Medicare Quality Monitoring System (MQMS) Report .../media/publications/... · Final Report August...

Contract No.: GS-10F-0050L Task Order No. CMS-02-01175 MPR Reference No.: 8908-280

Medicare Quality Monitoring System (MQMS) Report: Pneumonia, 1992-2002

Appendix B: Detailed Tables Appendix C: ICD-9 Codes for Pneumonia Cohorts Final Report August 2004

Robert Schmitz, Ph.D.

Submitted to: Centers for Medicare & Medicaid Services Center for Beneficiary Choices/ Quality Measurement and Health Assessment GroupSouth Bldg., S3-24-05 7500 Security Blvd. Mail Stop S3-02-01 Baltimore, MD 21244-1850

Project Officer: Lein Han

Submitted by: Mathematica Policy Research, Inc. 955 Massachusetts Avenue, Suite 801 Cambridge, MA 02139 Telephone: (617) 491-7900 Facsimile: (617) 491-8044

Project Director: Angela Merrill

PAGE IS INTENTIONALLY LEFT BLANK TO ALLOW FOR DOUBLE-SIDED COPYING

A P P E N D I X B . 1

D E T A I L E D T A B L E S F O R P N E U M O N I A

Table Page

B.1-1 Unadjusted Total Number of Discharges with a Principal Diagnosis of Pneumonia, 1992-2002 ...........................................................................3

B.1-2 Unadjusted Total Number of Beneficiaries Discharged with a Principal Diagnosis of Pneumonia, 1992-2002...........................................6

B.1-3 Comparison of Beneficiaries Hospitalized for Pneumonia with the Entire MQMS Fee-For-Service Medicare Population, 1992 and 2001.......9

B.1-4 Age/sex Adjusted Rates of Discharges for Pneumonia Per 1,000 Beneficiaries, 1992-2001...........................................................................11

B.1-5 Age/sex Adjusted Rates of Beneficiaries Discharged for Pneumonia per 1,000 Beneficiaries, 1992-2001...........................................................14

B.1-6 Age/sex Adjusted Average Length of Stay for Pneumonia Hospitalizations, 1992-2001......................................................................17

B.1-7 Total Medicare Payments for Discharges for Pneumonia, 1992-2002......20

B.1-8 Average Medicare Payments per Discharge with Pneumonia, 1992-2002 ...........................................................................................................23

B.1-9 Total Beneficiary Deductible and Coinsurance Payments for Discharges for Pneumonia, 1992-2002 .....................................................26

B.1-10 Average Number of Pneumonia Discharges Per Beneficiary Discharged With Pneumonia 1992-2002 ..................................................29

B.1-11 Average Number of All Discharges Per Beneficiary Discharged With Pneumonia, 1992-2002..............................................................................32

B.1-12 Age-Sex Adjusted All-Cause Readmission Rates per 1,000 Beneficiaries Discharged with Pneumonia, 1992-2001 ............................35

B.1-13 Age-Sex Adjusted All-Pneumonia Readmission Rates per 1,000 Beneficiaries Discharged with Pneumonia, 1992-2001 ............................41

B.1-14 Age-Sex Adjusted All-Cause Mortality Rates per 1,000 Beneficiaries Discharged with Pneumonia, 1992-2001 ..................................................47

B.1-3

Table B.1-1. Unadjusted Total Number of Discharges with a Principal Diagnosis of Pneumonia, 1992-2002 Year

Beneficiary Characteristics 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 All Enrollees 541,169 590,670 611,600 624,065 614,370 619,181 633,483 676,539 631,267 622,549 656,555 Gender

Male 259,690 281,528 290,058 293,828 288,226 288,100 292,194 311,786 289,928 286,375 301,248 Female 281,479 309,142 321,542 330,237 326,144 331,081 341,289 364,753 341,339 336,174 355,307

Age Group 0–54 19,359 23,136 26,067 27,893 28,508 28,918 30,171 33,115 32,346 33,885 35,869 55–64 22,237 24,706 26,421 27,762 28,619 29,338 31,271 34,245 33,577 34,199 38,196 65–69 66,455 71,544 72,951 72,268 69,317 66,839 65,871 68,606 62,557 62,068 66,361 70–74 90,305 97,900 102,052 102,865 99,295 98,318 98,171 103,539 93,889 91,710 95,104 75–79 103,321 112,039 113,426 115,817 113,382 115,343 116,921 126,196 117,912 114,686 120,011 80–84 100,997 109,985 115,032 117,916 116,186 117,455 120,600 128,191 117,509 116,609 124,044 85–89 77,717 85,321 88,579 90,760 90,685 92,987 96,957 103,927 98,325 95,905 100,681 90–94 43,130 47,351 48,718 49,773 49,643 50,789 53,260 56,954 54,355 53,445 55,807 95+ 17,648 18,688 18,354 19,011 18,735 19,194 20,261 21,766 20,797 20,042 20,482

Race White 472,611 521,260 537,667 544,167 533,764 536,274 548,447 583,038 546,004 539,040 565,247 Black 41,086 49,213 52,478 55,867 55,351 55,546 55,927 60,538 58,355 56,332 61,551 Other 12,189 12,092 16,004 18,078 19,507 23,978 25,840 29,516 24,694 25,371 28,135 Unknown 15,283 8,105 5,451 5,953 5,748 3,383 3,269 3,447 2,214 1,806 1,622

Dual-Enrollment Status Not Dual 408,944 439,044 449,193 454,888 445,196 445,581 455,611 486,506 448,524 439,902 464,100 Dual 132,225 151,626 162,407 169,177 169,174 173,600 177,872 190,033 182,743 182,647 192,455

Medicare Eligibility Status Aged without ESRD 495,106 537,244 553,234 561,211 549,771 553,634 564,157 601,238 556,919 545,495 572,387 Disabled without ESRD 37,107 42,660 46,843 49,296 50,727 50,164 53,047 58,027 57,247 58,526 63,939 All with ESRD 8,956 10,766 11,523 13,558 13,872 15,383 16,279 17,274 17,101 18,528 20,229

Urban/Rural Rural 171,910 187,803 197,614 200,772 198,456 206,413 212,213 225,259 207,376 198,249 204,468 Urban 369,259 402,867 413,986 423,293 415,914 412,768 421,270 451,280 423,891 424,300 452,087

Census Region Northeast 108,581 119,171 120,631 125,029 121,372 115,807 118,525 125,718 121,218 115,604 122,013 Midwest 143,941 157,692 164,091 165,621 163,894 161,897 172,091 184,822 166,650 162,706 169,981 South 204,988 225,094 241,324 245,620 242,689 252,876 251,309 267,005 254,502 253,785 269,056 West 77,416 82,374 79,185 80,489 79,244 81,438 83,295 89,897 80,605 81,969 87,637 Puerto Rico/Virgin Islands 6,243 6,339 6,369 7,306 7,171 7,163 8,263 9,097 8,292 8,485 7,868

State Alabama 11,478 12,983 14,225 13,893 13,522 14,287 14,410 15,232 13,760 14,205 14,896 Alaska 466 501 500 624 615 632 699 712 729 747 675 Arizona 6,011 6,604 6,342 6,228 6,225 6,464 6,461 7,103 6,286 6,465 7,745

Table B.1-1 (cont’d)

B.1-4

Year Beneficiary Characteristics 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002

Arkansas 8,146 8,964 9,557 9,480 9,240 10,019 9,948 9,798 9,187 8,586 9,830 California 41,325 42,146 40,774 40,568 39,591 41,076 42,180 43,376 39,797 40,809 42,750 Colorado 5,002 5,122 5,049 5,334 5,164 4,852 5,047 5,326 4,521 4,783 4,946 Connecticut 6,415 6,794 7,172 7,460 7,466 7,194 7,351 7,774 7,668 8,102 9,194 Delaware 1,267 1,358 1,473 1,433 1,565 1,539 1,688 1,872 1,807 1,885 1,959 District of Columbia 933 1,028 1,097 1,167 1,157 1,032 1,073 1,187 1,198 1,098 1,088 Florida 26,303 28,622 31,039 31,453 29,699 29,371 29,326 33,283 30,961 32,551 34,969 Georgia 15,343 17,541 19,387 19,561 19,515 19,832 19,559 20,502 19,992 19,219 19,012 Hawaii 1,100 1,152 1,184 1,333 1,377 1,416 1,569 1,701 1,423 1,436 1,567 Idaho 1,888 2,418 2,131 2,391 2,269 2,371 2,649 2,894 2,378 2,109 2,265 Illinois 26,610 29,327 30,293 30,931 31,079 29,400 32,052 34,757 30,911 30,010 32,448 Indiana 14,173 14,769 15,488 15,339 15,339 15,806 16,945 17,949 16,646 16,322 17,096 Iowa 7,783 8,839 9,054 9,580 9,404 9,469 10,443 11,493 9,655 9,076 8,747 Kansas 7,763 8,794 8,656 8,830 8,474 8,694 9,182 9,632 8,309 7,919 8,052 Kentucky 13,919 14,672 15,855 15,683 15,330 15,987 16,256 17,361 16,530 15,944 16,715 Louisiana 11,074 12,715 13,635 13,484 13,475 13,460 13,181 13,464 13,061 12,589 12,912 Maine 2,907 3,067 3,034 3,139 3,279 3,148 3,584 3,610 3,495 3,378 3,553 Maryland 8,359 9,195 9,678 10,588 10,093 9,443 9,518 10,404 10,593 11,047 11,656 Massachusetts 14,778 16,852 16,853 16,952 16,056 14,423 14,753 15,781 15,151 14,270 14,700 Michigan 18,210 20,354 21,702 21,890 22,161 21,539 22,985 24,529 22,954 23,036 25,043 Minnesota 7,788 8,673 8,612 8,710 8,267 8,691 9,710 11,666 9,910 9,822 9,577 Mississippi 7,835 9,104 9,817 10,077 10,080 10,933 11,059 11,250 10,281 10,059 10,384 Missouri 16,137 17,590 18,112 18,077 17,426 17,411 18,169 18,814 16,636 16,401 16,982 Montana 2,063 2,309 2,295 2,386 2,401 2,363 2,573 2,979 2,430 2,356 2,440 Nebraska 4,354 4,699 4,886 4,779 4,624 4,718 5,097 5,721 4,521 4,052 3,998 Nevada 1,983 2,361 2,421 2,625 2,500 2,437 2,534 2,663 2,363 2,345 2,752 New Hampshire 1,926 1,977 2,171 2,154 2,289 2,348 2,289 2,453 2,563 2,578 2,724 New Jersey 14,510 15,954 15,887 17,476 17,126 16,806 17,237 19,288 18,395 17,390 19,228 New Mexico 3,085 3,371 3,325 3,471 3,489 3,771 3,569 4,284 3,461 3,591 3,825 New York 35,506 39,200 38,953 41,390 40,591 38,702 39,989 42,482 40,686 38,135 39,963 North Carolina 14,740 16,788 16,874 19,018 19,015 19,531 20,831 21,973 21,289 20,361 21,311 North Dakota 2,087 2,221 2,297 2,516 2,302 2,325 2,442 2,741 2,113 2,020 1,644 Ohio 26,466 29,021 30,929 31,326 31,247 30,217 30,304 30,709 29,934 29,972 31,564 Oklahoma 10,688 11,886 12,055 12,075 11,802 12,938 12,545 12,867 11,901 11,531 12,497 Oregon 4,355 4,849 4,368 4,251 4,342 4,463 4,408 4,842 4,574 4,332 4,966 Pennsylvania 29,336 31,624 32,867 32,562 30,645 29,340 29,376 30,351 29,301 27,962 29,029 Rhode Island 1,981 2,286 2,276 2,400 2,492 2,410 2,350 2,311 2,345 2,159 2,149 South Carolina 6,386 7,078 7,462 8,549 8,639 8,817 9,028 10,140 10,048 10,003 11,144 South Dakota 3,031 3,124 3,181 3,405 3,014 3,181 3,326 3,791 2,945 2,645 2,697 Tennessee 15,864 17,194 19,493 19,145 19,215 20,762 20,310 21,109 20,223 19,855 20,706 Texas 34,645 37,149 39,706 39,447 39,047 42,643 39,701 42,702 40,807 42,545 46,287 Utah 2,013 2,346 2,075 2,373 2,218 2,487 2,436 3,409 2,954 3,022 3,404


B.1-5


Vermont 1,222 1,417 1,418 1,496 1,428 1,436 1,596 1,668 1,614 1,630 1,473 Virginia 11,860 12,315 13,053 13,548 13,981 14,294 14,851 15,894 15,353 14,962 16,005 Washington 7,044 8,052 7,571 7,680 8,010 7,913 7,973 9,142 8,468 8,734 9,134 West Virginia 6,148 6,502 6,918 7,019 7,314 7,988 8,025 7,967 7,511 7,345 7,685 Wisconsin 9,539 10,281 10,881 10,238 10,557 10,446 11,436 13,020 12,116 11,431 12,133 Wyoming 1,081 1,143 1,150 1,225 1,043 1,193 1,197 1,466 1,221 1,240 1,168 Puerto Rico/Virgin Islands 6,243 6,339 6,369 7,306 7,171 7,163 8,263 9,097 8,292 8,485 7,868

Source: CMS MedPAR and Denominator Files.

Notes: Based on short-term hospitalizations among the full-year fee-for-service Medicare population. State and region are based on beneficiary location.

B.1-6

Table B.1-2. Unadjusted Total Number of Beneficiaries Discharged with a Principal Diagnosis of Pneumonia, 1992-2002 Year


Male 231,835 251,479 257,368 260,774 255,603 254,464 258,435 276,481 256,828 253,163 266,613 Female 258,766 283,960 293,936 300,692 296,547 300,592 310,225 331,762 310,135 303,726 321,195

Age Group 0–54 17,053 20,400 22,689 24,688 25,080 25,491 26,646 29,136 28,586 29,895 31,442 55–64 19,749 22,056 23,353 24,415 25,150 25,879 27,527 30,258 29,564 30,072 33,562 65–69 60,829 65,480 66,304 65,407 62,655 60,226 59,313 61,945 56,312 55,520 59,524 70–74 82,303 89,040 92,311 92,969 89,284 88,180 88,109 93,229 84,419 82,014 85,148 75–79 93,597 101,676 102,426 104,313 102,054 103,262 105,068 113,462 105,745 102,639 107,454 80–84 91,385 99,610 103,744 105,917 104,481 105,193 108,241 115,209 105,655 104,444 111,253 85–89 70,498 77,313 79,963 81,791 81,706 83,668 87,327 93,842 88,525 85,999 90,428 90–94 39,105 42,924 43,891 44,895 44,838 45,761 48,166 51,432 49,247 48,164 50,402 95+ 16,082 16,940 16,623 17,071 16,902 17,396 18,263 19,730 18,910 18,142 18,595






State Alabama 10,377 11,780 12,899 12,458 12,200 12,836 12,945 13,655 12,407 12,726 13,418 Alaska 406 461 450 559 569 559 626 637 644 671 593 Arizona 5,522 6,047 5,767 5,653 5,635 5,854 5,897 6,471 5,729 5,895 6,997


B.1-7


Arkansas 7,376 8,081 8,589 8,482 8,237 8,954 8,883 8,828 8,270 7,689 8,816 California 37,195 37,800 36,441 36,072 35,148 36,471 37,360 38,866 35,403 36,156 37,989 Colorado 4,562 4,700 4,623 4,858 4,686 4,451 4,590 4,859 4,114 4,380 4,512 Connecticut 5,885 6,237 6,562 6,798 6,869 6,529 6,657 7,058 6,933 7,200 8,218 Delaware 1,180 1,260 1,352 1,319 1,433 1,401 1,526 1,714 1,651 1,693 1,781 District of Columbia 847 945 1,001 1,052 1,034 936 982 1,094 1,066 970 963 Florida 24,357 26,584 28,554 28,877 27,295 27,001 26,859 30,509 28,397 29,709 31,880 Georgia 13,693 15,666 17,215 17,422 17,299 17,737 17,477 18,304 17,911 17,037 17,072 Hawaii 1,011 1,054 1,085 1,205 1,258 1,265 1,416 1,567 1,290 1,288 1,453 Idaho 1,719 2,242 1,948 2,173 2,066 2,168 2,425 2,638 2,167 1,943 2,077 Illinois 24,024 26,449 27,034 27,817 27,896 26,184 28,582 31,223 27,564 26,670 28,972 Indiana 12,905 13,475 14,061 13,848 13,879 14,252 15,249 16,202 15,073 14,745 15,390 Iowa 7,095 8,101 8,156 8,553 8,432 8,471 9,393 10,291 8,680 8,128 7,867 Kansas 6,992 7,864 7,777 7,838 7,592 7,738 8,140 8,547 7,444 7,062 7,187 Kentucky 12,131 12,924 13,748 13,706 13,241 13,973 14,227 15,091 14,281 13,799 14,528 Louisiana 9,874 11,326 12,112 11,869 11,793 11,754 11,603 11,784 11,497 11,021 11,404 Maine 2,648 2,793 2,769 2,872 2,989 2,862 3,261 3,272 3,159 3,055 3,190 Maryland 7,636 8,382 8,788 9,535 9,107 8,542 8,597 9,411 9,535 9,931 10,406 Massachusetts 13,407 15,151 15,095 15,191 14,428 12,851 13,292 14,118 13,574 12,718 13,088 Michigan 16,693 18,727 19,742 19,884 20,142 19,498 20,901 22,388 20,785 20,735 22,488 Minnesota 7,022 7,815 7,692 7,843 7,464 7,798 8,725 10,483 8,905 8,820 8,579 Mississippi 7,033 8,115 8,754 8,878 8,894 9,608 9,797 9,976 9,205 8,950 9,220 Missouri 14,554 15,890 16,351 16,265 15,630 15,570 16,277 16,817 14,949 14,610 15,187 Montana 1,874 2,108 2,098 2,177 2,162 2,130 2,319 2,686 2,179 2,145 2,211 Nebraska 3,902 4,257 4,367 4,305 4,135 4,260 4,635 5,122 4,051 3,604 3,585 Nevada 1,824 2,181 2,216 2,363 2,265 2,209 2,310 2,436 2,151 2,150 2,469 New Hampshire 1,767 1,809 1,984 1,982 2,088 2,169 2,091 2,267 2,324 2,354 2,457 New Jersey 13,392 14,731 14,572 16,062 15,714 15,188 15,685 17,472 16,686 15,677 17,400 New Mexico 2,778 3,073 2,981 3,162 3,157 3,375 3,227 3,867 3,076 3,238 3,477 New York 32,268 35,661 35,302 37,431 36,484 34,737 35,902 38,075 36,355 33,934 35,636 North Carolina 13,496 15,191 15,341 17,203 17,198 17,676 18,724 19,879 19,297 18,306 19,252 North Dakota 1,870 1,986 2,035 2,212 2,044 2,032 2,166 2,455 1,860 1,765 1,460 Ohio 23,973 26,322 27,874 28,083 27,990 27,090 27,210 27,553 26,895 26,749 28,124 Oklahoma 9,573 10,594 10,689 10,643 10,355 11,302 11,031 11,343 10,521 10,097 10,887 Oregon 4,022 4,478 3,995 3,918 3,930 4,055 4,012 4,428 4,190 3,936 4,517 Pennsylvania 26,937 29,038 29,925 29,633 27,932 26,599 26,606 27,635 26,471 25,254 26,234 Rhode Island 1,836 2,105 2,107 2,199 2,296 2,178 2,111 2,081 2,124 1,928 1,956 South Carolina 5,881 6,508 6,841 7,794 7,841 8,018 8,214 9,218 9,145 9,055 10,124 South Dakota 2,706 2,715 2,782 2,986 2,612 2,763 2,880 3,329 2,613 2,309 2,348 Tennessee 14,126 15,202 17,067 16,815 16,811 18,154 17,936 18,599 17,815 17,438 18,167 Texas 31,227 33,615 35,695 35,259 35,045 38,068 35,534 38,325 36,594 38,079 41,284


B.1-8


Utah 1,864 2,173 1,927 2,195 2,037 2,278 2,235 3,165 2,722 2,771 3,117 Vermont 1,096 1,284 1,256 1,343 1,301 1,300 1,435 1,493 1,471 1,456 1,318 Virginia 10,752 11,188 11,861 12,279 12,608 12,871 13,352 14,325 13,870 13,487 14,361 Washington 6,485 7,419 6,929 7,053 7,330 7,194 7,278 8,292 7,697 7,927 8,336 West Virginia 5,440 5,720 6,043 6,173 6,433 6,924 7,041 7,023 6,549 6,432 6,682 Wisconsin 8,786 9,443 10,040 9,470 9,738 9,624 10,499 11,885 11,111 10,408 11,061 Wyoming 960 1,030 1,039 1,099 948 1,077 1,096 1,321 1,090 1,119 1,064 Puerto Rico/Virgin Islands 5,622 5,739 5,773 6,600 6,480 6,522 7,444 8,166 7,473 7,670 7,006

SOURCE: CMS MedPAR and Denominator Files.

NOTES: Based on short-term hospitalizations among the full-year fee-for-service Medicare population. State and region are based on beneficiary location.

B.1-9

Tab

le B.1-3. C

om

pariso

n o

f Ben

eficiaries Ho

spitalized

for P

neu

mo

nia w

ith th

e En

tire MQ

MS

F

ee-Fo

r-Service M

edicare P

op

ulatio

n, 1992 an

d 2001

P

neumonia P

opulation E

ntire Fee-for-S

ervice Population

1992

2001 1992

2001 A

ll En

rollees

490,601 556,889

32,095,866 31,503,207

(percent of population)

Gen

der

Male

47.3 45.5

42.5 43.6

Fem

ale 52.7

54.5 57.5

56.4 A

ge G

rou

p

0–54 3.5

5.4 6.2

9.3 55–64

4.0 5.4

4.1 5.7

65–69 12.4

10.0 25.4

21 70–74

16.8 14.7

23.7 21

75–79 19.1

18.4 17.9

18.2 80–84

18.6 18.8

12.1 12.8

85–89 14.4

15.4 6.7

7.4 90–94

8.0 8.6

2.8 3.2

95+

3.3 3.3

1.2 1.4

Race

White

87.3 86.6

85.4 85.8

Black

7.6 9.1

8.4 9.6

Other

2.2 4.0

2.9 4.4

Unknow

n 2.8

0.3 3.2

0.2 D

ual-E

nro

llmen

t Statu

s

N

ot Dual

76.3 71.4

88 83.5

Dual

23.7 28.6

12 16.5

Med

icare Elig

ibility S

tatus

Aged w

ithout ES

RD

91.7

87.8 89.6

85.2 D

isabled without E

SR

D

6.7 9.2

9.8 14

All w

ith ES

RD

1.7

3.0 0.6

0.9 U

rban

/Ru

ral

R

ural 31.3

31.4 25.4

27.4 U

rban 68.7

68.6 74.6

72.6 C

ensu

s Reg

ion

N

ortheast 20.2

18.6 22.3

19.6 M

idwest

26.6 26.1

25.5 25.5

South

37.7 40.7

35.4 38.2

West

14.3 13.2

15.5 15

State

Alabam

a 2.1

2.3 1.8

1.9 A

laska 0.1

0.1 0.1

0.1 A

rizona 1.1

1.1 1.3

1.3 A

rkansas 1.5

1.4 1.2

1.3 C

alifornia 7.6

6.5 7.6

6.8 C

olorado 0.9

0.8 1

0.9 C

onnecticut 1.2

1.3 1.4

1.3 D

elaware

0.2 0.3

0.3 0.3

District of C

olumbia

0.2 0.2

0.2 0.2

Florida

5.0 5.3

6.5 6.5

Georgia

2.8 3.1

2.4 2.7

Haw

aii 0.2

0.2 0.3

0.3 Idaho

0.4 0.3

0.4 0.5

Illinois 4.9

4.8 4.5

4.4 Indiana

2.6 2.6

2.4 2.5

Iowa

1.4 1.5

1.4 1.4

Kansas

1.4 1.3

1.1 1.1

Kentucky

2.5 2.5

1.6 1.8

Louisiana 2.0

2.0 1.7

1.5

T

able B.1-3 (cont’d)

B.1-10

P

neumonia P

opulation E

ntire Fee-for-S

ervice Population

1992

2001 1992

2001 A

ll En

rollees

490,601 556,889

32,095,866 31,503,207


Maine

0.5 0.5

0.6 0.7

Maryland

1.6 1.8

1.7 1.9

Massachusetts

2.7 2.3

2.6 2.2

Michigan

3.4 3.7

3.9 4

Minnesota

1.4 1.6

1.4 1.7

Mississippi

1.4 1.6

1.2 1.3

Missouri

3.0 2.6

2.4 2.2

Montana

0.4 0.4

0.4 0.4

Nebraska

0.8 0.6

0.7 0.7

Nevada

0.4 0.4

0.4 0.5

New

Ham

pshire 0.4

0.4 0.4

0.5 N

ew Jersey

2.7 2.8

3.3 3.1

New

Mexico

0.6 0.6

0.5 0.6

New

York

6.6 6.1

7.2 6.4

North C

arolina 2.8

3.3 2.9

3.4 N

orth Dakota

0.4 0.3

0.3 0.3

Ohio

4.9 4.8

4.8 4.3

Oklahom

a 2.0

1.8 1.4

1.4 O

regon 0.8

0.7 1.1

0.9 P

ennsylvania 5.5

4.5 6.1

4.8 R

hode Island 0.4

0.3 0.5

0.3 S

outh Carolina

1.2 1.6

1.4 1.8

South D

akota 0.6

0.4 0.3

0.4 T

ennessee 2.9

3.1 2.2

2.4 T

exas 6.4

6.8 5.7

6.1 U

tah 0.4

0.5 0.5

0.6 V

ermont

0.2 0.3

0.2 0.3

Virginia

2.2 2.4

2.3 2.7

Washington

1.3 1.4

1.8 1.8

West V

irginia 1.1

1.2 0.9

1 W

isconsin 1.8

1.9 2.2

2.3 W

yoming

0.2 0.2

0.2 0.2

Puerto R

ico/Virgin Islands

1.1 1.4

1.4 1.7

SO

UR

CE: C

MS

MedP

AR

and Denom

inator Files.

NO

TE

S: The pneum

onia population is the subset of the fee-for-service population that had one or m

ore discharges with pneum

onia as the principal diagnosis. State and region are

based on beneficiary location.

B.1-11

Table B.1-4. Age/sex Adjusted Rates of Discharges for Pneumonia Per 1,000 Beneficiaries, 1992-2001 Year

Beneficiary Characteristics 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 (rate per 1,000 beneficiaries) All Enrollees 17.13 18.35 18.77 19.12 18.94 19.33 19.95 21.22 19.47 18.60 18.97 Gender

Male 21.58 22.89 23.26 23.49 23.13 23.42 23.92 25.33 23.07 21.88 22.09 Female 14.68 15.86 16.33 16.78 16.68 17.13 17.82 19.02 17.58 16.86 17.33

Age Group 0–54 9.82 10.83 11.14 11.29 11.02 10.94 11.16 11.92 11.29 11.28 11.56 55–64 17.12 18.38 18.89 19.23 19.19 19.23 19.83 20.72 19.44 18.58 19.01 65–69 8.12 8.79 9.13 9.40 9.39 9.58 9.93 10.62 9.51 9.04 9.25 70–74 11.86 12.74 13.16 13.46 13.42 13.80 14.21 15.29 13.93 13.37 13.67 75–79 18.27 19.59 19.84 20.24 19.84 20.30 20.77 22.16 20.45 19.49 19.95 80–84 27.27 29.10 29.89 30.41 30.06 30.74 31.72 33.67 30.11 28.53 28.88 85–89 39.06 41.54 42.39 42.93 42.63 43.66 45.35 47.70 44.13 41.65 42.35 90–94 52.35 55.58 56.15 57.05 56.75 57.59 59.44 62.86 59.04 56.13 56.94 95+ 50.11 50.77 50.01 50.13 47.63 47.95 49.02 52.20 49.30 47.06 47.00

Race White 17.31 18.32 18.81 19.08 18.88 19.26 19.91 21.13 19.37 18.55 18.87 Black 15.84 17.84 18.50 19.83 19.83 20.17 20.62 22.17 20.70 19.01 20.11 Other 16.65 19.27 19.06 19.72 19.98 19.92 20.46 22.02 19.93 19.24 19.42 Unknown 16.26 29.13 18.86 18.25 17.81 20.13 20.21 21.59 22.87 19.66 18.51

Dual-Enrollment Status Not Dual 14.77 15.69 15.95 16.19 16.02 16.27 16.83 17.95 16.30 15.49 15.85 Dual 36.94 39.42 39.95 40.37 39.78 40.59 40.79 42.34 39.84 38.45 38.42

Medicare Eligibility Statusa Aged without ESRD 19.84 21.10 21.64 21.91 21.75 21.55 22.27 23.73 21.62 20.63 21.05 Disabled without ESRD 11.67 12.69 13.05 13.11 12.96 12.85 13.16 13.89 13.18 12.72 13.07 All with ESRD 58.89 61.43 65.06 67.68 74.32 76.78 76.70 83.74 79.15 76.44 78.47

Urban/Rural Rural 21.02 22.55 23.31 23.38 22.92 23.71 24.22 25.44 23.08 21.71 22.09 Urban 15.77 16.89 17.18 17.60 17.50 17.70 18.32 19.59 18.09 17.43 17.83

Census Region Northeast 15.34 16.53 16.59 17.23 17.24 17.06 17.97 19.20 18.34 16.95 17.46 Midwest 17.73 19.01 19.50 19.48 19.23 19.17 20.48 21.93 19.64 18.87 19.20 South 18.64 19.90 20.84 21.03 20.71 21.64 21.57 22.77 21.25 20.35 20.83 West 15.85 16.95 16.56 17.18 17.13 17.80 18.21 19.34 16.83 16.42 16.53 Puerto Rico/Virgin Islands 15.30 15.20 14.99 16.87 16.31 16.00 18.08 19.55 17.36 17.32 16.24

State Alabama 20.83 22.96 24.53 23.81 23.08 24.33 24.63 26.00 23.33 23.60 24.13 Alaska 20.29 20.58 19.37 22.88 21.24 20.76 21.86 21.15 20.52 20.08 17.31 Arizona 15.14 16.56 15.94 15.89 16.07 17.07 17.14 18.69 15.32 14.87 16.58


B1.-12

Year Beneficiary Characteristics 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 (rate per 1,000 beneficiaries)

Arkansas 21.12 22.76 23.88 23.32 22.66 24.59 24.49 24.18 22.47 20.86 22.79 California 17.55 18.38 18.40 19.04 18.96 19.92 20.44 20.82 18.72 18.51 17.99 Colorado 16.53 16.52 16.31 17.43 17.20 16.77 18.09 19.21 15.88 15.86 15.33 Connecticut 14.12 14.66 15.18 15.49 15.52 15.88 17.50 18.54 18.03 17.61 18.20 Delaware 15.11 15.61 16.47 15.73 17.25 16.95 18.48 18.82 17.65 17.61 17.67 District of Columbia 13.17 14.44 15.25 16.61 17.07 15.49 16.17 17.74 17.81 15.85 15.68 Florida 12.84 13.64 14.54 14.85 14.26 14.48 14.69 16.52 15.01 14.94 15.12 Georgia 21.92 24.27 26.08 25.65 25.11 25.39 25.05 26.05 24.91 23.08 22.25 Hawaii 12.52 12.78 12.90 13.85 14.18 14.24 15.66 16.36 13.14 13.31 14.00 Idaho 14.31 17.76 15.54 16.97 15.67 16.37 18.39 20.02 16.17 13.99 14.60 Illinois 18.87 20.50 20.99 21.29 21.53 20.50 22.44 24.33 21.56 20.41 21.13 Indiana 19.65 20.02 20.65 20.17 19.92 20.34 21.61 22.71 20.85 20.06 20.62 Iowa 17.14 19.17 19.51 20.44 19.93 19.96 21.88 24.05 20.08 18.75 17.92 Kansas 21.46 23.89 23.32 23.46 22.51 23.16 24.47 25.80 22.20 21.10 20.97 Kentucky 28.34 29.04 30.68 29.91 28.92 30.01 30.27 32.16 30.29 28.51 29.06 Louisiana 21.81 24.44 25.73 26.15 26.63 27.55 28.04 29.09 27.44 25.95 25.33 Maine 16.03 16.53 16.04 16.28 16.70 15.75 17.63 17.53 16.72 15.81 16.31 Maryland 16.30 17.42 17.88 19.31 18.90 18.29 18.54 19.79 19.19 17.99 18.58 Massachusetts 18.19 20.11 19.97 20.58 20.27 18.97 20.02 21.78 20.66 19.11 19.36 Michigan 15.60 16.91 17.67 17.47 17.47 16.92 17.99 19.11 17.72 17.55 18.25 Minnesota 16.75 18.18 17.64 17.50 16.29 16.85 18.42 21.07 17.63 17.10 16.49 Mississippi 21.81 24.82 26.31 26.61 26.34 28.20 28.28 28.64 25.99 25.29 25.55 Missouri 21.33 22.86 23.28 23.30 22.79 23.26 24.64 25.91 23.00 22.48 22.89 Montana 17.65 19.21 18.65 18.94 18.65 18.13 19.56 22.44 17.74 16.92 17.30 Nebraska 17.93 19.10 19.84 19.22 18.54 19.13 20.64 23.10 17.92 15.92 15.55 Nevada 16.56 19.20 19.32 20.77 19.63 18.97 19.20 19.53 16.50 15.60 17.16 New Hampshire 14.04 13.97 14.96 14.48 15.12 15.91 15.77 16.64 15.72 15.33 15.82 New Jersey 14.30 15.39 15.02 16.40 16.42 16.55 17.26 19.34 18.05 16.51 17.40 New Mexico 19.59 20.75 20.75 21.38 21.28 22.78 21.25 25.14 19.82 19.11 19.86 New York 15.67 17.12 16.97 18.16 18.28 18.05 19.02 20.31 19.34 17.81 18.49 North Carolina 17.40 19.08 18.54 20.26 19.73 19.98 21.05 21.95 20.78 19.47 19.94 North Dakota 20.40 21.42 21.93 23.78 21.60 21.77 22.73 25.37 19.51 18.53 15.01 Ohio 18.35 19.66 20.61 20.64 20.75 21.20 22.09 22.56 21.75 21.11 21.88 Oklahoma 23.94 26.20 26.30 26.17 25.67 28.35 27.71 28.64 26.49 25.42 26.99 Oregon 13.02 14.98 13.93 14.19 14.86 15.46 15.24 16.61 15.39 14.06 15.35 Pennsylvania 15.84 16.80 17.34 17.67 17.65 17.75 18.43 19.42 18.89 17.25 17.64 Rhode Island 13.53 15.44 15.14 15.73 16.47 16.98 19.36 20.09 20.09 18.64 18.49 South Carolina 15.63 16.69 16.95 18.79 18.51 18.40 18.22 19.95 19.22 18.67 20.23 South Dakota 26.42 26.84 26.95 28.50 25.03 26.14 27.11 30.62 23.66 21.20 21.48 Tennessee 23.66 24.96 27.64 26.57 26.21 28.12 27.61 28.69 27.19 26.13 27.09 Texas 19.87 20.79 21.74 21.76 21.57 23.64 22.33 24.10 22.52 21.75 22.50


B.1-13


Utah 13.16 15.26 13.51 15.00 13.79 15.48 14.77 18.05 15.25 15.23 16.72 Vermont 16.47 18.50 18.15 18.88 17.72 17.52 19.19 19.81 18.47 18.36 16.33 Virginia 17.55 17.66 18.19 18.49 18.72 18.81 19.32 20.34 18.89 17.70 18.47 Washington 12.98 14.51 13.62 13.99 15.01 15.18 15.46 17.42 15.55 15.00 14.80 West Virginia 23.29 24.11 25.21 25.14 25.82 27.88 27.65 27.35 25.58 24.78 25.59 Wisconsin 13.63 14.33 14.96 13.89 14.21 14.08 15.46 17.41 16.13 15.06 15.46 Wyoming 21.20 21.61 21.74 22.35 18.54 20.67 20.24 24.26 19.82 19.74 18.21 Puerto Rico/Virgin Islands 13.63 13.52 13.28 14.87 14.30 13.97 15.75 17.02 15.19 15.26 14.27


NOTES: Based on short-term hospitalizations among the full-year fee-for-service Medicare population. State and region are based on provider location. All results reported at the national level are standardized to the age-sex distribution of the July 1999 Medicare FFS population using the direct method. Results reported at the state level are standardized using the indirect method. a Age-sex–adjusted rates are not comparable across aged and disabled groups.

