1996 HOSPITAL INPATIENT DISCHARGE DATA (HIDD)

Transcription

1 New Mexico Health Policy Commission Health Information ANNUAL REPORT OF 1996 HOSPITAL INPATIENT DISCHARGE DATA (HIDD) Published February 1998

2 This report was prepared by the Health Policy Commission (HPC) and the Division of Government Research at the University of New Mexico under contract to the HPC. For more information, please contact: New Mexico Health Policy Commission Health Information 41 Don Gaspar Santa Fe, NM 871 () Population estimates used to calculate the rates in this report were obtained from Vital Records and Health Statistics, Office of Information Management, Public Health Division, New Mexico Department of Health. Information on licensed hospitals is obtained from the New Mexico Department of Health, Health Facility Licensing and Certification Bureau.

3 TABLE OF CONTENTS INTRODUCTION NEW MEXICO HOSPITALS REPORTING IN 1996 Map: Non-Federal General and Specialty Hospitals in New Mexico List of Hospitals with City of Location PATIENT DAYS FOR 199 vs Total Patient Days by Modified Major Diagnostic Category (MMDC)... 4 New Mexico Population... Overall Days per 1 State Residents... Days per 1 State Residents for Treatment of Mental Diseases... 6 Days per 1 State Residents for Treatment of Alcohol & Drug Dependency... 6 Map: Rate by County for Treatment of Mental Disease... 7 Map: Rate by County for Treatment of Alcohol & Drug Dependency... 8 Days per 1 State Residents for Treatment of Injuries Days per 1 State Residents for Treatment of Circulatory Diseases Map: Rate by County for Treatment of Injuries Map: Rate by County for Treatment of Circulatory Diseases...11 Days per 1 State Residents for Treatment of Respiratory Diseases Days per 1 State Residents for Treatment of Digestive Diseases Map: Rate by County for Treatment of Respiratory Diseases Map: Rate by County for Treatment of Digestive Diseases Days per 1 State Residents for Treatment of Neoplasms TOP REASONS FOR HOSPITALIZATION 199 vs Ages 18 and Under Ages 19 through Ages 4 through Ages 6 and Over PATIENT DAYS BY PRIMARY PAYER, 1996 Males by Age Group Females by Age Group HOSPITALIZATION AND ETHNICITY (Patient Days per 1 State Residents in ethnic group) All Modified Major Diagnostic Categories Pregnancy and Childbirth Injuries, Poisonings and Burns Endocrine and Metabolic Diseases Respiratory Diseases Circulatory Diseases Digestive Diseases Mental Diseases and Disorders DISCHARGE RATE BY COUNTY FOR MMDC=s, (per 1 County Residents) AMBULATORY CARE SENSITIVE CONDITIONS, 1996 Map: Urban, Small Urban, Rural Counties Ages 18 and Under Ages 19 through Ages 6 and Over...61

4 1 INTRODUCTION The New Mexico Health Information (HIS) was created in 1989 by the Health Information Act (24-14A1-3) and initially placed in the New Mexico Department of Health. In 1992 the HIS was administratively transferred to the New Mexico Health Policy Commission (HPC). During the 1994 legislative session the HIS Act was substantially amended and the HIS responsibilities were placed with the Health Policy Commission. The purpose of the HIS is to collect, analyze, and disseminate health information for the Commission, the Legislature, and other public and private agencies for use in health care planning and policy making. The information also serves to assist consumers in making informed decisions regarding their health care choices. Information is to be collected to assist the Commission in administering, monitoring, and evaluating the implementation of the state health policy. One part of the data collection inititative of the HIS is the Hospital Inpatient Discharge Data (HIDD). The HIS began limited data collection from all licensed, non-federal, general acute care and specialty hospitals with the final calendar quarter of 199. From fourth quarter 199 through 1994, the databases include seven patient variables (age, gender, length of stay, principal diagnosis code, principal procedure code, patient zip code of residence, and patient discharge status). As of 1 January 199, new regulations provided for the expansion of data reporting to 38 variables including payer information and additional clinical information. These additional data permit Commission staff to conduct expanded types of analysis and reporting, including linking with other major health databases to evaluate medical care outcomes, access and appropriateness of health care. A recent review of regulations and data needs resulted in amendments and additional rules promulgated in August With input from data providers, the NM Hospital and Health Association, researchers, plans, and consumers, the HIDD collection was again enhanced. The new information will be collected beginning with the first quarter of 1998 and will include additional diagnosis and procedure codes, principal procedure dates, total charges, physician identifiers, and payer groups and types. The additional data will provide the basis for implementation of a severity of illness adjustment process to better determine health care outcomes, aid in mapping efforts to look at geographic health issues and disease patterns in New Mexico, and expand consumer health information reports to help all New Mexicans make informed decisions on health care.

