State of Florida: Patients Admitted with APR DRG 139 Other Pneumonia. Reasons for Readmission
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1 Patients Readmitted within 15 days pril arch 2008 F+H++ B C D E F G H # of % of Total Patients Readmitted % of % of % of % of Other Pneumonia % % % % % Chronic Obstructive Pulmonary Disease % % % % % Heart Failure % % % % % ajor Respiratory nfections & nflammations % % % % % Septicemia & Disseminated nfections % % % % % Pulmonary Edema & Respiratory Failure % % % % % ajor Gastrointestinal & Peritoneal nfections % % % % 2 0.6% Renal Failure % % % % 9 2.8% Cardiac rrhythmia & Conduction Disorders % % % % 5 1.5% Other Respiratory Diagnosis Except Signs, Symptoms & inor Diagnoses % % 5 0.9% % 3 0.9% Respiratory System Signs, Symptoms & Other Diagnoses % % 8 1.5% % 1 0.3% Non-Bacterial Gastroenteritis, Nausea & Vomiting % % % % 1 0.3% Hypovolemia & Related Electrolyte Disorders % % 9 1.7% % 2 0.6% idney & Urinary Tract nfections % % 7 1.3% % 0 0.0% Syncope & Collapse % % % % 2 0.6% Respiratory System Diagnosis with Ventilator Support 96+ Hours % % 8 1.5% % 0 0.0% cute yocardial nfarction % % 6 1.1% % 1 0.3% ajor Depressive Disorders & Other/Unspecified Psychoses % % 1 0.2% % % Other & Unspecified Gastrointestinal Hemorrhage % % 8 1.5% 9 0.6% 2 0.6% CV & Precerebral Occlusion with nfarct % % % 7 0.4% 1 0.3% Other nemia & Disorders of Blood & Blood Forming Organs % % 8 1.5% % 2 0.6% ngina Pectoris & Coronary therosclerosis % % 5 0.9% % 4 1.2% Other Circulatory System Diagnoses % % 4 0.7% % 2 0.6% Seizure % % 1 0.2% % 0 0.0% sthma % % 2 0.4% % 0 0.0% Peripheral & Other Vascular Disorders % % 3 0.6% % 1 0.3% Pulmonary Embolism % % 7 1.3% % 0 0.0% Schizophrenia % % 0 0.0% % % Chest Pain % % 2 0.4% % 1 0.3% nterstitial ung Disease % % 3 0.6% % 1 0.3% Other Digestive System Diagnoses % % 7 1.3% 9 0.6% 1 0.3% Cellulitis & Other Bacterial Skin nfections % % 3 0.6% % 2 0.6% Diabetes % % 4 0.7% % 0 0.0% ntestinal Obstruction % % 5 0.9% 6 0.4% 0 0.0% Degenerative Nervous System Disorders Exc ult Sclerosis % % 3 0.6% 4 0.3% % Other Esophageal Disorders % % 3 0.6% % 3 0.9% Peptic Ulcer & Gastritis % % 1 0.2% % 1 0.3% Diverticulitis & Diverticulosis % % 3 0.6% % 1 0.3% Organic ental Health Disturbances % % 0 0.0% 3 0.2% % Transient schemia % % 6 1.1% 9 0.6% 0 0.0% bdominal Pain % % 1 0.2% % 2 0.6% Printed: 5/1/2009 Page 1 of 3