B.1-14

Table B.1-5. Age/sex Adjusted Rates of Beneficiaries Discharged for Pneumonia per 1,000 Beneficiaries, 1992-2001 Year Beneficiary Characteristics 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002

(rate per 1,000 beneficiaries) All Enrollees 15.51 16.62 16.91 17.19 17.02 17.33 17.90 19.07 17.49 16.64 16.98 Gender

Male 19.24 20.42 20.62 20.83 20.51 20.68 21.16 22.46 20.44 19.35 19.56 Female 13.46 14.54 14.90 15.25 15.14 15.54 16.18 17.28 15.95 15.21 15.65

Age Group 0–54 8.67 9.57 9.73 10.00 9.71 9.67 9.86 10.51 10.00 9.97 10.14 55–64 15.25 16.46 16.73 16.92 16.91 17.00 17.49 18.33 17.14 16.35 16.72 65–69 7.43 8.05 8.31 8.51 8.49 8.64 8.95 9.59 8.57 8.09 8.30 70–74 10.81 11.59 11.90 12.16 12.07 12.38 12.75 13.77 12.53 11.96 12.24 75–79 16.54 17.77 17.90 18.21 17.85 18.16 18.66 19.91 18.33 17.43 17.86 80–84 24.60 26.28 26.89 27.24 26.97 27.46 28.40 30.20 27.02 25.52 25.87 85–89 35.26 37.48 38.05 38.51 38.24 39.11 40.65 42.89 39.59 37.22 37.91 90–94 47.13 50.04 50.21 51.06 50.95 51.54 53.39 56.41 53.17 50.34 51.19 95+ 45.24 45.59 44.86 44.60 42.65 43.15 43.96 46.90 44.55 42.24 42.44






State Alabama 18.82 20.82 22.24 21.35 20.82 21.86 22.13 23.31 21.04 21.16 21.75 Alaska 17.70 18.96 17.45 20.53 19.68 18.39 19.61 18.96 18.17 18.07 15.24


B.1-15


(rate per 1,000 beneficiaries) Arizona 13.91 15.16 14.50 14.43 14.56 15.47 15.66 17.05 13.98 13.58 15.00 Arkansas 19.12 20.52 21.47 20.87 20.21 21.99 21.88 21.80 20.24 18.70 20.46 California 15.79 16.48 16.45 16.93 16.84 17.69 18.11 18.67 16.67 16.42 16.00 Colorado 15.07 15.16 14.94 15.88 15.61 15.38 16.46 17.53 14.46 14.53 13.99 Connecticut 12.94 13.44 13.87 14.10 14.26 14.40 15.83 16.82 16.29 15.64 16.26 Delaware 14.06 14.48 15.11 14.47 15.78 15.43 16.70 17.23 16.13 15.82 16.07 District of Columbia 11.94 13.25 13.89 14.95 15.24 14.03 14.79 16.33 15.83 13.99 13.88 Florida 11.88 12.66 13.37 13.63 13.11 13.31 13.45 15.15 13.77 13.65 13.80 Georgia 19.54 21.66 23.15 22.83 22.25 22.70 22.38 23.26 22.32 20.47 19.99 Hawaii 11.53 11.72 11.84 12.54 12.98 12.75 14.16 15.10 11.93 11.96 13.01 Idaho 13.03 16.47 14.21 15.43 14.27 14.97 16.84 18.26 14.74 12.90 13.40 Illinois 17.02 18.47 18.71 19.13 19.31 18.24 20.00 21.84 19.21 18.13 18.86 Indiana 17.87 18.25 18.73 18.19 18.01 18.33 19.44 20.49 18.87 18.12 18.56 Iowa 15.60 17.55 17.55 18.23 17.85 17.84 19.66 21.51 18.04 16.78 16.10 Kansas 19.30 21.34 20.93 20.80 20.15 20.60 21.67 22.88 19.88 18.81 18.71 Kentucky 24.70 25.58 26.61 26.15 24.99 26.25 26.51 27.98 26.20 24.70 25.29 Louisiana 19.44 21.77 22.86 23.02 23.31 24.06 24.69 25.47 24.16 22.73 22.39 Maine 14.59 15.04 14.63 14.89 15.22 14.32 16.04 15.89 15.12 14.31 14.65 Maryland 14.87 15.86 16.21 17.37 17.04 16.54 16.73 17.89 17.26 16.17 16.59 Massachusetts 16.47 18.05 17.86 18.42 18.20 16.89 18.03 19.48 18.50 17.03 17.24 Michigan 14.29 15.55 16.07 15.86 15.87 15.31 16.35 17.44 16.04 15.80 16.39 Minnesota 15.09 16.37 15.75 15.75 14.70 15.12 16.55 18.93 15.84 15.35 14.77 Mississippi 19.58 22.12 23.46 23.45 23.25 24.79 25.06 25.41 23.28 22.52 22.71 Missouri 19.21 20.63 20.99 20.94 20.43 20.79 22.07 23.16 20.67 20.03 20.48 Montana 16.04 17.54 17.05 17.29 16.80 16.35 17.64 20.25 15.92 15.42 15.69 Nebraska 16.05 17.28 17.72 17.29 16.56 17.25 18.75 20.66 16.05 14.15 13.93 Nevada 15.24 17.75 17.70 18.71 17.81 17.22 17.53 17.90 15.04 14.33 15.43 New Hampshire 12.86 12.77 13.65 13.31 13.78 14.69 14.40 15.38 14.25 14.00 14.28 New Jersey 13.18 14.20 13.76 15.06 15.05 14.94 15.69 17.51 16.36 14.87 15.74 New Mexico 17.65 18.92 18.61 19.50 19.27 20.41 19.23 22.72 17.64 17.25 18.08 New York 14.22 15.56 15.36 16.41 16.42 16.19 17.07 18.20 17.28 15.85 16.49 North Carolina 15.92 17.25 16.85 18.32 17.84 18.08 18.92 19.85 18.84 17.51 18.02 North Dakota 18.27 19.14 19.42 20.90 19.18 19.02 20.16 22.72 17.17 16.19 13.33 Ohio 16.61 17.82 18.56 18.49 18.58 18.99 19.83 20.23 19.54 18.84 19.50 Oklahoma 21.42 23.33 23.30 23.06 22.51 24.76 24.36 25.24 23.41 22.26 23.52 Oregon 12.02 13.84 12.74 13.09 13.46 14.06 13.88 15.21 14.12 12.80 13.99 Pennsylvania 14.53 15.41 15.77 16.06 16.07 16.07 16.67 17.67 17.05 15.57 15.93 Rhode Island 12.52 14.19 14.00 14.40 15.15 15.33 17.38 18.08 18.19 16.64 16.83 South Carolina 14.38 15.34 15.54 17.13 16.80 16.74 16.58 18.14 17.50 16.91 18.40 South Dakota 23.57 23.31 23.55 24.98 21.68 22.69 23.46 26.88 20.99 18.50 18.70


B.1-16


(rate per 1,000 beneficiaries) Tennessee 21.05 22.06 24.19 23.33 22.93 24.59 24.39 25.28 23.96 22.96 23.78 Texas 17.90 18.80 19.53 19.44 19.35 21.10 19.98 21.62 20.20 19.46 20.07 Utah 12.19 14.14 12.55 13.88 12.67 14.18 13.56 16.77 14.06 13.97 15.32 Vermont 14.76 16.75 16.07 16.94 16.14 15.86 17.25 17.73 16.84 16.41 14.62 Virginia 15.90 16.03 16.51 16.75 16.88 16.94 17.36 18.33 17.07 15.96 16.58 Washington 11.94 13.36 12.46 12.85 13.74 13.81 14.11 15.81 14.15 13.62 13.52 West Virginia 20.62 21.22 22.03 22.12 22.73 24.18 24.28 24.13 22.33 21.73 22.29 Wisconsin 12.54 13.15 13.80 12.84 13.10 12.97 14.18 15.89 14.79 13.71 14.10 Wyoming 18.82 19.47 19.64 20.05 16.85 18.66 18.54 21.87 17.71 17.82 16.60 Puerto Rico/Virgin Islands 12.31 12.27 12.06 13.46 12.95 12.75 14.23 15.32 13.73 13.83 12.74


NOTES: Based on short-term hospitalizations among the full-year fee-for-service Medicare population. State and region are based on provider location. All results reported at the national level are standardized to the age-sex distribution of the July 1999 Medicare FFS population using the direct method. Results reported at the state level are standardized using the indirect method. a Age-sex-adjusted rates are not comparable across aged and disabled groups.

B.1-17

Table B.1-6. Age/sex Adjusted Average Length of Stay for Pneumonia Hospitalizations, 1992-2001 Year

Beneficiary Characteristics 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 Average Length of Stay (days) All Enrollees 9.45 8.91 8.46 7.88 7.41 7.17 6.91 6.71 6.70 6.60 6.56 Gender

Male 9.44 8.86 8.42 7.80 7.36 7.13 6.86 6.66 6.63 6.53 6.48 Female 9.45 8.93 8.49 7.92 7.45 7.19 6.95 6.75 6.75 6.65 6.61

Age Group 0–54 9.16 8.64 8.30 7.61 7.23 6.97 6.72 6.60 6.54 6.55 6.49 55–64 9.53 8.90 8.37 7.74 7.40 7.15 6.96 6.70 6.69 6.62 6.62 65–69 9.08 8.56 8.17 7.63 7.23 6.99 6.72 6.51 6.53 6.42 6.41 70–74 9.30 8.82 8.39 7.83 7.37 7.15 6.87 6.66 6.64 6.57 6.50 75–79 9.63 9.10 8.59 8.00 7.54 7.27 7.04 6.82 6.84 6.71 6.66 80–84 9.81 9.21 8.73 8.15 7.58 7.34 7.11 6.88 6.86 6.76 6.71 85–89 9.98 9.32 8.87 8.26 7.65 7.39 7.14 6.99 6.95 6.76 6.70 90–94 9.97 9.29 8.82 8.16 7.60 7.31 7.07 6.89 6.82 6.61 6.59 95+ 9.78 9.30 8.82 7.98 7.53 7.26 6.97 6.88 6.76 6.61 6.53








B.1-18

Year Beneficiary Characteristics 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 Average Length of Stay (days)

Arizona 7.48 6.95 6.71 6.30 6.10 6.07 5.77 5.66 5.59 5.52 5.45 Arkansas 8.97 8.18 7.96 7.29 6.84 6.64 6.50 6.13 6.28 6.04 6.00 California 8.58 7.94 7.73 7.13 6.96 6.81 6.98 6.67 6.99 6.83 6.91 Colorado 7.95 7.15 6.71 6.08 5.83 5.54 5.41 5.27 5.37 5.24 5.23 Connecticut 11.63 10.67 9.46 8.53 7.84 7.47 6.98 6.71 6.63 6.65 6.62 Delaware 10.60 10.47 9.72 8.78 8.51 7.30 6.78 7.40 7.22 6.70 6.85 District of Columbia 12.73 12.18 10.80 10.70 9.44 9.09 9.46 8.80 8.73 8.05 7.90 Florida 9.72 9.13 8.58 8.02 7.57 7.23 7.18 7.07 7.05 7.17 7.04 Georgia 8.93 8.32 8.08 7.47 7.08 6.84 6.67 6.45 6.58 6.48 6.46 Hawaii 11.54 11.87 11.50 10.57 10.31 10.30 9.19 9.03 9.49 9.34 8.46 Idaho 6.09 5.96 5.79 5.44 5.20 5.21 5.19 5.14 5.23 5.41 5.30 Illinois 9.26 8.76 8.23 7.67 7.10 6.93 6.64 6.50 6.52 6.36 6.29 Indiana 9.00 8.33 7.77 7.34 6.84 6.50 6.32 6.24 6.14 5.94 5.95 Iowa 8.46 7.70 7.18 6.67 6.39 6.23 5.96 5.73 5.72 5.73 5.57 Kansas 8.15 7.64 7.37 6.92 6.48 6.40 6.17 6.06 5.95 5.92 6.15 Kentucky 9.53 8.95 8.59 7.84 7.30 6.95 6.79 6.64 6.57 6.49 6.44 Louisiana 8.79 8.61 8.21 7.56 6.92 6.77 6.74 6.55 6.63 6.65 6.73 Maine 9.42 8.76 8.36 7.89 6.79 6.52 6.14 5.98 5.97 5.81 5.84 Maryland 10.42 9.82 9.01 8.30 7.79 7.73 7.07 6.93 6.49 6.20 6.02 Massachusetts 9.81 9.20 8.29 7.64 7.03 6.76 6.36 6.29 6.15 6.15 5.96 Michigan 9.63 9.13 8.69 8.08 7.53 7.34 6.97 6.75 6.72 6.39 6.41 Minnesota 6.61 6.11 5.97 5.74 5.53 5.50 5.34 5.08 5.23 5.10 5.04 Mississippi 9.38 9.06 8.86 8.16 7.83 7.62 7.66 7.37 7.26 7.25 7.24 Missouri 8.79 8.26 7.90 7.25 6.78 6.71 6.44 6.18 6.28 6.09 6.20 Montana 6.80 6.48 6.32 5.99 5.69 5.52 5.60 5.36 5.45 5.17 5.27 Nebraska 7.47 6.96 6.64 6.26 5.98 5.91 5.85 5.78 6.03 6.19 6.24 Nevada 9.06 8.62 8.35 7.60 7.09 7.14 6.68 6.59 6.84 6.64 6.92 New Hampshire 8.68 8.44 8.00 7.44 6.72 6.59 6.27 5.87 5.64 5.76 5.61 New Jersey 14.38 13.57 12.85 11.74 10.72 10.26 9.39 9.15 8.83 8.59 8.57 New Mexico 7.37 7.06 6.95 6.45 6.19 6.08 5.92 5.65 5.76 5.88 5.78 New York 14.67 13.80 13.01 12.16 11.07 10.71 9.96 9.67 9.16 8.79 8.51 North Carolina 10.33 9.76 9.35 8.51 8.10 7.64 7.37 7.14 6.97 6.87 6.77 North Dakota 7.19 6.64 6.21 6.00 5.62 5.44 5.37 4.99 5.01 5.05 5.31 Ohio 9.57 8.76 8.33 7.69 7.11 6.89 6.47 6.32 6.29 6.19 6.17 Oklahoma 8.93 8.57 7.93 7.26 6.87 6.77 6.53 6.32 6.44 6.35 6.26 Oregon 6.03 5.71 5.46 5.25 5.10 5.13 5.07 5.01 4.99 5.06 5.08 Pennsylvania 10.52 9.96 9.26 8.38 7.85 7.52 7.14 6.92 6.69 6.52 6.48 Rhode Island 11.13 9.87 9.55 8.29 7.71 7.46 7.04 6.75 6.77 6.40 6.57 South Carolina 10.25 10.04 9.65 8.71 8.24 7.89 7.65 7.45 7.28 7.17 7.18 South Dakota 7.10 6.62 6.37 6.17 5.88 5.87 5.60 5.62 5.61 5.63 5.48

Table B.6 (cont’d)

B.1-19


Tennessee 9.14 8.57 8.02 7.50 7.13 6.84 6.76 6.44 6.54 6.43 6.41 Texas 8.47 8.19 7.92 7.29 6.91 6.71 6.67 6.50 6.58 6.60 6.62 Utah 6.11 5.81 5.85 5.42 5.28 5.30 5.17 5.13 5.28 5.06 4.94 Vermont 8.98 8.07 8.40 7.45 7.00 6.23 6.09 6.13 5.82 5.72 5.52 Virginia 10.09 9.49 8.94 8.49 7.85 7.86 7.43 7.24 7.09 7.08 6.79 Washington 6.66 6.13 5.79 5.36 5.26 5.25 4.98 5.03 5.01 5.00 4.97 West Virginia 9.59 8.79 8.57 7.87 7.47 7.25 7.06 7.05 7.01 7.03 6.93 Wisconsin 7.94 7.44 7.22 6.75 6.34 6.13 5.83 5.81 5.83 5.61 5.54 Wyoming 6.42 6.12 6.19 5.85 5.58 5.75 5.59 5.37 5.49 5.33 5.29 Puerto Rico/Virgin Islands 10.88 10.47 10.21 10.29 9.80 9.86 9.41 9.30 9.24 9.28 9.26



B.1-20

Table B.1-7. Total Medicare Payments for Discharges for Pneumonia, 1992-2002 Year

Beneficiary Characteristics 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 (in thousands of dollars) All Enrollees 3,285,014 3,661,303 3,808,801 3,898,588 3,929,046 3,995,076 3,900,248 4,083,559 3,853,619 3,890,146 4,207,261 Gender

Male 1,608,336 1,787,720 1,853,444 1,877,258 1,887,640 1,912,228 1,855,708 1,940,013 1,816,741 1,844,549 2,000,799 Female 1,676,679 1,873,583 1,955,358 2,021,330 2,041,405 2,082,848 2,044,540 2,143,546 2,036,878 2,045,598 2,206,462

Age Group 0–54 133,197 166,488 192,046 202,032 211,716 216,419 215,511 234,499 229,315 244,809 267,502 55–64 139,319 159,915 172,475 181,958 195,122 203,993 207,762 217,611 220,292 228,071 263,301 65–69 411,645 450,175 465,504 462,379 459,449 445,835 414,365 424,454 391,944 396,307 434,514 70–74 561,038 620,617 649,377 661,116 650,719 655,571 622,028 640,107 581,422 591,317 626,824 75–79 636,841 707,112 714,550 727,720 737,193 756,833 730,070 773,418 734,614 729,685 784,116 80–84 606,292 670,759 703,300 723,468 723,348 738,878 731,050 758,076 702,885 716,482 783,014 85–89 452,663 505,134 526,948 542,691 548,990 567,032 566,477 600,612 575,389 568,242 608,010 90–94 245,577 274,703 279,432 289,385 293,008 297,672 300,034 314,946 304,246 303,929 323,539 95+ 98,443 106,401 105,169 107,839 109,501 112,842 112,952 119,835 113,513 111,305 116,442

Race White 2,808,330 3,141,420 3,244,005 3,289,994 3,298,087 3,331,298 3,247,671 3,389,188 3,197,202 3,232,719 3,467,760 Black 298,552 373,529 408,201 432,656 445,949 454,175 435,684 458,025 449,457 446,091 500,452 Other 84,531 91,128 122,457 139,351 149,973 188,050 197,513 215,914 192,795 200,622 228,310 Unknown 93,601 55,226 34,139 36,588 35,037 21,553 19,381 20,432 14,166 10,715 10,739

Dual-Enrollment Status Not Dual 2,476,837 2,701,785 2,763,368 2,795,395 2,796,100 2,817,081 2,741,848 2,867,573 2,667,667 2,667,542 2,869,450 Dual 808,177 959,518 1,045,434 1,103,194 1,132,946 1,177,995 1,158,400 1,215,986 1,185,952 1,222,604 1,337,811

Medicare Eligibility Status Aged without ESRD 2,975,955 3,287,629 3,394,243 3,451,452 3,455,263 3,504,439 3,407,114 3,562,129 3,329,987 3,339,702 3,585,958 Disabled without ESRD 238,217 284,424 317,806 331,663 353,295 352,550 357,424 379,738 381,495 398,665 446,798 All with ESRD 70,842 89,250 96,753 115,473 120,487 138,087 135,711 141,691 142,137 151,780 174,506

Urban/Rural Rural 805,111 871,134 921,862 952,516 970,261 1,015,919 991,945 1,046,565 974,569 969,447 1,027,499 Urban 2,479,903 2,790,169 2,886,940 2,946,072 2,958,785 2,979,157 2,908,304 3,036,993 2,879,051 2,920,699 3,179,762

Census Region Northeast 838,476 954,166 961,096 961,944 956,513 943,697 930,339 982,050 939,173 918,132 988,255 Midwest 776,643 848,993 896,735 934,775 940,649 940,676 938,612 990,733 907,579 903,251 962,681 South 1,120,423 1,257,706 1,355,813 1,407,291 1,421,751 1,470,367 1,398,409 1,460,556 1,394,936 1,438,601 1,555,175 West 531,448 581,880 575,390 572,938 589,092 618,102 606,967 622,711 587,444 604,442 675,700 Puerto Rico/Virgin Islands 18,025 18,558 19,767 21,640 21,041 22,235 25,922 27,508 24,487 25,720 25,450

State Alabama 59,297 69,585 75,374 76,277 76,241 79,619 73,047 73,210 66,387 67,493 71,957 Alaska 3,735 4,033 4,171 5,232 4,896 5,719 5,503 6,386 5,926 6,295 5,643


B.1-21

Year Beneficiary Characteristics 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 (in thousands of dollars)

Arizona 46,049 49,768 47,300 39,228 40,255 42,466 39,995 43,408 37,257 38,573 48,134 Arkansas 38,740 40,621 43,839 42,211 41,836 46,000 41,924 40,668 39,819 38,726 44,590 California 317,388 343,751 347,075 344,087 352,302 370,177 370,409 360,058 352,525 361,455 407,199 Colorado 28,788 29,988 29,727 30,190 32,227 29,110 28,956 29,926 26,272 28,284 29,811 Connecticut 48,198 49,507 54,429 56,565 59,501 60,378 57,201 57,124 58,176 63,621 72,914 Delaware 11,279 13,321 12,262 8,685 10,198 9,639 10,175 10,949 10,880 11,754 11,551 District of Columbia 9,331 12,163 12,595 14,109 13,193 12,465 14,951 16,162 15,568 12,116 12,542 Florida 163,889 188,680 202,556 210,628 197,665 191,175 182,842 202,606 186,758 204,718 223,884 Georgia 86,243 91,666 103,771 110,759 113,969 114,152 108,383 112,186 112,743 111,009 113,110 Hawaii 8,182 9,994 10,374 11,411 11,600 13,736 13,402 14,670 13,085 12,638 13,375 Idaho 8,054 9,761 8,754 9,726 10,023 10,668 11,393 12,352 9,929 10,152 10,952 Illinois 148,493 171,417 181,266 190,951 196,757 189,823 189,077 200,515 181,937 180,119 195,403 Indiana 76,054 79,365 81,305 84,023 84,720 87,835 87,615 91,292 84,629 84,854 89,624 Iowa 35,204 36,713 37,082 38,997 40,906 42,606 44,486 48,041 42,447 41,510 39,933 Kansas 35,044 36,781 37,252 38,511 38,659 40,862 41,091 43,371 37,555 36,822 38,527 Kentucky 67,904 71,548 78,229 79,773 81,665 81,793 79,345 83,399 79,892 81,606 88,107 Louisiana 64,294 75,255 81,844 81,704 81,045 80,993 74,622 75,019 71,916 71,235 73,403 Maine 13,174 13,840 13,891 15,716 15,475 15,716 17,015 17,243 16,726 17,033 18,873 Maryland 59,790 65,504 65,707 67,371 65,468 65,947 66,762 75,049 69,900 76,548 83,758 Massachusetts 100,045 118,918 121,032 125,934 120,333 109,492 106,664 112,539 107,520 103,949 108,082 Michigan 116,517 127,731 142,499 151,248 151,988 147,351 150,913 157,225 146,036 146,557 163,111 Minnesota 37,907 41,600 41,347 43,410 42,405 45,214 48,602 56,004 48,921 50,011 50,093 Mississippi 36,752 41,230 44,344 46,113 48,812 52,515 50,846 51,163 45,616 46,641 50,671 Missouri 87,750 96,119 102,146 105,457 100,620 103,787 104,322 105,006 92,513 92,686 99,217 Montana 8,858 10,536 9,850 10,254 10,685 10,523 11,680 12,660 11,584 10,698 11,804 Nebraska 18,022 19,385 21,712 21,685 22,203 22,277 23,580 28,385 24,317 21,774 22,353 Nevada 14,569 17,430 18,873 19,776 19,085 19,220 16,889 17,325 16,428 16,467 19,309 New Hampshire 9,578 10,009 11,938 11,421 12,781 13,273 13,158 13,174 13,907 14,654 15,098 New Jersey 103,550 117,764 117,788 125,102 129,573 136,640 135,416 152,929 148,703 156,449 176,844 New Mexico 14,589 16,023 16,687 17,194 18,082 19,949 18,918 21,314 18,105 19,869 21,346 New York 320,837 370,961 370,397 402,556 398,792 393,836 389,999 418,814 389,772 363,294 384,624 North Carolina 77,314 87,538 91,875 106,607 110,131 112,274 114,950 121,202 116,396 113,597 121,928 North Dakota 8,941 10,423 10,351 11,717 10,806 10,978 11,819 12,757 10,286 9,930 9,331 Ohio 153,085 168,882 178,462 185,779 187,628 183,894 169,328 170,535 165,811 168,664 180,079 Oklahoma 54,037 57,777 55,916 57,605 57,177 62,440 58,509 58,988 54,550 55,161 59,792 Oregon 22,400 24,125 21,536 21,609 23,890 24,863 23,746 25,445 24,526 24,330 27,816 Pennsylvania 224,151 251,015 248,951 200,168 195,168 189,816 186,713 186,072 180,078 175,951 188,487 Rhode Island 13,383 15,709 16,104 17,337 18,276 17,542 16,508 16,026 16,083 14,376 15,340 South Carolina 31,976 36,017 39,528 45,986 49,667 50,629 49,344 55,827 54,956 56,329 64,577 South Dakota 12,744 11,817 12,262 13,699 12,299 13,443 13,235 15,544 13,020 12,553 12,198


B.1-22


Tennessee 80,990 93,418 107,984 108,693 113,640 118,848 110,096 111,930 109,265 107,084 116,969 Texas 186,863 217,649 237,878 242,223 243,204 265,942 240,321 246,299 240,077 260,244 290,336 Utah 10,901 13,255 11,656 14,034 13,320 15,468 12,596 17,454 15,053 15,653 17,048 Vermont 5,560 6,445 6,567 7,146 6,615 7,004 7,662 8,129 8,207 8,806 7,994 Virginia 60,101 64,430 68,702 74,765 79,371 83,505 82,166 86,110 82,644 86,295 88,358 Washington 42,619 47,382 43,762 44,285 47,780 49,709 47,528 54,783 50,594 53,637 57,326 West Virginia 31,624 31,304 33,407 33,780 38,468 42,430 40,126 39,791 37,569 38,046 39,641 Wisconsin 46,880 48,759 51,050 49,299 51,658 52,607 54,545 62,056 60,107 57,770 62,812 Wyoming 5,315 5,833 5,626 5,913 4,948 6,497 5,951 6,930 6,160 6,392 5,936 Puerto Rico/Virgin Islands 18,025 18,558 19,767 21,640 21,041 22,235 25,922 27,508 24,487 25,720 25,450


NOTES: Based on short-term hospitalizations among the full-year fee-for-service Medicare population. State and region are based on provider location. In cases of hospital transfers, only payments from the second hospitalization are included in totals.