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6 General Hospitals Reporting to HIDD in Hospital City 1. Artesia General Hospital Artesia 2. Cibola General Hospital Grants 3. DeBaca General Hospital Ft. Sumner 4. Dr. Dan Trigg Memorial Hospital Tucumcari. Eastern New Mexico Medical Center Roswell 6. Espanola Hospital Espanola 7. Gerald Champion Memorial Hospital Alamogordo 8. Gila Regional Medical Center Silver City 9. Guadalupe County Hospital Santa Rosa 1. Guadalupe Medical Center Carlsbad 11. Holy Cross Hospital Taos 12. Lea Regional Hospital Hobbs 13. Lincoln County Medical Center Ruidoso 14. Los Alamos Medical Center Los Alamos. Lovelace Health s, Inc. Albuquerque 16. Memorial Medical Center Las Cruces 17. Mimbres Memorial Hospital Deming 18. Miners= Colfax Medical Center Raton 19. Nor-Lea Hospital District Lovington 2. Northeastern Regional Hospital Las Vegas 21. Plains Regional Medical Center - Clovis Clovis 22. Plains Regional Medical Ce nter - Portales Portales 23. Presbyterian Hospital Albuquerque 24. Presbyterian Kaseman Hospital Albuquerque 2. Rehoboth McKinley Christian Hospital Gallup 26. San Juan Regional Medical Center Farmington 27. Sierra Vista Hospital Truth or Consequences 28. Socorro General Hospital Socorro 29. St. Joseph Medical Center Albuquerque 3. St. Joseph NE Heights Hospital Albuquerque 31. St. Joseph West Mesa Hospital Albuquerque 32. St. Vincent Hospital Santa Fe 33. Union County General Hospital Clayton 34. University of New Mexico Hospital Albuquerque Specialty Hospitals Reporting to HIDD in 1996 Hospital City 1. Alliance of Santa Teresa Santa Teresa 2. Buena Vista Rehabilitation Clovis 3. Carrie Tingley Hospital Albuquerque 4. Charter-Heights BHS NE Albuquerque. Desert Hills Center for Youth and Families Albuquerque 6. Healthsouth Rehabilitation Hospital Albuquerque 7. Horizon Specialty Hospital-Albuquerque Albuquerque 8. Interface-The Rehab Center Farmington 9. Las Vegas Medical Center Las Vegas 1. Lovelace Health s, Park Center Albuquerque 11. Memorial Hospital Albuquerque 12. Mesilla Valley Hospital (youth) Las Cruces 13. Mesilla Valley Hospital (adult) Las Cruces 14. New Mexico Rehabilitation Center Roswell. Northern New Mexico Rehab Center Las Vegas 16. Northern New Mexico Midwifery Center Taos 17. Pinon Hills Hospital Santa Fe 18. Rehoboth McKinley Christian Health/BHS Gallup 19. St. Joseph Rehab Hospital Albuquerque 2. THC-Albuquerque Albuquerque 21. Turquoise Lodge Albuquerque

7 PATIENT DAYS PER 1 STATE RESIDENTS, 199 vs While the New Mexico population and total number of discharges both increased, the total number of patient days decreased between 199 and The largest decrease in both total patient days and the hospitalization rate per 1 state residents was for alcohol and drug abuse. However, the hospitalization rate for substance abuse for males under one year of age more than doubled (from 3 to 7) between 199 and In 1996, males ages 3 to 44 accrued the greatest number of days for substance abuse, a shift from 199 when males ages 2 to 34 had the greatest number of days in a treatment facility. For treatment of injuries, males showed a 2% decline in usage rate while females showed a 3% increase between 199 and The hospitalization rate for circulatory disease increased for males under one year of age and those over 8 years old. Total patient days for respiratory disease increased for most age groups for both males and females. The biggest shift in hospitalization rates for digestive diseases occured in the over 8 age group with males showing a 36% decrease and females showing a 1% increase. Overall the hospitalization rate for neoplasms increased about 2%, however females over 8 showed a 33% increase from 199 to METHODOLOGY NOTE: The AInjury@ category includes injuries, poisonings, and burns.

8 HOSPITAL INPATIENT DISCHARGE DATA (HIDD) REPORT All non-federal, licensed general and specialty hospitals report limited inpatient discharge data on each patient to the New Mexico Health Policy Commission. An inpatient discharge occurs when a person who was admitted to a hospital leaves that hospital. There are 34 general hospitals and 21 specialty hospitals in New Mexico, which are shown on the map on th e 1 preceding page. The general and specialty hospitals reported a total of 184,971 discharges of New Mexico residents in In 199 there were 181,394 reported discharges of New Mexico residents. Discharges of out-of-state residents and discharges with unknown or missing ZIP codes were not included in this report. This report was prepared by the Division of Government Research at the University of New Mexico for the New Mexico Health Policy Commission under contract. The chart and figures that follow represent a synopsis of these data. For more information, please contact: New Mexico Health Policy Commission Health Information 41 Don Gaspar Santa Fe, NM 871 () TOTAL PATIENT DAYS BY DIAGNOSTIC CATEGORY FOR 199 vs Included in this report were a total of 923,3 patient days in 199, and 899,994 patient days in The breakdown of these 2 patient days is displayed below. The categories which are represented in the charts above (and the accompanying figures) are based on a modification of the Major Diagnostic Categories (MDCs) which separa tes injuries and neoplasms into their own unique groupings. Conventional MDCs distribute these diagnoses across other categories by body site, which obscures their impact. Under the conventional MDCs, only 1,912 patient days in 199 were attributable to injuries. 1 One specialty hospital did not report acceptable Hospital Inpatient Discharge Data to the New Mexico Health Policy Commission for Patient days for the treatment of Mental Diseases & Disorders are artificially low in comparison with data from years previous to 199 as the Forensic unit at the State Mental Hospital no longer reports to the HIDD system because of Federal Regulations concerning patient privacy.

9 NEW MEXICO POPULATION, 199 vs These figures are a comparative summary of the state population by age and gender. These population estimates were used to compute the various rates which appear in the figures that follow. The total population of the state increased from 1,68,41 in 199 to 1,713,412 in This represents a 1.6% increase over a one year period Female Male Female Male 11,6 37,242 9,999 68,73 98,8 134, ,12 12, ,16,8 13, Under 1,423 2,643 1,8 62,87 94,66 129, , , ,341 7,62 13,828 11,674 37,3 9,929 69,987 11, ,61 13, ,14 13,42,3 13, Under 1,6 26,2 1,93 64,31 96, ,314 13, , ,183 8,42 13,7 8, Total, 7, 7,, 829, ,6 Total, 7, 7,, 842,46 OVERALL PATIENT DAYS PER 1, STATE RESIDENTS, 199 vs The figures below show the rates for hospital usage (in patient days) for all causes. The highest rates of usage per 1, state residents were consistent for both time periods for people over the age of 6. Schizophrenic Disorders and Rehabilitation Procedures accounted for the largest number of patient days for both males and females in these age groups. Females between the ages of and 34 had the second highest hospital usage rate, primarily for normal deliveries. Males under 1 and between the ages of 4 and 64 and females under 1 and over the age of 6 showed a slight increase in hospital use while all other groups show a decline. Female Male Female Male 3,6 8+ 4,41 3, 8+ 3,964 1, ,22 1, ,1 1, ,122 1, , Under Under 1 63, 2, 2,,, 2, 2,,