2 Patients Readmitted within 15 days pril arch 2008 F+H++ B C D E F G H # of % of Total Patients Readmitted % of % of % of % of Bipolar Disorders % % 0 0.0% 6 0.4% % Electrolyte Disorders Except Hypovolemia Related % % 4 0.7% 7 0.4% 1 0.3% Sickle Cell nemia Crisis % % 1 0.2% % 0 0.0% Other Back & Neck Disorders, Fractures & njuries % % 7 1.3% 7 0.4% 0 0.0% Other idney & Urinary Tract Diagnoses, Signs & Symptoms % % 5 0.9% 5 0.3% 1 0.3% Cardiac Catheterization for schemic Heart Disease % % 2 0.4% % 1 0.3% Cardiac Catheterization with Circulatory Disorder Except schemic Heart Disease % % 4 0.7% % 0 0.0% Connective Tissue Disorders % % 1 0.2% % 0 0.0% Nontraumatic Stupor & Coma % % 2 0.4% 5 0.3% 1 0.3% Tracheostomy with -T ech. Ventilation without Extensive Procedure % % 1 0.2% 5 0.3% 2 0.6% Fever % % 2 0.4% 7 0.4% 1 0.3% alnutrition, Failure To Thrive & Other Nutritional Disorders % % 2 0.4% 3 0.2% 3 0.9% Bronchiolitis & RSV Pneumonia % % 0 0.0% % 0 0.0% Other nfectious & Parasitic Diseases % % 2 0.4% 7 0.4% 0 0.0% Other usculoskeletal System & Connective Tissue Diagnoses % % 1 0.2% 7 0.4% 1 0.3% Poisoning of edicinal gents % % 2 0.4% 7 0.4% 0 0.0% Disorders of Pancreas Except alignancy % % 0 0.0% 9 0.6% 0 0.0% Other Disorders of Nervous System 9 0.3% % 4 0.7% 1 0.1% 3 0.9% Disorders of the Gallbladder & Biliary Tract 8 0.3% % 1 0.2% 5 0.3% 1 0.3% HV with One Signif HV Cond or without Significant Related Conditions 7 0.2% % 0 0.0% 7 0.4% 0 0.0% nfections of The Upper Respiratory Tract 7 0.2% % 1 0.2% 5 0.3% 1 0.3% ntracranial Hemorrhage 7 0.2% % 3 0.6% 3 0.2% 0 0.0% ajor Esophageal Disorders 7 0.2% % 1 0.2% 4 0.3% 0 0.0% cute & Subacute Endocarditis 6 0.2% % 2 0.4% 3 0.2% 0 0.0% lcohol buse & Dependence 6 0.2% % 0 0.0% 3 0.2% 3 0.9% Gastrointestinal Vascular nsufficiency 6 0.2% % 1 0.2% 4 0.3% 0 0.0% HV with ajor HV Related Condition 6 0.2% % 0 0.0% 6 0.4% 0 0.0% Hypertension 6 0.2% % 1 0.2% 2 0.1% 2 0.6% ale Reproductive System Diagnoses Except alignancy 6 0.2% % 1 0.2% 2 0.1% 1 0.3% Other Disorders of The iver 6 0.2% % 1 0.2% 1 0.1% 2 0.6% Peripheral, Cranial & utonomic Nerve Disorders 6 0.2% % 2 0.4% 3 0.2% 0 0.0% Vertigo & Other abyrinth Disorders 6 0.2% % 0 0.0% 5 0.3% 1 0.3% lcoholic iver Disease 5 0.2% % 0 0.0% 4 0.3% 1 0.3% HV with ultiple ajor HV Related Conditions 5 0.2% % 1 0.2% 4 0.3% 0 0.0% igraine & Other Headaches 5 0.2% % 1 0.2% 3 0.2% 0 0.0% Other Ear, Nose, outh,throat & Cranial/Facial Diagnoses 5 0.2% % 1 0.2% 4 0.3% 0 0.0% Other Endocrine Disorders 5 0.2% % 0 0.0% 4 0.3% 1 0.3% Skin Ulcers 5 0.2% % 2 0.4% 1 0.1% 1 0.3% Viral llness 5 0.2% % 0 0.0% 4 0.3% 1 0.3% llergic Reactions 4 0.1% % 0 0.0% 4 0.3% 0 0.0% Coagulation & Platelet Disorders 4 0.1% % 0 0.0% 3 0.2% 0 0.0% Printed: 5/1/2009 Page 2 of 3
