BC Hospital Admission and Readmission Analysis
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1 British Columbia Hospital Episode and Readmission Analysis Paul Yang University of Victoria November 28, 2012
Transcript of BC Hospital Admission and Readmission Analysis
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British Columbia Hospital Episode and Readmission Analysis
Paul Yang
University of Victoria
November 28, 2012
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Introduction
Discharge Abstract Database (DAD) Care Episodes DAD Analysis for Hospital Care Episodes the Health System Matrix in BC (the Blue Matrix)
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DAD Analysis for Hospital Care Episodes
CIHI’s definition of DAD episode of careAn episode of care refers to all contiguous in-patient hospitalizations and same-day surgery visits. (CIHI, 2005)
Understanding the health of the BC Population
Health System Matrix “The Blue Matrix”
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Look at the Specific Health Care Services Used
Divide the Population into Different Segments reflecting their Health Status
Measure the Services used in a Year
Shade of Blue indicates intensity of service
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High/Medium/Low Chronic Conditions Pop Segments
(CHF, Congestive Heart Failure; AMI, Acute Myocardial Infarction; CABG, Coronary Artery Bypass Graft; CKD_pre Dialysis, Pre-Dialysis Chronic Kidney Disease; COPD, Chronic Obstructive Pulmonary Disease; Depr, Depression; DM, Diabetes; HTN, Hypertension; OA, Osteoarthritis; Ostpr, Osteoporocis; RA, Rheumatoid Arthritis.) (Burd, 2011)
Back to Discussions
Objective and MethodologyThe objective of this project was to explore the use of the
CIHI’s care episode definition to describe hospital resource utilization. Study Design – the project was a population level
trend study. Algorithms
Crude rate: R = E/P* C (E: events, P: population C: 1,000 or 10,000) (Oleske, 2009)
LOS = discharge date – admit date (Oleske, 2009) ALOS of Cases = Total LOS /number of cases ALOS of Episodes = Total LOS/number of episodes
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Results
Crude Rates and ALOS Acute Myocardial Infraction Angina Chronic Obstructive Pulmonary Diseases Pre-dialysis Chronic Kidney Disease
Low/Medium/High Complex Chronic Conditions High resource area vs. low resource area
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AMI Crude Rates and ALOS01-IHA 02-FHA
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03-VCHA 04-VIHA 05-NHA BC
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Crude Rate
ALOS
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Angina Crude Rates and ALOS01-IHA 02-FHA
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03-VCHA 04-VIHA 05-NHA BC
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Crude Rate
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Chronic Obstructive Pulmonary Diseases Crude Rates and ALOS
01-IHA 02-FHA
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Crude Rate
ALOS
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Case
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Pre-dialysis Chronic Kidney Disease Crude Rates and ALOS
01-IHA 02-FHA
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03-VCHA 04-VIHA 05-NHA BC
Crude Rate
ALOS
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Case
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Low/Medium/High Complex Chronic Condition Crude Rates and ALOS BC 2002 to 2009
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Crude Rate
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Back to Discussions
Case
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Different Resource Areas Comparison – Crude Rates and ALOS
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AMI Angina COPD PCKDCrude Rate
ALOS
Back to Discussions
Discussions Admission and Discharge Date Data Quality Issues
Overlapping hospital stays Embedded hospital stays
Chronic Condition Population Segments Definition Results
Crude Rates vs. Age Standardization Rates Age, Race, Gender
Average Length of Stay Early discharge Treatment phases
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Conclusions
ALOS: Case vs. Episode ALOS and Healthcare Resource Chronic Conditions
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