B.1-23

Table B.1-8. Average Medicare Payments per Discharge with Pneumonia, 1992-2002 Year


Male 6,193 6,350 6,390 6,389 6,549 6,637 6,351 6,222 6,266 6,441 6,642 Female 5,957 6,061 6,081 6,121 6,259 6,291 5,991 5,877 5,967 6,085 6,210

Age Group 0–54 6,880 7,196 7,367 7,243 7,427 7,484 7,143 7,081 7,089 7,225 7,458 55–64 6,265 6,473 6,528 6,554 6,818 6,953 6,644 6,355 6,561 6,669 6,893 65–69 6,194 6,292 6,381 6,398 6,628 6,670 6,291 6,187 6,265 6,385 6,548 70–74 6,213 6,339 6,363 6,427 6,553 6,668 6,336 6,182 6,193 6,448 6,591 75–79 6,164 6,311 6,300 6,283 6,502 6,562 6,244 6,129 6,230 6,362 6,534 80–84 6,003 6,099 6,114 6,135 6,226 6,291 6,062 5,914 5,982 6,144 6,312 85–89 5,825 5,920 5,949 5,979 6,054 6,098 5,843 5,779 5,852 5,925 6,039 90–94 5,694 5,801 5,736 5,814 5,902 5,861 5,633 5,530 5,597 5,687 5,797 95+ 5,578 5,694 5,730 5,672 5,845 5,879 5,575 5,506 5,458 5,554 5,685



Medicare Eligibility Status Aged without ESRD 6,011 6,119 6,135 6,150 6,285 6,330 6,039 5,925 5,979 6,122 6,265 Disabled without ESRD 6,420 6,667 6,784 6,728 6,965 7,028 6,738 6,544 6,664 6,812 6,988 ESRD only 7,910 8,290 8,396 8,517 8,686 8,977 8,337 8,203 8,312 8,192 8,627



State Alabama 5,229 5,425 5,356 5,588 5,702 5,661 5,153 4,846 4,865 4,805 4,881 Alaska 8,102 8,082 8,147 8,507 7,734 9,006 7,729 8,653 8,242 8,682 8,776 Arizona 7,300 7,075 6,985 5,946 6,131 6,174 5,788 5,596 5,559 5,649 5,856


B.1-24


Arkansas 4,619 4,400 4,414 4,470 4,552 4,572 4,199 4,146 4,303 4,513 4,532 California 7,633 8,122 8,493 8,470 8,856 8,948 8,708 8,243 8,783 8,792 9,475 Colorado 5,753 5,868 5,916 5,646 6,242 5,997 5,774 5,587 5,847 5,950 6,048 Connecticut 7,470 7,213 7,619 7,583 7,938 8,357 7,736 7,371 7,522 7,801 7,898 Delaware 9,260 9,860 8,581 6,438 6,799 6,620 6,254 6,260 6,319 6,405 6,207 District of Columbia 8,399 9,600 9,764 10,436 9,737 10,037 11,034 10,980 10,379 8,955 9,678 Florida 6,186 6,513 6,457 6,575 6,574 6,362 6,095 5,979 5,931 6,181 6,223 Georgia 5,549 5,159 5,300 5,557 5,790 5,721 5,495 5,400 5,586 5,727 5,894 Hawaii 7,451 8,293 8,532 8,305 8,369 9,440 8,167 8,246 8,895 8,692 8,407 Idaho 4,509 4,260 4,437 4,342 4,585 4,691 4,499 4,505 4,457 5,091 5,052 Illinois 5,736 5,981 6,135 6,359 6,499 6,652 6,100 5,933 6,059 6,178 6,221 Indiana 5,261 5,248 5,154 5,354 5,403 5,440 5,066 5,020 5,002 5,105 5,175 Iowa 4,536 4,125 4,068 4,020 4,293 4,438 4,217 4,143 4,326 4,519 4,495 Kansas 4,647 4,265 4,398 4,488 4,705 4,834 4,609 4,634 4,637 4,767 4,889 Kentucky 4,870 4,885 4,931 5,093 5,298 5,108 4,862 4,780 4,802 5,062 5,217 Louisiana 5,720 5,847 5,919 5,996 5,962 5,961 5,604 5,491 5,433 5,581 5,629 Maine 4,581 4,590 4,646 5,107 4,813 5,086 4,841 4,890 4,864 5,132 5,420 Maryland 7,157 7,204 6,821 6,341 6,504 7,032 7,125 7,237 6,669 6,946 7,151 Massachusetts 6,664 6,939 7,059 7,312 7,385 7,493 7,128 7,012 6,980 7,189 7,216 Michigan 6,556 6,454 6,715 7,083 7,044 7,030 6,754 6,591 6,542 6,527 6,680 Minnesota 4,879 4,845 4,871 5,034 5,178 5,254 5,078 4,892 5,004 5,165 5,388 Mississippi 4,707 4,562 4,546 4,582 4,857 4,800 4,610 4,541 4,446 4,664 4,878 Missouri 5,316 5,398 5,511 5,679 5,638 5,830 5,611 5,457 5,479 5,536 5,739 Montana 4,336 4,607 4,322 4,330 4,486 4,587 4,595 4,357 4,831 4,609 4,898 Nebraska 4,182 4,164 4,517 4,659 4,840 4,821 4,693 5,053 5,505 5,538 5,772 Nevada 6,964 7,045 7,474 7,236 7,167 7,633 6,549 6,291 6,744 6,833 6,894 New Hampshire 5,092 5,227 5,527 5,449 5,583 5,819 5,804 5,517 5,574 5,799 5,834 New Jersey 7,185 7,458 7,537 7,254 7,667 8,240 7,947 8,000 8,182 9,072 9,242 New Mexico 4,787 4,805 5,081 5,081 5,234 5,318 5,341 4,927 5,248 5,573 5,629 New York 9,149 9,612 9,659 9,877 9,953 10,336 9,896 10,009 9,705 9,691 9,814 North Carolina 5,233 5,201 5,423 5,574 5,768 5,719 5,479 5,476 5,444 5,571 5,689 North Dakota 4,017 4,370 4,164 4,278 4,445 4,334 4,482 4,284 4,464 4,522 4,987 Ohio 5,849 5,893 5,848 5,998 6,094 6,174 5,698 5,658 5,636 5,741 5,813 Oklahoma 5,191 5,030 4,831 4,927 4,974 4,990 4,814 4,765 4,780 4,993 4,952 Oregon 5,228 4,992 4,986 5,152 5,538 5,727 5,528 5,351 5,481 5,718 5,701 Pennsylvania 7,612 7,919 7,552 6,137 6,334 6,448 6,329 6,113 6,124 6,261 6,464 Rhode Island 6,645 6,830 7,107 7,221 7,204 7,255 6,896 6,791 6,755 6,610 6,963 South Carolina 5,164 5,248 5,473 5,557 5,925 5,938 5,673 5,678 5,642 5,748 5,969 South Dakota 4,149 3,746 3,790 4,000 4,013 4,166 3,927 4,074 4,293 4,501 4,389 Tennessee 4,898 5,177 5,311 5,457 5,677 5,511 5,220 5,119 5,193 5,196 5,440 Texas 5,388 5,826 5,943 6,039 6,149 6,147 5,958 5,687 5,793 6,018 6,174


B.1-25


Utah 5,333 5,546 5,477 5,754 5,938 6,165 5,143 5,018 5,053 5,092 4,934 Vermont 4,720 4,670 4,825 4,894 4,882 5,042 4,953 5,006 5,133 5,538 5,457 Virginia 5,146 5,329 5,359 5,610 5,776 5,892 5,569 5,510 5,463 5,818 5,612 Washington 6,146 5,955 5,833 5,853 6,055 6,343 6,000 6,044 6,061 6,220 6,368 West Virginia 5,124 4,781 4,750 4,768 5,151 5,247 4,910 4,940 4,918 5,130 5,142 Wisconsin 4,915 4,768 4,721 4,854 4,967 5,118 4,822 4,832 5,013 5,115 5,219 Wyoming 4,982 5,303 4,966 4,940 4,983 5,539 5,095 4,829 5,207 5,274 5,157 Puerto Rico/Virgin Islands 2,912 2,952 3,115 2,974 2,956 3,130 3,158 3,039 2,963 3,050 3,249



B.1-26

Table B.1-9. Total Beneficiary Deductible and Coinsurance Payments for Discharges for Pneumonia, 1992-2002 Year

Beneficiary Characteristics 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 (in thousands of dollars)

All Enrollees 304,123 340,859 355,127 362,579 359,238 368,662 379,197 409,270 380,511 378,956 409,618 Gender

Male 143,569 160,245 165,751 168,027 166,558 169,630 172,912 187,098 172,850 172,857 187,045 Female 160,554 180,615 189,376 194,553 192,679 199,032 206,284 222,173 207,660 206,098 222,573

Age Group 0–54 10,857 13,652 15,318 16,213 17,064 17,706 18,551 20,363 20,046 21,477 23,142 55–64 12,201 14,240 15,098 16,166 16,772 17,363 18,867 20,600 20,334 20,802 24,248 65–69 37,849 41,790 42,779 42,669 41,286 40,582 40,244 42,549 38,807 38,775 42,665 70–74 51,061 56,794 59,795 60,299 58,559 59,095 59,682 63,717 57,360 56,737 60,632 75–79 58,509 65,419 66,070 67,596 66,598 69,283 70,288 76,758 71,335 70,392 74,817 80–84 56,873 62,795 66,006 67,925 67,014 69,166 71,315 76,601 69,996 70,233 76,326 85–89 43,051 48,420 51,064 52,021 51,996 54,302 56,783 61,979 58,069 56,801 61,127 90–94 23,751 27,029 28,201 28,508 28,943 29,721 31,408 33,587 32,093 31,618 33,933 95+ 9,970 10,719 10,796 11,183 11,006 11,443 12,059 13,115 12,472 12,122 12,729

Race White 263,547 298,448 310,119 314,471 311,353 317,959 327,431 351,439 327,993 326,931 351,031 Black 24,967 30,728 32,221 33,860 33,269 33,935 33,812 37,255 35,645 34,858 39,291 Other 6,926 7,127 9,608 10,705 11,270 14,747 15,994 18,543 15,550 16,060 18,299 Unknown 8,683 4,557 3,179 3,544 3,345 2,021 1,960 2,034 1,323 1,106 997





State Alabama 6,318 7,242 7,937 7,714 7,648 8,337 8,467 8,971 8,211 8,470 9,192 Alaska 225 280 291 379 368 395 424 420 450 492 452


B.1-27


(in thousands of dollars) Arizona 2,955 3,525 3,479 3,497 3,567 3,779 3,858 4,296 3,739 3,863 4,811 Arkansas 4,362 4,847 5,218 5,250 5,167 5,727 5,784 5,800 5,355 4,951 5,995 California 21,790 22,796 22,239 22,459 22,372 24,180 25,241 26,203 23,904 25,197 27,411 Colorado 2,666 2,779 2,794 3,060 3,007 2,913 2,994 3,214 2,712 2,967 3,138 Connecticut 3,954 4,031 4,200 4,338 4,488 4,240 4,259 4,610 4,616 4,850 5,707 Delaware 746 908 934 854 926 944 1,033 1,187 1,149 1,141 1,328 District of Columbia 699 732 858 839 749 647 772 932 841 768 692 Florida 14,318 15,967 17,331 17,604 16,982 17,064 17,339 20,164 18,656 19,551 21,634 Georgia 8,277 9,436 10,780 10,921 10,914 11,416 11,513 12,112 11,800 11,403 11,664 Hawaii 697 781 983 921 933 1,150 1,151 1,243 1,233 1,051 1,277 Idaho 977 1,316 1,187 1,344 1,330 1,431 1,642 1,791 1,461 1,334 1,447 Illinois 14,387 16,358 16,777 17,197 17,664 16,859 18,697 20,489 17,873 17,390 19,377 Indiana 7,634 8,127 8,508 8,596 8,718 9,277 9,940 10,614 9,990 9,844 10,504 Iowa 4,195 4,909 5,028 5,421 5,464 5,596 6,289 7,019 5,862 5,611 5,491 Kansas 4,085 4,880 4,777 4,918 4,889 5,076 5,399 5,752 4,984 4,780 5,034 Kentucky 7,359 7,704 8,568 8,623 8,406 8,881 9,244 9,897 9,359 9,131 9,912 Louisiana 5,772 6,960 7,560 7,476 7,477 7,654 7,604 7,873 7,607 7,517 8,061 Maine 1,572 1,726 1,723 1,836 1,893 1,868 2,142 2,178 2,149 2,109 2,236 Maryland 4,929 5,618 5,446 5,680 5,438 5,477 5,559 6,224 6,331 6,941 7,124 Massachusetts 8,426 9,533 9,546 9,588 9,051 8,209 8,419 9,255 8,978 8,389 8,816 Michigan 10,140 11,666 12,188 12,616 12,970 12,687 13,740 14,905 13,965 13,911 15,490 Minnesota 3,957 4,616 4,627 4,875 4,717 5,146 5,783 7,040 5,973 5,770 5,849 Mississippi 4,187 5,014 5,567 5,592 5,603 6,228 6,508 6,537 6,078 6,037 6,372 Missouri 8,575 9,693 10,056 9,922 9,741 10,049 10,697 11,185 9,751 9,665 10,418 Montana 1,056 1,260 1,225 1,342 1,374 1,403 1,536 1,847 1,445 1,458 1,552 Nebraska 2,322 2,576 2,725 2,717 2,629 2,785 3,078 3,470 2,673 2,459 2,495 Nevada 1,114 1,335 1,385 1,499 1,455 1,515 1,523 1,598 1,464 1,472 1,764 New Hampshire 1,096 1,138 1,241 1,268 1,330 1,416 1,396 1,522 1,563 1,572 1,722 New Jersey 10,773 11,920 12,021 12,674 11,688 11,320 11,139 12,478 11,837 11,347 12,765 New Mexico 1,670 1,852 1,867 2,005 2,036 2,308 2,138 2,687 2,065 2,258 2,483 New York 28,765 31,047 31,294 31,155 29,519 28,059 27,712 29,536 27,213 25,713 27,311 North Carolina 8,626 9,893 10,047 11,097 11,419 11,967 12,638 13,034 12,750 12,566 13,488 North Dakota 1,070 1,216 1,284 1,399 1,318 1,371 1,500 1,697 1,248 1,219 1,049 Ohio 14,350 15,906 17,026 17,411 17,712 17,159 17,326 17,716 17,353 17,397 18,855 Oklahoma 5,671 6,612 6,601 6,684 6,647 7,413 7,187 7,475 6,985 6,818 7,523 Oregon 2,324 2,659 2,514 2,479 2,557 2,700 2,688 2,986 2,893 2,730 3,175 Pennsylvania 14,612 18,330 19,182 18,872 17,965 17,044 17,206 17,857 17,095 16,668 17,589 Rhode Island 1,244 1,267 1,392 1,383 1,495 1,516 1,322 1,365 1,428 1,276 1,293 South Carolina 3,742 4,224 4,500 5,108 5,107 5,345 5,476 6,337 6,150 6,154 7,180 South Dakota 1,573 1,657 1,742 1,897 1,695 1,843 1,959 2,271 1,731 1,584 1,664


B.1-28


(in thousands of dollars) Tennessee 8,381 9,225 10,565 10,526 10,614 11,681 11,721 12,428 11,847 11,721 12,445 Texas 18,310 20,571 22,145 22,222 22,141 25,134 23,501 25,615 24,548 25,935 28,980 Utah 1,100 1,346 1,191 1,438 1,337 1,556 1,535 2,226 1,882 1,976 2,238 Vermont 649 795 849 917 839 828 985 1,029 1,019 1,016 926 Virginia 6,479 6,871 7,345 7,889 8,088 8,567 9,006 9,642 9,476 9,513 10,011 Washington 3,646 4,384 4,186 4,356 4,674 4,658 4,752 5,513 5,191 5,355 5,729 West Virginia 3,263 3,499 3,767 3,750 4,065 4,478 4,652 4,506 4,277 4,347 4,508 Wisconsin 5,131 5,596 6,127 5,921 6,155 6,300 6,948 8,011 7,440 7,008 7,580 Wyoming 570 619 636 696 616 735 711 906 713 785 771 Puerto Rico/Virgin Islands 3,381 3,617 3,668 4,351 4,279 4,330 5,063 5,604 5,194 5,474 5,085


NOTES: Based on short-term hospitalizations among the full-year fee-for-service Medicare population. State and region are based on beneficiary location. In cases of hospital transfers, only payments from the second hospitalization are included in totals.

B.1-29

Table B.1-10. Average Number of Pneumonia Discharges Per Beneficiary Discharged With Pneumonia 1992-2002 Year Beneficiary Characteristics 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 All Enrollees 1.10 1.10 1.11 1.11 1.11 1.12 1.11 1.11 1.11 1.12 1.12 Gender

Male 1.12 1.12 1.13 1.13 1.13 1.13 1.13 1.13 1.13 1.13 1.13 Female 1.09 1.09 1.09 1.10 1.10 1.10 1.10 1.10 1.10 1.11 1.11

Age Group 0–54 1.14 1.13 1.15 1.13 1.14 1.13 1.13 1.14 1.13 1.13 1.14 55–64 1.13 1.12 1.13 1.14 1.14 1.13 1.14 1.13 1.14 1.14 1.14 65–69 1.09 1.09 1.10 1.10 1.11 1.11 1.11 1.11 1.11 1.12 1.11 70–74 1.10 1.10 1.11 1.11 1.11 1.11 1.11 1.11 1.11 1.12 1.12 75–79 1.10 1.10 1.11 1.11 1.11 1.12 1.11 1.11 1.12 1.12 1.12 80–84 1.11 1.10 1.11 1.11 1.11 1.12 1.11 1.11 1.11 1.12 1.11 85–89 1.10 1.10 1.11 1.11 1.11 1.11 1.11 1.11 1.11 1.12 1.11 90–94 1.10 1.10 1.11 1.11 1.11 1.11 1.11 1.11 1.10 1.11 1.11 95+ 1.10 1.10 1.10 1.11 1.11 1.10 1.11 1.10 1.10 1.10 1.10



Medicare Eligibility Status Aged without ESRD 1.10 1.10 1.11 1.11 1.11 1.11 1.11 1.11 1.11 1.12 1.11 Disabled without ESRD 1.13 1.13 1.14 1.13 1.14 1.14 1.14 1.13 1.14 1.14 1.14 All with ESRD 1.10 1.10 1.12 1.12 1.11 1.12 1.12 1.13 1.12 1.13 1.13





B.1-30




B.1-31




NOTES: Based on short-term hospitalizations among the full-year fee-for-service Medicare population. State and region are based on provider location.

B.1-32

Table B.1-11. Average Number of All Discharges Per Beneficiary Discharged With Pneumonia, 1992-2002 Year

Beneficiary Characteristics 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 All Enrollees 2.00 1.99 2.02 2.05 2.08 2.11 2.10 2.09 2.14 2.20 2.19 Gender

Male 2.07 2.05 2.08 2.10 2.13 2.16 2.15 2.13 2.18 2.23 2.22 Female 1.94 1.93 1.97 2.01 2.04 2.07 2.06 2.06 2.11 2.17 2.16

Age Group 0–54 2.44 2.40 2.44 2.42 2.49 2.49 2.45 2.45 2.47 2.52 2.55 55–64 2.40 2.36 2.36 2.42 2.44 2.46 2.44 2.41 2.45 2.52 2.51 65–69 2.07 2.05 2.07 2.11 2.13 2.18 2.16 2.14 2.19 2.24 2.24 70–74 2.04 2.03 2.06 2.08 2.12 2.16 2.14 2.13 2.18 2.22 2.22 75–79 2.01 1.99 2.02 2.05 2.08 2.13 2.11 2.09 2.15 2.22 2.20 80–84 1.96 1.94 1.98 2.01 2.03 2.07 2.05 2.06 2.10 2.16 2.15 85–89 1.89 1.87 1.91 1.95 1.98 2.01 2.01 2.00 2.05 2.11 2.09 90–94 1.81 1.81 1.84 1.87 1.90 1.91 1.90 1.92 1.96 2.00 2.00 95+ 1.71 1.71 1.76 1.78 1.81 1.81 1.83 1.83 1.83 1.88 1.87








B.1-33




B.1-34





B.1-35

Table B.1-12. Age-Sex Adjusted All-Cause Readmission Rates per 1,000 Beneficiaries Discharged with Pneumonia, 1992-2001 Year

Beneficiary Characteristics 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 (within 30-days from discharge) All Enrollees 163 161.24 164.36 168.16 174 177.69 173.66 174.29 180.06 186.12 189.92 Gender

Male 181.33 178.46 180.14 183.8 188.42 192.53 187.09 187.93 192.97 196.73 201.74 Female 149.62 148.81 152.55 156.91 163.57 167.11 163.63 164.1 170.56 178.47 181.3

Age Group 0–54 181.49 169.59 179.79 171.43 186.71 180.63 173.23 177.15 181.12 184.17 189.34 55–64 179.92 183.71 183.6 186.59 193.9 192.91 190.04 182.12 190.89 200.09 197.44 65–69 156.85 152.37 155.18 160.91 165.43 168.51 163.84 163.45 172.03 180.06 183.43 70–74 158.36 157.93 159.15 164.05 169.31 175.95 171.96 170.35 177.18 178.49 184.25 75–79 161.94 161.02 162.11 169.22 174.42 178.18 174.63 175.95 181.38 189.07 192.68 80–84 164.11 165.26 168.74 171.6 176.33 182.03 178.92 180.27 185.52 193.53 195.03 85–89 163.45 167.13 169.02 177.93 177.66 187.71 181.97 188.6 189.44 196.08 202.12 90–94 163.5 163.85 168.57 174.31 180.78 186.5 183.39 187.06 188.85 197.02 202.75 95+ 158.5 163.06 172.97 169.52 176.88 184.81 180.02 195.35 184.51 199.11 203.14

Race White 160.13 157.36 161.09 165.31 170.02 173.99 169.7 170.69 175.6 181.64 185.46 Black 186.41 185.82 190.63 194.54 208.11 210.22 207.43 203.18 214.67 224.27 224.97 Other 170.32 168.18 170.43 167.03 176.71 177.03 179.25 178.59 187.69 184.3 192.56 Unknown 162.88 260.13 151.47 167.57 177.32 182 162.12 184.35 212.32 213.42 215.3




Census Region Northeast 167.74 166.95 172.55 172.1 179.02 189.03 185.82 184.95 188.86 197.56 204.68 Midwest 158.32 156.49 157.12 164.18 167.9 172.18 165.46 169.43 173.19 182.32 187.27 South 165.88 163.81 166.72 171.87 178.93 179.75 177.36 177.78 182.52 188.02 189.59 West 157.73 155.09 158.81 159.18 163.77 167.85 162.39 159.64 173.12 173.03 176.54 Puerto Rico/Virgin Islands 163.36 160.87 168.45 158.99 176.69 172.88 182.02 174 188.43 181.85 198.73

State Alabama 177.41 166.26 165.16 175.55 182.87 186.12 185.52 181.38 183.49 186.43 185.41 Alaska 210.28 126.52 165.2 117 134.96 202.14 120.01 147.8 178.19 136.93 180.61


B.1-36

Year Beneficiary Characteristics 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 (within 30-days from discharge)

Arizona 150.33 147.5 145.26 150.57 152.6 151.58 154.57 155.98 167.76 175.62 171.93 Arkansas 156.55 156.77 162.44 168.4 176.47 175.15 170.07 177.01 179.08 185.44 185.07 California 167.16 166.82 173.66 177.02 181.77 189.64 178.87 180.5 186.65 191.57 196.3 Colorado 135.25 131.18 145.85 129.41 147.6 149.1 155.48 146.54 160.15 147.35 161.97 Connecticut 151.89 153.21 157.63 157.96 162.04 174.4 177.51 169.85 184.41 186.36 186.94 Delaware 169.3 153.45 154.25 169.78 176.01 204.41 177.49 177.07 174.78 195.63 175.43 District of Columbia 207.61 225.59 227.87 213.95 225.97 204.15 216.95 214.96 224.29 219.94 241.04 Florida 157.25 156.07 163.71 170.85 175.3 181.44 178.73 175.33 178.75 189.96 197.88 Georgia 177.24 177.57 174.45 181.7 196.67 187.53 176.72 181.75 185.14 191.72 186.29 Hawaii 151.79 118.7 139.15 148.89 143.57 161.94 147.34 132.79 172.61 156.01 154.38 Idaho 133.42 123.38 137.65 138.63 131.56 133.5 124.31 131.52 146.46 141.83 124.99 Illinois 171.11 173.47 178.34 179.52 182.76 188.99 184.36 184.88 197.16 201.16 207.26 Indiana 150.88 155.4 156.66 162.47 161.6 162.36 157.82 165.97 163.37 168.04 172.84 Iowa 136.61 139.69 141.25 145.94 145.02 155.32 148.97 159.96 153.07 160.33 161.67 Kansas 135.38 150.72 138.91 157.79 152.52 163.72 153.99 167.42 157.51 164.66 160.97 Kentucky 190.78 190.24 178.63 187.91 199.25 194.9 188.45 200.15 206.14 215.04 208.16 Louisiana 181.9 181.16 181.45 185.43 191.54 195.97 195.24 192.3 201.53 200.01 201.27 Maine 154.15 174 168.33 166.16 158.77 156.32 157.14 157.37 158.27 160.26 179.07 Maryland 196.71 198.67 203.79 206.19 212.36 213.08 205.36 211.23 213.19 225.82 233.43 Massachusetts 174.58 179.75 180.31 178.81 184.93 193.82 185.98 189.13 188.51 204.98 205.47 Michigan 166.72 165.8 163.6 174.46 175.58 185.94 170.74 175.19 176.06 191.97 199.67 Minnesota 152.42 156.96 155.53 148.52 152.81 159.42 153.25 154.75 152.99 165.47 177.61 Mississippi 184.53 184.5 181.91 198.05 195.56 198.14 192.11 197.85 188.78 196.84 194.32 Missouri 154.57 149.81 149.15 161.91 162.96 178.92 172.13 173.56 181.52 192.6 208.82 Montana 176.79 156.76 143.78 145.26 157.82 151.64 157.7 155.17 169.93 159.02 163.94 Nebraska 136.59 129.81 137.14 139.84 142.87 149.02 146.59 155.17 138.95 171.13 155.41 Nevada 166.08 162.77 162.54 154.89 182.88 174.16 186.32 180.07 178.03 180.46 197.24 New Hampshire 136.43 127.32 135.75 144 149.63 140.17 156.9 140.47 146.17 155.71 165.77 New Jersey 174.84 177.42 187.41 186.33 189.99 206.33 200.01 196.67 208.63 220.16 228.29 New Mexico 146.6 143.35 135.19 141.35 131.13 140.9 137.43 137.64 145.97 146.86 142.5 New York 169.26 165.52 176.92 178.56 187.97 197.52 192.9 197.32 199.24 211.5 215.99 North Carolina 152.43 157.24 152.96 161.73 167.76 171.52 167.52 176.1 182.06 182.97 183.81 North Dakota 147.46 141.89 129.14 144.75 134.15 151.63 155.4 151.65 146.16 152.14 151.45 Ohio 169.56 165.89 168.84 177.52 186.12 185.33 183.19 190.92 187.75 199.61 201.13 Oklahoma 152.11 146.5 147.73 160.44 156.52 170.4 170.46 167.48 175.28 176.48 182.49 Oregon 125.09 137.17 130.42 140.56 136.82 134.25 144.75 150.43 148.03 155.29 151.1 Pennsylvania 172.87 174.33 178.48 178.92 179.42 187.4 188.7 192.15 197.41 198.16 205.17 Rhode Island 163.12 157.44 152.03 170.96 176.23 201.37 202.52 191.57 177.03 202.16 197.54 South Carolina 158.9 167.1 154.74 161.02 165.67 174.47 171.89 175.36 181.52 182.84 192.8 South Dakota 145.92 157.26 159.82 148.36 151.14 166.13 158.66 146.62 155.02 167.77 145.83


B.1-37


Tennessee 174.21 176.07 175.35 182.31 189.65 188.46 182.3 179.59 189.65 191.91 197.41 Texas 160.2 156.67 161.54 166.07 172.69 178.47 177.92 174.12 180.54 186.97 187.57 Utah 107.36 103.87 116.07 121.31 113.65 115.58 116.81 106.67 121.39 138.1 128.19 Vermont 149.88 132.71 151.95 145.67 145.75 157.14 139.35 141 153.81 150.46 156.17 Virginia 168.33 167.42 181.03 171.07 185.49 175.95 184.57 183.93 180.53 183.07 192.47 Washington 152.99 145.95 147.38 154.6 151.99 154.3 151.85 154.51 163.06 159.15 167.67 West Virginia 174.04 177.69 193.37 183.95 193.43 203.68 206.01 215.89 210.48 217.55 208.05 Wisconsin 130.43 137.45 136.86 146.06 151.11 141.65 143.04 148.14 149.41 155.18 162.67 Wyoming 158.37 127.76 120.36 113.02 115.83 146.27 124.1 135.11 155.83 140.81 136.56 Puerto Rico/Virgin Islands 171.29 169.06 171.69 163.88 180.85 181.43 189.05 177.93 196.78 186.3 201.79


B.1-38

Year Beneficiary Characteristics 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 (within 365-days from discharge) All Enrollees 589.64 583.92 590.42 591.79 606.49 610.87 600.76 595.09 611.36 627.83 n.a. Gender

Male 623.82 616.73 621.11 619.02 630.44 636.82 625.33 616.72 631.81 644.46 n.a. Female 566.01 561.42 569.22 573.66 591.13 593.78 584.56 580.74 597.78 617.47 n.a.

Age Group 0–54 632.19 619.41 620.94 609.7 623.71 622.1 607.31 607.78 618.96 634.6 n.a. 55–64 655.9 644.59 651.28 651.07 660.61 658.31 651.08 641.44 653.54 666.41 n.a. 65–69 547.39 542.36 551.76 557.56 572.49 577.62 566.94 559.56 577.52 595.31 n.a. 70–74 568.74 565.26 569.36 573.5 592.25 595.36 585.65 579.07 597.27 611.1 n.a. 75–79 590.34 584.67 590.96 590.46 604.68 614.55 602.76 595.79 612.9 631.29 n.a. 80–84 608.94 604.41 612.89 612.87 625.87 630.74 622.52 614.57 632.4 651.54 n.a. 85–89 626.72 623.4 626.64 632.37 649.11 653.28 643.49 639.91 653.95 670.75 n.a. 90–94 641.71 636.83 647.17 647.67 659.73 665.45 657.4 660.45 672.63 690.62 n.a. 95+ 652.18 652.63 663.87 680.26 681.36 676.58 683.91 687.72 688.3 704.79 n.a.

Race White 584.52 576.79 583.61 585.68 599.14 603.53 593.32 588.13 605.1 620.08 n.a. Black 630.36 624.52 637.33 636.63 663.33 664.77 654.69 644.6 656.78 687.98 n.a. Other 598.6 605.46 611.69 600.43 613.92 614.77 610.13 601.75 619.78 629.32 n.a. Unknown 599.76 735.5 582.28 583.24 600.6 607.22 587.84 594.66 648.08 653.05 n.a.

Dual-Enrollment Status Not Dual 568.21 559.87 564.57 565.24 579.58 583.78 572.08 564.96 581.21 596.6 n.a. Dual 666.05 662.39 669.8 668.64 681.23 684.29 677.41 673.33 686.08 702.91 n.a.

Medicare Eligibility Statusa Aged without ESRD 626.66 621.84 631.02 633.37 647.69 646.66 636.04 629.96 646.78 662.92 n.a. Disabled without ESRD 618.2 603.28 607.82 598.66 611.22 608.81 596.57 595.17 606.83 619.41 n.a. All with ESRD 875.2 868.71 866.22 870.24 882.46 879.52 881.22 868.18 878.98 883.41 n.a.

Urban/Rural Rural 587.87 580.9 585.4 589.57 604.14 604.86 595.15 589.98 605.5 622.34 n.a. Urban 590.33 585.05 592.6 592.71 607.46 613.89 603.44 597.6 614.17 630.29 n.a.

Census Region Northeast 596.3 585.84 600.27 592.33 606.89 622.44 608.72 605.31 618.42 639.11 n.a. Midwest 583.52 576.39 577.58 582.29 599.39 603.95 590.55 585.45 603.55 623.59 n.a. South 598.57 594.67 599 603.76 617.44 618.33 611.06 607.83 619.15 636.03 n.a. West 567.46 565.29 573.25 573.15 585.41 584.79 578.94 561.41 592.24 598.12 n.a. Puerto Rico/Virgin Islands 584.71 567.68 596.6 580.24 603.76 601.62 590.97 596.03 601.63 590.49 n.a.

State Alabama 636.73 618.81 619.1 626.14 637.97 638.97 643.23 629.43 637.55 655.81 n.a. Alaska 656.91 552.55 582.23 534.65 559.94 594.64 553.56 572.63 629.58 593.77 n.a. Arizona 549.64 548.68 551.1 561.69 572.04 571.65 567.58 544.31 583.98 587.33 n.a. Arkansas 602.77 601.21 603.33 605.48 630.29 618.41 600.8 609.54 613.97 637.76 n.a.