10 6 PATIENT DAYS PER 1, STATE RESIDENTS FOR THE TREATMENT OF MENTAL DISEASES, 199 vs These figures display the rates for hospital usage (in patient days) for the treatment of all varieties of mental diseases/disorders. Discharges for people between the ages of and 24 are proportional to their population, as they make up approximately 31 percent of the population and 3 percent of all discharges for mental diseases in 199 and 37 percent in 199. As stays for mental diseases tend to be lengthy this age group, they accounted for 9 percent of all patient days in 199 and 1 percent in The average rate of hospital usage remained fairly constant from 199 to 1996 with a slight decline for both Males and Females in most age groups Female Male Female Male Under 1 Under PATIENT DAYS PER 1, STATE RESIDENTS FOR THE TREATMENT OF ALCOHOL AND DRUG DEPENDENCY, 199 vs The comparative rates for hospital usage (in patient days) for the treatment of alcohol and other drug dependency problems are illustrated in the figure below. There are several noteworthy trends: 1) major reductions in the rate of hospital usage (in patient days) for most age categories; 2) males aged 2 to 34 years no longer accrue the greatest number of days spent in a treatment facility, instead males aged 3 to 44 accrue the greatest number of days spent in a treatment facility; and 3) with the exception of males aged 7 years and older all other age groups of both genders demonstrated slight to moderate declines in the duration of hospital stays for alcohol and drug dependency problems from 199 to Female Male Female Male Under 1 3 Under

11 Patient Days Per 1, State Residents for the Treatment of Mental Diseases, 1996 San Juan Rio Arriba Taos Colfax Union Name Ment_rate McKinley Catron Grant Cibola Luna Sierra Sandoval Bernalillo Valencia Socorro Dona Ana Los Alamos Santa Fe Torrance Otero Lincoln Mora San Miguel Guadalupe De Baca Chaves Eddy Harding Quay Curry Roosevelt Lea Bernalillo Valencia Colfax Sierra Grant Torrance Rio Arriba Socorro Eddy Cibola Hidalgo Sandoval Lincoln San Miguel San Juan Chaves Santa Fe Luna Otero Dona Ana McKinley Curry Guadalupe Lea Taos Los Alamos Catron Roosevelt Mora Quay Union De Baca Harding Hidalgo Patient Days Per 1, Residents

12 Patient Days Per 1, State Residents for the Treatment of Drug & Alcohol Dependency, 1996 San Juan Rio Arriba Taos Colfax Union Name Alc_rate McKinley Catron Grant Cibola Luna Sierra Sandoval Bernalillo Valencia Socorro Dona Ana Los Alamos Santa Fe Torrance Otero Lincoln Mora San Miguel Guadalupe De Baca Chaves Eddy Harding Quay Curry Roosevelt Lea McKinley Lincoln San Juan Valencia Bernalillo Chaves Rio Arriba Cibola Catron Grant Guadalupe Sierra Sandoval Socorro De Baca Dona Ana Otero Quay Santa Fe Lea Curry Eddy Taos Torrance Hidalgo Colfax Luna San Miguel Roosevelt Los Alamos Union Harding Mora Hidalgo Patient Days Per 1, Residents

13 9 PATIENT DAYS PER 1, STATE RESIDENTS FOR THE TREATMENT OF INJURIES, 199 vs These figures below show the comparative rates of hospital usage (in patient days) for the treatment of all varieties of injuries. There are several important trends: 1) the average rate of hospital usage for the treatment of injuries declined slightly from 199 to 1996; 2) between 199 and 1996, males showed a 2 percent decline in the total number of days spent in treatment for an injury, while females demonstrated an 3 percent increase Female Male Female Male Under Under PATIENT DAYS PER 1, STATE RESIDENTS FOR THE TREATMENT OF CIRCULATORY DISEASES, 199 vs The rates of hospital usage (in number of patient days) for the treatment of cardiovascular diseases/disorders are displayed below. The patterns of hospital usage are very similar between 199 and It should be noted however, that the rates of hospital usage for these diseases/disorders increased from 199 to 1996 for males under 4, between the ages of 4-64, and over 8 and females aged years and older. 199 Female Male Female Male Under Under

14 Patient Days Per 1, State Residents for the Treatment of Injuries, 1996 San Juan Rio Arriba Taos Colfax Union Name Inj_rate McKinley Catron Grant Cibola Luna Sierra Sandoval Bernalillo Valencia Socorro Dona Ana Los Alamos Santa Fe Torrance Otero Lincoln Mora San Miguel Guadalupe De Baca Chaves Eddy Harding Quay Curry Roosevelt Lea Guadalupe Sierra Chaves Mora San Juan De Baca Rio Arriba San Miguel Taos Quay Socorro Luna Eddy Lincoln McKinley Santa Fe Valencia Bernalillo Cibola Sandoval Dona Ana Grant Torrance Union Hidalgo Otero Colfax Curry Roosevelt Harding Los Alamos Catron Lea Hidalgo Patient Days Per 1, Residents

15 Patient Days Per 1, State Residents for the Treatment of Circulatory Diseases, 1996 San Juan Rio Arriba Taos Colfax Union Name Circ_rate McKinley Catron Grant Cibola Luna Sierra Sandoval Bernalillo Valencia Socorro Dona Ana Los Alamos Santa Fe Torrance Otero Lincoln Mora San Miguel Guadalupe De Baca Chaves Eddy Harding Quay Curry Roosevelt Lea Sierra Harding Luna De Baca Chaves Colfax Grant Quay Guadalupe Valencia San Juan Eddy Curry Lincoln Socorro Otero Torrance Bernalillo Rio Arriba Mora Dona Ana Taos Catron Union Cibola Sandoval San Miguel Santa Fe Hidalgo Los Alamos McKinley Roosevelt Lea Hidalgo Patient Days Per 1, Residents

