Calculating & Reporting Healthcare Statistics

Calculating & Reporting Healthcare Statistics Second Edition Chapter 8 Morbidity and Other Miscellaneous Rates

Infections • Morbidity • State of being diseased or the number of sick persons or cases of disease in relation to a specific population • May be infectious or have other causes • For example, the presence of concomitant (taking place at the same time) chronic (of long duration) conditions may constitute comorbidity • Moreover, morbidity may be • preexisting (prior to admission to the hospital) or • iatrogenic, or occurring because of the patient’s treatment ©2006 All rights reserved.

Infections • Nosocomial Infections • Acquired in the hospital • Can be attributable to • Specific patient care units (PCUs) • Specific operations • Patients with specified disease • Medical staff units • Individual physicians • Hospital employees ©2006 All rights reserved.

Infections • Nosocomial Infection Rate Formula • Total number of nosocomial infections for a period X 100 / Total number of discharges, including deaths, for the same period ©2006 All rights reserved.

Infection Rate • May be calculated separately for specific infections such as • Surgical wound infections • Puerperal infections, which occur immediately after childbirth • Infections of the respiratory tract, urinary tract, bloodstream, and so on • Complications that may results from an infection • Other types of complications that require special attention by medical staff and administration include • Wound disruptions • Decubitus ulcers • Postoperative hemorrhages • Adverse drug reactions ©2006 All rights reserved.

Postoperative Infections • May be difficult to determine as it is not always evident if the patient entered the hospital with an infection or acquired one because of the surgical techniques used • The medical staff should provided guidance to the HIM practitioner and the infection control committee on what constitutes a clean surgical case and which infection should be considered a postoperative infection ©2006 All rights reserved.

Postoperative Infections • Two terms need to be considered • A surgical procedure • Any single, separate, systematic process upon or within the body that can be complete in itself • Normally is performed by a physician, dentist, or other licensed practitioner • Can be performed with or without instruments • Performed to restore disunited or deficient parts, remove diseased or injured tissues, extract foreign matter, assist in obstetrical delivery, or aid in diagnosis ©2006 All rights reserved.

Postoperative Infection Rate • Ratio of all infections in clean surgical cases to the number of surgical operations • Clean surgical case is one in which no infection existed prior to surgery ©2006 All rights reserved.

Cesarean Section • Most hospitals determine the percentage of deliveries that are performed by Cesarean Section (commonly called C-section) as compared to spontaneous or vaginal deliveries • There has been much attention given to high C-section rates by specific physicians, hospitals and areas of the country because of concerns about adverse effects to the mother and child • Additionally, it may be necessary to report C-section rates to accrediting agencies or the AMA for such reasons as residency programs ©2006 All rights reserved.

Cesarean Section • Delivery • The process of delivering a liveborn infant or dead fetus (and placenta) by manual, instrumental, or surgical means • A pregnant mother who delivers has one delivery, however, she may have multiple births • For example, a woman who delivers a liveborn infant is counted as one delivery and one live birth • A woman who delivers liveborn twins is counted as one delivery and two live births • A woman who delivers a stillbirth is counted as one delivery and one fetal death ©2006 All rights reserved.

Cesarean Section • Delivery • A woman may be admitted to the hospital for a condition of her pregnancy, however, she may not deliver her infant during that hospitalization • For example, a patient who is admitted in labor but later discovered that this is an instance of false labor would be classified as an obstetrics patient, not delivered ©2006 All rights reserved.

Consultations • The response by one healthcare professional to another healthcare professional’s request to provide recommendations and/or opinions regarding the care of a particular patient/resident • A patient’s attending physician may occasionally request a consultant (another physician or health care practitioner) to examine a patient and give an opinion as to his/her condition • A consultant will should also review the medical record and then prepare a consultation report that includes the findings of the examination and recommendations for treating the patient ©2006 All rights reserved.

Other Rates • These are reported according to individual healthcare facility needs • May be reported for external agencies • The best rule of thumb is to use the “other rates” formula ©2006 All rights reserved.

Calculating & Reporting Healthcare Statistics