B.1-39


California 597.85 609.18 616.15 623.52 627.39 632.23 623.73 611.49 631.6 644.04 n.a. Colorado 541.91 535.11 553.2 531.85 564.44 556.48 558.97 540.83 588.24 570.82 n.a. Connecticut 569.47 570.75 564.56 556.03 576.1 608.96 592.45 582.1 614.38 641.08 n.a. Delaware 593.95 577.51 569.82 613.3 590.33 627.94 621.97 610.4 623.16 635.58 n.a. District of Columbia 659.54 625.24 650.84 658.28 657.57 660.65 660.41 630.18 660.24 671.03 n.a. Florida 585.64 584.23 591.9 595.62 605.49 613.2 607.47 594.63 611.33 624.78 n.a. Georgia 633.62 626.02 615.38 625.15 637.95 626.72 610.68 605.29 620.41 639.82 n.a. Hawaii 563.02 537.22 525.42 533.36 558.11 576.75 548.15 528.06 573.62 574.89 n.a. Idaho 534.09 506.55 535.89 548.06 559.9 529.66 559.47 532.33 559.16 560.87 n.a. Illinois 618.71 612.89 617.35 611.19 621.27 644.03 631.54 620.79 641.99 660.31 n.a. Indiana 605.84 593.58 597.96 599.98 610.61 614.85 600.95 601.54 620.31 623.03 n.a. Iowa 560.63 558.06 557.49 571.37 575.66 592.75 575.37 573.49 584.25 616.44 n.a. Kansas 574.55 585.04 574.23 590.66 611.53 606.55 587.35 588.38 593.95 610.38 n.a. Kentucky 640.36 637.14 628.21 634.09 655.36 641.82 641.37 642.57 664.95 678.25 n.a. Louisiana 642.92 630.2 637.7 648.77 660.68 671.79 661.4 672.21 678.91 686.53 n.a. Maine 583.41 581.75 585.45 572.82 582.41 607.49 585.05 598.51 597.87 614.79 n.a. Maryland 628.47 627.5 651.5 646.68 662.65 661.95 641.69 640.95 655.15 674.06 n.a. Massachusetts 616.63 607.12 618.34 608.05 621.34 639.09 613.92 611.47 639.36 655.98 n.a. Michigan 590.12 587.6 591.8 597.02 609.89 621.13 604.24 597.05 619.04 643.13 n.a. Minnesota 580.04 567.48 558.27 571.22 577.37 577.54 569.89 559.09 573.59 599.92 n.a. Mississippi 653.76 637.48 641.22 660.03 654.17 661.58 644.7 640.04 641.5 655.29 n.a. Missouri 594.51 588.91 584.04 593.47 617.91 622.85 606.64 618.54 623.53 652.03 n.a. Montana 618.13 569.88 556.72 559.05 580.95 582.81 589.19 556.27 609.63 578.87 n.a. Nebraska 534.83 544.54 544.06 560.03 571.1 569.16 569.42 561.96 573.32 599.1 n.a. Nevada 574.89 573.56 573.61 553.22 582.53 608 592.46 571.39 582.31 602.86 n.a. New Hampshire 549.95 534.84 545.48 528.12 568.44 565.34 538.97 537.91 544.26 585.39 n.a. New Jersey 627.27 609.34 629.78 615.64 632.67 652.84 638.22 631.71 646.34 672.05 n.a. New Mexico 562.64 530.91 560.01 535.55 551.55 549.1 542.71 528.38 574.37 575.02 n.a. New York 606.79 594.56 611.12 603.53 622.11 633.03 624.3 622.02 632.43 655.83 n.a. North Carolina 578.32 584.26 587.22 589.66 602.75 619.61 609.23 612.55 625.42 631.34 n.a. North Dakota 576.6 578.35 566.26 560.7 564.72 592.62 573.97 562.1 573.05 582.66 n.a. Ohio 613.65 597.96 608.42 610.05 637.59 631.51 624.7 619.18 633.24 652 n.a. Oklahoma 608.33 603.65 598.5 622.96 631.32 634.06 622.96 626.84 618.49 648.58 n.a. Oregon 535.65 531.42 544.67 539.04 551.14 549.84 552.69 543.44 543.12 589.53 n.a. Pennsylvania 623.2 619.32 630.79 628.59 640.56 644.52 640.51 632.68 652.78 661.45 n.a. Rhode Island 560.85 568.44 574.35 595.58 593.19 645.44 622.53 612.81 619.63 636.16 n.a. South Carolina 598.65 598.7 597.12 586.72 615.01 619.76 607.64 614.78 619.96 640.23 n.a. South Dakota 586.15 601.89 579.06 580.82 587.83 612.77 576.67 573.71 585.54 602.67 n.a. Tennessee 626.64 626.42 625.93 625.86 641.72 629.51 625.76 626.9 640.72 655.76 n.a. Texas 593.7 594.79 610.33 617.59 629.83 633.17 629.26 624 637.85 657.57 n.a.


B.1-40


Utah 464.73 478.88 495.55 505.75 514.91 499 519.61 490.88 525.82 533.41 n.a. Vermont 557.1 537.54 556.33 562.66 572.95 564.91 550.07 535.35 569.86 587.06 n.a. Virginia 603.08 602.29 608.11 599.8 625.49 616.14 617.84 613.38 610.65 636.2 n.a. Washington 567.94 536.21 552.31 559.48 574.77 569.06 560.14 563.49 575.62 580.2 n.a. West Virginia 634.3 628.94 648.62 632.88 648.96 654.97 651.13 659.43 661.33 678.61 n.a. Wisconsin 544.95 549.12 542.51 553.43 570.57 567.54 562.68 558.68 566.37 598.15 n.a. Wyoming 562.75 555.53 551.37 545.24 540.65 584.76 572.83 529.5 588.28 530.83 n.a. Puerto Rico/Virgin Islands 597.91 573 608.21 588.96 615.38 614.21 602.04 607.29 613.76 600.76 n.a.


NOTES: Based on short-term hospitalizations among the full-year fee-for-service Medicare population. State and region are based on provider location. Rates are based on the first pneumonia hospitalization for a beneficiary in a calendar year. All results reported at the national level are standardized to the age-sex distribution of the July 1999 Medicare FFS population using the direct method. Results reported at the state level are standardized using the indirect method. a Age-sex–adjusted rates are not comparable across aged and disabled groups.

* = Results suppressed due to small sample size.

n.a. = not available

B.1-41

Table B.1-13. Age-Sex Adjusted All-Pneumonia Readmission Rates per 1,000 Beneficiaries Discharged with Pneumonia, 1992-2001


(within 30-days from admission) All Enrollees 36.31 37.33 38.59 41.24 42.73 43.92 43.38 44.27 42.99 45.05 46.33 Gender

Male 44.52 45.32 46.52 49.03 49.8 51.05 50.71 51.4 49.62 50.95 52.27 Female 30.42 31.73 32.92 35.84 37.67 38.99 38.19 39.17 38.23 40.84 42.02

Age Group 0–54 39.86 39.14 41.29 37.6 42.2 40.56 41.77 44.45 41.11 42.38 45.18 55–64 37.62 39.22 41.04 44.65 47.5 47.01 45.34 44.34 44.85 49.45 49.19 65–69 32.21 32.7 34.47 37.48 39.03 39.81 39.11 40.24 40.45 42.89 43.92 70–74 34.36 35.16 35.86 39.69 40.98 42.72 43.08 42.15 41.6 43.14 43.31 75–79 36.83 38.49 39.26 42.77 43.82 45.11 43.52 45.58 43.76 45 47.82 80–84 39.59 40.71 42.25 45.01 44.7 48.75 46.92 46.96 45.37 47.93 48.56 85–89 41.15 44.31 43.87 48.75 47.91 50.24 49.8 51.12 47.42 49.56 51.61 90–94 43.54 45.09 46.38 48.89 51.17 51.13 50.91 54.91 51.39 53.32 53.21 95+ 44.03 50.47 51.75 53.35 52.05 56.28 56.52 59.05 53.14 57.6 58.2





Census Region Northeast 35.1 35.16 38.48 38.72 40.42 44.83 43.95 45.4 44.29 46.78 48.04 Midwest 34.35 36.19 36.97 39.78 40.41 41.41 40.83 42.99 39.76 42.78 44.64 South 37.18 38.66 39.16 43.01 44.64 45.3 44.89 45.2 44.43 46.4 47.11 West 39.08 38.63 40.23 42.63 44.55 44.11 43.22 42.07 42.85 43.07 44.34 Puerto Rico/Virgin Islands 43.69 39 40.71 38.09 46.37 39.73 46.28 52.5 47.59 46.45 56.13

State Alabama 37.57 39.5 37.16 44.24 47.33 48.71 49.64 46.15 43.19 46.3 44.5


B.1-42


(within 30-days from admission) Alaska * * * * * 53.57 * * 45.78 * * Arizona 39.73 37.68 39.86 40.42 41.82 42.75 40.69 44.46 36.57 44.77 46.09 Arkansas 36.55 37.77 37.28 44.11 46.06 43.19 49.63 44.29 45.81 45.57 47.33 California 44.84 46.8 47.59 49.84 52.56 53.05 50.75 49.38 49.99 50.78 51.51 Colorado 30.71 30.3 37.68 33.44 41.63 35.91 39.36 33.72 38.31 31.99 38.84 Connecticut 35.59 35.31 39.83 40.33 37.03 48.63 45.47 45.05 46.4 47.45 49.58 Delaware 34.11 35.62 34.29 31.53 45.33 42.54 47.67 42.91 43.24 37.01 33.58 District of Columbia * 47.74 46.05 38.86 50.35 47.95 41.11 47.51 49.27 52.16 59.23 Florida 33.9 32.2 35.66 42.85 39.94 41.1 42.22 42.04 40.82 45.7 46.88 Georgia 44.03 45.24 45.79 49.06 53.06 49.09 46.4 50.38 47.85 51.09 49.65 Hawaii 30.59 * 31.93 40.85 41.48 45.08 42.79 33.17 40.45 33.09 39.19 Idaho 31.47 32.03 41.35 27.35 31.39 35 34.12 29.45 30.12 28.61 30.76 Illinois 37.14 41.51 43.11 46.02 43.65 47.56 48.11 46.67 46.27 47.93 47.68 Indiana 32.61 35.92 37.47 39.75 38.19 37.74 39.64 42.81 35.95 37.19 41.95 Iowa 29.72 29.89 31.09 38.2 36.13 37.76 36.02 42.69 38.95 36.2 39.45 Kansas 33.87 41.41 35.86 38.4 36.95 46.22 41.61 43.52 40.16 41.28 41.1 Kentucky 52.95 49.92 49.59 51.18 57.19 54.3 52.03 60.97 55.76 60.91 56.41 Louisiana 43.15 46.39 44.45 50.71 49.91 53.82 51.5 51.87 47.51 54.67 51.49 Maine 27.69 33.56 34.43 34.03 38.44 31.36 34.12 41.9 36.04 34.25 44.29 Maryland 38.93 42.11 48.88 48.34 47.6 49.97 48.86 46.94 47.13 52.71 55.78 Massachusetts 38.87 43.66 44.96 46.5 47.17 50.58 45.87 48.48 44.52 49.38 48.62 Michigan 36.13 36.79 37.73 41.51 43.68 43.9 41.78 41.28 39.95 45.11 47.91 Minnesota 36.75 38.3 44.85 37.37 35.71 38.02 40.48 39.07 36.4 40.62 39.81 Mississippi 43.56 47.01 42.93 52.88 46.75 53.59 54.41 52.61 46.9 46.96 54.15 Missouri 35.82 36.2 34.12 41.17 42.9 44.61 44.8 46.04 43.59 45.95 46.89 Montana 40.78 37.59 31.66 33.79 35.4 35.13 42.57 36.66 41.68 33.86 37.67 Nebraska 35.67 35.26 37.2 37.85 37.3 41.17 34.62 43.72 37.5 42.35 41.97 Nevada 40.83 37.03 38.28 50.78 48.56 43.22 47.88 52.64 48.85 45.26 48.02 New Hampshire 25.37 31.76 31.26 43.76 28.88 37.85 42.6 38.53 40.6 30.13 46.45 New Jersey 33.01 36.98 40.35 40.27 39.29 50.23 48.17 46.91 49.33 52.65 53.59 New Mexico 46.97 39.04 36.92 42.61 36.43 41.25 41.42 40.91 44.11 42.39 34.2 New York 43.05 39.67 46.02 44.88 46.67 51.37 50.82 53.69 52.5 55.58 54.88 North Carolina 35.2 39.17 38.26 43.45 42.62 43.05 42.08 43.64 43.77 44.55 44.67 North Dakota 29.04 32.17 29.85 40.16 36.15 44.06 38.43 39.28 36.22 38.28 38.34 Ohio 39.28 40.57 41.63 47.47 49.7 47.64 47.03 51.73 44.15 48.92 51.87 Oklahoma 39.39 39.82 36.32 46.05 46.41 53.68 49.13 50.66 49.97 48.49 50.51 Oregon 26.83 29.11 32.27 32.74 42.94 38.64 36.65 39.08 34.62 40.45 36.67 Pennsylvania 32.34 34.79 36.37 37.05 39.54 39.02 40.76 43.59 40.83 42.6 44.16 Rhode Island 34.41 33.33 26.63 37.87 37.09 47.18 51.16 51.53 41.14 44.5 43.15 South Carolina 35.11 36.46 35.69 40.84 39.25 39.15 38.4 40.04 44.77 43.35 47.27


B.1-43


(within 30-days from admission) South Dakota 37.74 39.91 44.46 42.23 39.45 44.4 49.47 43.52 42.33 45.57 34.57 Tennessee 43.53 47.95 46.86 52.38 52.94 55.97 51.71 53.08 54.16 53.19 55.63 Texas 36.76 40.43 39.54 42.91 45.8 47.61 45.76 46.63 46.36 46.04 47.23 Utah 27.92 25.92 29.78 25.72 31.75 36.27 30.73 27.16 29.47 35.43 36.06 Vermont 42.58 38.27 43.02 43.95 36.37 50.98 34.27 43.37 33.31 45.33 46.02 Virginia 38.14 39.29 40.03 39.97 46.12 42.07 44.76 46.61 40.5 41.7 48.1 Washington 32.99 33.15 33.54 40.07 40.65 36.05 38.56 39.64 36.75 40.67 39.92 West Virginia 45.01 46.62 53.76 51.32 53.85 55.07 59.13 53.16 55.02 57.32 58.66 Wisconsin 27.6 31.15 29.91 29.36 31.19 29.13 32.11 34.82 28.83 31.02 33.55 Wyoming 44.12 36.23 34.91 32.01 * 35.04 * 32.96 39.69 35.48 37.89 Puerto Rico/Virgin Islands 49.85 45.41 45.3 42.67 49.09 44.02 52.36 54.56 52.24 51.19 60.35


B.1-44


(within 365-days from admission) All Enrollees 203.89 205.19 209.29 210.69 221.02 222.52 216.88 210.3 215.46 230 n.a. Gender

Male 242.57 240.91 245.06 243.49 252.19 255.71 249.57 239.07 244.82 256.5 n.a. Female 177.47 180.87 185.23 188.96 200.46 200.33 194.84 190.96 195.48 212.16 n.a.






Census Region Northeast 193.71 192.34 204.9 195.1 209.17 218.9 212.92 208.87 212.79 231.68 n.a. Midwest 203.78 203.7 205.98 208.43 218.42 221.05 215.83 206.83 211.36 229.17 n.a. South 209.31 213.29 214.05 218.85 228.96 226.42 221.51 216.96 219.92 233.47 n.a. West 203.05 204.22 208.31 214.01 219.22 220.37 211.41 199.03 214.47 221.29 n.a. Puerto Rico/Virgin Islands 215.43 193.7 207.43 207.61 216.74 200.63 212.97 219.16 205.88 210.74 n.a.

State Alabama 220.77 227.4 208.95 230.61 227.94 234.56 228.31 221.2 217.49 235.84 n.a. Alaska 300.64 200.37 218.67 234.77 207.68 234.88 202.52 216.97 225.02 200.63 n.a. Arizona 197.07 188.16 192.58 207.73 207.99 204.4 197 177.19 186.6 201.73 n.a. Arkansas 221.64 234.26 223.95 228.48 250.68 238.52 225.61 223.04 216.38 236.28 n.a.


B.1-45


(within 365-days from admission) California 233.33 244.38 246.45 255.18 255.03 259.7 244.89 232.08 249.83 256.34 n.a. Colorado 180.94 179.34 196.16 184.35 202.7 197.54 190.44 186.24 200.2 187.65 n.a. Connecticut 197.73 196.16 204.55 194.39 196.43 229.7 214.11 208.78 226.43 256.96 n.a. Delaware 181.92 189.27 187.71 204.3 198.25 222.63 228.17 204.43 208.69 253.82 n.a. District of Columbia 203.72 184.39 200.57 206.69 224.3 221.02 209.21 182.66 199.21 223.91 n.a. Florida 181.98 180.2 191 198.1 194.68 196.85 200.33 189.25 195.71 209.54 n.a. Georgia 241.03 246.36 240.32 246.29 254.83 242.37 230.71 229.85 228.02 248.48 n.a. Hawaii 183.98 181.97 175.75 184.6 186.98 212.85 206.58 184.65 206.35 215.95 n.a. Idaho 179.75 164.96 190.76 185.43 190.86 185.86 192.08 165.2 171.73 190.47 n.a. Illinois 223.68 231.53 233.43 230.16 235.6 250.64 244.45 225.42 236.3 253.65 n.a. Indiana 214.64 212.37 217.53 217.61 222.74 226.54 222.01 221.64 219.75 227 n.a. Iowa 198.63 194.21 204.54 224.62 222.05 228.34 222.41 213.58 221.13 227.61 n.a. Kansas 228.61 224 218.3 227.83 244.55 237.77 233.84 224.37 216.9 237.58 n.a. Kentucky 270.28 271.58 272.49 264.92 282.53 272.53 275.4 270.66 282.66 299.86 n.a. Louisiana 246.51 242.59 249.17 255.37 266.25 276.46 260.3 272.38 260.71 271.4 n.a. Maine 186.14 182.74 197.58 184.82 204.68 205.4 180.46 204.95 193.8 223.15 n.a. Maryland 212.54 209.55 233.88 227.49 245.05 235.33 231.36 222.9 243.65 247.41 n.a. Massachusetts 218.32 228.8 235.62 224.67 232.32 240.91 220.16 223.31 228.01 239.04 n.a. Michigan 204.11 202.54 202.22 208.65 217.74 220.16 208.11 198.01 214.87 237.39 n.a. Minnesota 207.67 209.77 214.69 201.12 204.67 212.95 208.37 204.5 202.88 215.81 n.a. Mississippi 238.99 248.05 228.43 256.16 250.65 251.53 240.13 238.54 230.31 243.32 n.a. Missouri 230.52 230.14 220.21 230.62 241.75 242.42 235.11 235.32 222.49 249.82 n.a. Montana 199.25 175.79 183.6 194.31 196.6 217.18 206.17 186.82 212.8 203.81 n.a. Nebraska 215.58 215.13 203.32 206.23 212.29 219.05 207.76 205.29 200.75 220.26 n.a. Nevada 207.96 198.18 196.07 209.52 217.23 212.14 214.37 190.81 209.45 207.18 n.a. New Hampshire 152.97 180.08 174.54 172.11 199.79 194.83 189.97 179.89 190.56 206.87 n.a. New Jersey 201.09 193.35 210.55 201.33 217.94 238.29 227.17 220.67 229.85 247.73 n.a. New Mexico 236.72 207.54 214.09 196.74 217.78 212.08 210.65 209.75 226.44 224.23 n.a. New York 221.94 212.77 225.26 216.25 235.97 240.82 235.35 233.32 238.78 257.67 n.a. North Carolina 213.38 218.65 214.71 218.17 224.48 224.1 220.4 218.2 221.28 231.75 n.a. North Dakota 209.29 211.5 227.45 227.58 232.55 257.25 241.37 213.01 210.7 221.75 n.a. Ohio 223.74 223.35 225.82 228.28 246.74 242.59 238.42 232.28 230.99 250.48 n.a. Oklahoma 253.67 252.55 252.27 268.02 280.19 279.07 265.76 260.09 246.27 266.11 n.a. Oregon 190.95 177.25 194.6 182.07 210.47 188.77 186.85 181.2 183.06 210.54 n.a. Pennsylvania 195.1 201.6 211.77 202.41 216.93 217.57 218.16 210.41 215.83 232.78 n.a. Rhode Island 188.97 194.39 182.17 185.39 206.45 234.87 238.95 220.52 236.35 233.38 n.a. South Carolina 203.44 196.58 212.37 202.36 215.61 205.07 200.19 205.23 203.74 227.43 n.a. South Dakota 237.55 263.44 260.74 238.84 252.39 257.53 255.45 220.43 219.35 239.53 n.a. Tennessee 240.15 256.18 256.29 253.04 269.62 259.99 253.22 252.81 258.91 271.13 n.a. Texas 223.67 228.59 227.52 239.99 249.74 244.38 237.14 236.28 239.39 248.96 n.a.


B.1-46


(within 365-days from admission) Utah 159.76 156.2 160.39 172.69 186.29 190.95 185.46 155.04 165.53 195.14 n.a. Vermont 204.36 204.2 219.89 202.45 210.22 223.17 200.96 196.38 195.74 228.05 n.a. Virginia 205.89 216.28 204.73 213.06 233.37 220.05 226.88 217.17 214.08 233.62 n.a. Washington 182 180.71 187.67 196.33 207.57 202.36 202.43 204.49 204.52 214.35 n.a. West Virginia 247.01 255.43 264.83 256.24 271.46 281.07 269.67 258.89 264.8 285.24 n.a. Wisconsin 173.59 178.61 166.75 171.63 178.45 185.74 183.32 183.6 171.39 200.2 n.a. Wyoming 209.43 221.69 210.28 192.5 181.2 237.12 167.54 177.08 228.79 198.35 n.a. Puerto Rico/Virgin Islands 232.27 206.57 223.08 218.5 225.93 212.78 225.8 231.08 220.13 223.58 n.a.


NOTES: Based on short-term hospitalizations among the full-year fee-for-service Medicare population. State and region are based on provider location. Rates are based on the first pneumonia hospitalization for a beneficiary in a calendar year. All results reported at the national level are standardized to the age-sex distribution of the July 1999 Medicare FFS population using the direct method. Results reported at the state level are standardized using the indirect method. a Age-sex–adjusted rates are not comparable across aged and disabled groups.



B.1-47

Table B.1-14. Age-Sex Adjusted All-Cause Mortality Rates per 1,000 Beneficiaries Discharged with Pneumonia, 1992-2001 Year

Beneficiary Characteristics 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 (within 30-days from admission) All Enrollees 115.99 115.15 113.4 111.57 110.69 107.44 104.73 102.56 104.91 104.19 103.39 Gender

Male 138.61 137.63 133.78 132.95 130.41 127.22 122.53 118.96 120.75 120.32 119.25 Female 99.36 98.6 98.42 95.89 96.4 92.99 91.98 90.89 93.55 92.29 91.98

Age Group 0–54 56.26 54.31 57.35 50.13 47.5 44.54 41.87 43.21 43.74 43.22 43.61 55–64 80.79 81.44 80.12 74.35 72.63 71.54 69.7 66.25 67.09 67.41 63.46 65–69 88.97 85.99 86.01 86.86 84.88 81.71 78.46 75.2 79.07 76.7 76.17 70–74 105.16 102.72 100.38 100.34 101.26 96.82 94.49 90.45 93.91 91.43 92.22 75–79 125.8 126.65 122.87 120.93 121.43 116.2 115.23 111.75 113.27 113.76 112.12 80–84 155.38 155.05 152.13 148.45 148.16 146.13 140.46 139.79 142.94 142.69 141.29 85–89 189.71 192.07 186.67 184.68 181.41 180.12 178.21 178.73 177.99 180.09 176.83 90–94 220.12 222.87 225.43 224.33 222.31 220.23 218.47 220.6 223 222.73 223.79 95+ 264.58 274.34 262.24 262.67 263.95 265.48 266.58 275.62 269.2 268.22 281.57


Dual-Enrollment Status Not Dual 116 114.71 112.2 110.84 109.8 106.14 103.14 100.32 102.84 102.13 101.83 Dual 117.25 118.69 119.1 116.17 115.05 113.36 111.84 111.85 112.59 112.1 109.87

Medicare Eligibility Statusa Aged without ESRD 139.75 141.73 138.64 136.61 135.21 122.84 118.97 116.37 118.95 117.97 116.95 Disabled without ESRD 68.41 67.08 67.74 60.33 57.87 55.89 53.74 52.99 54.23 54.2 53.28 All with ESRD 133.05 144.15 137.04 135.56 142.09 129.97 135 138.29 123.7 122.13 121.56


Census Region Northeast 118.87 116.34 116 114.4 113.34 112.9 110.34 108.79 105.44 107.69 105.91 Midwest 111.74 110.41 109.18 108.59 107.02 104.48 100.23 97.6 100.79 98.44 99.1 South 113.24 115.23 111.32 111.07 110.07 104.7 103.3 101.61 105.63 104.55 102.96 West 123.47 120.12 121.34 111.48 113.03 112.19 107.91 105.41 108.4 108.37 108.49 Puerto Rico/Virgin Islands 168.3 149.18 155.79 157.4 150.14 143.47 141.18 127.73 127.75 125.72 127.56



B.1-48


(within 30-days from admission) Arizona 150.41 141.43 131.98 133.01 137.55 131.87 136.1 128.07 126.77 130.38 128.47 Arkansas 131.24 139.97 131.36 136.08 143.91 126.92 123.02 125.85 133.74 130.59 125.65 California 157.79 156.07 158.73 145.96 145.2 147.89 141.27 139.54 142.04 140.29 139.92 Colorado 135.39 114.51 118.45 118.44 127.37 114.82 124.36 112.27 108.49 118.71 119.98 Connecticut 139.54 146.36 148.45 139.78 143.74 146.05 145.66 137.12 139.39 138.11 133.99 Delaware 163.6 171.37 151.01 139.04 149.5 131.38 152.05 144.08 148.8 143.08 117.78 District of Columbia 160.56 131.25 143.76 128.01 116.12 122.38 110.39 122.79 112.63 107.08 129.64 Florida 144.56 149.3 137.36 140.79 137.63 135.28 127.38 124.11 128.69 128.98 128.95 Georgia 142.08 145.22 145.43 141.21 140.56 133.51 132.89 133.83 141.4 142.65 146.16 Hawaii 138.16 140.42 138.07 110.43 126 131.16 116.46 115.64 108.02 136.18 129.64 Idaho 123.96 124.72 120.93 106.64 109.83 115.49 117.32 106.02 122.67 129.54 108.27 Illinois 136.03 140.31 142.96 137.99 132.68 132.02 126.27 122.65 124.75 122.92 125.57 Indiana 145.83 145.22 144.91 138.72 136.94 132.83 120.25 127.2 126.07 124.43 128.14 Iowa 121.93 131.88 121.97 119.55 112.67 115.77 114.41 108.03 110.92 107.74 108.95 Kansas 116.16 119.92 113.21 119.09 112.57 132.26 116.07 111.21 116.38 119.3 120.87 Kentucky 129.39 131.05 126.55 128.57 124.22 123.21 121.94 122.12 128.12 127.59 118.28 Louisiana 131.94 141.31 133.15 127.75 130.41 125.55 122.51 128.13 129.04 128.21 118.66 Maine 99.86 118.6 122.71 119.47 117.02 110.5 111.99 115.11 106.77 122.4 115.11 Maryland 143.55 139.93 138.97 136.8 133.53 138.02 132.82 131.15 121.51 122.73 120.96 Massachusetts 129.48 130.81 129.25 134.23 132.95 130.72 133.4 127.58 130.11 130.09 126.9 Michigan 156.46 145.27 140.96 143.37 141.96 134.07 134.77 134.98 132.41 130.5 130.08 Minnesota 119.17 127.7 118.28 116.83 115.13 112.92 105.03 103.97 105.06 109.68 107.6 Mississippi 141.36 134.55 133.66 130.2 124.34 122.14 127.61 118.42 128.82 130.97 140.62 Missouri 135.39 136.22 129.57 130.97 132.6 128.94 123.22 123.76 125.93 119.49 120.76 Montana 116.8 104.88 111.85 105.95 103.98 100.68 102.82 97.72 105.12 102.14 113.36 Nebraska 130.07 127.13 133.94 126.68 125.37 119.71 123.27 117.72 124.88 120.31 130.01 Nevada 162.04 179.23 155.4 160.81 143.79 142.9 155.52 144.55 154.71 136.61 137.48 New Hampshire 137.65 130.87 137.1 142.29 146.11 134.21 130.32 124.8 123.54 126.68 136.45 New Jersey 158.63 153.93 153.03 148.64 142.2 140.09 127.07 131.98 130.66 126.67 128.08 New Mexico 127.45 119.74 130 114.26 120.38 116.12 115.1 120.83 125.93 138.61 130.31 New York 154.71 154.15 151.7 150.32 149.63 147.64 146.53 146.56 141.68 144.65 143.86 North Carolina 147.76 155.4 147.86 145.48 144.86 143.26 135.94 139.89 139.58 141.12 138.86 North Dakota 103.01 100.41 102.5 94.79 98.15 95.04 98.84 97.89 110.37 95.16 100.72 Ohio 146.24 145.54 146.66 142.42 143.58 145.39 142.32 144.67 140.15 136.27 134.21 Oklahoma 147.29 149.72 146.59 140.81 139.24 132.3 137.65 132.38 126.17 127.6 130.15 Oregon 137.24 145.78 140.32 135.09 142.96 138.64 130.89 130.94 142.81 135.37 127.78 Pennsylvania 138.73 133.42 134.31 133.25 132.42 131.26 129.78 129.53 125.86 128.55 124.55 Rhode Island 136.21 127.48 134.4 144.34 135.09 138.91 136.79 122.42 129.36 134.97 124.54 South Carolina 161.59 156.24 156.63 156.27 156.84 144.25 145.3 131.3 137.65 146 142.7 South Dakota 105.77 104.36 106.35 101.57 99.56 89.85 89.7 86.93 98.18 102.24 99.54


B.1-49


(within 30-days from admission) Tennessee 136.29 137.93 136.34 138.01 139.53 133.97 136.88 135.44 143.11 140.45 139.65 Texas 140.67 145.06 139.24 140.01 138.18 127.31 130.45 130.45 135.53 135.83 130.58 Utah 127.33 115.51 131.92 114.01 128.33 116.55 117.97 114.4 127.06 130.32 111.75 Vermont 145.44 136.17 122.33 109.99 109.38 126.47 129.08 119.31 105.97 122.51 106.35 Virginia 146.34 148.01 146.12 144.66 144.51 138.07 137.04 136.22 136.86 133.78 132.97 Washington 141.31 134.38 133.63 129.9 130.73 132.88 127.58 131.77 132.14 132.29 138.86 West Virginia 147.04 139.3 142.14 137.3 135.39 136.37 129.21 139.68 135.88 133.55 125.67 Wisconsin 132.17 132.2 127.36 131.84 129.32 123.74 120.7 116.54 123.4 117.17 121.77 Wyoming 106.32 121.62 110.64 107.7 100.66 120.04 117.33 93.92 133.87 111.77 135.59 Puerto Rico/Virgin Islands 203.48 188.39 192.51 191.01 186.96 182.61 174.57 162.28 159.05 154.83 161.37


B.1-50


(within 365-days from admission) All Enrollees 315.71 311.41 308.4 303.84 305.74 304.09 298.54 290.82 301.62 306.75 n.a. Gender

Male 374.6 368.77 362.24 357.87 356.49 356.32 346.22 334.4 344.12 347.53 n.a. Female 272.07 268.46 268.31 263.83 268.64 265.87 263.73 259.03 270.55 276.77 n.a.

Age Group 0–54 192.2 181.5 191.77 172.64 161.12 154.67 151.73 154.5 155.09 158.05 n.a. 55–64 264.64 256.5 251.55 243.98 246.98 238.28 235.25 225.44 235.69 239.47 n.a. 65–69 262.62 254.89 253.39 251.1 252.12 252.74 245.04 236.39 246.62 251.42 n.a. 70–74 291.93 287.98 283.64 281.55 290.13 285.17 282.45 270.58 284.06 284.75 n.a. 75–79 336.42 335.41 328.37 324.51 328.97 329.69 323.6 314.34 324.34 331.27 n.a. 80–84 393 390 387.1 382.52 382.32 385.6 376.21 365.55 381.23 389.29 n.a. 85–89 457.55 458.5 449.49 448.07 450.31 450.24 443.29 440.07 452.47 463 n.a. 90–94 524.91 520.58 520.89 523.84 525.1 522.1 517.8 520.16 531.06 539.04 n.a. 95+ 599.91 607.16 598.7 602.11 603.89 601.78 600.63 608.65 615.01 624.2 n.a.

Race White 312.78 303.14 304.23 301.11 302.29 301.37 295.25 288.53 298.03 303.32 n.a. Black 356.79 344.64 347.78 337.93 346.01 345.89 339.37 326.17 336.45 351.69 n.a. Other 310.16 348.53 299.41 287.26 289.83 278.52 281.95 267.14 294.57 282 n.a. Unknown 304.26 655.56 355.5 281.04 299.38 286.86 296.51 294.06 415.74 294.72 n.a.


Medicare Eligibility Statusa Aged without ESRD 366.86 364.31 362.89 355.49 359.17 339.9 333.08 324.09 336.56 341.3 n.a. Disabled without ESRD 220.41 211.8 213.41 198.01 189.98 184 179.97 176.45 182.67 184.56 n.a. All with ESRD 468.54 472.75 478.47 465.15 482.34 474.71 478.57 473.19 479.16 473.2 n.a.



State Alabama 367.65 357.48 336.28 353.88 355.31 343.9 342.82 336.14 336.88 350.13 n.a. Alaska 303.45 272.26 318.58 268.59 255.17 272.05 233.03 275.74 270.77 283.31 n.a. Arizona 356.47 340.82 331.32 329.22 342.13 327.41 329.13 306.96 317.41 341.39 n.a. Arkansas 346.27 352.78 344.59 340.12 351.75 335.59 327.75 335.51 351.44 342.56 n.a.