3 Patients Readmitted within 15 days pril arch 2008 F+H++ B C D E F G H # of % of Total Patients Readmitted % of % of % of % of Hepatic Coma & Other ajor cute iver Disorders 4 0.1% % 0 0.0% 2 0.1% 1 0.3% HV with ultiple Significant HV Related Conditions 4 0.1% % 1 0.2% 3 0.2% 0 0.0% Other Complications of Treatment 4 0.1% % 2 0.4% 2 0.1% 0 0.0% Depression Except ajor Depressive Disorder 3 0.1% % 0 0.0% 1 0.1% 1 0.3% Female Reproductive System nfections 3 0.1% % 2 0.4% 0 0.0% 0 0.0% nflammatory Bowel Disease 3 0.1% % 0 0.0% 1 0.1% 0 0.0% ajor Hematologic/mmunologic Diag Exc Sickle Cell Crisis & Coagul 3 0.1% % 0 0.0% 2 0.1% 1 0.3% ajor Skin Disorders 3 0.1% % 0 0.0% 3 0.2% 0 0.0% Other Drug buse & Dependence 3 0.1% % 1 0.2% 1 0.1% 0 0.0% Other Skin, Subcutaneous Tissue & Breast Disorders 3 0.1% % 0 0.0% 2 0.1% 0 0.0% Urinary Stones & cquired Upper Urinary Tract Obstruction 3 0.1% % 1 0.2% 2 0.1% 0 0.0% cute nxiety & Delirium States 2 0.1% % 0 0.0% 2 0.1% 0 0.0% Cardiomyopathy 2 0.1% % 0 0.0% 0 0.0% 2 0.6% Non-bacterial nfections of Nervous System Exc Viral eningitis 2 0.1% % 0 0.0% 2 0.1% 0 0.0% Nonspecific CV & Precerebral Occlusion without nfarct 2 0.1% % 0 0.0% 1 0.1% 1 0.3% Opioid buse & Dependence 2 0.1% % 0 0.0% 2 0.1% 0 0.0% Other njury, Poisoning & Toxic Effect Diagnoses 2 0.1% % 0 0.0% 2 0.1% 0 0.0% Post-Operative, Post-Traumatic, Other Device nfections 2 0.1% % 0 0.0% 1 0.1% 1 0.3% Toxic Effects of Non-edicinal Substances 2 0.1% % 1 0.2% 1 0.1% 0 0.0% djustment Disorders & Neuroses Except Depressive Diagnoses 1 0.0% % 0 0.0% 0 0.0% 1 0.3% Bacterial & Tuberculous nfections of Nervous System 1 0.0% % 0 0.0% 0 0.0% 0 0.0% BPD & other Chronic Respiratory Diseases rising in Perinatal Period 1 0.0% % 0 0.0% 1 0.1% 0 0.0% Cardiac rrest 1 0.0% % 1 0.2% 0 0.0% 0 0.0% Disorders of Personality & mpulse Control 1 0.0% % 0 0.0% 1 0.1% 0 0.0% ultiple Sclerosis & Other Demyelinating Diseases 1 0.0% % 0 0.0% 1 0.1% 0 0.0% Nephritis & Nephrosis 1 0.0% % 0 0.0% 1 0.1% 0 0.0% Osteomyelitis, Septic rthritis & Other usculoskeletal nfections 1 0.0% % 1 0.2% 0 0.0% 0 0.0% Spinal Disorders & njuries 1 0.0% % 0 0.0% 0 0.0% 1 0.3% Viral eningitis 1 0.0% % 0 0.0% 1 0.1% 0 0.0% Total 3, % 2, % % 1, % % Printed: 5/1/2009 Page 3 of 3