16 12 PATIENT DAYS PER 1, STATE RESIDENTS FOR THE TREATMENT OF RESPIRATORY DISEASES, 199 vs These figures represent the rates of hospital usage (in patient days) for the treatment of respiratory diseases. While the patterns of hospital usage appear to be very similar between 199 and 1996, the actual total number of patient days for males and females increased by 2 percent and 3 percent respectively. In the Under 1" category males exhibited an increase of about 2 percent in the rate of hospital usage for respiratory diseases and females about 2 percent from 199 to The largest number of patient days for patients under 1 for both sexes was noted in stays for the treatment of Short Gestation/Low Birth weight and Acute Bronchitis Female Male Female Male , Under Under 1 3 1, 1, 1, 1, Female PATIENT DAYS PER 1, STATE RESIDENTS FOR THE TREATMENT OF DIGESTIVE DISEASES, 199 vs The figures below summarize data from 199 and 1996 for the rates of hospital usage (in patient days) spent in treatment for digestive diseases/disorders. Males in the 8+ category showed a 36 percent decrease in the rate of hospital usage wherea s females in the same category showed a 1 percent increase. Overall, the total number of patient days spent in a hospital for these diseases/disorders increased slightly by about 3 percent from 199 to Under 1 Male Female Under 1 Male

17 Patient Days Per 1, State Residents for the Treatment of Respiratory Diseases, 1996 San Juan Rio Arriba Taos Colfax Union Name Resp_rate McKinley Catron Grant Cibola Luna Sierra Sandoval Bernalillo Valencia Socorro Dona Ana Los Alamos Santa Fe Torrance Otero Lincoln Mora San Miguel Guadalupe De Baca Chaves Eddy Harding Quay Curry Roosevelt Lea Colfax Lea San Miguel Luna Sierra Union Socorro De Baca Eddy Chaves Guadalupe Roosevelt Rio Arriba Grant Catron Curry Mora Harding Quay Hidalgo San Juan Taos Lincoln Bernalillo Otero Torrance Valencia McKinley Cibola Dona Ana Sandoval Los Alamos Santa Fe Hidalgo Patient Days Per 1, Residents

18 Patient Days Per 1, State Residents for the Treatment of Digestive Diseases, 1996 San Juan Rio Arriba Taos Colfax Union Name Dig_rate McKinley Catron Grant Cibola Luna Sierra Sandoval Bernalillo Valencia Socorro Dona Ana Los Alamos Santa Fe Torrance Otero Lincoln Mora San Miguel Guadalupe De Baca Chaves Eddy Harding Quay Curry Roosevelt Lea Colfax Socorro Quay Sierra San Miguel Lincoln Mora Eddy Luna Curry Rio Arriba Grant Union Guadalupe Bernalillo Otero Valencia Chaves De Baca Roosevelt Harding Hidalgo San Juan Lea Santa Fe Dona Ana Taos Cibola Catron Sandoval Torrance Los Alamos McKinley Hidalgo Patient Days Per 1, Residents

19 PATIENT DAYS PER 1, STATE RESIDENTS FOR THE TREATMENT OF NEOPLASMS, 199 vs The figures below summarize data from 199 and 1996 for the rates of hospital usage (in patient days) spent in treatment for diseases/disorders involving neoplasms. While the patterns of hospital usage appear to be very similar between 199 and 1996, and most age groups of both sexes had static or slightly decreased us age rates, females in the 8+ category showed a 33% increase. Total patient days spent in treatment for these diseases/disorders increased approximately 2 percent from 199 to Female Male Female Male Under Under

20 TOP REASONS FOR HOSPITALIZATIONS, 199 vs There were no major shifts in the top 2 reasons for hospitalization within each age group from 199 to Ages 18 and under showed few differences between males and females with bronchitis, asthma and pneumonia being among the top reasons for hospitalizations. Ages 6 and over also showed few differences between males and females; however the most frequent reasons for hospitalization in this age group included pneumonia, heart disease and stroke (CVA). In the age group from 19 to 44 years old, females were most frequently hospitalized for pregnancy related diagnoses and males for substance abuse problems. In the 4 to 64 year old age group, heart disease was a frequent problem for males, while the number one diagnosis for females was cholelithiasis (gall bladder disorder). Diabetes appeared as a top 2 reason for hospitalization among all age groups of males in 1996.

21 Top 2 Reasons for Hospitalization 16 Frequency By Diagnosis - Ages 18 & Under 1996 Rank Females # of Discharges Males # of Discharges 1 Acute Bronchitis 622 Acute Bronchitis Perineal Trauma with Delivery 62 Affective Psychoses 21 3 Affective Psychoses 4 Pneumonia Normal Delivery 487 Asthma 46 Early/Threatened Labor 446 Acute Appendicitis 3 6 Pneumonia 413 Fluid/Electrolyte Disorder 29 7 Asthma 328 Viral Pneumonia 29 8 Fluid/Electrolyte Disorder 263 General Symptoms Oth Fetal PBX Aff Mother 29 Hyperkinetic Syndrome Acute Appendicitis 27 Depressive Disorder Viral Pneumonia 224 Oth Perinatal Jaundice Hypertension Compl Preg 27 Conduct Disturbance General Symptoms 198 Ac Laryngitis/Tracheitis Oth Compl w/ Labor/Del 19 Emotional Dis Child/Adol 122 Oth Current Cond in Pregnancy 184 Oth Noninf Gastroenteritis Depressive Disorder 18 Drug Dependence Kidney Infection 178 Adjustment Reaction Adjustment Reaction 7 Short Gestation/Low Birthweight Umbilical Cord Comp 7 Oth Respiratory Cond 11 2 Oth Amniotic Cavity Prob 2 Oth Abdomen/ Pelvis SX 9 21 Abnormal Forces of Labor 14 Diabetes Milletus Oth Comp of Pregnancy 144 Chr T & A Disease Oth Noninf Gastroenteritis 127 Intestinal Infection Chr T & A Disease 118 Oth Nonorganic Psychoses 8 2 Oth Abdomen/Pelvis SX 114 Vir/Chlamyd Inf Rank Females # of Discharges Males # of Discharges 1 Affective Psychoses 61 Acute Bronchitis 64 2 Perineal Trauma with Delivery 46 Pneumonia 89 3 Early/Threatened Labor 37 Affective Psychoses 7 4 Normal Delivery 492 Asthma 16 Pneumonia 42 Acute Appendicitis Acute Bronchitis 41 Fluid/Electrolyte Disorder 33 7 Asthma 341 Conduct Disturbance 22 8 Fluid/Electrolyte Disorder 298 General Symptoms Oth Fetal PBX Aff Mother 21 Viral Pneumonia 2 1 Acute Appendicitis 24 Hyperkinetic Syndrome Hypertension Compl Preg 214 Ac Laryngitis/Tracheitis Oth Current Cond in Preg 27 Adjustment Reaction Oth Amniotic Cavity Prob 2 Oth Noninf Gastroenteritis General Symptoms 196 Oth Perinatal Jaundice 138 Adjustment Reaction 179 Short Gestation/Low Birthweight Viral Pneumonia 6 Drug Dependence Kidney Infection Emotional Dis Child/Adol Oth Compl w/ Labor/Del Oth Respiratory Cond 1 19 Oth Comp of Pregnancy 146 Vir/Chlamyd Inf CCE 99 2 Oth Noninf Gastroenteritis 138 Oth Cellulitis/Abcess Umbilical Cord Compl 131 Oth Abdomen/ Pelvis SX Abnormal Forces of Labor 129 Intestinal Infection Short Gestation/Low Birthweight 122 Neurotic Diseases Oth Abdomen/Pelvis SX 18 Chr T & A Disease 78 2 Oth Perinatal Jaundice 13 Septicemia 7

