Mortality Rates Statewide in-hospital mortality rates showed a statistically significant decrease from federal fiscal year to federal fiscal year in 12 of the 15 conditions reported. The largest decrease was in, where the mortality rate decreased from 15.4% in to 8.8% in. No condition showed a statistically significant increase in in-hospital mortality rate during this time period. 8.8% 15.4% 9.7% 15.9% 5.4% 8.2% Heart Attack - 7.0% 9.1% Colorectal Procedures 1.6% 2.2% 2.6% 3.9% 4.2% 3.2% 2.8% 1.9% 2.9% 2.2% Diabetes - 0.7% 0.4% 0.6% 0.4% 0.7% 0.5% 12 Conditions Decreased 0% 2% 4% 6% 8% 10% 12% 14% 16% 18% Mortality Rate PHC4 Hospital Performance Report Oct 2015 through Sept Data Key Findings 1
Mortality Rates Across different areas of the state, in-hospital mortality rates showed statistically significant differences in the following conditions from federal fiscal year to federal fiscal year. Heart Attack - Colorectal Procedures Heart Attack - Heart Attack - Colorectal Procedures Diabetes - 0.7% 0.4% 0.7% 0.3% 1.3% 0.8% 0.4% 1.7% 2.3% 2.9% 3.0% 2.3% 1.8% 1.8% 1.4% 4.2% 4.5% 3.5% 3.2% 2.8% 3.0% 3.4% 2.4% 2.4% 2.5% 2.4% 1.6% 3.1% 2.8% Western 3.5% 3.6% 2.9% 4.7% 4.3% 4.1% 6.0% 6.7% 6.8% 7.6% 7.6% 8.1% 8.9% 8.8% 8.4% 8.2% 9.0% 9.5% 0% 5% 10% 15% 20% Mortality Rate 10.1% 10.1% 10.9% Central and Northeastern Southeastern 13.2% 15.6% 15.5% 10 Conditions Decreased 15.7% 7 Conditions Decreased 16.4% 17.2% 11 Conditions Decreased PHC4 Hospital Performance Report Oct 2015 through Sept Data Key Findings 2
Mortality Rates Taking patient risk into account, the following in-hospital mortality rates across the different areas of the state were significantly higher or lower than expected in federal fiscal year. Western Central and Northeastern Southeastern Conditions with Mortality Rates Statistically Lower than Expected Pulmonary Disease (COPD) Heart Attack Medical Management Kidney Failure Acute Pneumonia Aspiration Pneumonia Infectious Conditions with Mortality Rates Statistically Higher than Expected Heart Attack Medical Management Pneumonia Infectious Pulmonary Disease (COPD) Tract Infections Kidney Failure Acute Pneumonia Aspiration Western : After accounting for patient risk, hospitals in Western as a whole had in-hospital mortality rates that were significantly higher than expected for six conditions, the greatest difference occurring in (10.1% actual, 8.6% expected). Central and Northeastern : After accounting for patient risk, hospitals in Central and Northeastern as a whole had in-hospital mortality rates that were significantly higher than expected for four conditions, the greatest difference occurring in Pneumonia Aspiration (6.7% actual, 5.1% expected). Southeastern : After accounting for patient risk, hospitals in Southeastern as a whole had inhospital mortality rates that were significantly lower than expected for nine conditions, the greatest difference occurring in Pneumonia Aspiration (4.1% actual, 5.5% expected). PHC4 Hospital Performance Report Oct 2015 through Sept Data Key Findings 3
Readmission Rates Statewide 30-day readmission rates showed a statistically significant decrease from federal fiscal year to federal fiscal year in 11 of the 13 conditions reported. The largest decrease was in, where the readmission rate decreased from 21.4% in to 17.9% in. No condition showed a statistically significant increase in 30-day readmission rate during this time period. * 17.9% 21.4% 21.0% 24.4% 23.8% 26.2% 14.6% 12.3% 17.5% 15.3% * 25.7% 23.6% 22.7% 20.7% 15.7% 17.1% 20.6% 21.9% Gallbladder Removal - Laparoscopic 6.5% 7.5% Abnormal Heartbeat 15.1% 14.3% 11 Conditions Decreased 0% 2% 4% 6% 8% 10% 12% 14% 16% 18% 20% 22% 24% 26% 28% 30% Readmission Rate * Readmission rates for these conditions were based on unplanned readmissions only; patients readmitted for reasons defined as typically planned were not counted. Readmission rates for all other conditions were based on all readmissions for any reason. PHC4 Hospital Performance Report Oct 2015 through Sept Data Key Findings 4
Readmission Rates Across different areas of the state, 30-day readmission rates showed statistically significant differences in the following conditions from federal fiscal year to federal fiscal year. * * * * Abnormal Heartbeat Chest Pain Western 24.5% 21.5% 21.2% 18.4% 14.5% 13.0% 20.9% 19.5% 17.3% 15.9% 26.1% 24.7% Central and Northeastern 22.3% 18.1% 19.4% 16.8% 12.9% 11.2% 23.5% 22.1% 17.2% 16.1% Southeastern 23.5% 18.5% 27.7% 24.0% 15.8% 12.6% 18.6% 15.4% 25.4% 22.2% 23.8% 20.7% 18.0% 15.3% 27.3% 24.8% 24.1% 22.7% 15.7% 14.8% 13.6% 15.6% 6 Conditions Decreased 5 Conditions Decreased 10 Conditions Decreased 1 Condition Increased 0% 5% 10% 15% 20% 25% 30% 35% 40% 45% Readmission Rate * Readmission rates for these conditions were based on unplanned readmissions only; patients readmitted for reasons defined as typically planned were not counted. Readmission rates for all other conditions were based on all readmissions for any reason. PHC4 Hospital Performance Report Oct 2015 through Sept Data Key Findings 5