B.1-51


(within 365-days from admission) California 394.51 389.75 397.08 381.14 378.3 382.3 368.88 357.55 375.95 375.9 n.a. Colorado 333.7 325.83 328.17 304.04 331.98 315.87 314.13 307.97 328.45 324.66 n.a. Connecticut 378.16 377.29 377.14 357.15 363.47 380.84 369.99 350.05 373.93 375.44 n.a. Delaware 401.35 387.36 371.82 373.24 380.46 369.25 390.86 380.54 366.82 377.68 n.a. District of Columbia 383.16 388.7 394.71 387.29 354.66 352.45 367.14 346.18 359.71 359.22 n.a. Florida 367.82 364.53 355.72 357.75 353.97 356.21 347.96 333.63 345.52 355.38 n.a. Georgia 364.61 371.07 363.43 363.61 370.93 359.61 351.31 348.79 364.75 375.43 n.a. Hawaii 367.34 345.11 326.51 332.86 320.9 327.95 311.13 297.3 337.87 344.87 n.a. Idaho 332.18 311.94 327.58 306.02 305.89 303.1 317.3 294.09 326.92 324.68 n.a. Illinois 371.25 371.34 376.68 366.87 354.74 365.21 350.61 336.62 356.04 355.85 n.a. Indiana 370.06 370.34 361.26 362.5 358.49 353.03 340.07 347.37 349.72 354.81 n.a. Iowa 332.9 339.03 327.41 327.65 320.93 322.96 312.62 296.7 315.45 322.59 n.a. Kansas 328.6 321.93 307.35 320.6 322.77 333.28 312.81 313.48 323.98 336.09 n.a. Kentucky 353.65 361.75 346.89 348.91 347.04 340.48 344.03 343.87 359.61 367.49 n.a. Louisiana 354.39 361.79 354.05 353.38 358.19 361.19 354.96 360.94 373.45 370.29 n.a. Maine 313.49 324.63 309.77 323.88 306.92 332.01 308.79 322.91 306.77 340.23 n.a. Maryland 377.07 371.5 366.32 363.08 379.31 382.27 373.38 366.03 362.04 370.43 n.a. Massachusetts 353.05 354.94 358.78 355.3 355.66 362.07 355.84 341.87 358.91 365.4 n.a. Michigan 387.27 379.21 366.12 363.79 363.08 366.3 359.6 346.66 359.4 369.81 n.a. Minnesota 321.86 331.29 312.94 319.64 318.85 312.31 306.05 289.84 306.14 315.74 n.a. Mississippi 356.47 351.64 348.01 341.26 333.31 332.6 341.48 331.53 346.68 354.39 n.a. Missouri 357.14 357.46 344.26 350.57 358.95 355.46 342.46 341.44 344.03 349.6 n.a. Montana 315.94 300.68 319.39 309.42 299.7 314.48 305.82 295.78 308.18 316.99 n.a. Nebraska 332.52 337.92 322.65 332.25 337.7 325.25 329.44 320.22 332.15 343.52 n.a. Nevada 408.93 386.38 371.43 365.37 352.3 374.81 369.85 336.58 380.98 359.49 n.a. New Hampshire 338.8 334.75 329.44 332.56 345.22 332.88 323.06 320.97 314.98 349.02 n.a. New Jersey 403.75 393.04 391.93 376.26 374.62 377.53 368.97 365.17 372.13 377.43 n.a. New Mexico 343.23 306.3 337.19 307.95 307.63 309.25 310.65 293.07 330.91 338.63 n.a. New York 398.39 389.03 389.55 375.98 381.66 386.15 379.27 373.45 377.09 389.77 n.a. North Carolina 369.59 375.96 362.26 363.12 364.22 362.75 360.66 361.68 364.09 370.53 n.a. North Dakota 314.57 289.27 284.54 286.95 292.04 290.96 283.67 272.35 310.62 302.72 n.a. Ohio 381.76 376.89 374.31 370.06 380.13 385.09 375.49 375.12 374.21 380.95 n.a. Oklahoma 372.1 376.99 365.16 370.41 374.37 368.24 365.89 361.23 353.7 354.04 n.a. Oregon 352.7 351.41 346.37 356.16 356.15 350.33 337.76 337 350.07 362.43 n.a. Pennsylvania 370.25 362.17 364.06 356.75 358.92 363.64 360.69 354.87 360.63 368.26 n.a. Rhode Island 367.94 335.8 337.8 340.6 347.3 364.07 361.73 347.47 361.75 345.12 n.a. South Carolina 386.19 391.29 381.62 367.74 376.58 363.58 360.97 346.39 356.95 368.18 n.a. South Dakota 292.65 295.95 302.89 281.87 286.39 288.06 279.78 270.19 278.33 304.21 n.a. Tennessee 358.21 359.36 352.39 353.73 359.16 356.59 357.53 352.34 374.97 377.5 n.a. Texas 363.91 364.71 359.92 363.63 369.69 350.41 356.77 353.26 366.84 373.27 n.a.


B.1-52


(within 365-days from admission) Utah 305.49 297.96 311.35 292.78 318.29 308.1 308.24 294.01 321.45 330.21 n.a. Vermont 364.35 318.91 323.26 313.18 336.6 344.41 328.83 308.63 324.36 350.72 n.a. Virginia 363.78 371.34 364.13 360.34 370.55 364.12 363.91 354.9 359.82 368.98 n.a. Washington 364.78 352.24 349.89 349.07 347.38 349.32 345.74 348.23 358.88 352.52 n.a. West Virginia 373.22 372.82 371.5 364.13 358.07 358.04 352.38 372.85 366.48 374.18 n.a. Wisconsin 338 335.54 322.32 336.03 332.81 335 324.17 309.13 323.56 331.42 n.a. Wyoming 290.77 319.23 317.13 294.41 294.99 305.28 299.37 273.81 340.06 304.89 n.a. Puerto Rico/Virgin Islands 414.86 387.43 406.33 398.45 396 389.89 370.77 357.02 358.66 349.22 n.a.


NOTES: Based on short-term hospitalizations among the full-year fee-for-service Medicare population. State and region are based on provider location. Rates are based on each pneumonia discharge for a beneficiary in a calendar year. All results reported at the national level are standardized to the age-sex distribution of the July 1999 Medicare FFS population using the direct method. Results reported at the state level are standardized using the indirect method. a Age-sex–adjusted rates are not comparable across aged and disabled groups.




D E T A I L E D T A B L E S F O R S E P T I C E M I A W I T H P N E U M O N I A

Table

Page

B.2-1

Unadjusted T

otal Num

ber of Discharges W

ith a Diagnosis of

Septicemia w

ith Pneumonia, 1992-2002

.....................................................3

B.2-2

Unadjusted T

otal Num

ber of Beneficiaries D

ischarged With

Septicemia W


....................................................6

B.2-3

Com

parison of Beneficiaries H

ospitalized for Septicemia w

ith P

neumonia w

ith the Entire M

QM

S Fee-For-S

ervice Medicare

Population, 1992 and 2001..........................................................................9

B.2-4

Age/Sex A

djusted Rates of D

ischarges for Septicemia w

ith Pneum

onia Per 1,000 Beneficiaries, 1992-2002

.......................................11

B.2-5

Age/Sex A

djusted Rates of B

eneficiaries Discharged for septicem

ia w

ith Pneumonia Per 1,000 B

eneficiaries, 1992-2002...............................14

B.2-6

Age/Sex A

djusted Average L

ength of Stay for Septicemia w

ith Pneum

onia Hospitalizations, 1992-2002...................................................17

B.2-7

Total M

edicare Paym

ents for Discharges for Septicem

ia with

Pneumonia, 1992-2002..............................................................................20

B.2-8

Average M

edicare Payments per D

ischarge with Septicem

ia with

Pneumonia, 1992-2002..............................................................................23

B.2-9

Total B

eneficiary Deductible and C

oinsurance Payments for

Discharges for Septicem

ia with Pneum

onia, 1992-2002..........................26

B.2-10

Average N

umber of Pneum

onia-Related D

ischarges Per Beneficiary

Discharged W

ith Septicemia w

ith Pneumonia, 1992-2002.......................29

B.2-11

Average N

umber of A

ll Discharges Per B

eneficiary Discharged W

ith Septicem

ia With Pneum

onia, 1992-2002..................................................32

B.2-12

Age-Sex A

djusted All-C

ause Readm

ission Rates per 1,000

Beneficiaris D

ischarged with Septicem

ia with Pneum

onia, 1992-2001...35

B.2-13

Age-Sex A

djusted All-Pneum

onia Readm


Beneficiaries D

ischarged with Septicem

ia with PN

, 1992-2001..............37

B.2-14

Age-Sex A

djusted All-C

ause Mortality R

ates per 1,000 Beneficiaris

Discharged w

ith Septicemia w


.......................39

B.2-3

Table B.2-1. Unadjusted Total Number of Discharges With a Diagnosis of Septicemia with Pneumonia, 1992-2002 Year


Male 11,760 13,837 15,291 16,679 18,311 19,064 18,071 18,006 16,886 17,876 20,147 Female 14,181 16,795 18,880 20,772 22,518 23,728 22,900 22,484 20,944 21,561 23,576

Age Group 0–54 797 1,094 1,317 1,480 1,613 1,767 1,745 1,783 1,714 1,980 2,238 55–64 907 1,005 1,208 1,352 1,577 1,690 1,714 1,789 1,745 2,041 2,439 65–69 2,547 2,951 3,250 3,427 3,826 3,765 3,498 3,324 3,177 3,394 3,868 70–74 3,751 4,378 4,916 5,487 5,753 5,865 5,573 5,399 4,931 5,017 5,570 75–79 4,570 5,436 5,928 6,700 7,124 7,532 7,252 7,139 6,716 6,974 7,631 80–84 5,160 6,203 6,806 7,328 7,975 8,422 7,767 8,028 7,219 7,560 8,497 85–89 4,438 5,219 5,876 6,381 7,155 7,563 7,227 7,037 6,717 6,835 7,442 90–94 2,627 3,077 3,484 3,748 4,079 4,390 4,397 4,256 3,956 4,128 4,308 95+ 1,144 1,269 1,386 1,548 1,727 1,798 1,798 1,735 1,655 1,508 1,730

Race White 21,450 25,389 28,290 30,838 33,454 34,951 33,091 32,621 30,517 31,655 35,187 Black 3,126 4,055 4,581 5,186 5,622 5,935 5,813 5,756 5,452 5,817 6,278 Other 573 635 953 1,013 1,321 1,651 1,809 1,887 1,719 1,825 2,118 Unknown 792 553 347 414 432 255 258 226 142 140 140


Medicare Eligibility Status Aged without ESRD 23,838 27,996 31,012 33,854 36,687 38,317 36,416 35,717 33,218 34,096 37,499 Disabled without ESRD 1,376 1,655 2,057 2,284 2,522 2,656 2,661 2,790 2,745 3,154 3,651 All with ESRD 727 981 1,102 1,313 1,620 1,819 1,894 1,983 1,867 2,187 2,573


Census Region Northeast 5,082 6,034 6,555 7,169 7,511 8,009 7,894 7,940 7,916 7,911 8,554 Midwest 6,547 7,709 8,358 9,238 10,099 10,306 9,918 9,981 9,019 9,238 10,615 South 10,222 12,292 14,145 15,661 17,319 18,467 17,386 16,991 15,762 16,618 18,320 West 3,783 4,303 4,768 4,951 5,342 5,356 5,021 4,798 4,343 4,907 5,423 Puerto Rico/Virgin Islands 307 294 345 432 558 654 752 780 790 763 811

State Alabama 526 607 742 798 840 858 906 889 853 814 935 Alaska * * * * 26 31 * 27 * * 27 Arizona 280 291 356 359 371 404 338 339 301 328 421 Arkansas 398 457 559 596 593 740 701 666 602 588 605


B.2-4


California 2,294 2,625 2,948 2,949 3,207 3,277 3,118 2,914 2,601 3,071 3,329 Colorado 217 244 225 293 280 260 212 200 181 215 217 Connecticut 223 275 280 286 337 419 360 368 427 419 527 Delaware 62 82 115 122 108 113 95 71 66 80 102 District of Columbia 59 102 99 104 118 132 118 140 131 109 122 Florida 1,678 2,030 2,268 2,463 2,701 2,810 2,529 2,685 2,428 2,749 3,027 Georgia 846 992 1,151 1,289 1,516 1,524 1,475 1,441 1,331 1,347 1,451 Hawaii 68 56 90 91 82 89 91 114 76 89 104 Idaho 64 69 99 97 99 107 85 88 90 91 60 Illinois 1,496 1,824 2,045 2,222 2,410 2,472 2,321 2,414 2,301 2,382 2,837 Indiana 679 723 814 809 956 1,017 986 1,054 1,003 969 1,068 Iowa 355 375 386 446 495 452 494 476 442 413 391 Kansas 269 333 392 349 446 394 360 385 316 320 355 Kentucky 474 614 619 742 842 905 903 873 959 1,088 1,183 Louisiana 652 756 901 1,031 1,053 1,150 990 1,035 936 1,013 1,019 Maine 96 122 110 105 117 122 119 114 133 150 173 Maryland 517 646 778 860 968 857 847 766 798 995 1,149 Massachusetts 481 617 706 737 777 765 731 697 685 606 645 Michigan 911 1,216 1,302 1,484 1,595 1,619 1,578 1,609 1,334 1,489 1,910 Minnesota 310 296 301 300 274 313 339 363 360 326 394 Mississippi 370 407 469 493 586 640 631 613 591 513 536 Missouri 598 715 746 884 914 1,040 1,010 1,003 853 845 1,100 Montana 75 89 81 99 116 94 104 72 70 81 92 Nebraska 116 150 154 151 172 159 156 187 124 148 163 Nevada 102 103 127 165 197 153 146 138 144 124 186 New Hampshire 59 76 82 92 89 97 92 98 94 105 92 New Jersey 781 914 1,072 1,313 1,520 1,709 1,796 1,949 1,994 1,853 1,895 New Mexico 90 117 140 153 163 155 171 122 128 119 160 New York 1,907 2,081 2,130 2,298 2,319 2,550 2,574 2,613 2,627 2,755 3,155 North Carolina 761 884 965 1,149 1,177 1,338 1,316 1,236 1,153 1,193 1,374 North Dakota 80 66 71 94 87 83 86 73 64 72 69 Ohio 1,161 1,409 1,549 1,844 2,065 2,119 2,012 1,874 1,668 1,749 1,749 Oklahoma 461 472 598 614 706 793 713 741 670 631 673 Oregon 166 214 206 204 216 218 180 197 198 192 176 Pennsylvania 1,391 1,749 1,921 2,155 2,091 2,090 2,006 1,888 1,767 1,848 1,853 Rhode Island 124 161 212 146 209 209 169 159 151 133 160 South Carolina 328 397 403 499 583 599 585 632 593 690 678 South Dakota 91 94 108 126 121 111 106 83 79 83 77 Tennessee 715 950 1,036 1,057 1,209 1,256 1,230 1,198 1,021 1,104 1,175 Texas 1,677 2,042 2,440 2,724 3,054 3,295 2,964 2,679 2,322 2,292 2,730 Utah 76 104 88 116 121 119 125 145 126 107 152 Vermont * 39 42 37 52 48 47 54 38 42 54


B.2-5


Virginia 490 608 729 826 884 1,020 950 939 980 1,056 1,174 Washington 302 359 375 366 422 432 402 390 365 429 456 West Virginia 208 246 273 294 381 437 433 387 328 356 387 Wisconsin 481 508 490 529 564 527 470 460 475 442 502 Wyoming 40 * * 34 42 * 28 52 40 44 43 Puerto Rico/Virgin Islands 307 294 345 432 558 654 752 780 790 763 811



B.2-6

Table B.2-2. Unadjusted Total Number of Beneficiaries Discharged With Septicemia With Pneumonia, 1992-2002 Year


Male 11,602 13,624 15,026 16,351 17,916 18,681 17,685 17,653 16,519 17,399 19,565 Female 14,027 16,592 18,618 20,443 22,144 23,313 22,468 22,020 20,549 21,079 23,038

Age Group 0–54 788 1,075 1,294 1,452 1,576 1,723 1,697 1,751 1,665 1,914 2,149 55–64 899 992 1,188 1,331 1,546 1,653 1,658 1,735 1,696 1,981 2,371 65–69 2,528 2,917 3,204 3,370 3,766 3,708 3,439 3,270 3,114 3,306 3,772 70–74 3,702 4,336 4,838 5,391 5,640 5,759 5,475 5,280 4,824 4,913 5,432 75–79 4,512 5,343 5,827 6,580 6,993 7,384 7,113 6,990 6,604 6,811 7,470 80–84 5,100 6,120 6,713 7,192 7,822 8,262 7,601 7,867 7,072 7,369 8,283 85–89 4,376 5,146 5,770 6,262 7,013 7,425 7,093 6,896 6,588 6,665 7,239 90–94 2,598 3,031 3,439 3,692 4,011 4,315 4,316 4,176 3,883 4,034 4,197 95+ 1,126 1,256 1,371 1,524 1,693 1,765 1,761 1,708 1,622 1,485 1,690

Race White 21,203 25,071 27,886 30,372 32,900 34,363 32,509 32,042 29,995 30,983 34,410 Black 3,080 3,977 4,483 5,016 5,457 5,766 5,618 5,566 5,259 5,590 6,000 Other 570 620 933 998 1,277 1,615 1,771 1,843 1,675 1,768 2,054 Unknown 776 548 342 408 426 250 255 222 139 137 139


Medicare Eligibility Status Aged without ESRD 23,548 27,620 30,539 33,257 36,008 37,626 35,729 35,006 32,582 33,296 36,583 Disabled without ESRD 1,360 1,627 2,025 2,249 2,471 2,595 2,580 2,717 2,666 3,055 3,530 All with ESRD 721 969 1,080 1,288 1,581 1,773 1,844 1,950 1,820 2,127 2,490



State Alabama 522 598 734 779 828 840 892 868 833 800 916 Alaska * * * * 26 30 * 27 * * 27 Arizona 278 289 352 356 366 398 336 334 300 327 414


B.2-7


Arkansas 388 447 551 587 584 724 686 654 591 571 590 California 2,266 2,586 2,895 2,900 3,113 3,207 3,051 2,847 2,557 3,005 3,237 Colorado 215 244 223 288 277 257 209 197 179 211 215 Connecticut 223 273 278 284 334 411 359 362 418 414 516 Delaware 62 82 113 119 106 112 95 70 65 79 102 District of Columbia 58 102 95 101 117 128 114 133 127 104 112 Florida 1,658 2,002 2,238 2,422 2,650 2,762 2,485 2,618 2,376 2,678 2,952 Georgia 836 973 1,132 1,262 1,486 1,495 1,443 1,407 1,294 1,312 1,413 Hawaii 67 55 88 90 82 88 90 113 74 88 104 Idaho 64 69 99 96 96 106 84 86 90 90 60 Illinois 1,463 1,796 1,994 2,172 2,360 2,418 2,265 2,359 2,249 2,301 2,749 Indiana 664 713 799 797 946 1,002 975 1,034 973 954 1,041 Iowa 350 372 383 438 489 447 489 469 438 407 388 Kansas 269 328 387 349 444 389 357 383 309 310 351 Kentucky 467 605 612 737 823 880 887 858 934 1,060 1,154 Louisiana 647 740 878 1,012 1,035 1,123 947 1,005 909 983 982 Maine 95 122 110 105 115 121 116 114 133 148 168 Maryland 514 636 757 843 943 843 824 754 789 965 1,118 Massachusetts 477 613 703 726 771 756 721 683 680 595 633 Michigan 903 1,200 1,281 1,451 1,558 1,594 1,541 1,562 1,306 1,449 1,856 Minnesota 307 293 294 298 270 312 336 360 358 324 385 Mississippi 369 398 464 483 568 630 621 598 580 502 519 Missouri 593 706 740 875 904 1,029 998 986 838 835 1,080 Montana 73 89 80 99 116 94 104 71 69 81 92 Nebraska 115 150 152 147 169 156 151 184 122 144 161 Nevada 99 103 127 162 194 151 143 137 141 122 185 New Hampshire 58 76 81 89 89 94 91 98 93 104 92 New Jersey 772 903 1,049 1,295 1,497 1,676 1,746 1,910 1,934 1,784 1,832 New Mexico 90 115 139 153 163 153 167 121 127 119 157 New York 1,880 2,054 2,107 2,260 2,271 2,489 2,507 2,544 2,541 2,640 3,011 North Carolina 755 872 954 1,136 1,155 1,308 1,295 1,216 1,141 1,180 1,357 North Dakota 77 64 71 93 86 81 85 73 63 71 67 Ohio 1,155 1,395 1,526 1,812 2,031 2,080 1,981 1,829 1,635 1,699 1,707 Oklahoma 456 463 589 606 696 783 706 728 658 617 658 Oregon 164 213 204 203 215 213 177 195 196 191 173 Pennsylvania 1,376 1,727 1,898 2,117 2,063 2,053 1,969 1,857 1,742 1,812 1,822 Rhode Island 123 160 206 143 207 209 168 154 146 130 153 South Carolina 327 388 395 470 558 590 573 623 586 677 667 South Dakota 88 93 107 124 119 110 104 82 78 80 76 Tennessee 705 927 1,013 1,028 1,175 1,226 1,194 1,174 995 1,088 1,144 Texas 1,653 2,009 2,403 2,666 2,985 3,221 2,890 2,634 2,285 2,237 2,660


B.2-8


Utah 74 103 88 115 121 118 124 143 125 106 152 Vermont * 39 42 37 51 48 47 53 36 41 54 Virginia 487 605 720 814 871 1,007 934 926 970 1,033 1,157 Washington 300 356 369 362 418 427 399 388 362 423 449 West Virginia 206 246 270 289 375 428 423 382 322 342 378 Wisconsin 471 500 488 522 556 523 467 451 473 439 490 Wyoming 38 * * 34 42 * 28 52 40 44 41 Puerto Rico/Virgin Islands 305 292 333 424 546 637 738 767 766 745 786



B.2-9

Tab

le B.2-3. C

om

pariso

n o

f Ben

eficiaries Ho

spitalized

for S

epticem

ia with

Pn

eum

on

ia with

th

e En

tire MQ

MS

Fee-F

or-S

ervice Med

icare Po

pu

lation

, 1992 and

2001

Septicem

ia Population

Entire F

ee-for-Service P

opulation

1994 2001

1994 2001

All E

nro

llees 25,629

38,478 32,095,866

31,503,207

(percent of population) G

end

er

M

ale 45.3

45.2 42.5

43.6 F

emale

54.7 54.8

57.5 56.4

Ag

e Gro

up

0–54

3.1 5.0

6.2 9.3

55–64 3.5

5.1 4.1

5.7 65–69

9.9 8.6

25.4 21

70–74 14.4

12.8 23.7

21 75–79

17.6 17.7

17.9 18.2

80–84 19.9

19.2 12.1

12.8 85–89

17.1 17.3

6.7 7.4

90–94 10.1

10.5 2.8

3.2 95+

4.4

3.9 1.2

1.4 R

ace

W

hite 82.7

80.5 85.4

85.8 B

lack 12.0

14.5 8.4

9.6 O

ther 2.2

4.6 2.9

4.4 U

nknown

3.0 0.4

3.2 0.2

Du

al-En

rollm

ent S

tatus

Not D

ual 71.1

64.7 88

83.5 D

ual 28.9

35.3 12

16.5 M

edicare E

ligib

ility Statu

s

A

ged without E

SR

D

91.9 86.5

89.6 85.2

Disabled w

ithout ES

RD

5.3

7.9 9.8

14 A

ll with E

SR

D

2.8 5.5

0.6 0.9

Urb

an/R

ural

Rural

25.2 26.3

25.4 27.4

Urban

74.8 73.7

74.6 72.6

Cen

sus R

egio

n

Northeast

19.6 19.9

22.3 19.6

Midw

est 25.2

23.4 25.5

25.5 S

outh 39.4

42.2 35.4

38.2 W

est 14.6

12.5 15.5

15 S

tate

A

labama

2.0 2.1

1.8 1.9

Alaska

* *

0.1 0.1

Arizona

1.1 0.8

1.3 1.3

Arkansas

1.5 1.5

1.2 1.3

California

8.8 7.8

7.6 6.8

Colorado

0.8 0.5

1 0.9

Connecticut

0.9 1.1

1.4 1.3

Delaw

are 0.2

0.2 0.3

0.3 D

istrict of Colum

bia 0.2

0.3 0.2

0.2 F

lorida 6.5

7.0 6.5

6.5 G

eorgia 3.3

3.4 2.4

2.7 H

awaii

0.3 0.2

0.3 0.3

Idaho 0.2

0.2 0.4

0.5 Illinois

5.7 6.0

4.5 4.4

Indiana 2.6

2.5 2.4

2.5 Iow

a 1.4

1.1 1.4

1.4 K

ansas 1.0

0.8 1.1

1.1 K

entucky 1.8

2.8 1.6

1.8 Louisiana

2.5 2.6

1.7 1.5

Table B

.2-3 (cont’d)

B.2-10

S

epticemia P

opulation E

ntire Fee-for-S

ervice Population

1994

2001 1994

2001 A

ll En

rollees

25,629 38,478

32,095,866 31,503,207


Maine

0.4 0.4

0.6 0.7

Maryland

2.0 2.5

1.7 1.9

Massachusetts

1.9 1.5

2.6 2.2

Michigan

3.5 3.8

3.9 4

Minnesota

1.2 0.8

1.4 1.7

Mississippi

1.4 1.3

1.2 1.3

Missouri

2.3 2.2

2.4 2.2

Montana

0.3 0.2

0.4 0.4

Nebraska

0.4 0.4

0.7 0.7

Nevada

0.4 0.3

0.4 0.5

New

Ham

pshire 0.2

0.3 0.4

0.5 N

ew Jersey

3.0 4.6

3.3 3.1

New

Mexico

0.4 0.3

0.5 0.6

New

York

7.3 6.9

7.2 6.4

North C

arolina 2.9

3.1 2.9

3.4 N

orth Dakota

0.3 0.2

0.3 0.3

Ohio

4.5 4.4

4.8 4.3

Oklahom

a 1.8

1.6 1.4

1.4 O

regon 0.6

0.5 1.1

0.9 P

ennsylvania 5.4

4.7 6.1

4.8 R

hode Island 0.5

0.3 0.5

0.3 S

outh Carolina

1.3 1.8

1.4 1.8

South D

akota 0.3

0.2 0.3

0.4 T

ennessee 2.8

2.8 2.2

2.4 T

exas 6.4

5.8 5.7

6.1 U

tah 0.3

0.3 0.5

0.6 V

ermont

* 0.1

0.2 0.3

Virginia

1.9 2.7

2.3 2.7

Washington

1.2 1.1

1.8 1.8

West V

irginia 0.8

0.9 0.9

1 W

isconsin 1.8

1.1 2.2

2.3 W

yoming

0.1 0.1

0.2 0.2

Puerto R

ico/Virgin Islands

1.2 1.9

1.4 1.7

SO

UR

CE: C

MS

MedP

AR

and Denom

inator Files.

NO

TE

S: The heart failure population is the subset of the fee-for-service population that had one or m

ore discharges w

ith stroke as the principal diagnosis. State and region are based on beneficiary location.

B.2-11

Table B.2-4. Age/Sex Adjusted Rates of Discharges for Septicemia with Pneumonia Per 1,000 Beneficiaries, 1992-2002 Year


Male 1.01 1.16 1.26 1.36 1.50 1.58 1.51 1.49 1.36 1.38 1.49 Female 0.72 0.84 0.93 1.03 1.12 1.19 1.16 1.13 1.04 1.05 1.12

Age Group 0–54 0.40 0.50 0.54 0.59 0.61 0.66 0.63 0.63 0.58 0.65 0.70 55–64 0.70 0.76 0.87 0.94 1.05 1.08 1.08 1.07 1.00 1.09 1.19 65–69 0.31 0.36 0.41 0.45 0.52 0.54 0.53 0.51 0.48 0.49 0.54 70–74 0.49 0.57 0.63 0.72 0.78 0.82 0.81 0.80 0.73 0.73 0.80 75–79 0.81 0.95 1.03 1.17 1.25 1.32 1.29 1.25 1.16 1.19 1.27 80–84 1.38 1.63 1.75 1.87 2.04 2.19 2.03 2.10 1.84 1.84 1.98 85–89 2.18 2.49 2.74 2.95 3.31 3.49 3.34 3.19 2.97 2.93 3.12 90–94 3.14 3.56 3.98 4.23 4.56 4.88 4.72 4.56 4.18 4.31 4.34 95+ 3.09 3.31 3.71 3.90 4.27 4.38 4.21 4.09 3.79 3.44 4.00






State Alabama 0.97 1.09 1.30 1.38 1.45 1.48 1.56 1.53 1.46 1.37 1.53 Alaska * * * * 0.94 1.06 * 0.84 * * 0.72 Arizona 0.72 0.74 0.91 0.93 0.97 1.08 0.91 0.90 0.74 0.76 0.91 Arkansas 1.04 1.17 1.41 1.48 1.47 1.83 1.74 1.65 1.48 1.44 1.41


B.2-12


California 0.98 1.15 1.33 1.39 1.54 1.59 1.51 1.40 1.22 1.39 1.40 Colorado 0.72 0.79 0.73 0.96 0.94 0.90 0.76 0.72 0.64 0.72 0.68 Connecticut 0.49 0.59 0.59 0.59 0.70 0.92 0.84 0.86 0.99 0.90 1.03 Delaware 0.76 0.96 1.31 1.36 1.21 1.26 1.05 0.72 0.65 0.76 0.93 District of Columbia 0.82 1.41 1.36 1.46 1.71 1.94 1.74 2.05 1.90 1.54 1.72 Florida 0.83 0.98 1.07 1.17 1.30 1.39 1.26 1.33 1.17 1.26 1.31 Georgia 1.23 1.40 1.57 1.72 1.98 1.98 1.91 1.85 1.68 1.64 1.72 Hawaii 0.80 0.64 1.01 0.98 0.87 0.92 0.93 1.13 0.72 0.84 0.95 Idaho 0.49 0.51 0.73 0.70 0.69 0.74 0.59 0.61 0.62 0.61 0.39 Illinois 1.07 1.28 1.42 1.53 1.67 1.72 1.62 1.68 1.60 1.61 1.84 Indiana 0.95 0.99 1.10 1.07 1.25 1.32 1.27 1.34 1.26 1.20 1.29 Iowa 0.78 0.81 0.82 0.94 1.04 0.94 1.02 0.98 0.91 0.84 0.79 Kansas 0.74 0.90 1.05 0.92 1.17 1.04 0.95 1.02 0.83 0.84 0.91 Kentucky 0.98 1.23 1.22 1.44 1.61 1.72 1.70 1.64 1.78 1.97 2.09 Louisiana 1.29 1.46 1.71 2.00 2.08 2.35 2.09 2.22 1.96 2.08 2.00 Maine 0.53 0.66 0.58 0.55 0.60 0.61 0.59 0.56 0.64 0.71 0.80 Maryland 1.02 1.24 1.45 1.59 1.83 1.67 1.65 1.46 1.45 1.63 1.84 Massachusetts 0.59 0.73 0.83 0.89 0.97 1.00 0.98 0.95 0.92 0.80 0.84 Michigan 0.79 1.03 1.08 1.20 1.27 1.28 1.24 1.26 1.04 1.14 1.40 Minnesota 0.66 0.62 0.61 0.60 0.54 0.61 0.64 0.65 0.64 0.57 0.68 Mississippi 1.04 1.12 1.26 1.31 1.54 1.66 1.62 1.57 1.50 1.30 1.33 Missouri 0.79 0.93 0.96 1.14 1.19 1.39 1.36 1.38 1.17 1.15 1.48 Montana 0.65 0.75 0.66 0.79 0.91 0.73 0.79 0.54 0.51 0.58 0.65 Nebraska 0.47 0.60 0.62 0.60 0.68 0.64 0.62 0.75 0.49 0.57 0.63 Nevada 0.89 0.87 1.06 1.36 1.60 1.23 1.14 1.04 1.04 0.85 1.20 New Hampshire 0.43 0.54 0.57 0.62 0.59 0.66 0.63 0.66 0.58 0.63 0.54 New Jersey 0.78 0.89 1.02 1.24 1.46 1.68 1.79 1.94 1.94 1.75 1.71 New Mexico 0.58 0.73 0.89 0.96 1.01 0.95 1.03 0.73 0.74 0.64 0.84 New York 0.84 0.91 0.93 1.01 1.04 1.18 1.21 1.24 1.24 1.27 1.45 North Carolina 0.92 1.02 1.08 1.25 1.24 1.39 1.35 1.25 1.14 1.16 1.30 North Dakota 0.78 0.63 0.67 0.88 0.81 0.77 0.79 0.67 0.58 0.65 0.62 Ohio 0.82 0.97 1.04 1.23 1.38 1.49 1.47 1.38 1.21 1.23 1.21 Oklahoma 1.04 1.04 1.31 1.33 1.54 1.74 1.57 1.65 1.49 1.39 1.46 Oregon 0.50 0.67 0.66 0.69 0.74 0.76 0.63 0.68 0.67 0.63 0.55 Pennsylvania 0.76 0.94 1.02 1.18 1.21 1.26 1.25 1.20 1.13 1.13 1.11 Rhode Island 0.85 1.09 1.41 0.95 1.37 1.46 1.37 1.36 1.27 1.13 1.35 South Carolina 0.82 0.96 0.94 1.12 1.28 1.28 1.21 1.27 1.16 1.31 1.25 South Dakota 0.79 0.80 0.91 1.05 1.00 0.90 0.85 0.66 0.63 0.66 0.61 Tennessee 1.08 1.40 1.49 1.49 1.67 1.72 1.69 1.65 1.39 1.47 1.56 Texas 0.97 1.15 1.35 1.51 1.70 1.84 1.67 1.52 1.29 1.18 1.34 Utah 0.50 0.69 0.58 0.74 0.76 0.75 0.76 0.78 0.66 0.54 0.75 Vermont * 0.51 0.54 0.47 0.65 0.59 0.57 0.64 0.44 0.47 0.60


B.2-13


Virginia 0.74 0.89 1.03 1.14 1.20 1.36 1.25 1.21 1.22 1.26 1.37 Washington 0.56 0.65 0.68 0.67 0.79 0.83 0.78 0.74 0.67 0.74 0.74 West Virginia 0.80 0.93 1.01 1.07 1.37 1.55 1.51 1.35 1.13 1.22 1.31 Wisconsin 0.69 0.71 0.67 0.72 0.76 0.71 0.63 0.61 0.63 0.58 0.64 Wyoming 0.80 * * 0.63 0.76 * 0.48 0.87 0.66 0.71 0.68 Puerto Rico/Virgin Islands 0.66 0.61 0.70 0.86 1.09 1.25 1.41 1.43 1.42 1.35 1.45


NOTES: Based on short-term hospitalizations among the full-year fee-for-service Medicare population. State and region are based on provider location. All results reported at the national level are standardized to the age-sex distribution of the July 1999 Medicare FFS population using the direct method. Results reported at the state level are standardized using the indirect method. a Age-Sex–Adjusted rates are not comparable across aged and disabled groups.