22 17 Top 2 Reasons for Hospitalization Frequency By Diagnosis - Ages Rank Females # of Discharges Males # of Discharges 1 Perineal Trauma with Delivery 4,27 Alcohol Dependence Synd Normal Delivery 3,123 Affective Psychoses Early/Threatened Labor 2,436 Schizophrenic Disorders Oth Fetal PBX Aff Mother 1,874 Drug Dependence 64 Abn Pelvic Organ in Preg 1,424 Acute Appendicitis Oth Current Cond in Pregnancy 1,4 Intervertebral Disc Dis 33 7 Hypertension Compl Preg 1,333 Resp Syst/Oth Chest SX 3 8 Oth Amniotic Cavity Prob 1,163 Diabetes Mellitus Cholelithiasis 1,2 Oth Cellulitis/Abscess Abnormal Forces of Labor 1, Pneumonia Affective Psychoses 969 Diseases of the Pancreas Umbilical Cord Compl 883 Renal/Urethral Calculus Oth Comp of Labor/Del 84 General Symptoms Malposition of Fetus 74 Cholelithiasis 24 Obstructed Labor 6 Chr Liver Dis/Cirrhosis Uterine Leiomyoma 631 Alcoholic Psychoses Prolonged Pregnancy 66 Acute Myocardial Infarction (AMI) Oth Comp of Pregnancy 63 HIV Disease 19 Endometriosis 482 Diseases of the Esophagus 3 2 Female Genital Symptoms 34 Adjustment Reaction 21 Oth Obstetrical Trauma 343 Oth Nonorganic Psychoses Disorder of Menstruation 341 Oth Abdomen/Pelvis SX Drug Dependence 33 Nondependent Drug Abuse Oth Abdomen/Pelvis SX 333 Asthma Alcohol Dependence Synd 326 Depressive Disorder Rank Females # of Discharges Males # of Discharges 1 Perineal Trauma w/ Delivery 3,662 Alcohol Dependence Normal Delivery 3,223 Drug Dependence 77 3 Early/Threatened Labor 2,3 Affective Psychoses 76 4 Oth Fetal PBX Aff Mother 1,72 Schizophrenic Disorders 633 Oth Current Cond in Preg 1,36 Acute Appendicitis Abn Pelvic Organ in Preg 1,3 Intervertebral Disc Dis Hypertension Comp Preg 1,33 Resp/Oth Chest SX Oth Amniotic Cavity Prob 1,142 Other Cellulitis/Abcess Affective Psychoses 1,6 Diabetes Milletus 27 1 Abnormal Forces of Labor 1,2 Pneumonia 2 11 Cholelithiasis 1,2 Renal/Urethral Calculus Oth Comp Labor/ Delivery 818 General Symptoms Umbilical Cord Comp 76 Acute Myocardial Infarction (AMI) Malposition of Fetus 7 Diseases of the Pancreas 178 Uterine Leiomyoma 66 Cholelithiasis Obstructed Labor 626 Nondependent Drug Abuse Oth Comp of Preg 67 HIV Disease Prolonged Pregnancy 8 Adjustment Reaction 9 19 Endometriosis 4 Oth Nonorganic Psychoses Disorder of Menstruation 413 Alcoholic Psychoses Drug Dependence 398 Diseases of the Esophagus Alcohol Dependence Syndrome 366 Oth Abdomen/Pelvic SX Oth Obstetrical Trauma 37 Chr Liver Dis/Cirrhosis Noninfl. Disorder of A. Uterine 3 Intestinal Obstruction 16 2 Asthma 333 Other Joint Derangement 13