4 Patients Readmitted within 15 days pril arch 2008 H++Q+ N B ++O+R C D B/ E F G H N O P Q R S # of % Readmitted Patients # of to nother Readmission Patients Readmitted dmitted Patients Hospital Rate dmitted Readmitted Charges dmitted Readmitted Charges dmitted Readmitted Charges dmitted Readmitted Charges ll Others 1, % 5.8% $2,120,822 $1,363,617 $358, $792, $430,169 1, $2,530, $89,804 Commercial HO 3, % 4.8% $4,335,252 $1,549,926 $638, $329, $621,623 2, $5,299, $272,649 Commercial nsurance 1, % 5.1% $1,477,377 $348,493 $61, $179, $225,308 1, $1,353, $129,075 Commercial PPO 3, % 4.0% $4,135,422 $857,172 $692, $677, $719,710 3, $4,254, $32,439 edicaid 5, % 4.9% $7,278,016 $2,219,709 $3,748, $2,386, $1,141,130 5, $8,534, $1,185,145 edicare 24,945 2, % 9.4% $66,824,540 $20,265,656 $12,253,075 5, $35,252,208 4, $21,735,806 13, $35,561,273 1, $6,793,984 Self Pay/Underinsured 2, % 4.3% $2,919,353 $439,554 $191, $ $158,677 2, $2,471, $920,311 Total 42,359 3, % 7.5% $89,090,782 $27,044,127 $17,943,455 5, $39,618,194 5, $25,032,423 29,738 1,577 $60,004,340 1, $9,423,407 Printed: 5/1/2009 Page 1 of 1
5 Patients Readmitted within 15 days pril arch 2008 H++Q+ N B E+F+G or ++O+R C D B/ E F G H /H / N O P O/N Q R S R/Q Total Patients Patients to nother Readmission Patients Readmitted dmitted Readmitted Hospital Rate dmitted Readmitted Rate dmitted Readmitted Rate dmitted Readmitted Rate dmitted Readmitted Rate ll Others 1, % 5.8% % % 1, % % Commercial HO 3, % 4.8% % % 2, % % Commercial nsurance 1, % 5.1% % % 1, % % Commercial PPO 3, % 4.0% % % 3, % % edicaid 5, % 4.9% % % 5, % % edicare 24,945 2, % 9.4% 1, , % 4, % 13, % 1, % Self Pay/Underinsured 2, % 4.3% % % 2, % % Total 42,359 3, % 7.5% 2, , % 5, % 29,738 1, % 1, % Without ental Health ssue Patients Patients to nother Readmission Patients Readmitted dmitted Readmitted Hospital Rate dmitted Readmitted Rate dmitted Readmitted Rate dmitted Readmitted Rate dmitted Readmitted Rate ll Others 1, % 5.5% % % 1, % % Commercial HO 3, % 4.7% % % 2, % % Commercial nsurance 1, % 4.8% % % 1, % % Commercial PPO 3, % 3.7% % % 3, % % edicaid 5, % 4.3% % % 4, % % edicare 23,426 2, % 9.3% 1, , % 4, % 12, % 1, % Self Pay/Underinsured 2, % 3.7% % % 2, % % Total 39,911 2, % 7.2% 2, , % 4, % 28,392 1, % 1, % With ental Health ssue Patients Patients to nother Readmission Patients Readmitted dmitted Readmitted Hospital Rate dmitted Readmitted Rate dmitted Readmitted Rate dmitted Readmitted Rate dmitted Readmitted Rate ll Others % 9.1% % % % % Commercial HO % 8.6% % % % % Commercial nsurance % 13.3% % % % % Commercial PPO % 12.4% % % % % edicaid % 15.4% % % % % edicare 1, % 12.0% % % % % Self Pay/Underinsured % 9.8% % % % % Total 2, % 12.0% % % 1, % % Printed: 5/1/2009 Page 1 of 1
State of Florida: Patients Admitted with APR DRG 194 Heart Failure Reasons for Readmission
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