B.2-14

Table B.2-5. Age/Sex Adjusted Rates of Beneficiaries Discharged for Septicemia with Pneumonia Per 1,000 Beneficiaries, 1992-2002

Year Beneficiary Characteristics 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 All Enrollees 0.81 0.94 1.03 1.12 1.23 1.30 1.26 1.24 1.14 1.14 1.23 Gender

Male 0.99 1.14 1.24 1.34 1.47 1.55 1.47 1.46 1.33 1.35 1.45 Female 0.71 0.83 0.92 1.01 1.10 1.17 1.13 1.11 1.02 1.03 1.10

Age Group 0–54 0.40 0.49 0.53 0.58 0.60 0.64 0.61 0.62 0.57 0.62 0.67 55–64 0.69 0.75 0.86 0.93 1.03 1.06 1.05 1.03 0.97 1.06 1.16 65–69 0.31 0.36 0.40 0.44 0.51 0.53 0.52 0.51 0.47 0.48 0.52 70–74 0.49 0.56 0.62 0.71 0.76 0.81 0.79 0.78 0.72 0.72 0.78 75–79 0.80 0.93 1.02 1.15 1.22 1.30 1.26 1.23 1.15 1.16 1.24 80–84 1.37 1.61 1.73 1.84 2.00 2.15 1.99 2.06 1.81 1.80 1.93 85–89 2.15 2.45 2.69 2.89 3.24 3.42 3.28 3.12 2.91 2.86 3.03 90–94 3.11 3.51 3.92 4.16 4.48 4.80 4.64 4.48 4.11 4.21 4.23 95+ 3.04 3.28 3.67 3.84 4.18 4.30 4.12 4.03 3.71 3.39 3.90






State Alabama 0.96 1.07 1.28 1.35 1.43 1.44 1.54 1.49 1.43 1.34 1.50 Alaska * * * * 0.94 1.03 * 0.84 * * 0.72


B.2-15


Arizona 0.71 0.74 0.90 0.92 0.96 1.06 0.90 0.89 0.74 0.76 0.90 Arkansas 1.02 1.15 1.39 1.46 1.44 1.79 1.70 1.62 1.46 1.40 1.38 California 0.97 1.13 1.31 1.36 1.49 1.56 1.48 1.37 1.20 1.36 1.36 Colorado 0.72 0.79 0.73 0.95 0.93 0.89 0.75 0.71 0.63 0.70 0.67 Connecticut 0.49 0.59 0.59 0.59 0.69 0.90 0.84 0.85 0.97 0.89 1.01 Delaware 0.76 0.96 1.29 1.33 1.19 1.25 1.05 0.71 0.64 0.75 0.93 District of Columbia 0.81 1.41 1.30 1.41 1.69 1.88 1.68 1.94 1.84 1.47 1.58 Florida 0.82 0.96 1.06 1.15 1.28 1.36 1.24 1.30 1.15 1.23 1.28 Georgia 1.22 1.37 1.55 1.68 1.94 1.94 1.87 1.81 1.63 1.60 1.68 Hawaii 0.79 0.63 0.99 0.96 0.87 0.91 0.92 1.12 0.70 0.84 0.95 Idaho 0.49 0.51 0.73 0.69 0.67 0.74 0.59 0.60 0.62 0.60 0.39 Illinois 1.04 1.26 1.39 1.50 1.64 1.69 1.58 1.64 1.56 1.56 1.78 Indiana 0.93 0.98 1.08 1.06 1.24 1.30 1.25 1.32 1.23 1.18 1.26 Iowa 0.76 0.80 0.82 0.93 1.03 0.93 1.01 0.97 0.90 0.83 0.78 Kansas 0.74 0.88 1.03 0.92 1.17 1.03 0.94 1.01 0.82 0.82 0.90 Kentucky 0.96 1.21 1.20 1.43 1.57 1.68 1.67 1.61 1.74 1.92 2.04 Louisiana 1.28 1.43 1.67 1.97 2.05 2.29 2.00 2.16 1.90 2.02 1.92 Maine 0.53 0.66 0.58 0.55 0.59 0.61 0.57 0.56 0.64 0.70 0.77 Maryland 1.02 1.22 1.42 1.55 1.78 1.64 1.61 1.44 1.43 1.58 1.79 Massachusetts 0.58 0.73 0.83 0.87 0.96 0.98 0.97 0.93 0.91 0.79 0.82 Michigan 0.79 1.01 1.06 1.17 1.24 1.27 1.22 1.22 1.01 1.11 1.36 Minnesota 0.66 0.61 0.60 0.60 0.53 0.60 0.64 0.65 0.64 0.56 0.66 Mississippi 1.03 1.09 1.25 1.28 1.49 1.63 1.60 1.53 1.47 1.27 1.29 Missouri 0.78 0.92 0.95 1.13 1.18 1.37 1.35 1.35 1.15 1.14 1.45 Montana 0.63 0.75 0.66 0.79 0.91 0.73 0.79 0.54 0.51 0.58 0.65 Nebraska 0.47 0.60 0.61 0.59 0.67 0.63 0.60 0.73 0.48 0.56 0.62 Nevada 0.86 0.87 1.06 1.33 1.58 1.22 1.12 1.04 1.02 0.84 1.19 New Hampshire 0.43 0.54 0.56 0.60 0.59 0.64 0.63 0.66 0.57 0.62 0.54 New Jersey 0.77 0.88 1.00 1.22 1.44 1.65 1.74 1.90 1.89 1.68 1.65 New Mexico 0.58 0.72 0.88 0.96 1.01 0.94 1.01 0.72 0.74 0.64 0.83 New York 0.83 0.90 0.92 0.99 1.02 1.15 1.18 1.20 1.20 1.22 1.38 North Carolina 0.91 1.01 1.07 1.23 1.22 1.36 1.33 1.23 1.13 1.14 1.29 North Dakota 0.75 0.61 0.67 0.87 0.80 0.75 0.78 0.67 0.57 0.64 0.60 Ohio 0.81 0.96 1.03 1.21 1.36 1.47 1.45 1.34 1.19 1.20 1.18 Oklahoma 1.02 1.02 1.29 1.32 1.52 1.72 1.56 1.62 1.46 1.36 1.43 Oregon 0.50 0.66 0.66 0.68 0.74 0.74 0.61 0.67 0.66 0.62 0.54 Pennsylvania 0.75 0.93 1.01 1.15 1.19 1.24 1.22 1.18 1.11 1.11 1.09 Rhode Island 0.84 1.08 1.37 0.93 1.36 1.46 1.36 1.31 1.23 1.10 1.29 South Carolina 0.82 0.94 0.92 1.06 1.22 1.26 1.18 1.25 1.14 1.29 1.23 South Dakota 0.76 0.79 0.90 1.03 0.98 0.89 0.84 0.65 0.62 0.63 0.60 Tennessee 1.07 1.36 1.46 1.45 1.62 1.68 1.64 1.61 1.35 1.45 1.51


B.2-16


Texas 0.96 1.14 1.33 1.48 1.66 1.80 1.63 1.49 1.27 1.15 1.30 Utah 0.49 0.68 0.58 0.74 0.76 0.74 0.76 0.76 0.65 0.54 0.75 Vermont * 0.51 0.54 0.47 0.63 0.59 0.57 0.63 0.41 0.46 0.60 Virginia 0.73 0.88 1.02 1.13 1.18 1.34 1.23 1.20 1.21 1.24 1.35 Washington 0.56 0.65 0.67 0.66 0.79 0.82 0.77 0.74 0.67 0.73 0.73 West Virginia 0.79 0.93 1.00 1.05 1.35 1.52 1.48 1.33 1.11 1.17 1.28 Wisconsin 0.67 0.70 0.67 0.71 0.75 0.70 0.63 0.60 0.63 0.57 0.62 Wyoming 0.76 * * 0.63 0.76 * 0.48 0.87 0.66 0.71 0.65 Puerto Rico/Virgin Islands 0.65 0.61 0.68 0.84 1.07 1.22 1.38 1.41 1.38 1.32 1.40



B.2-17

Table B.2-6. Age/Sex Adjusted Average Length of Stay for Septicemia with Pneumonia Hospitalizations, 1992-2002 Year Beneficiary Characteristics 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 All Enrollees 13.44 12.59 11.81 11.03 10.46 10.09 10.04 10.23 10.38 10.51 10.53 Gender

Male 13.16 12.5 11.69 10.91 10.31 9.92 9.94 10.17 10.17 10.36 10.39 Female 13.63 12.63 11.9 11.13 10.56 10.24 10.11 10.29 10.57 10.64 10.66

Age Group 0–54 14.85 14.19 13.36 12.65 12.32 11.88 11.3 11.77 12.07 12.58 12.44 55–64 14.09 13.92 12.41 11.76 12.33 11 11.05 11.28 11.44 11.28 12.04 65–69 13.59 12.6 11.91 11.27 10.44 10.23 10.39 10.79 10.79 10.96 10.9 70–74 13.56 12.54 11.87 11.02 10.58 10.21 10.11 10.15 10.66 10.76 10.67 75–79 13.3 12.39 11.72 10.79 10.08 9.85 9.8 9.83 9.98 10.16 10.13 80–84 12.74 11.91 11.15 10.5 9.56 9.37 9.31 9.44 9.52 9.42 9.72 85–89 12.29 11.55 11.07 10.06 9.45 9.1 9.02 9.15 8.96 8.96 8.91 90–94 12.08 11.58 10.21 9.26 8.83 8.3 8.22 8.47 8.39 8.49 8.44 95+ 12.06 11.03 9.54 9.25 8.42 8.5 8.31 8.63 7.97 8.41 7.89

Race White 12.96 12.13 11.35 10.59 10.03 9.71 9.6 9.73 9.84 9.97 10.02 Black 16.49 15.29 14.4 13.23 12.59 11.98 11.7 12.38 12.4 12.58 12.54 Other 14.08 12.62 12.58 11.78 11.49 10.95 11.85 11.64 12.66 12.75 12.32 Unknown 13.46 15.33 10.89 9.49 9.47 12.32 10.46 8 9.72 8.55 9.81

Dual-Enrollment Status Not Dual 13.44 12.41 11.68 11.01 10.52 10.15 10.08 10.18 10.35 10.48 10.43 Dual 13.59 13 12.17 11.26 10.54 10.04 10.04 10.3 10.59 10.63 10.73




State Alabama 13.35 11.74 11.69 11.28 10.55 9.35 9.22 9.03 9.25 9.68 9.43 Alaska * * * * 6.47 7.5 * * * * 10.27 Arizona 10.1 8.5 8.08 7.8 6.95 7.03 7.16 7.02 7.4 7.52 8.08


B.2-18


Arkansas 11.42 10.02 9.44 8.41 8.81 8.42 8.13 7.95 7.97 8.16 8.12 California 10.47 9.9 9.27 8.98 8.74 8.7 9.11 9.03 9.76 9.73 10.09 Colorado 10.14 9.93 8.02 8.78 7.26 7.05 7.37 9.6 7.7 8.19 7.71 Connecticut 14.04 14.42 12.14 11.23 10.87 9.14 9.45 10.24 9.45 8.98 9.66 Delaware 15.82 12.55 10.89 11.68 9.67 10.3 9.34 11.14 8.43 12.86 13.18 District of Columbia 23.11 19.27 16.46 18.38 16.33 15.15 14.3 15.34 13.39 14.9 16.3 Florida 12.02 12.07 11.05 10.12 9.32 9.34 9.1 9.49 10.08 10.1 10.11 Georgia 11.93 11.6 10.59 9.75 8.78 8.64 8.18 8.79 8.79 8.6 9.03 Hawaii 18.88 19.17 12.98 15.34 15.21 11.39 17.81 12.87 15.18 12.55 14.26 Idaho 7.79 7.45 6.72 6.16 6.64 6.69 7.44 6.36 6.77 8.78 10.72 Illinois 12.09 11.58 10.57 9.9 9.44 9 8.61 9.02 8.75 8.88 8.75 Indiana 11.5 10.67 9.39 9.05 8.8 8.57 8.08 8.24 8.04 7.93 8.32 Iowa 10.66 9.5 9.48 8.54 8.21 7.65 7.74 7.4 7.32 7.3 7.47 Kansas 9.93 9.35 8.64 9.33 8.8 7.93 8.12 8.55 8.24 8.79 8.68 Kentucky 11.84 12.08 10.55 9.9 9.06 8.97 8.9 8.85 8.52 8.57 9.07 Louisiana 12.54 11.13 10.42 9.26 8.54 8.13 8.55 8.85 8.35 8.93 9.26 Maine 13.07 11.58 9.15 9.04 9.54 10.54 7.61 8.69 9.07 8.78 7.62 Maryland 14.83 13.64 12.21 11.41 10.64 10.61 9.66 10.61 9.68 9.11 9.09 Massachusetts 12.28 11.73 10.94 9.74 9.28 9.02 8.1 8.23 8.87 9.16 9.41 Michigan 13.71 12.86 11.95 11.49 10.67 10.55 9.89 10.56 9.85 9.52 9.36 Minnesota 8.79 8.14 8.23 7.18 7.89 7.73 7.42 7.59 7.51 7.09 7.87 Mississippi 12.56 12.34 12.16 10.07 10.14 9.83 10.01 9.82 9.75 9.48 11.14 Missouri 10.72 11.08 10.29 9.45 8.56 8.06 8.15 8.11 7.79 7.76 7.83 Montana 8.06 8.17 7.48 8.19 7.87 6.38 7.37 7.15 8.15 7.8 7.64 Nebraska 10.18 9.17 8.86 7.28 7.25 8.26 8.24 7.23 9.49 9.8 9.52 Nevada 11.55 14.13 10.7 8.53 10.22 8.7 8.32 9.67 10.36 11.57 10.05 New Hampshire 12.14 8.91 11.61 10.25 8.97 8.27 7.56 6.88 6.81 8.38 8.02 New Jersey 20.55 20.55 18.71 16.49 15.31 13.93 13.98 13.57 13.93 13.64 13.79 New Mexico 8.85 9.77 7.69 8.35 8.36 7.81 8.39 7.9 8 8.23 9.29 New York 24.43 21.4 20.15 18.83 17.03 16.3 16.41 15.91 15.53 15.93 15.11 North Carolina 13.26 13.24 12.26 11.22 11.38 10.19 9.52 9.5 9.22 9.07 9.47 North Dakota 8.96 9.24 7.92 7.83 8.28 7.95 6.87 6.61 7.01 7.46 6.73 Ohio 12.1 10.66 10.28 9.48 8.98 8.63 8.15 8.31 8.36 8.33 8.41 Oklahoma 11.45 10.14 9.67 9.09 7.86 8.01 8.01 7.71 8.62 7.83 8.23 Oregon 7.4 6.61 6.31 6.05 6.39 5.65 6.17 5.87 6.76 6.57 6.85 Pennsylvania 13.9 12.77 12.56 10.81 10.31 9.78 8.96 9.1 9.17 9.37 8.91 Rhode Island 15.12 13.91 14.38 12.19 10.58 10.13 10.28 10.64 9.63 9.51 10.95 South Carolina 12.8 12.24 12.8 11.77 10.72 10.51 9.41 10.77 10.2 10.53 10.68 South Dakota 7.64 8.69 8.78 8.26 7.27 6.75 7.61 8.79 7.55 9.07 7.09 Tennessee 12.24 11.88 10.93 10.13 9.76 9.24 8.79 8.81 9.29 9 9.27 Texas 10.71 10.25 9.89 8.92 8.46 8.19 8.56 8.64 8.46 9.45 9.43


B.2-19


Utah 7.76 6.47 7.2 6.56 6.36 7.31 8.24 6.47 7.54 7.43 7.55 Vermont * 7.57 9.09 7.87 8.5 7.95 7.12 9.61 5.39 10.59 8.68 Virginia 12.01 12.07 10.92 10.62 10.74 9.63 9.94 10.41 9.52 9.51 9.47 Washington 8.29 7.41 7.47 6.76 6.4 6.71 7.01 6.26 6.71 6.88 7.48 West Virginia 13.37 10.84 10.76 10.02 10.04 8.79 9.31 9.95 9.16 9.9 9.36 Wisconsin 10.09 9.13 9.18 8.09 8.59 8.24 7.79 7.53 7.97 7.66 8.08 Wyoming 7.12 * * 8.36 6.76 * 7.42 10.21 8.3 6.78 6.35 Puerto Rico/Virgin Islands 12.83 13.7 13.63 12.88 11.76 12.76 13.2 13.36 13.77 14.48 13.49



B.2-20

Table B.2-7. Total Medicare Payments for Discharges for Septicemia with Pneumonia, 1992-2002 Year

Beneficiary Characteristics 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 (in thousands of dollars) All Enrollees 215,333 260,647 293,792 321,992 361,578 394,631 380,450 393,128 376,771 427,882 506,033 Gender

Male 99,751 120,389 135,139 147,371 167,577 181,057 174,574 183,771 173,422 197,604 238,793 Female 115,582 140,258 158,652 174,620 194,001 213,574 205,876 209,356 203,349 230,277 267,240

Age Group 0–54 8,187 12,585 14,380 17,421 19,685 22,171 21,087 23,970 22,871 29,597 36,539 55–64 9,240 10,886 12,465 13,796 18,901 19,484 19,596 22,472 21,976 26,602 35,526 65–69 22,317 27,799 31,274 33,067 37,927 39,517 38,389 36,862 35,167 42,207 51,051 70–74 32,579 39,913 45,132 49,897 55,779 58,561 55,759 55,968 54,670 59,257 69,605 75–79 38,742 45,941 51,095 58,721 64,326 71,147 69,998 69,276 68,347 78,257 88,457 80–84 41,332 50,174 56,073 59,690 65,122 72,544 67,831 74,875 69,468 75,751 93,141 85–89 34,413 40,135 47,462 49,835 56,146 63,078 59,832 60,848 58,394 65,533 74,417 90–94 19,657 23,783 25,915 27,984 30,755 33,876 34,072 34,518 32,700 37,675 41,233 95+ 8,866 9,432 9,996 11,579 12,937 14,252 13,886 14,338 13,177 13,002 16,065






State Alabama 3,822 4,166 5,377 6,052 6,639 6,138 6,279 6,028 5,872 6,457 7,492 Alaska * * * * 263 352 * * * * 484


B.2-21


Arizona 2,886 3,030 3,285 3,392 3,460 3,440 2,970 3,064 2,765 3,203 4,581 Arkansas 2,287 2,709 3,151 3,169 3,643 4,700 4,109 4,199 4,046 4,353 4,733 California 21,220 26,530 30,227 32,355 36,716 39,027 37,852 37,048 36,295 46,464 52,766 Colorado 1,712 2,040 1,677 2,228 2,263 2,186 2,027 2,070 2,013 2,318 2,456 Connecticut 2,103 2,576 2,626 2,698 3,761 4,674 3,967 4,523 4,886 5,335 7,473 Delaware 1,108 1,218 1,102 1,067 822 1,047 1,041 635 593 1,161 1,172 District of Columbia 1,115 1,694 1,652 1,521 2,223 1,819 2,276 2,631 1,786 1,784 1,783 Florida 12,824 16,454 19,200 20,761 22,459 25,485 22,163 24,871 22,359 26,960 31,969 Georgia 6,451 7,567 8,510 9,455 11,881 11,903 11,041 12,176 11,451 12,359 15,457 Hawaii 656 939 869 1,510 996 936 1,376 1,454 991 997 1,179 Idaho 370 395 631 612 529 696 683 612 562 812 934 Illinois 11,190 14,990 17,493 19,794 22,256 23,092 21,142 21,716 21,018 23,507 27,894 Indiana 4,898 5,377 5,675 5,962 7,210 7,812 7,464 8,315 8,064 7,821 10,240 Iowa 2,092 1,990 2,290 2,651 3,045 2,844 3,163 3,257 3,006 3,012 3,001 Kansas 1,510 2,003 2,227 2,386 3,044 2,486 2,840 2,561 2,176 2,634 2,939 Kentucky 3,046 3,979 3,976 4,782 5,662 6,797 6,373 6,195 7,087 8,864 10,618 Louisiana 5,562 6,345 7,189 8,094 8,748 9,137 8,236 8,717 7,555 9,430 10,316 Maine 611 668 641 739 779 1,084 735 1,017 1,031 1,444 1,523 Maryland 5,548 7,239 8,068 8,441 10,036 9,181 9,557 10,092 9,939 12,561 15,822 Massachusetts 4,029 5,436 6,038 6,780 7,559 7,963 7,007 6,596 7,221 6,644 8,101 Michigan 7,787 11,065 11,958 15,440 16,512 17,234 16,289 17,516 12,866 14,940 21,467 Minnesota 2,226 1,928 2,043 2,030 2,121 2,376 2,524 3,105 3,647 2,876 4,198 Mississippi 2,413 2,739 2,976 3,298 3,955 4,227 4,517 4,486 4,415 4,174 4,970 Missouri 4,313 5,297 6,003 7,055 7,395 8,596 8,737 8,524 7,259 7,648 10,852 Montana 451 541 486 626 898 517 633 486 789 714 866 Nebraska 615 976 1,087 916 1,006 1,465 1,446 1,329 1,283 1,300 1,995 Nevada 810 1,234 1,531 1,337 1,951 1,689 1,297 1,753 1,554 1,544 2,072 New Hampshire 352 459 656 581 764 678 681 780 684 850 792 New Jersey 7,460 10,343 11,292 13,539 15,670 19,316 21,965 26,850 30,643 32,606 37,622 New Mexico 451 948 900 900 1,289 1,344 1,533 866 1,154 1,142 1,768 New York 27,238 27,842 30,105 33,904 31,750 38,175 40,276 43,752 44,004 48,687 57,218 North Carolina 5,478 6,290 6,896 9,077 9,713 11,052 10,204 9,869 9,560 10,155 13,673 North Dakota 582 474 441 603 608 766 531 473 529 478 604 Ohio 8,442 10,204 11,455 13,698 16,119 17,681 16,283 15,880 13,780 15,940 16,186 Oklahoma 2,924 2,667 3,313 3,590 4,247 5,324 4,927 4,702 4,641 4,419 5,341 Oregon 1,080 1,433 1,159 1,355 1,562 1,471 1,368 1,379 1,619 1,512 1,598 Pennsylvania 14,138 18,332 21,363 18,252 18,297 20,687 17,263 17,422 17,490 20,842 19,110 Rhode Island 1,019 1,653 2,232 1,327 1,799 1,896 1,775 1,669 1,384 1,351 1,801 South Carolina 1,959 2,690 2,660 3,360 4,746 4,537 4,818 5,128 5,063 6,649 6,702 South Dakota 533 477 590 719 727 625 766 726 603 815 591


B-22


Tennessee 5,536 6,723 7,894 8,264 9,762 10,851 9,732 9,595 8,763 10,153 11,835 Texas 12,289 15,611 19,479 20,866 25,404 28,291 26,461 24,317 20,366 24,347 30,539 Utah 574 683 657 837 1,073 1,200 1,302 1,295 1,030 1,115 1,510 Vermont * 217 262 263 345 323 363 432 216 443 517 Virginia 3,066 3,913 4,977 5,833 7,185 8,140 7,709 7,961 8,314 9,174 11,108 Washington 2,313 2,541 3,140 2,678 3,330 3,387 3,923 3,275 3,239 4,307 5,187 West Virginia 1,507 1,589 1,686 1,770 2,884 3,074 3,081 3,200 2,456 3,001 3,180 Wisconsin 3,178 3,136 3,032 3,289 3,998 3,750 3,605 3,623 3,747 3,746 4,953 Wyoming 192 * * 199 291 * 226 487 416 370 292 Puerto Rico/Virgin Islands 1,083 1,079 1,371 1,670 2,185 3,009 3,617 4,078 4,258 4,278 4,552



B.2-23

Table B.2-8. Average Medicare Payments per Discharge with Septicemia with Pneumonia, 1992-2002 Year Beneficiary Characteristics 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 All Enrollees 215,333 260,647 293,792 321,992 361,578 394,631 380,450 393,128 376,771 427,882 506,033 Gender

Male 99,751 120,389 135,139 147,371 167,577 181,057 174,574 183,771 173,422 197,604 238,793 Female 115,582 140,258 158,652 174,620 194,001 213,574 205,876 209,356 203,349 230,277 267,240

Age Group 0–54 8,187 12,585 14,380 17,421 19,685 22,171 21,087 23,970 22,871 29,597 36,539 55–64 9,240 10,886 12,465 13,796 18,901 19,484 19,596 22,472 21,976 26,602 35,526 65–69 22,317 27,799 31,274 33,067 37,927 39,517 38,389 36,862 35,167 42,207 51,051 70–74 32,579 39,913 45,132 49,897 55,779 58,561 55,759 55,968 54,670 59,257 69,605 75–79 38,742 45,941 51,095 58,721 64,326 71,147 69,998 69,276 68,347 78,257 88,457 80–84 41,332 50,174 56,073 59,690 65,122 72,544 67,831 74,875 69,468 75,751 93,141 85–89 34,413 40,135 47,462 49,835 56,146 63,078 59,832 60,848 58,394 65,533 74,417 90–94 19,657 23,783 25,915 27,984 30,755 33,876 34,072 34,518 32,700 37,675 41,233 95+ 8,866 9,432 9,996 11,579 12,937 14,252 13,886 14,338 13,177 13,002 16,065






State Alabama 3,822 4,166 5,377 6,052 6,639 6,138 6,279 6,028 5,872 6,457 7,492 Alaska * * * * 263 352 * * * * 484 Arizona 2,886 3,030 3,285 3,392 3,460 3,440 2,970 3,064 2,765 3,203 4,581


B.2-24


Arkansas 2,287 2,709 3,151 3,169 3,643 4,700 4,109 4,199 4,046 4,353 4,733 California 21,220 26,530 30,227 32,355 36,716 39,027 37,852 37,048 36,295 46,464 52,766 Colorado 1,712 2,040 1,677 2,228 2,263 2,186 2,027 2,070 2,013 2,318 2,456 Connecticut 2,103 2,576 2,626 2,698 3,761 4,674 3,967 4,523 4,886 5,335 7,473 Delaware 1,108 1,218 1,102 1,067 822 1,047 1,041 635 593 1,161 1,172 District of Columbia 1,115 1,694 1,652 1,521 2,223 1,819 2,276 2,631 1,786 1,784 1,783 Florida 12,824 16,454 19,200 20,761 22,459 25,485 22,163 24,871 22,359 26,960 31,969 Georgia 6,451 7,567 8,510 9,455 11,881 11,903 11,041 12,176 11,451 12,359 15,457 Hawaii 656 939 869 1,510 996 936 1,376 1,454 991 997 1,179 Idaho 370 395 631 612 529 696 683 612 562 812 934 Illinois 11,190 14,990 17,493 19,794 22,256 23,092 21,142 21,716 21,018 23,507 27,894 Indiana 4,898 5,377 5,675 5,962 7,210 7,812 7,464 8,315 8,064 7,821 10,240 Iowa 2,092 1,990 2,290 2,651 3,045 2,844 3,163 3,257 3,006 3,012 3,001 Kansas 1,510 2,003 2,227 2,386 3,044 2,486 2,840 2,561 2,176 2,634 2,939 Kentucky 3,046 3,979 3,976 4,782 5,662 6,797 6,373 6,195 7,087 8,864 10,618 Louisiana 5,562 6,345 7,189 8,094 8,748 9,137 8,236 8,717 7,555 9,430 10,316 Maine 611 668 641 739 779 1,084 735 1,017 1,031 1,444 1,523 Maryland 5,548 7,239 8,068 8,441 10,036 9,181 9,557 10,092 9,939 12,561 15,822 Massachusetts 4,029 5,436 6,038 6,780 7,559 7,963 7,007 6,596 7,221 6,644 8,101 Michigan 7,787 11,065 11,958 15,440 16,512 17,234 16,289 17,516 12,866 14,940 21,467 Minnesota 2,226 1,928 2,043 2,030 2,121 2,376 2,524 3,105 3,647 2,876 4,198 Mississippi 2,413 2,739 2,976 3,298 3,955 4,227 4,517 4,486 4,415 4,174 4,970 Missouri 4,313 5,297 6,003 7,055 7,395 8,596 8,737 8,524 7,259 7,648 10,852 Montana 451 541 486 626 898 517 633 486 789 714 866 Nebraska 615 976 1,087 916 1,006 1,465 1,446 1,329 1,283 1,300 1,995 Nevada 810 1,234 1,531 1,337 1,951 1,689 1,297 1,753 1,554 1,544 2,072 New Hampshire 352 459 656 581 764 678 681 780 684 850 792 New Jersey 7,460 10,343 11,292 13,539 15,670 19,316 21,965 26,850 30,643 32,606 37,622 New Mexico 451 948 900 900 1,289 1,344 1,533 866 1,154 1,142 1,768 New York 27,238 27,842 30,105 33,904 31,750 38,175 40,276 43,752 44,004 48,687 57,218 North Carolina 5,478 6,290 6,896 9,077 9,713 11,052 10,204 9,869 9,560 10,155 13,673 North Dakota 582 474 441 603 608 766 531 473 529 478 604 Ohio 8,442 10,204 11,455 13,698 16,119 17,681 16,283 15,880 13,780 15,940 16,186 Oklahoma 2,924 2,667 3,313 3,590 4,247 5,324 4,927 4,702 4,641 4,419 5,341 Oregon 1,080 1,433 1,159 1,355 1,562 1,471 1,368 1,379 1,619 1,512 1,598 Pennsylvania 14,138 18,332 21,363 18,252 18,297 20,687 17,263 17,422 17,490 20,842 19,110 Rhode Island 1,019 1,653 2,232 1,327 1,799 1,896 1,775 1,669 1,384 1,351 1,801 South Carolina 1,959 2,690 2,660 3,360 4,746 4,537 4,818 5,128 5,063 6,649 6,702 South Dakota 533 477 590 719 727 625 766 726 603 815 591 Tennessee 5,536 6,723 7,894 8,264 9,762 10,851 9,732 9,595 8,763 10,153 11,835 Texas 12,289 15,611 19,479 20,866 25,404 28,291 26,461 24,317 20,366 24,347 30,539


B.2-25


Utah 574 683 657 837 1,073 1,200 1,302 1,295 1,030 1,115 1,510 Vermont * 217 262 263 345 323 363 432 216 443 517 Virginia 3,066 3,913 4,977 5,833 7,185 8,140 7,709 7,961 8,314 9,174 11,108 Washington 2,313 2,541 3,140 2,678 3,330 3,387 3,923 3,275 3,239 4,307 5,187 West Virginia 1,507 1,589 1,686 1,770 2,884 3,074 3,081 3,200 2,456 3,001 3,180 Wisconsin 3,178 3,136 3,032 3,289 3,998 3,750 3,605 3,623 3,747 3,746 4,953 Wyoming 192 * * 199 291 * 226 487 416 370 292 Puerto Rico/Virgin Islands 1,083 1,079 1,371 1,670 2,185 3,009 3,617 4,078 4,258 4,278 4,552



B.2-26

Table B.2-9. Total Beneficiary Deductible and Coinsurance Payments for Discharges for Septicemia with Pneumonia, 1992-2002

Year Beneficiary Characteristics 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 All Enrollees 17,981 21,029 22,223 23,843 25,951 26,645 25,746 25,843 25,025 26,800 30,077 Gender