23 Top 2 Reasons for Hospitalization 18 Frequency By Diagnosis - Ages Rank Females # of Discharges Males # of Discharges 1 Cholelithiasis 677 Oth Ischemic Hrt Dis Resp Syst/Oth Chest SX 668 Acute Myocardial Infarction (AMI) Uterine Leiomyoma 467 Resp Syst/Oth Chest SX Oth Chr Ischemic Hrt Dis 424 Diabetes Milletus 42 Affective Psychoses 414 Alcohol Dependence Syndrome 38 6 Pneumonia 392 Pneumonia 3 7 Diabetes Milletus 34 Cholelithiasis 38 8 Genital Prolapse 329 Heart Failure Mal Neopl Female Breast 323 Cardiac Dysrhythmias Osteoarthrosis et al 322 General Symptoms Acute Myocardial Infarction (AMI) 321 Intervertebral Disc Dis Asthma 267 Affective Psychoses Heart Failure 24 Osteo Arthrosis, et al Chronic Bronchitis 221 Oth Ac Ischemic Heart Dis 226 Cardiac Dysrhythmias 22 Renal/Urethral Calculus Female Genital Symptoms 214 Chr Liver Dis/Cirrhosis Schizophrenic Disorders 28 Oth Cellulitis/ Abscess Fluid/Electrolyte Disorders 196 Chr Bronchitis Intestinal Obstruction 191 Mal Neopl Prostate General Symptoms 186 Diseases of Pancreas 21 Oth Abdomen/Pelvis SX 177 Inguinal Hernia 4 22 Intervertebral Disc Dic 176 Fluid/Electrolyte Disorder Oth Cellulitis/Abscess 1 Hyperplasia of Prostate Disorder of Menstruation 148 Diseases of the Esophagus 13 2 Oth Venous Thrombosis 14 Schizophrenic Disorders Rank Females # of Discharges Males # of Discharges 1 Cholelithiasis 68 Acute Myocardial Infarction (AMI) Resp Syst/Oth Chest SX 88 Oth Ischemic Hrt Dis Uterine Leiomyoma 48 Resp Syst/Oth Chest SX 61 4 Affective Psychoses 442 Alcohol Dependence Synd 362 Pneumonia 374 Cholelithiasis Oth Chr Ischemic Hrt Dis 339 Diabetes Milletus Mal Neopl Female Breast 337 Pneumonia 32 8 Genital Prolapse 32 Heart Failure 27 9 Diabetes Milletus 321 Intervertebral Disc Dis Acute Myocardial Infarction (AMI) 289 Cardiac Dysrhythmias Asthma 26 Affective Psychoses Osteoarthrosis et al 261 Oth Ac Isch Hrt Dis Heart Failure 244 General Symptoms Female Genital Symptoms 211 Mal Neopl Prostate 194 Fluid/Electrolye Disorder 29 Osteoarthrosis et al Cardiac Dysrhythmias 197 Chr Liver Dis/Cirrhosis Intervertebral Disc Dis 186 Renal/Urethral Calculus Chronic Bronchitis 177 Oth Cellulitis/ Abscess General Symptoms 17 Chr Bronchits 8 2 Septicemia 167 Diverticula of Intestine Schizophrenic Disorders 166 Hyperplasia of Prostate Disorder of Menstruation 2 Fluid/Electrolyte Dis Intestinal Obstruction 146 Diseases of Esophagus Oth Abdomen/Pelvis SX 146 Ac Appendicitis Diverticula of Intestine 138 Schizophrenic Dis 122

24 19 Top 2 Reasons for Hospitalization Frequency By Diagnosis - Ages 6 & Over 1996 Rank Females # of Discharges Males # of Discharges 1 Pneumonia 1,364 Pneumonia 1,18 2 Heart Failure 1,363 Acute Myocardial Infarction (AMI) 1,7 3 Osteoarthritis et al 942 Heart Failure 1,4 4 Fluid/Electrolyte Disorder 766 Oth Chr Ischemic Heart Dis 1,8 Oth Chr Ischemic Hrt Dis 748 Cardiac Dysrhythmias Acute Myocardial Infarction (AMI) 746 Osteoarthrosis et al 41 7 Cardiac Dysrythmias 721 Hyperplasia of Prostate 13 8 Resp Syst Oth Chest SX 649 Chr Bronchitis Cholelithiasis 7 Oth Bacterial Pneumonia 43 1 Chronic Bronchitis 6 Resp Syst/Oth Chest SX General Symptoms 26 General Symptoms Oth Urinary Tract Disorder 49 Cholelithiasis Intestinal Obstruction 442 Fluid/Electrolyte Disord Cerebral Artery Occlusion 434 Septicemia 3 Septicemia 413 Cerebral Artery Occlusion Diabetes Milletus 41 Mal Neopl Prostate Cataract 382 Intestinal Obstruction 3 18 Diverticula of Intestine 378 Diabetes Milletus Oth Bacterial Pneumonia 374 Oth Urinary Tract Disord 34 2 Genital Prolapse 341 Precerebral Occlusion 3 21 Oth Bone/Cart Disorder 341 Oth Ac Ischemic Heart Dis CVA (stroke) 324 Oth Lung Diseases Mal Neopl Female Breast 314 Cataract Oth Lung Diseases 3 CVA (stroke) 21 2 Oth Venous Thrombosis 268 Inguinal Hernia Rank Females # of Discharges Males # of Discharges 1 Heart Failure 1,286 Pneumonia 1,133 2 Pneumonia 1,29 Heart Failure Osteoarthrosis et al 822 Acute Myocardial Infarction (AMI) Acute Myocardial Infarction (AMI) 7 Oth Chr Ischemic Hrt Dis 83 Fluid/Electrolyte Disorder 73 Cardiac Dysrhythmias 71 6 Cardiac Dysrhythmias 666 Hyperplasia of Prostate 7 Resp Syst/Oth Chest SX 63 Osteoarthrosis et al Oth Chr Ischemic Hrt Dis 613 Chronic Bronchitis Cholelithiasis 62 Resp Syst/ Oth Chest SX Chronic Bronchitis 48 Oth Bacterial Pneumonia Oth Urinary Tract Disord 441 Fluid/Electrolyte Dis Intestinal Obstruction 417 Cholelithiasis General Symptoms 4 General Symptoms Cerebral Artery Occlusion 392 Septicemia 339 Septicemia 388 Oth Urinary Tract Disord Cataract 367 Cerebral Artery Occlusion Diabetes Mellitus 34 Oth Ac Ischemic Hrt Dis Oth Bacterial Pneumonia 339 Diabetes Mellitus Oth Bone/Cart Disorder 332 Intestinal Obstruction 3 2 Genital Prolapse 322 Mal Neopl Prostate CVA (stroke) 31 Precerebral Occlusion Diverticula of Intestine 299 Oth Lung Diseases Mal Neopl Female Breast 289 CVA (stroke) Gastrointestinal Hemorrage 281 Gastrointestinal Hemorrage Oth Acute Ischemic Hrt Dis 28 Cataract 26

