforceDevelopment Health ProfessionsEducationFoundation OSHPD (Coronary) Clinical Advisory Panel Healthcare Information Cal-Mortgage Loan Insurance Administration CA Health Policy & Data Advisory Commission Health Data Transparency & Effectiveness Committee Technical Advisory Committee

  3. Data Flow from Facilities • Utilization Data (4,715): • - Skilled Nursing (1,144) • - Hospices (281) • - Community & Free Clinics (983) • - Dialysis Clinics (401) • - Surgical Clinics (209) • Home Health (1,215) • Hospitals (510) • Financial Data: Inpatient Facilities (447) DataProducts Aggregate Financial & Utilization Data Healthcare Information Division Coronary Artery Bypass Graft Surgery Hosp. (121) Cardiac Surgeons (284) Clinical Data & Research • Inpatient Facilities (443): • Acute Care Hosp. (386) • Chemical Dependency Hosp. (6) • Acute Psych. Hosp. (30) • Psych. Facilities (21) • Emergency Department (322) • Ambulatory Surgery (574): • Acute Care (375) • Surgical Clinic (hosp.) (115) • Surgical Clinic (non-hosp.) (84) PatientDischarge Data

  4. Requests for OSHPD Data Examples: Peter McNair, and Hal Luft, UCSF : • Readmissions That are the Sequelae of Hospital Acquired Conditions; • Realigning Hospital Incentives by Bundling Readmissions and Outlier Costs into Prospective Payments and Engaging Insurers Craig Newgard, MD, MPH, Oregon Health & Science University: • Improving Pre Hospital Trauma Triage: Generating a Cost-Effective and Resource-Efficient Mechanism for the Field Triage of Injured Persons Ashish Jha, MD, MPH, Harvard : • Postpartum Readmission: Reasons, Risk Factors & Regional Variation Andrew D. Racine, M.D., Albert Einstein College of Medicine: • The Impact of Palivizumab on Hospitalization Rates for Bronchiolitis in California Mitchell Berman, M.D., Columbia University: • Outcome After Treatment of Cerebrovascular Disease, Outcome of Patients with Parkinson's Disease Following General Anesthesia Data Use Agreement Information - Contact:Jonathan Teague, Email: jteague@oshpd.ca.gov Phone: (916) 326-3805

  5. Quality Measures’ Reporting Levels by OSHPD Area-Level • Inpatient Utilization • Prevention Quality Hospital-Level • Inpatient Mortality • Inpatient Volume & Utilization • Pediatric Quality • Patient Safety • Coronary Artery Bypass Graft Surgery • Maternal Outcomes* • Hip Fracture Repair Mortality* Surgeon-Level • Coronary Artery Bypass Graft Surgery *not yet released OSHPD measures in red AHRQ measures in blue

  6. AHRQ Quality Indicators Reported by OSHPD • Mortality Inpatient (15 available measures) 2006 – 2007: 8 reported 2008: 4 new (12 total) • Volume and Utilization Inpatient (13 available measures) 2005 – 2008: 11 reported • Area-Level Utilization Inpatient (4 available measures) 2005 – 2008: all reported • Area-Level Patient Safety (7 available measures) 2005 – 2008: 4 reported • Area-Level Prevention Quality (14 available measures) 2005 – 2008: all reported • Area-Level Pediatric (5 available measures) 2005 - 2008: all reported

  7. AHRQ Inpatient Mortality Indicators

  8. AHRQ Inpatient Volume & Utilization Indicators • Volume Indicators: All measures reported by OSHPD, since 2005 • Esophageal Resection • Pancreatic Resection • Abdominal Aortic Aneurysm Repair • Carotid Endarterectomy • Coronary Artery Bypass Graft Surgery • Percutaneous Transluminal Coronary Angioplasty • Utilization Indicators: 7 available; 5 reported by OSHPD since 2005 • Cesarean Delivery Rate • Cesarean Delivery Rate – Primary • Vaginal Birth After Cesarean (VBAC) Rate, All • Vaginal Birth After Cesarean (VBAC) Rate, Uncomplicated • Laparoscopic Cholecystectomy Under Consideration: Bi-lateral cardiac catheterization & Incidental appendectomy in elderly

  9. Diabetes Short-term Complications Perforated Appendix Diabetes Long-term Complications Chronic Obstructive Pulmonary Disease (COPD) Hypertension Congestive Heart Failure (CHF) Low Birth Weight Dehydration Bacterial Pneumonia Urinary Tract Infections Angina without Procedure Uncontrolled Diabetes Adult Asthma Lower-extremity Amputations among Patients with Diabetes AHRQ Prevention Quality Indicators(Area-Level Measures) All 14 available measures reported by OSHPD since 2005:

  10. AHRQ Pediatric Quality Indicator (Area-Level Measures) All 5 available area-level rates reported by OHSPD since 2005: • Asthma Admission Rate • Diabetes Short-Term Complication Rate • Gastroenteritis Admission Rate • Perforated Appendix Admission Rate • Urinary Tract Infection Admission Rate AHRQ Utilization Rates All 4 available area-level rates reported by OSHPD since 2005: • Coronary Artery Bypass Graft Surgery • Percutaneous Transluminal Coronary Angioplasty • Hysterectomy • Laminectomy or Spinal Fusion

  11. Patient Safety Indicators,Area-Level Rates (7 available) 4 reported by OSHPD beginning with 2005 data: • Iatrogenic Pneumothorax, Secondary Diagnosis Field • Selected Infections due to Medical Care, Secondary Diagnosis Field • Postoperative Wound Dehiscence • Postoperative Hemorrhage or Hematoma No plans/undecided about Accidental Puncture/Laceration, Foreign Object Left in Body & Transfusion Reaction

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