Male 8,072 9,269 9,883 10,486 11,486 11,818 11,360 11,563 11,152 12,430 13,807 Female 9,910 11,760 12,339 13,357 14,466 14,827 14,386 14,280 13,873 14,370 16,270

Age Group 0–54 583 873 977 1,069 1,273 1,365 1,371 1,353 1,326 1,587 1,932 55–64 706 782 914 1,008 1,222 1,053 1,250 1,269 1,466 1,613 2,158 65–69 1,753 2,224 2,143 2,442 2,494 2,507 2,485 2,394 2,330 2,485 2,942 70–74 2,672 3,006 3,363 3,568 3,787 3,801 3,622 3,490 3,429 3,832 4,091 75–79 3,212 3,760 3,804 4,054 4,435 4,816 4,539 4,547 4,570 4,908 5,219 80–84 3,611 4,153 4,271 4,496 4,732 5,089 4,593 4,904 4,588 4,718 5,567 85–89 2,925 3,341 3,911 3,979 4,434 4,404 4,293 4,303 4,049 4,273 4,559 90–94 1,710 2,124 2,000 2,231 2,539 2,557 2,508 2,581 2,291 2,472 2,544 95+ 809 765 840 996 1,034 1,054 1,084 1,001 976 912 1,066

Race White 14,099 16,507 17,702 18,847 20,440 21,016 19,961 20,138 19,398 20,439 22,708 Black 2,821 3,645 3,604 4,021 4,268 4,396 4,246 4,401 4,162 4,798 5,613 Other 442 435 717 651 980 1,091 1,366 1,188 1,377 1,481 1,674 Unknown 619 443 200 323 262 144 172 115 89 81 82


Medicare Eligibility Status Aged without ESRD 16,297 18,980 19,842 21,224 22,658 23,512 22,248 22,229 21,347 22,557 24,580 Disabled without ESRD 1,004 1,303 1,533 1,627 1,869 1,878 2,016 2,029 2,106 2,519 3,044 All with ESRD 681 745 847 992 1,424 1,256 1,482 1,585 1,572 1,724 2,453



State Alabama 310 409 432 467 509 482 472 491 487 560 530 Alaska * * * * 15 17 * 15 * * 21


B.2-27


Arizona 132 156 188 194 220 230 224 180 163 179 246 Arkansas 214 248 288 296 318 426 395 341 389 337 418 California 1,253 1,541 1,677 1,668 1,840 1,923 1,966 1,773 1,700 2,152 2,395 Colorado 119 157 114 152 164 164 116 144 105 145 126 Connecticut 146 196 178 198 204 249 206 206 287 270 378 Delaware 49 54 66 73 58 58 63 44 45 81 91 District of Columbia 111 134 79 159 126 142 89 200 117 114 153 Florida 928 1,220 1,293 1,339 1,569 1,570 1,381 1,660 1,471 1,604 1,948 Georgia 542 531 676 738 826 822 777 775 746 763 908 Hawaii 59 79 69 72 110 59 95 99 69 106 70 Idaho 31 38 52 51 57 65 45 44 53 47 33 Illinois 940 1,117 1,153 1,279 1,493 1,439 1,320 1,390 1,356 1,361 1,647 Indiana 452 376 433 422 563 570 569 568 539 506 606 Iowa 177 200 227 244 278 265 271 296 258 246 262 Kansas 135 186 210 192 278 236 216 218 192 216 273 Kentucky 300 392 320 410 444 520 490 463 501 564 697 Louisiana 367 441 475 571 554 620 568 658 530 691 677 Maine 90 67 58 62 88 74 69 59 97 97 133 Maryland 452 513 512 526 535 505 550 497 524 648 743 Massachusetts 307 345 474 402 448 462 397 397 446 419 394 Michigan 593 805 793 1,021 1,024 1,016 978 1,042 943 924 1,220 Minnesota 154 154 155 163 165 182 202 260 191 173 266 Mississippi 209 258 287 277 316 402 449 413 329 309 388 Missouri 345 448 429 483 496 595 594 581 482 515 657 Montana 31 40 43 61 59 53 58 41 41 42 54 Nebraska 57 104 128 79 85 94 97 108 83 72 99 Nevada 66 108 67 84 148 86 85 96 112 96 132 New Hampshire 40 43 59 46 59 75 50 49 50 69 57 New Jersey 957 1,163 1,164 1,363 1,513 1,377 1,571 1,498 1,776 1,825 1,909 New Mexico 42 65 73 94 93 91 104 72 65 73 111 New York 3,034 2,987 2,877 2,862 2,818 2,589 2,660 2,767 2,884 3,071 3,194 North Carolina 544 610 638 807 815 886 809 780 760 762 940 North Dakota 36 29 35 47 47 59 53 47 39 35 45 Ohio 699 808 828 992 1,156 1,255 1,058 1,074 941 981 1,018 Oklahoma 247 278 332 364 372 434 430 426 406 387 384 Oregon 89 113 118 117 124 122 104 113 121 111 94 Pennsylvania 928 1,235 1,338 1,229 1,304 1,271 1,195 1,129 1,148 1,278 1,109 Rhode Island 106 122 187 83 126 149 103 111 91 109 102 South Carolina 244 300 283 375 354 413 376 382 391 467 509 South Dakota 50 44 55 80 62 58 56 55 48 41 46 Tennessee 452 564 636 577 663 722 669 723 638 674 703


B.2-28


Texas 928 1,150 1,404 1,578 1,688 1,870 1,764 1,578 1,372 1,582 1,868 Utah 37 60 54 69 73 68 69 88 79 69 92 Vermont * 20 22 21 32 36 38 23 20 24 64 Virginia 284 345 407 518 531 660 631 635 646 683 846 Washington 150 188 219 212 236 264 239 222 197 253 293 West Virginia 99 161 140 150 199 206 256 251 167 251 243 Wisconsin 251 259 283 273 319 300 284 248 262 244 298 Wyoming 18 * * 19 24 * 16 30 22 25 30 Puerto Rico/Virgin Islands 159 156 180 268 353 405 456 483 629 536 557



B.2-29

Table B.2-10. Average Number of Pneumonia-Related Discharges Per Beneficiary Discharged With Septicemia with Pneumonia, 1992-2002


Male 1.01 1.02 1.02 1.02 1.02 1.02 1.02 1.02 1.02 1.03 1.03 Female 1.01 1.01 1.01 1.02 1.02 1.02 1.02 1.02 1.02 1.02 1.02

Age Group 0–54 1.01 1.02 1.02 1.02 1.02 1.03 1.03 1.02 1.03 1.03 1.04 55–64 1.01 1.01 1.02 1.02 1.02 1.02 1.03 1.03 1.03 1.03 1.03 65–69 1.01 1.01 1.01 1.02 1.02 1.02 1.02 1.02 1.02 1.03 1.03 70–74 1.01 1.01 1.02 1.02 1.02 1.02 1.02 1.02 1.02 1.02 1.03 75–79 1.01 1.02 1.02 1.02 1.02 1.02 1.02 1.02 1.02 1.02 1.02 80–84 1.01 1.01 1.01 1.02 1.02 1.02 1.02 1.02 1.02 1.03 1.03 85–89 1.01 1.01 1.02 1.02 1.02 1.02 1.02 1.02 1.02 1.03 1.03 90–94 1.01 1.02 1.01 1.02 1.02 1.02 1.02 1.02 1.02 1.02 1.03 95+ 1.02 1.01 1.01 1.02 1.02 1.02 1.02 1.02 1.02 1.02 1.02






State Alabama 1.01 1.01 1.01 1.03 1.01 1.02 1.02 1.02 1.02 1.02 1.02 Alaska * * * * 1 1.04 * * * * 1


B.2-30


Arizona 1.01 1 1.01 1.01 1.01 1.01 1 1.01 1 1 1.02 Arkansas 1.03 1.01 1.01 1.02 1.01 1.02 1.03 1.02 1.02 1.03 1.03 California 1.01 1.01 1.02 1.02 1.03 1.02 1.02 1.02 1.02 1.02 1.03 Colorado 1.01 1 1.01 1.02 1.01 1.02 1.01 1.02 1.01 1.02 1.01 Connecticut 1 1.01 1 1.01 1.01 1.02 1.01 1.02 1.02 1.01 1.02 Delaware 1 1.01 1.02 1.03 1.02 1.01 1 1.02 1 1.01 1 District of Columbia 1.02 1.01 1.04 1.01 1.02 1.02 1.02 1.05 1.03 1.03 1.05 Florida 1.01 1.01 1.01 1.02 1.02 1.02 1.02 1.03 1.02 1.03 1.03 Georgia 1.01 1.02 1.02 1.02 1.02 1.02 1.02 1.02 1.03 1.03 1.03 Hawaii 1.01 1.02 1.02 1.01 1 1.01 1.01 1.01 1.03 1.01 1 Idaho 1 1 1 1 1.03 1.01 1 1.02 1 1.01 1 Illinois 1.02 1.02 1.03 1.02 1.02 1.02 1.02 1.03 1.02 1.04 1.03 Indiana 1.02 1.01 1.02 1.01 1.01 1.01 1.02 1.02 1.03 1.02 1.02 Iowa 1.02 1.01 1.01 1.02 1.01 1 1.01 1.02 1.01 1.01 1 Kansas 1 1.02 1.01 1 1 1.01 1.01 1.01 1.02 1.03 1.02 Kentucky 1.02 1.02 1.01 1.01 1.02 1.03 1.02 1.02 1.02 1.03 1.03 Louisiana 1.01 1.02 1.03 1.02 1.02 1.03 1.05 1.03 1.03 1.03 1.04 Maine 1.01 1 1 1 1.02 1.01 1.02 1 1 1.01 1.02 Maryland 1.01 1.01 1.03 1.02 1.03 1.02 1.03 1.02 1.01 1.03 1.03 Massachusetts 1.01 1.01 1 1.02 1.01 1.01 1.02 1.02 1.01 1.02 1.02 Michigan 1.01 1.01 1.02 1.02 1.02 1.02 1.02 1.03 1.02 1.03 1.03 Minnesota 1.01 1.01 1.01 1.01 1.01 1 1.01 1.01 1 1.01 1.02 Mississippi 1.01 1.03 1.01 1.02 1.03 1.02 1.01 1.02 1.02 1.02 1.03 Missouri 1.01 1.01 1.01 1.01 1.01 1.01 1.01 1.02 1.02 1.01 1.02 Montana 1.03 1 1.02 1.01 1 1 1 1.01 1.01 1 1 Nebraska 1.01 1 1.01 1.03 1.02 1.02 1.03 1.02 1.02 1.03 1.01 Nevada 1.03 1 1 1.02 1.01 1.01 1.02 1.01 1.02 1 1.01 New Hampshire 1.02 1 1.01 1.03 1 1.03 1.01 1.01 1.01 1.01 1 New Jersey 1.01 1.01 1.02 1.01 1.02 1.02 1.03 1.02 1.03 1.04 1.03 New Mexico 1 1.03 1.01 1 1 1.02 1.02 1.01 1.01 1 1.02 New York 1.01 1.01 1.01 1.02 1.02 1.02 1.03 1.03 1.04 1.04 1.05 North Carolina 1.01 1.01 1.01 1.01 1.02 1.02 1.01 1.02 1.01 1.01 1.01 North Dakota 1.03 1.03 1 1.01 1.02 1.02 1.01 1 1 1.01 1.03 Ohio 1.01 1.01 1.01 1.02 1.02 1.02 1.02 1.02 1.02 1.03 1.02 Oklahoma 1.01 1.02 1.02 1.01 1.01 1.01 1.01 1.02 1.02 1.02 1.02 Oregon 1.01 1 1.01 1 1 1.02 1.02 1.01 1.01 1.01 1.02 Pennsylvania 1.01 1.01 1.01 1.02 1.01 1.02 1.02 1.02 1.01 1.02 1.02 Rhode Island 1.01 1.01 1.03 1.02 1.01 1 1.01 1.03 1.03 1.02 1.05 South Carolina 1 1.02 1.02 1.06 1.05 1.02 1.02 1.01 1.01 1.02 1.02 South Dakota 1.03 1 1.01 1.02 1.02 1.02 1.02 1.01 1.02 1.03 1.01 Tennessee 1.01 1.02 1.02 1.03 1.03 1.02 1.03 1.02 1.03 1.02 1.03


B.2-31


Texas 1.01 1.02 1.02 1.02 1.02 1.02 1.02 1.02 1.02 1.02 1.03 Utah 1.03 1.01 1 1 1 1.01 1.01 1.01 1.01 1.01 1 Vermont * 1 1 1.03 1.02 1 1 1 1.06 1.03 1 Virginia 1.01 1.01 1.01 1.01 1.02 1.01 1.02 1.01 1.01 1.02 1.01 Washington 1.01 1.01 1.02 1.01 1.01 1.01 1.01 1.01 1.01 1.01 1.02 West Virginia 1.01 1 1.01 1.02 1.01 1.02 1.02 1.01 1.01 1.04 1.02 Wisconsin 1.02 1.02 1 1.01 1.01 1.01 1.01 1.02 1 1.01 1.02 Wyoming 1.06 * * 1 1 * 1 1 1 1 1.03 Puerto Rico/Virgin Islands 1.01 1.01 1.04 1.02 1.02 1.03 1.02 1.02 1.03 1.02 1.03



B.2-32

Table B.2-11. Average Number of All Discharges Per Beneficiary Discharged With Septicemia With Pneumonia, 1992-2002


Male 2.25 2.23 2.25 2.32 2.33 2.36 2.37 2.4 2.45 2.51 2.53 Female 2.04 2.07 2.11 2.13 2.18 2.22 2.24 2.27 2.3 2.39 2.4

Age Group 0–54 2.77 2.8 2.76 2.87 3.02 2.95 3.01 2.95 2.86 3.06 3.04 55–64 2.51 2.55 2.66 2.59 2.68 2.72 2.65 2.85 2.81 2.82 2.85 65–69 2.33 2.29 2.3 2.36 2.34 2.41 2.52 2.5 2.57 2.61 2.68 70–74 2.23 2.26 2.29 2.32 2.37 2.42 2.42 2.47 2.52 2.57 2.57 75–79 2.19 2.18 2.24 2.26 2.28 2.3 2.34 2.37 2.4 2.48 2.51 80–84 2.07 2.09 2.11 2.17 2.21 2.25 2.25 2.25 2.31 2.39 2.4 85–89 2.01 2 2.04 2.06 2.07 2.12 2.12 2.16 2.19 2.27 2.28 90–94 1.89 1.93 1.9 1.97 2 2.01 2 2.05 2.07 2.13 2.14 95+ 1.78 1.76 1.84 1.84 1.92 1.92 1.93 1.94 1.97 2.04 1.98






State Alabama 2.26 2.18 2.21 2.31 2.26 2.37 2.35 2.37 2.36 2.44 2.49 Alaska * * * * 2.12 2.43 * * * * 1.96


B.2-33


Arizona 1.96 1.83 1.98 1.94 1.92 2.02 2.03 2.15 2.06 2.19 2.21 Arkansas 2.15 2.28 2.11 2.33 2.2 2.27 2.21 2.35 2.28 2.42 2.5 California 2.11 2.15 2.15 2.17 2.26 2.31 2.27 2.33 2.34 2.41 2.43 Colorado 2.08 1.94 2.02 1.9 1.95 2.06 1.99 1.93 1.94 1.93 2.25 Connecticut 1.86 2 2.1 2.04 2.14 2.09 2.09 2.26 2.32 2.28 2.33 Delaware 1.9 2.1 1.96 1.94 2.18 2.18 2.05 2.05 1.74 2.22 2.38 District of Columbia 2.4 2.41 2.83 2.67 2.57 2.81 2.78 2.92 2.93 3.23 2.98 Florida 2.08 2.11 2.16 2.22 2.24 2.32 2.33 2.35 2.35 2.49 2.52 Georgia 2.31 2.24 2.24 2.4 2.29 2.33 2.31 2.35 2.32 2.41 2.41 Hawaii 1.99 1.76 1.81 1.94 2.04 2.03 1.98 1.93 1.94 2.07 2.21 Idaho 2.02 2.15 2.01 1.77 2.06 1.83 1.95 2.21 2.07 2.09 1.89 Illinois 2.23 2.39 2.35 2.4 2.47 2.45 2.39 2.41 2.56 2.65 2.68 Indiana 2.14 2.08 2.12 2.09 2.14 2.18 2.21 2.21 2.34 2.32 2.34 Iowa 1.91 1.83 1.99 2.06 2.07 2.09 2.2 2.12 2.01 2.03 2.13 Kansas 1.99 1.93 2.07 2.14 2 1.98 2.06 2.2 2.06 2.16 2 Kentucky 2.34 2.31 2.38 2.18 2.4 2.4 2.42 2.48 2.55 2.56 2.5 Louisiana 2.36 2.34 2.56 2.51 2.43 2.6 2.59 2.53 2.6 2.65 2.61 Maine 2.19 1.79 1.95 2.01 2.16 2.1 2.27 2.17 2.17 2.21 2.06 Maryland 2.39 2.51 2.54 2.55 2.58 2.56 2.54 2.73 2.71 2.93 2.84 Massachusetts 2.06 2.16 2.12 2.16 2.15 2.21 2.19 2.28 2.28 2.43 2.39 Michigan 2.13 2.12 2.18 2.39 2.3 2.33 2.42 2.44 2.41 2.57 2.63 Minnesota 2.01 2.04 2.05 2.04 2.02 2.05 2.08 2.14 2.22 2.25 2.21 Mississippi 2.26 2.36 2.42 2.5 2.39 2.53 2.51 2.46 2.59 2.55 2.55 Missouri 2.13 2.07 2.03 2.15 2.12 2.13 2.19 2.21 2.38 2.37 2.43 Montana 2.09 2.3 2.07 2.01 1.94 1.97 2.16 2.29 1.92 2.16 2.04 Nebraska 2.05 1.84 1.82 2.16 1.93 2.04 2.13 2.25 2.03 2.25 2.14 Nevada 1.88 1.9 1.96 2.05 2.09 2.02 2.49 2.15 2.33 2.24 2.14 New Hampshire 2 2.03 1.6 2.06 1.65 1.69 1.96 2.21 1.97 2.16 2.14 New Jersey 2.26 2.2 2.2 2.3 2.37 2.39 2.44 2.44 2.52 2.61 2.63 New Mexico 1.9 2.02 2.05 1.8 1.82 1.94 2.17 2.08 2.38 2 2.26 New York 2.05 2.06 2.12 2.13 2.29 2.26 2.33 2.45 2.45 2.56 2.52 North Carolina 1.95 2 1.99 2.08 2.19 2.18 2.17 2.18 2.14 2.24 2.32 North Dakota 2 2.25 1.9 2.43 2.12 2.23 2.17 2.37 2.17 2.4 2.22 Ohio 2.13 2.13 2.21 2.24 2.26 2.29 2.3 2.27 2.47 2.48 2.62 Oklahoma 2.2 2.06 2.13 2.06 2.08 2.01 2.14 2.15 2.28 2.3 2.29 Oregon 1.84 1.79 1.75 1.75 1.72 1.85 2.04 1.97 1.88 2.03 2.04 Pennsylvania 2.19 2.18 2.23 2.25 2.21 2.3 2.3 2.31 2.37 2.41 2.39 Rhode Island 2.31 2.08 1.84 2.2 1.99 2.08 2.27 2.27 2.33 2.26 2.26 South Carolina 2.1 2.1 2.14 2.12 2.26 2.12 2.19 2.24 2.27 2.27 2.39 South Dakota 2.05 2.12 1.96 2.04 2.2 2.16 2.06 2.14 2.17 2.42 2.04 Tennessee 2.19 2.26 2.32 2.28 2.32 2.3 2.38 2.37 2.35 2.43 2.49


B.2-34


Texas 2.2 2.16 2.16 2.2 2.28 2.31 2.36 2.37 2.31 2.43 2.43 Utah 1.64 1.66 1.52 1.77 1.76 1.91 1.83 1.82 1.79 2.17 2 Vermont * 1.56 1.74 1.58 1.96 1.73 2.16 1.76 2.19 2.36 1.9 Virginia 2.04 2.12 2.17 2.15 2.25 2.25 2.22 2.28 2.22 2.34 2.32 Washington 2.01 2.01 1.94 1.95 2.03 2.05 1.85 1.89 2.14 2.1 2.14 West Virginia 2.23 2.2 2.21 2.23 2.35 2.54 2.46 2.46 2.38 2.55 2.47 Wisconsin 1.96 1.88 1.95 1.95 1.99 1.98 2.01 2.02 2.16 2.14 2.12 Wyoming 2.53 * * 1.92 1.83 * 2.07 1.95 1.85 2.17 1.78 Puerto Rico/Virgin Islands 1.99 2.03 2.22 2.05 2.13 2.14 2.09 2.16 2.23 2.29 2.42



B.2-35

Table B.2-12. Age-Sex Adjusted All-Cause Readmission Rates per 1,000 Beneficiaries Discharged with Septicemia with Pneumonia, 1992-2001 Year

Beneficiary Characteristics 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 (within 30-days from discharge) All Enrollees 196.46 195.91 203.2 207.31 214.5 218.5 228.06 234.5 242.95 262.19 258.68 Gender

Male 218.25 215.55 218.89 218.48 226.47 229.97 240.99 244.54 252.59 273.16 272.85 Female 180.59 181.65 191.74 199.15 206.22 210.92 218.63 227.97 236.5 254.96 248.77

Age Group 0–54 245.42 211.07 222.77 255.91 262.61 274.88 246.75 233.88 260.74 276.28 285.77 55–64 218.81 234.47 260.28 230.96 239.82 223.85 239.53 275.12 274.11 273.86 279.47 65–69 190.26 188.07 198 194.3 197.2 206.17 224.38 235.97 251.28 267.78 250.25 70–74 194.38 192.75 195.88 194.66 212.99 212.77 224.12 232.16 235.28 256.54 249.1 75–79 189.67 199.58 199.14 202.4 209.78 216.46 225.92 230.28 230.01 260.66 260.44 80–84 184.77 190.64 194.35 210.08 217.04 218.3 231.71 235.3 234.36 258.84 259.59 85–89 183.34 188.59 198.26 209.66 200.31 211.83 222.93 225 247.16 251.64 263.65 90–94 182.73 184.35 194.41 208.33 212.97 213.62 216.6 232.47 240.53 265.31 247.7 95+ 211.53 188.87 215.45 218.45 226.72 214.55 233.46 221.36 234.34 253.21 271.76

Race White 186.38 186.92 194.78 197.04 204.15 208.41 217.15 221.91 229.54 248.31 247.16 Black 239.5 246.2 239.96 258.34 262.35 273.32 290.64 298.96 304.41 335.14 318.53 Other 230.81 226.66 241.99 228.21 240.79 241.43 221.96 258.98 266.04 275.54 263.05 Unknown 222.62 240.18 153.52 175.82 311.31 391.03 196.73 * 364.68 * *






B.2-36

Year Beneficiary Characteristics 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 (within 365-days from discharge) All Enrollees 632 631.32 637 639.65 653.26 663.33 670.06 681.47 688.32 701.24 n.a. Gender

Male 660.73 668.45 666.87 667.53 679.98 690.32 698.86 706.73 703.65 724.4 n.a. Female 613.17 606.03 615.41 620.75 635.6 645.15 650.73 664.4 678.96 685.29 n.a.

Age Group 0–54 710.21 693.35 698.62 706.19 734.21 729.68 705.28 712.05 719.31 726.01 n.a. 55–64 679.39 674.9 707.73 680.03 720.94 718.18 733.92 734.39 747.61 728.14 n.a. 65–69 597.98 591.89 595.13 600.69 598.99 615.23 653.84 665.04 672.89 672.43 n.a. 70–74 603.55 606.58 609.79 620.58 638 645.73 647.55 662.54 675.25 683.06 n.a. 75–79 628.45 632.04 635.4 632.56 650.16 661.79 658.68 677.44 671.39 710.82 n.a. 80–84 641.3 644.96 650.48 658.59 666.72 681.11 681.94 685.18 695.59 714.64 n.a. 85–89 670.01 670.39 671.17 674.96 679.7 696.34 696.72 703.36 710.34 729.48 n.a. 90–94 675.46 690.19 665.36 675.17 699.95 709.1 697.5 704.09 716.38 743.54 n.a. 95+ 696.48 722.76 736.83 712.57 730 729.16 731.3 762.69 762.69 767.22 n.a.


Dual-Enrollment Status Not Dual 605 601.43 606.04 615.39 620.54 632.83 642.88 647.41 654.19 668.72 n.a. Dual 706.39 713.8 714.27 702.41 730.8 728.61 728.24 744.87 750.15 761.81 n.a.





NOTES: Based on short-term hospitalizations among the full-year fee-for-service Medicare population. State and region are based on provider location. Rates are based on the first septicemia hospitalization for a beneficiary in a calendar year. All results reported at the national level are standardized to the age-sex distribution of the July 1999 Medicare FFS population using the direct method. Results reported at the state level are standardized using the indirect method. a Age-sex–adjusted rates are not comparable across aged and disabled groups.



B.2-37

Table B.2-13. Age-Sex Adjusted All-Pneumonia Readmission Rates per 1,000 Beneficiaries Discharged with Septicemia with PN, 1992-2001 Year


Male 46.22 54.73 53.3 53.31 54.83 56.89 59.22 63.09 63.52 70.68 68.98 Female 33.33 34.44 37.69 41.97 42.9 43.17 48.56 50.08 48.4 55.71 53.14

Age Group 0–54 * 46.85 52.86 45.59 49.16 46.42 40.88 42.45 55.68 59.92 44.87 55–64 * 47.39 48.86 39.31 55.18 42.44 51.53 62.98 61.42 62.03 65.65 65–69 26.89 33.47 35.38 46.99 39.67 44.24 52.61 50.87 51.85 59.71 62.4 70–74 38.72 39.42 43.63 42.77 47.79 48.24 51.65 59.1 50.51 57.28 52.36 75–79 42.67 47.07 45.32 45.62 46 50.76 52.37 54.54 49.4 61.89 63.16 80–84 44 46.68 42.55 54.02 55.29 54.18 59.51 58.74 59.67 68.89 65.21 85–89 49.39 54.1 57.56 54.75 53.03 56.25 58.95 62.85 66.06 67.84 68.27 90–94 57.2 52.09 53.51 52.04 57.74 57.67 66.69 64.27 69.56 81.08 67.17 95+ 91.76 64.87 46.74 54.36 70.43 70.78 77.92 78.7 88.46 73.21 77.19

Race White 37.14 40.95 42.49 43.83 44.94 47.31 50.21 52.1 51.96 58.1 57.84 Black 46.47 55.52 51.95 61.06 62.28 59.67 72.57 75.66 67.86 84.36 72.94 Other * * 48.3 53.68 72.03 54.07 39.65 63.2 73.24 71.08 66.57 Unknown 40.32 * * * * * * * * * *


Medicare Eligibility Statusa Aged without ESRD 54.79 53.1 48.77 50 54.97 51.92 60.55 59.88 58.39 73.64 64.91 Disabled without ESRD 33.48 54.25 49.12 45.83 53.5 47.93 45.63 58.07 60.25 59.89 53.88 All with ESRD * 54.94 45.77 51.41 52.61 49.43 48.31 55.59 52.15 53.76 68.36


Census Region Northeast 36.95 40.32 40.52 45.22 45.61 46.49 52.3 58.48 57.76 67.81 72.16 Midwest 38.22 43.32 45.55 47.24 43.38 47.59 52.38 55.94 52.96 56.11 57.49 South 38.5 46.09 44.33 47.67 51.56 50.65 54.41 55.97 56.69 64.27 57.86 West 38.01 39.51 42.37 42.86 47.11 49.19 45.8 52.94 40.52 57.06 51.81 Puerto Rico/Virgin Islands * * * * * * * * 80.63 * 81.49


B.2-38


Male 248.06 266.59 264.57 264.68 269.35 277.68 275.48 290.02 294.36 310.16 n.a. Female 184.97 196.12 194.94 206.95 209.47 216.59 219.28 229.3 228.53 245.42 n.a.


Race White 205.68 220.86 214.7 217.61 223.9 232.18 234.97 244.78 248.46 262.15 n.a. Black 226.18 251.17 263.28 308.36 282.18 297.91 297.81 312.78 310.96 342.34 n.a. Other 272.17 216.14 251.67 247.19 317.19 275.85 230.69 285.53 272.33 270.91 n.a. Unknown 246.65 349.78 263.88 183.52 218.18 143.31 221.24 243.16 * * n.a.




Census Region Northeast 212.35 216.27 213.2 222.88 222.99 235.17 258.67 265.39 279.21 294.33 n.a. Midwest 200.72 216.56 231.4 227.99 222.87 232.86 239.11 256.24 248.01 256.85 n.a. South 212.76 237.86 226.53 238.87 242.7 248.56 239.9 252.62 259.42 279.08 n.a. West 212.66 221.2 207.25 223.11 240.93 251.47 230.99 250.27 224.03 252.34 n.a. Puerto Rico/Virgin Islands * * 345.79 150.4 277.32 300.94 285.72 235.47 301.56 256.67 n.a.


NOTES: Based on short-term hospitalizations among the full-year fee-for-service Medicare population. State and region are based on provider location. Rates are based on the first septicemia hospitalization for a beneficiary in a calendar year. All results reported at the national level are standardized to the age-sex distribution of the July 1999 Medicare FFS population using the direct method. Results reported at the state level are standardized using the indirect method. a Age-sex–adjusted rates are not comparable across aged and disabled groups.



B.2-39

Table B.2-14. Age-Sex Adjusted All-Cause Mortality Rates per 1,000 Beneficiaries Discharged with Septicemia with Pneumonia, 1992-2001 Year

Beneficiary Characteristics 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 (within 30-days from admission) All Enrollees 268.73 269.65 274.7 268.91 264.49 269.82 277.12 293.07 297.68 309.21 307.89 Gender

Male 293.39 295.59 298.7 290 289.28 288.79 297.77 314.52 315.9 325.52 326.46 Female 249.73 250.26 256.63 252.56 246.16 255.08 261.92 276.57 283.6 296.21 294.5

Age Group 0–54 164.21 155.17 193.37 153.67 158.06 149.71 143.01 169.81 187.2 173.74 184.63 55–64 215.58 198.08 221.6 215.09 186.33 226.14 212.02 258.11 224.65 235.76 240.42 65–69 228.13 232.99 238.51 231.29 223.36 234.61 240.15 246.73 267.08 261.55 270.45 70–74 259.97 256.1 253.18 251.99 251.37 249.42 266.84 275.42 277.17 303.22 291.32 75–79 296.97 296.49 290.53 292.58 289.43 291.61 296.04 320.32 310.62 340.62 332.2 80–84 322.49 341.07 334.81 328.5 328.05 329.75 348.92 358.39 367.59 372.96 367.52 85–89 358.92 369.71 375.55 382.58 381.87 383.59 389.55 406.46 413.43 426.6 438.18 90–94 398.94 390.83 420.79 411.96 410.73 434.63 447.38 456.39 451.26 488.52 472.04 95+ 458.21 476.42 468.67 476.36 472.15 456.17 488.71 494.7 519.43 487.77 529.44



Medicare Eligibility Statusa Aged without ESRD 314.07 315.08 311.13 307.86 303.46 298.72 309.1 326.83 328.07 342.67 340.44 Disabled without ESRD 185.15 183.24 197.88 179 172.15 182.37 174.15 204.09 208.8 196.29 206.14 All with ESRD 323.15 261.08 307.38 325.44 289.14 293.93 284.65 346.85 325.75 327.57 357.05




B.2-40



Male 558.47 561.71 557.4 544.02 547.76 546.4 558.57 577.97 589.31 598.06 n.a. Female 476.61 469.72 474.43 469.7 469.06 475.77 487.66 506.34 523.86 532.62 n.a.

Age Group 0–54 379.06 365.56 385.06 361.87 365.13 327.59 329.99 354.55 386.45 380.69 n.a. 55–64 444.76 433.69 478.1 443.09 436.07 462.69 441.93 486.05 482.67 497.99 n.a. 65–69 462.59 454.48 457.45 449.8 444.66 453.42 469.2 495.69 514.3 507.01 n.a. 70–74 495.88 485.4 476.95 478.62 486.01 487.92 514.99 518.01 536.44 548.8 n.a. 75–79 547.5 545.9 536.15 526.12 532.32 538.2 544.79 569.66 574.68 601.29 n.a. 80–84 573.47 597.83 589.73 581.52 584.17 591.6 604.61 617.24 632.05 637.77 n.a. 85–89 644.17 652 650.18 656.85 642.05 653.31 660.62 674.9 688.81 704.82 n.a. 90–94 692.5 691.94 702.31 691.16 707.84 718.13 717.73 735.73 742.75 771.21 n.a. 95+ 751.79 775.74 777.68 761.35 764.98 751.05 789.51 791.23 799.32 799.64 n.a.