25 PATIENT DAYS BY PRIMARY PAYER For ages 18 and under, there were no major differences between males and females with Medicaid being the most frequently used source of payment (8% - 6%), private insurance paying about 32% of the time, and Medicare use almost non-existent. In the age group from 19 to 64 years old, private insurance accounts for the largest number of patient days for both males and females (4% - 46%); however, Medicaid is second in number of patient days for females (28%) while AAll Others@ is second for males (24%). For males ages 19-64, Medicare paid for more actual discharges than Medicaid, however those Medicare discharges accounted for fewer total patient days than did the Medicaid discharges. For females in the same age group, Medicaid paid for a larger number of patient days as well as a greater number of discharges than did Medicare. As expected in the 6 and over age group, Medicare accounts for the largest number of patient days for both males and females (73% - 79%) with private insurance accounting for most of the balance of the patient days (19% - 23%). METHODOLOGY NOTE: The category AAll Others@ includes IHS/PHS, CHAMPUS/VA/Military, Law Enforcement, Workers= Comp, Self Pay, and Charity.

26 Paycat % total days Patient Days by Primary Payer, 1996 For Males Ages 18 & Under Medicare.12% Medicaid 6.2% Private Insurance 32.% Private Patient Dis- All Others 7.6% Insurance Days charges 32% Medicare All Others Medicaid 63,416 1,634 Los Total %total days 8% Private 33,763 8,232 Medicare Medicare Insurance Medicaid % All others 8, 2,417 Pricate Insurance Total,363 21,31 All others Medicaid % Patient Days by Primary Payer, 1996 For Males -64 Years of Age Medicare 14.% Medicaid 16.% Patient Dis- Private Insurance 4.6% Days charges All Others All Others 24% 24% Medicare 2,33 4,3 los totlos %totlos Medicaid 29,691 2,91 Medicare 2,33 18, Private 82,22,87 Medicaid 29,691 18, Insurance Private Insurance Private 82,22 18, Medicare All others 43,6 7,7 All Others Insurance 43,6 18, % Total 18,27 3,71 4% 18,27 For Males Ages Medicaid 17% Medicare 73.% Medicaid Patient Days 2.% by Primary Payer, 1996 For Males Ages 6 & Over Private Insurance 23.% All others 1.6% los totlos %totlos Private Patient Dis- Medicare Medicaid 99,48 136,31 Insurance 72.9% Days charges Medicaid 2% 2,69 136,31 23% 2.% Medicare 99,48 16,68 All others Private Insurance 32,91 136,31 23.% Medicaid 2, % All others 2,22 136,31 1.6% Private 32,91, ,31 Insurance All others 2, Total 136,31 22,197 Medicare 73%

27 21 Paycat % total days Patient Days by Primary Payer, 1996 Medicare For.4% Females Ages 18 and Under Medicaid 8.3% Private Insurance 32.2% Patient Dis- All Others 8.9% Days charges All Others Medicare 9% Medicare % Medicaid 1,1 11,944 Los Total %total days Private 28,24 8,414 Medicare Insurance Private Insurance Medicaid All others 7,849 2,62 32% Medicaid Pricate Insurance % Total 87,88 23,3 All others For Females Patient Years Days of Age by Primary Payer, 1996 Medicare For Females Ages % Medicaid 27.6% Patient Dis- Private Insurance 47.1% Days charges All Others All Others 16% Medicare 2,144 3,271 16% los totlos %totlos Medicare Medicaid 8,347 16,398 Medicare 2,144 21, % Private 99,41 3,2 Medicaid 8,347 21, Insurance Private Private Insurance 99,41 21, All others 32,991 8,62 Insurance All Others 46% 32,991 21, Total 21,883 8,21 21,883 Medicaid 28% Medicare 78.4% Patient Days by Primary Payer, 1996 Medicaid 1.% For Females Ages 6 & Over Private Insurance 19.2% All others 1.1% Private los Medicaid totlos %totlos Patient Dis- Insurance Medicare 142,92 1% 182, % 19% Days charges Medicaid 2,61 182,631 1.% All others Medicare 142,92 22,787 Private Insurance 3,91 182, % 1% Medicaid 2, All others 1, , % Private 3,91 6,66 182,631 Insurance All others 1,964 3 Medicare Total 182,631 29,464 79%

28 PATIENT DAYS BY ETHNICITY, 199 vs.1996 Overall, Anglos had the highest number of patient days per 1 population, followed by African Americans, then Hispanics. Pregnancy related patient days increased for both African Americans and Hispanics, but was relatively constant for Native Americans and Anglos. Mental illness related hospital days declined for all ethnicities, but relatively more decrease occurred for African Americans, followed by Hispanics. METHODOLOGY NOTES: C The Modified Major Diagnosis Category (MMDC) for AInjury@ includes all injuries, poisonings, and burns. C C C Since Indian Health Service (IHS) does not report discharges to the Health Information (HIS), the patient days for Native Americans are under reported by varying amounts for all categories. Ethnicity is reported to the HIS by the hospitals and is largely selfreported. All hospitalization rates were calculated per 1 State residents (based on ethnic group) except for the treatment of pregnancy and childbirth. In the latter case the number of female residents of New Mexico under the age of 6 was used as the denominator.

29 22 HOSPITALIZATION AND ETHNICITY The following charts demonstrate the variable morbidity which different conditions have on New Mexicans according to their ethnicity as measured by patient days of hospitalization. Ethnicity is reported to the Health Information by hospitals and is largely self-reported. Since Indian Health Service (IHS) hospitals do not report discharges to the Health Information, the patient days for Native Americans are under reported by varying amounts for all categories. It should be noted that data reported include only those hospitalizations of New Mexicans in New Mexico hospitals. Patient Days per 1, Population for the Treatment of All Modified Major Diagnostic Categories (MMDCs) by Ethnicity 199 vs Rate per 1, Population b African American Hispanic Native American Anglo Patient Days per 1, Female Population for the Treatment of Pregnancy & Childbirth by Ethnicity 199 vs Rate per 1, Population African American Hispanic Native American Anglo