Readmission Rates Taking patient risk into account, the following 30-day readmission rates across the different areas of the state were significantly higher or lower than expected in federal fiscal year. Western Central and Northeastern Southeastern Conditions with Readmission Rates Statistically Lower than Expected Abnormal Heartbeat Chest Pain Pulmonary Disease (COPD) Diabetes Kidney Failure Acute Pneumonia Aspiration * * Conditions with Readmission Rates Statistically Higher than Expected Kidney Failure Acute * Chest Pain Pulmonary Disease (COPD) * Readmission rates for these conditions were based on unplanned readmissions only; patients readmitted for reasons defined as typically planned were not counted. Readmission rates for all other conditions were based on all readmissions for any reason. Western : After accounting for patient risk, hospitals in Western as a whole had 30-day readmission rates that were significantly higher than expected for five conditions, the greatest difference occurring in (24.8% actual, 23.2% expected). Central and Northeastern : After accounting for patient risk, hospitals in Central and Northeastern as a whole had 30-day readmission rates that were significantly lower than expected for nine conditions, the greatest difference occurring in Pneumonia Aspiration (18.1% actual, 20.2% expected). Southeastern : After accounting for patient risk, hospitals in Southeastern as a whole had 30-day readmission rates that were significantly higher than expected for two conditions, the greatest difference occurring in Chest Pain (15.6% actual, 14.2% expected).. PHC4 Hospital Performance Report Oct 2015 through Sept Data Key Findings 6
Volume of Hospital Admissions The following chart shows the statewide percent change in volume, from federal fiscal year to federal fiscal year, for each of the 16 conditions and procedures included in this report (admission totals from federal fiscal year are shown in parentheses). Chest Pain had the largest percentage decrease in volume (-63%), from 17,635 discharges in to 6,544 in. had the largest percentage increase in volume (+82%), from 34,655 discharges in to 63,134 in. -63% (6,544) Chest Pain -31% (28,929) -24% (30,419) -23% (9,916) Gallbladder Removal - Laparoscopic -22% (7,065) -19% (20,104) -17% (37,335) Abnormal Heartbeat -12% (11,868) Colorectal Procedures -7% (16,083) Diabetes - -4% (47,358) -2% (11,051) Heart Attack - -1% (23,725) +8% (22,454) Heart Attack - Angioplasty/Stent +12% (13,989) +24% (15,427) +82% (63,134) -75% -60% -45% -30% -15% +0% +15% +30% +45% +60% +75% +90% Percent Change in Volume PHC4 Hospital Performance Report Oct 2015 through Sept Data Key Findings 7
Medicare Fee-for-Service Payments Calendar Year 2015 Data for Residents Medicare fee-for-service was the primary payer for 36.9% of the statewide admissions for residents in 2015 for the conditions and procedures in this report, for a total of nearly $1.05 billion ($1,048,941,367). For Western, Medicare fee-for-service was the primary payer for 28.5% of admissions in this report, for a total of over $243 million. For Central and Northeastern, Medicare fee-for-service was the primary payer for 45.1% of admissions in this report, for a total of nearly $336 million. For Southeastern, Medicare fee-for-service was the primary payer for 38.2% of admissions in this report, for a total of nearly $470 million. The condition with the lowest statewide average Medicare fee-for-service payment in 2015 was Chest Pain, at $3,691 per hospitalization. The condition with the highest statewide average Medicare fee-for-service payment in 2015 was Colorectal Procedures, at $17,896 per hospitalization. Condition or Procedure with Lowest Average Payment Condition or Procedure with Highest Average Payment Statewide Chest Pain: $3,691 Colorectal Procedures: $17,896 Western Central and Northeastern Southeastern Chest Pain: $3,316 Colorectal Procedures: $17,611 Chest Pain: $3,252 Colorectal Procedures: $16,979 Chest Pain: $4,321 Colorectal Procedures: $18,784 PHC4 Hospital Performance Report Oct 2015 through Sept Data Key Findings 8