30 23 Injuries & Poisonings MDC=21 Patient African Days AmHispanic per 1, Native Population AmeAnglo for the Treatment of Injuries 42.8 & Poisonings 6.6 by Ethnicity vs Rate per 1, Population African American Hispanic Native American Anglo Rate per 1, Population Endocrine Patient & Metabolic Days Disease per 1, Population MDC=1 for the Treatment of African Endocrine AmHispanic & Metabolic Native Diseases AmeAngloby Ethnicity vs Respiratory MDC=4 African AmHispanic Native AmeAnglo African American Hispanic Native American Anglo Patient Days per 1, Population for the Treatment of Respiratory Diseases by Ethnicity 199 vs Rate per 1, Population African American Hispanic Native American Anglo

31 24 Rate per 1, Population Patient Days per 1, Population for the Treatment of Circulatory Circulatory Diseases mmdc= by Ethnicity African AmHispanic 199 Native vs. AmeAnglo African American Hispanic Native American Anglo Rate per 1, Population Patient Digestive Days per 1, Population mmdc=6 for the Treatment of Digestive African AmHispanic Diseases by Native Ethnicity AmeAnglo vs mental mmdc= African AmHispanic Native AmeAnglo African American Hispanic Native American Anglo Patient Days per 1, Population for the Treatment of Mental Diseases & Disorders by Ethnicity 199 vs Rate per 1, Population African American Hispanic Native American Anglo

32 DISCHARGE RATE BY COUNTY FOR MMDC=s, Eddy, Guadalupe and Hidalgo counties, although with higher than average overall hospitalization rates the past three years, are showing a steady decline in rates for most Modified Major Diagnosis Categories (MMDC=s). Dona Ana and San Juan counties with overall hospitalization rates below the state average are demonstrating an upward trend in hospitalization rates. The county with the highest rate of hospitalization in 1996 for circulatory disease is Sierra County; for injury and poisoning, Guadalupe County; for respiratory system diseases and disorders, Lea County; for digestive system diseases and disorders, Quay County; for mental diseases and disorders, Grant, Hidalgo, and San Miguel Counties share the highest rate (7.3) per 1 population; for musculoskeletal system disorders and diseases, Los Alamos County; and for neoplasms, Sierra County. Harding County has an exceptionally low rate of hospitalization for mental disorders. Counties that are below statewide hospitalization rates for most MMDC =s include Cibola, Curry, McKinley, Otero, Roosevelt, San Juan, Sandoval, Santa Fe and Torrance. The remaining counties show a variety of patterns with some MMDC=s increasing in discharge rates over three years, others decreasing, some above statewide averages and some below. METHODOLOGY NOTES: C The Modified Major Diagnostic Category (MMDC) for AInjury@ includes all injuries, poisonings, and burns. C C C All rates in this section refer to discharges per 1 county population rather than patient days per 1 county population. The size of the county=s population and the population demographics, such as average age of residents, should be taken into account in interpreting reported data. Indian Health Service facilities do not report to the HIS. As such, counties with large Native American populations may have artificially lower rates.

33 Bernalillo C Bernalillo County State Rate Rate of Hospitalizations for Modified Major Diagnosis Categories (MMDCs) per 1, Population Three Year Comparison 2 3 Bernalillo County 2 State Rate 2 Rate per 1, Population Circulatory Injury & Poisoning Respiratory Digestive Mental Diseases & Disorders Musculoskeletal Neoplasms Data Table Modified Major County State County State County State Diagnosis Category (MMDC) Rate 94 Rate 94 Rate 9 Rate 9 Rate 96 Rate 96 Circulatory Injury & Poisoning Respiratory Digestive Mental Diseases & Disorders Musculoskeletal Neoplasms

34 Catron Cou Catron County State Rate Rate of Hospitalizations for Modified Major Diagnosis Categories (MMDCs) per 1, Population Three Year Comparison 3 Catron County 2 State Rate 2 Rate per 1, Population Circulatory Injury & Respiratory Digestive Neoplasms Poisoning Mental Diseases & Disorders Musculoskeletal Data Table Modified Major County State County State County State Diagnosis Category (MMDC) Rate 94 Rate 94 Rate 9 Rate 9 Rate 96 Rate 96 Circulatory Injury & Poisoning Respiratory Digestive Mental Diseases & Disorders Musculoskeletal Neoplasms

35 Chaves Cou Chaves County State Rate Rate of Hospitalizations for Modified Major Diagnosis Categories (MMDCs) per 1, Population Three Year Comparison 27 3 Chaves County 2 State Rate 2 Rate per 1, Population Circulatory Injury & Poisoning Respiratory Digestive Mental Diseases & Disorders Musculoskeletal Neoplasms Data Table Modified Major County State County State County State Diagnosis Category (MMDC) Rate 94 Rate 94 Rate 9 Rate 9 Rate 96 Rate 96 Circulatory Injury & Poisoning Respiratory Digestive Mental Diseases & Disorders Musculoskeletal Neoplasms

36 Cibola Coun Cibola County State Rate Rate of Hospitalizations for Modified Major Diagnosis Categories (MMDCs) per 1, Population Three Year Comparison 3 Cibola County 2 State Rate 2 Rate per 1, Population Circulatory Injury & Respiratory Digestive Neoplasms Poisoning Mental Diseases & Disorders Musculoskeletal Data Table Modified Major County State County State County State Diagnosis Category (MMDC) Rate 94 Rate 94 Rate 9 Rate 9 Rate 96 Rate 96 Circulatory Injury & Poisoning Respiratory Digestive Mental Diseases & Disorders Musculoskeletal Neoplasms

37 Colfax Coun State Rate Colfax County Rate of Hospitalizations for Modified Major Diagnosis Categories (MMDCs) per 1, Population Three Year Comparison 29 3 Colfax County 2 State Rate 2 Rate per 1, Population Circulatory Injury & Poisoning Respiratory Digestive Mental Diseases & Disorders Musculoskeletal Neoplasms Data Table Modified Major County State County State County State Diagnosis Category (MMDC) Rate 94 Rate 94 Rate 9 Rate 9 Rate 96 Rate 96 Circulatory Injury & Poisoning Respiratory Digestive Mental Diseases & Disorders Musculoskeletal Neoplasms