Urban/Rural Rural 475.49 487.7 495.27 470.17 482.27 475.08 476.21 505.09 514.02 522.47 n.a. Urban 523.05 517.17 515.47 512.52 510.25 516.33 533.15 549.22 566 574.42 n.a.



NOTES: Based on short-term hospitalizations among the full-year fee-for-service Medicare population. State and region are based on provider location. Rates are based on each septicemia discharge for a beneficiary in a calendar year. All results reported at the national level are standardized to the age-sex distribution of the July 1999 Medicare FFS population using the direct method. Results reported at the state level are standardized using the indirect method. a Age-sex–adjusted rates are not comparable across aged and disabled groups.




D E T A I L E D T A B L E S F O R R E S P I R A T O R Y F A I L U R E W I T H P N E U M O N I A

Table

Page

B.3-1

Unadjusted T

otal Num

ber of Discharges W

ith A D

iagnosis of R

espiratory Failure, 1992-2002...................................................................3

B.3-2

Unadjusted T

otal Num

ber of Beneficiaries D

ischarged With

Respiratory Failure, 1992-2002...................................................................6

B.3-3

Com

parison of Beneficiaries H

ospitalized for Respiratory Failure

with Pneum

onia with the E

ntire MQ

MS Fee-For-Service M

edicare Population, 1992 and 2001

..........................................................................9

B.3-4

Age/sex A

djusted Rates of D

ischarges for Respiratory Failure Per

1,000 Beneficiaries, 1992-2001.................................................................11

B.3-5

Age/sex A

djusted Rates of B

eneficiaries Discharged for R

espiratory Failure Per 1,000 B

eneficiaries, 1992-2001..............................................14

B.3-6

Age/sex A

djusted Average L

ength of Stay for Respiratory Failure

Hospitalizations, 1992-2001......................................................................17

B.3-7

Total M

edicare Paym

ents for Discharges for R

espiratory Failure,1992-2002

.....................................................................................20

B.3-8

Average M

edicare Payments per D

ischarge with R

espiratory Failure, 1992-2002..................................................................................................23

B.3-9

Total B

eneficiary Deductible and C

oinsurance Payments for

Discharges for R

espiratory Failure, 1992-2002........................................26

B.3-10

Average N

umber of Pneum

onia-Related D

ischarges Per Beneficiary

Discharged W

ith Respiratory Failure, 1992-2002

....................................29

B.3-11

Average N

umber of A

ll Discharges Per B

eneficiary Discharged W

ith R

espiratory Failure, 1992-2002.................................................................32

B.1-12

Age-Sex A

djusted All-C

ause Readm


Beneficiaries D

ischarged with R

espiratory Failure, 1992-2002...............35

B.3-13

Age-Sex A

djusted All-Pneum

onia Readm


Beneficiaries D

ischarged with R

espiratory Failure, 1992-2002...............37

B.3-14

Age-Sex A

djusted All-C

ause Mortality R

ates per 1,000 Beneficiaries

Discharged w

ith Respiratory Failure, 1992-2002

.....................................39

B.3-3

Table B.3-1. Unadjusted Total Number of Discharges With A Diagnosis of Respiratory Failure, 1992-2002 Year


Male 9,338 10,238 11,471 13,767 15,967 17,866 18,086 18,263 18,792 19,230 21,726 Female 8,821 10,189 11,668 13,990 16,971 19,133 19,622 20,479 20,906 21,695 24,160

Age Group 0–54 618 794 951 1,245 1,625 1,729 1,811 1,960 2,178 2,512 2,945 55–64 1,264 1,441 1,681 2,036 2,419 2,693 2,749 3,037 3,253 3,521 4,126 65–69 3,193 3,530 3,847 4,516 5,004 5,605 5,310 5,325 5,347 5,499 6,338 70–74 4,008 4,356 4,915 5,752 6,749 7,387 7,414 7,391 7,363 7,441 8,111 75–79 3,754 4,091 4,618 5,570 6,521 7,477 7,597 7,848 8,024 8,183 8,788 80–84 2,754 3,266 3,707 4,404 5,355 6,122 6,319 6,328 6,447 6,623 7,644 85–89 1,679 1,897 2,212 2,745 3,435 3,739 4,041 4,335 4,509 4,467 4,982 90–94 660 786 928 1,114 1,384 1,696 1,844 1,861 1,979 2,024 2,238 95+ 229 266 280 375 446 551 623 657 598 655 714



Medicare Eligibility Status Aged without ESRD 16,181 18,054 20,344 24,236 28,597 32,300 32,833 33,494 33,952 34,453 38,232 Disabled without ESRD 1,768 2,092 2,442 3,022 3,745 3,964 4,121 4,489 4,934 5,448 6,399 All with ESRD 210 281 353 499 596 735 754 759 812 1,024 1,255



State Alabama 545 615 699 744 792 859 923 864 850 952 1,144 Alaska * 27 * * * * 31 33 30 29 30 Arizona 287 320 325 409 413 454 403 440 436 431 503


B.3-4


Arkansas 273 316 366 432 534 553 582 571 424 414 505 California 1,480 1,641 1,899 2,144 2,643 2,732 2,844 2,565 2,498 2,707 2,943 Colorado 212 254 232 329 291 353 302 314 256 281 352 Connecticut 232 223 283 359 489 480 508 524 587 651 752 Delaware 38 48 53 50 80 108 134 140 171 165 234 District of Columbia * 34 40 37 47 59 78 68 75 82 101 Florida 1,581 1,809 2,235 2,512 2,840 2,954 2,862 3,298 3,135 3,297 3,631 Georgia 618 631 767 857 937 1,081 1,069 1,102 1,130 1,102 1,318 Hawaii * 30 30 61 63 77 78 100 64 54 93 Idaho 36 70 72 87 96 115 80 94 87 103 128 Illinois 760 798 878 1,029 1,305 1,408 1,519 1,612 1,682 1,861 2,185 Indiana 440 521 560 668 887 919 1,037 1,062 1,067 1,052 1,093 Iowa 222 224 273 281 326 351 481 538 472 467 512 Kansas 206 241 229 284 330 371 344 317 325 312 386 Kentucky 478 592 598 740 931 1,194 1,181 1,191 1,253 1,448 1,612 Louisiana 288 388 444 575 576 638 557 506 502 559 577 Maine 92 96 102 116 144 155 210 177 189 251 259 Maryland 336 438 537 746 794 911 880 901 992 1,211 1,378 Massachusetts 414 443 498 665 782 826 852 752 809 776 770 Michigan 676 798 922 1,143 1,371 1,539 1,600 1,507 1,606 1,685 1,992 Minnesota 200 203 201 220 243 299 361 450 364 442 441 Mississippi 179 169 202 235 311 402 360 371 386 358 420 Missouri 525 651 685 823 936 1,155 1,245 1,200 1,235 1,204 1,445 Montana 59 56 73 84 87 90 111 109 83 106 76 Nebraska 75 72 77 129 153 139 134 167 164 173 201 Nevada 134 82 77 155 197 234 171 200 218 251 317 New Hampshire 43 57 58 78 83 111 117 104 117 141 133 New Jersey 477 513 638 812 1,101 1,293 1,484 1,682 1,830 1,752 1,844 New Mexico 80 103 108 142 136 156 152 128 130 120 145 New York 921 981 1,074 1,261 1,394 1,618 1,675 1,863 2,270 2,547 2,779 North Carolina 542 597 680 912 1,050 1,211 1,158 1,322 1,501 1,347 1,561 North Dakota 54 53 68 57 73 73 68 93 72 69 78 Ohio 794 862 1,011 1,206 1,592 1,902 1,924 1,793 1,975 1,906 2,069 Oklahoma 424 393 487 529 584 644 638 653 638 606 689 Oregon 131 161 171 174 210 212 178 188 200 200 261 Pennsylvania 997 1,096 1,179 1,304 1,612 1,684 1,716 1,777 1,744 1,770 1,846 Rhode Island 120 99 73 77 157 152 142 143 145 115 133 South Carolina 232 236 268 346 485 486 554 602 724 690 790 South Dakota 36 35 46 41 57 66 66 75 69 59 72 Tennessee 516 614 680 878 997 1,150 1,303 1,404 1,223 1,178 1,355 Texas 984 1,179 1,466 1,759 2,107 2,624 2,361 2,423 2,432 2,500 2,911 Utah 61 83 71 126 150 169 173 182 165 170 205


B.3-5


Vermont 30 29 44 45 41 59 55 56 80 94 95 Virginia 387 509 546 755 955 1,175 1,181 1,331 1,300 1,241 1,371 Washington 283 383 421 481 545 561 551 558 581 642 702 West Virginia 195 218 220 300 360 499 519 439 589 543 593 Wisconsin 267 288 303 333 378 415 448 422 462 442 517 Wyoming * 27 27 29 35 32 56 47 48 66 60 Puerto Rico/Virgin Islands 120 121 127 181 215 226 252 284 313 303 279



B.3-6

Table B.3-2. Unadjusted Total Number of Beneficiaries Discharged With Respiratory Failure, 1992-2002 Year


Male 9,053 9,903 11,133 13,304 15,387 17,139 17,379 17,558 17,973 18,368 20,675 Female 8,622 9,942 11,347 13,555 16,424 18,438 18,914 19,792 20,112 20,742 23,142

Age Group 0–54 591 759 897 1,182 1,547 1,630 1,723 1,869 2,060 2,370 2,749 55–64 1,212 1,358 1,590 1,933 2,284 2,542 2,593 2,852 3,039 3,273 3,863 65–69 3,075 3,408 3,726 4,348 4,787 5,326 5,052 5,086 5,050 5,186 5,999 70–74 3,888 4,218 4,770 5,545 6,498 7,042 7,087 7,085 7,007 7,085 7,705 75–79 3,673 3,996 4,503 5,406 6,316 7,202 7,335 7,588 7,708 7,828 8,399 80–84 2,698 3,193 3,621 4,292 5,209 5,960 6,137 6,149 6,274 6,394 7,359 85–89 1,654 1,872 2,184 2,693 3,371 3,668 3,947 4,234 4,404 4,347 4,851 90–94 657 777 914 1,090 1,359 1,664 1,804 1,836 1,953 1,983 2,193 95+ 227 264 275 370 440 543 615 651 590 644 699



Medicare Eligibility Status Aged without ESRD 15,777 17,593 19,824 23,503 27,686 31,135 31,674 32,371 32,666 33,035 36,627 Disabled without ESRD 1,692 1,979 2,306 2,865 3,543 3,732 3,889 4,241 4,629 5,079 5,972 All with ESRD 206 273 350 491 582 710 730 738 790 996 1,218



State Alabama 522 598 682 721 763 830 886 837 826 911 1,079 Alaska * 27 * * * * 30 33 30 28 29 Arizona 277 311 316 396 402 445 380 426 424 418 481


B.3-7


Arkansas 261 309 356 417 512 531 565 549 413 401 491 California 1,441 1,585 1,838 2,053 2,557 2,598 2,725 2,467 2,411 2,570 2,822 Colorado 208 243 229 316 285 341 293 293 245 270 337 Connecticut 229 220 281 348 467 454 487 505 553 612 722 Delaware 38 45 53 50 78 104 128 135 163 156 229 District of Columbia * 34 40 35 46 58 72 67 70 79 99 Florida 1,540 1,761 2,186 2,426 2,738 2,838 2,778 3,175 2,999 3,148 3,445 Georgia 597 613 738 829 900 1,042 1,033 1,066 1,084 1,057 1,266 Hawaii * 30 30 59 60 76 75 99 63 53 87 Idaho 34 68 72 83 93 109 76 92 87 100 122 Illinois 742 776 859 1,004 1,272 1,359 1,466 1,552 1,618 1,772 2,073 Indiana 428 506 542 634 842 884 1,003 1,020 1,021 1,005 1,055 Iowa 217 217 263 276 315 343 459 516 451 446 490 Kansas 199 236 220 273 315 360 335 307 319 303 368 Kentucky 466 559 577 705 893 1,120 1,119 1,128 1,166 1,362 1,496 Louisiana 276 379 431 553 562 614 533 492 491 541 557 Maine 89 93 98 112 138 147 197 167 186 240 248 Maryland 333 426 512 709 755 874 828 850 938 1,147 1,310 Massachusetts 404 433 482 643 760 783 825 729 771 746 742 Michigan 660 780 894 1,116 1,336 1,490 1,538 1,467 1,544 1,609 1,911 Minnesota 196 198 197 218 234 287 348 433 357 429 426 Mississippi 172 166 197 228 306 390 352 353 368 346 396 Missouri 509 629 666 796 906 1,111 1,189 1,153 1,171 1,147 1,365 Montana 58 56 70 81 85 88 109 107 79 103 74 Nebraska 72 72 77 128 149 135 125 161 156 165 191 Nevada 131 81 76 152 192 230 165 196 211 243 304 New Hampshire 42 56 57 78 83 109 113 103 116 138 128 New Jersey 466 505 625 792 1,053 1,235 1,438 1,630 1,741 1,660 1,731 New Mexico 79 99 104 135 135 154 148 125 128 119 142 New York 906 962 1,045 1,241 1,359 1,571 1,625 1,810 2,195 2,448 2,663 North Carolina 525 580 652 885 1,014 1,162 1,128 1,278 1,452 1,287 1,499 North Dakota 53 50 67 56 72 70 65 87 69 67 75 Ohio 775 836 982 1,181 1,537 1,829 1,850 1,735 1,860 1,812 1,988 Oklahoma 408 381 476 519 555 625 619 639 614 579 668 Oregon 126 160 167 173 207 205 175 182 198 195 252 Pennsylvania 976 1,062 1,148 1,273 1,555 1,634 1,646 1,712 1,686 1,696 1,781 Rhode Island 118 98 72 75 151 146 135 140 143 113 130 South Carolina 223 225 260 333 470 469 547 580 697 665 763 South Dakota 33 33 46 41 54 66 65 71 68 56 70 Tennessee 502 585 654 829 958 1,094 1,243 1,326 1,168 1,119 1,265 Texas 954 1,144 1,420 1,697 2,041 2,521 2,275 2,339 2,322 2,390 2,768


B.3-8


Utah 59 82 69 125 146 166 168 176 160 167 194 Vermont 29 27 44 44 39 57 54 56 79 89 95 Virginia 383 494 530 734 920 1,122 1,133 1,277 1,248 1,167 1,314 Washington 276 371 402 458 528 538 521 542 567 619 674 West Virginia 189 213 214 287 340 482 488 427 556 524 568 Wisconsin 260 283 296 319 368 399 440 412 449 430 503 Wyoming * 27 27 29 33 32 54 45 48 63 59 Puerto Rico/Virgin Islands 115 121 125 179 209 225 244 283 306 300 272



B.3-9

Tab

le B

.3-3.

Co

mp

arison

o

f B

eneficiaries

Ho

spitalized

fo

r R

espirato

ry F

ailure

with

P

neu

mo

nia

with

th

e E

ntire

MQ

MS

F

ee-Fo

r-Service

Med

icare P

op

ulatio

n,

1992 and

2001

Respiratory F

ailure E

ntire Fee-for-S

ervice Population

1992

2001 1992

2001 A

ll En

rollees

17,675 39,110

32,095,866 31,503,207


Gen

der

Male

51.2 47.0

42.5 43.6

Fem

ale 48.8

53.0 57.5

56.4 A

ge G

rou

p

0–54 3.3

6.1 6.2

9.3 55–64

6.9 8.4

4.1 5.7

65–69 17.4

13.3 25.4

21 70–74

22.0 18.1

23.7 21

75–79 20.8

20.0 17.9

18.2 80–84

15.3 16.3

12.1 12.8

85–89 9.4

11.1 6.7

7.4 90–94

3.7 5.1

2.8 3.2

95+

1.3 1.6

1.2 1.4

Race

White

87.5 85.9

85.4 85.8

Black

7.6 10.3

8.4 9.6

Other

2.2 3.5

2.9 4.4

Unknow

n 2.7

0.2 3.2

0.2 D

ual-E

nro

llmen

t Statu

s

N

ot Dual

76.8 68.3

88 83.5

Dual

23.2 31.7

12 16.5

Med

icare Elig

ibility S

tatus

Aged w

ithout ES

RD

89.3

84.5 89.6

85.2 D

isabled without E

SR

D

9.6 13.0

9.8 14

All w

ith ES

RD

1.2

2.5 0.6

0.9 U

rban

/Ru

ral

R

ural 26.4

25.5 25.4

27.4 U

rban 73.6

74.5 74.6

72.6 C

ensu

s Reg

ion

N

ortheast 18.4

19.8 22.3

19.6 M

idwest

23.4 23.6

25.5 25.5

South

41.9 43.2

35.4 38.2

West

15.6 12.7

15.5 15

State

Alabam

a 3.0

2.3 1.8

1.9 A

laska *

0.1 0.1

0.1 A

rizona 1.6

1.1 1.3

1.3 A

rkansas 1.5

1.0 1.2

1.3 C

alifornia 8.2

6.6 7.6

6.8 C

olorado 1.2

0.7 1

0.9 C

onnecticut 1.3

1.6 1.4

1.3 D

elaware

0.2 0.4

0.3 0.3

District of C

olumbia

* 0.2

0.2 0.2

Florida

8.7 8.0

6.5 6.5

Georgia

3.4 2.7

2.4 2.7

Haw

aii *

0.1 0.3

0.3 Idaho

0.2 0.3

0.4 0.5

Illinois 4.2

4.5 4.5

4.4 Indiana

2.4 2.6

2.4 2.5

Iowa

1.2 1.1

1.4 1.4

Kansas

1.1 0.8

1.1 1.1

Kentucky

2.6 3.5

1.6 1.8

Table B

.3-3 (cont’d)

B.3-10

R

espiratory Failure

Entire F

ee-for-Service P

opulation

1992 2001

1992 2001

All E

nro

llees 17,675

39,110 32,095,866

31,503,207

(percent of population) Louisiana

1.6 1.4

1.7 1.5

Maine

0.5 0.6

0.6 0.7

Maryland

1.9 2.9

1.7 1.9

Massachusetts

2.3 1.9

2.6 2.2

Michigan

3.7 4.1

3.9 4

Minnesota

1.1 1.1

1.4 1.7

Mississippi

1.0 0.9

1.2 1.3

Missouri

2.9 2.9

2.4 2.2

Montana

0.3 0.3

0.4 0.4

Nebraska

0.4 0.4

0.7 0.7

Nevada

0.7 0.6

0.4 0.5

New

Ham

pshire 0.2

0.4 0.4

0.5 N

ew Jersey

2.6 4.2

3.3 3.1

New

Mexico

0.4 0.3

0.5 0.6

New

York

5.1 6.3

7.2 6.4

North C

arolina 3.0

3.3 2.9

3.4 N

orth Dakota

0.3 0.2

0.3 0.3

Ohio

4.4 4.6

4.8 4.3

Oklahom

a 2.3

1.5 1.4

1.4 O

regon 0.7

0.5 1.1

0.9 P

ennsylvania 5.5

4.3 6.1

4.8 R

hode Island 0.7

0.3 0.5

0.3 S

outh Carolina

1.3 1.7

1.4 1.8

South D

akota 0.2

0.1 0.3

0.4 T

ennessee 2.8

2.9 2.2

2.4 T

exas 5.4

6.1 5.7

6.1 U

tah 0.3

0.4 0.5

0.6 V

ermont

0.2 0.2

0.2 0.3

Virginia

2.2 3.0

2.3 2.7

Washington

1.6 1.6

1.8 1.8

West V

irginia 1.1

1.3 0.9

1 W

isconsin 1.5

1.1 2.2

2.3 W

yoming

* 0.2

0.2 0.2

Puerto R

ico/Virgin Islands

0.7 0.8

1.4 1.7

SO

UR

CE: C

MS

MedP

AR

and Denom

inator Files.

B.3-11

Table B.3-4. Age/sex Adjusted Rates of Discharges for Respiratory Failure Per 1,000 Beneficiaries, 1992-2001 Year

Beneficiary Characteristics 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 (rate per 1,000 beneficiaries) All Enrollees 0.57 0.64 0.71 0.86 1.02 1.17 1.20 1.23 1.24 1.24 1.34 Gender

Male 0.72 0.78 0.86 1.03 1.21 1.38 1.42 1.42 1.43 1.40 1.52 Female 0.48 0.55 0.62 0.75 0.91 1.04 1.08 1.12 1.14 1.15 1.24

Age Group 0–54 0.31 0.37 0.41 0.50 0.63 0.65 0.67 0.71 0.76 0.83 0.94 55–64 0.97 1.08 1.20 1.40 1.62 1.75 1.73 1.82 1.86 1.90 2.05 65–69 0.39 0.43 0.48 0.59 0.68 0.80 0.80 0.82 0.81 0.80 0.88 70–74 0.53 0.57 0.63 0.75 0.91 1.04 1.07 1.09 1.09 1.09 1.17 75–79 0.66 0.72 0.81 0.97 1.14 1.32 1.35 1.38 1.39 1.39 1.46 80–84 0.75 0.86 0.97 1.14 1.38 1.60 1.66 1.66 1.65 1.62 1.78 85–89 0.85 0.93 1.06 1.29 1.61 1.75 1.88 1.97 2.01 1.92 2.09 90–94 0.80 0.91 1.05 1.28 1.53 1.85 2.04 2.01 2.17 2.11 2.28 95+ 0.61 0.69 0.72 0.96 1.13 1.38 1.51 1.55 1.43 1.48 1.63






State Alabama 0.96 1.06 1.17 1.24 1.32 1.43 1.54 1.44 1.41 1.54 1.80 Alaska * 1.03 * * * * 0.91 0.92 0.79 0.73 0.72 Arizona 0.70 0.78 0.80 1.02 1.05 1.18 1.06 1.15 1.05 0.98 1.06


B.3-12


Arkansas 0.69 0.79 0.90 1.04 1.29 1.33 1.41 1.39 1.02 0.99 1.15 California 0.62 0.71 0.85 1.01 1.27 1.33 1.38 1.24 1.18 1.23 1.24 Colorado 0.69 0.81 0.74 1.06 0.96 1.21 1.08 1.13 0.90 0.92 1.08 Connecticut 0.51 0.48 0.60 0.75 1.03 1.08 1.25 1.29 1.43 1.46 1.53 Delaware 0.44 0.53 0.57 0.53 0.86 1.16 1.44 1.37 1.64 1.51 2.07 District of Columbia * 0.49 0.57 0.54 0.71 0.92 1.22 1.06 1.16 1.23 1.51 Florida 0.76 0.85 1.04 1.18 1.37 1.47 1.45 1.66 1.54 1.53 1.58 Georgia 0.85 0.84 1.00 1.09 1.17 1.34 1.33 1.36 1.37 1.28 1.49 Hawaii * 0.32 0.31 0.61 0.63 0.75 0.75 0.93 0.57 0.49 0.81 Idaho 0.27 0.51 0.52 0.61 0.66 0.79 0.55 0.65 0.59 0.68 0.82 Illinois 0.53 0.55 0.60 0.71 0.90 0.98 1.07 1.14 1.19 1.28 1.44 Indiana 0.60 0.69 0.73 0.86 1.13 1.17 1.31 1.33 1.32 1.28 1.31 Iowa 0.50 0.49 0.60 0.61 0.71 0.76 1.03 1.16 1.01 1.00 1.08 Kansas 0.58 0.67 0.63 0.77 0.89 1.01 0.94 0.87 0.89 0.85 1.03 Kentucky 0.94 1.13 1.12 1.36 1.70 2.17 2.13 2.13 2.22 2.50 2.69 Louisiana 0.56 0.73 0.82 1.10 1.13 1.30 1.19 1.10 1.05 1.15 1.12 Maine 0.50 0.51 0.53 0.60 0.73 0.77 1.02 0.85 0.90 1.17 1.18 Maryland 0.64 0.81 0.97 1.33 1.47 1.75 1.71 1.71 1.79 1.96 2.19 Massachusetts 0.51 0.53 0.59 0.82 1.00 1.11 1.18 1.07 1.13 1.06 1.04 Michigan 0.56 0.65 0.73 0.89 1.06 1.19 1.24 1.16 1.23 1.28 1.44 Minnesota 0.44 0.43 0.42 0.45 0.48 0.58 0.69 0.82 0.65 0.78 0.77 Mississippi 0.49 0.45 0.53 0.61 0.80 1.02 0.90 0.93 0.96 0.88 1.01 Missouri 0.69 0.85 0.88 1.06 1.23 1.55 1.70 1.66 1.72 1.66 1.95 Montana 0.50 0.46 0.58 0.66 0.67 0.69 0.84 0.82 0.61 0.76 0.54 Nebraska 0.32 0.30 0.32 0.53 0.63 0.58 0.56 0.69 0.67 0.70 0.80 Nevada 1.03 0.62 0.57 1.15 1.45 1.72 1.23 1.39 1.44 1.59 1.88 New Hampshire 0.31 0.40 0.40 0.52 0.54 0.75 0.81 0.71 0.72 0.84 0.77 New Jersey 0.46 0.49 0.59 0.76 1.05 1.28 1.50 1.71 1.82 1.69 1.69 New Mexico 0.49 0.62 0.66 0.85 0.81 0.92 0.88 0.73 0.73 0.62 0.73 New York 0.41 0.43 0.47 0.55 0.63 0.76 0.81 0.90 1.10 1.21 1.30 North Carolina 0.61 0.65 0.72 0.94 1.05 1.20 1.13 1.28 1.42 1.25 1.42 North Dakota 0.54 0.52 0.66 0.55 0.70 0.70 0.65 0.89 0.69 0.66 0.74 Ohio 0.54 0.57 0.66 0.78 1.04 1.32 1.40 1.32 1.43 1.34 1.43 Oklahoma 0.94 0.86 1.06 1.14 1.27 1.41 1.41 1.45 1.42 1.33 1.48 Oregon 0.39 0.49 0.54 0.58 0.71 0.73 0.61 0.64 0.67 0.65 0.81 Pennsylvania 0.53 0.57 0.61 0.70 0.93 1.03 1.09 1.16 1.15 1.12 1.15 Rhode Island 0.81 0.67 0.49 0.51 1.05 1.09 1.21 1.28 1.28 1.02 1.18 South Carolina 0.54 0.53 0.58 0.72 0.99 0.97 1.07 1.13 1.33 1.24 1.38 South Dakota 0.32 0.31 0.40 0.35 0.48 0.55 0.55 0.62 0.57 0.49 0.59 Tennessee 0.75 0.87 0.94 1.18 1.32 1.52 1.73 1.86 1.60 1.51 1.72 Texas 0.55 0.65 0.79 0.96 1.15 1.44 1.32 1.36 1.33 1.26 1.39


B.3-13


Utah 0.39 0.53 0.46 0.79 0.92 1.04 1.04 0.96 0.85 0.85 1.00 Vermont 0.40 0.38 0.56 0.56 0.51 0.72 0.66 0.66 0.91 1.06 1.05 Virginia 0.55 0.71 0.74 1.00 1.24 1.51 1.50 1.67 1.56 1.44 1.55 Washington 0.51 0.68 0.75 0.87 1.02 1.08 1.07 1.07 1.07 1.11 1.14 West Virginia 0.71 0.78 0.77 1.03 1.22 1.68 1.72 1.45 1.93 1.76 1.90 Wisconsin 0.38 0.40 0.42 0.45 0.51 0.56 0.61 0.57 0.63 0.59 0.67 Wyoming * 0.50 0.50 0.52 0.61 0.54 0.93 0.77 0.77 1.04 0.92 Puerto Rico/Virgin Islands 0.27 0.27 0.27 0.38 0.44 0.45 0.49 0.54 0.58 0.55 0.51



B.3-14

Table B.3-5. Age/sex Adjusted Rates of Beneficiaries Discharged for Respiratory Failure Per 1,000 Beneficiaries, 1992-2001 Year Beneficiary Characteristics 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002

(rate per 1,000 beneficiaries) All Enrollees 0.56 0.62 0.69 0.83 0.99 1.12 1.16 1.19 1.19 1.18 1.28 Gender

Male 0.70 0.75 0.84 1.00 1.17 1.33 1.36 1.37 1.37 1.34 1.45 Female 0.47 0.53 0.60 0.72 0.88 1.00 1.03 1.08 1.09 1.09 1.18

Age Group 0–54 0.30 0.35 0.39 0.48 0.60 0.61 0.64 0.68 0.72 0.79 0.88 55–64 0.93 1.01 1.13 1.32 1.53 1.65 1.63 1.71 1.74 1.77 1.92 65–69 0.37 0.42 0.47 0.56 0.65 0.76 0.76 0.79 0.77 0.75 0.84 70–74 0.51 0.55 0.62 0.73 0.88 0.99 1.03 1.05 1.04 1.03 1.11 75–79 0.65 0.70 0.79 0.95 1.11 1.27 1.30 1.33 1.34 1.33 1.40 80–84 0.73 0.84 0.95 1.11 1.34 1.56 1.61 1.61 1.61 1.56 1.71 85–89 0.84 0.91 1.04 1.27 1.58 1.72 1.84 1.92 1.97 1.87 2.04 90–94 0.80 0.90 1.03 1.25 1.50 1.82 2.00 1.98 2.14 2.06 2.23 95+ 0.61 0.69 0.71 0.95 1.11 1.36 1.49 1.54 1.40 1.46 1.60






State Alabama 0.92 1.03 1.14 1.21 1.27 1.38 1.48 1.40 1.37 1.48 1.70 Alaska * 1.03 * * * * 0.88 0.92 0.79 0.71 0.70


B.3-15


(rate per 1,000 beneficiaries) Arizona 0.68 0.76 0.77 0.99 1.02 1.16 1.00 1.11 1.02 0.95 1.01 Arkansas 0.66 0.77 0.87 1.01 1.23 1.28 1.37 1.33 0.99 0.96 1.12 California 0.61 0.69 0.83 0.96 1.23 1.26 1.32 1.19 1.14 1.17 1.19 Colorado 0.68 0.77 0.73 1.02 0.94 1.17 1.05 1.05 0.86 0.89 1.03 Connecticut 0.50 0.47 0.59 0.73 0.98 1.02 1.19 1.24 1.34 1.37 1.47 Delaware 0.44 0.50 0.57 0.53 0.84 1.12 1.37 1.33 1.56 1.43 2.03 District of Columbia * 0.49 0.57 0.51 0.70 0.90 1.12 1.04 1.08 1.18 1.48 Florida 0.74 0.83 1.02 1.14 1.32 1.41 1.40 1.59 1.47 1.46 1.50 Georgia 0.82 0.82 0.96 1.05 1.12 1.30 1.29 1.32 1.31 1.23 1.44 Hawaii * 0.32 0.31 0.59 0.60 0.74 0.73 0.92 0.57 0.48 0.76 Idaho 0.25 0.49 0.52 0.58 0.64 0.75 0.53 0.64 0.59 0.66 0.78 Illinois 0.52 0.54 0.59 0.69 0.88 0.95 1.03 1.10 1.14 1.22 1.36 Indiana 0.58 0.67 0.71 0.82 1.08 1.12 1.26 1.28 1.27 1.23 1.26 Iowa 0.48 0.48 0.58 0.60 0.68 0.74 0.99 1.11 0.96 0.95 1.03 Kansas 0.56 0.65 0.60 0.74 0.85 0.98 0.91 0.84 0.87 0.83 0.98 Kentucky 0.92 1.07 1.08 1.30 1.63 2.04 2.02 2.02 2.07 2.35 2.51 Louisiana 0.53 0.72 0.80 1.06 1.10 1.25 1.14 1.07 1.03 1.11 1.09 Maine 0.49 0.50 0.51 0.57 0.70 0.73 0.96 0.80 0.88 1.11 1.13 Maryland 0.63 0.79 0.92 1.27 1.40 1.68 1.60 1.61 1.69 1.85 2.08 Massachusetts 0.50 0.52 0.57 0.79 0.97 1.05 1.15 1.03 1.08 1.02 1.00 Michigan 0.55 0.63 0.71 0.87 1.03 1.15 1.19 1.13 1.18 1.22 1.38 Minnesota 0.43 0.42 0.41 0.44 0.46 0.56 0.66 0.79 0.64 0.75 0.74 Mississippi 0.47 0.45 0.52 0.59 0.79 0.99 0.88 0.88 0.91 0.85 0.95 Missouri 0.67 0.82 0.85 1.03 1.19 1.49 1.62 1.60 1.63 1.58 1.85 Montana 0.49 0.46 0.56 0.64 0.65 0.67 0.83 0.81 0.58 0.74 0.53 Nebraska 0.30 0.30 0.32 0.53 0.61 0.56 0.52 0.67 0.64 0.67 0.76 Nevada 1.01 0.61 0.57 1.13 1.42 1.69 1.19 1.37 1.40 1.54 1.80 New Hampshire 0.30 0.39 0.39 0.52 0.54 0.74 0.78 0.70 0.71 0.82 0.74 New Jersey 0.45 0.48 0.58 0.74 1.01 1.22 1.45 1.66 1.73 1.60 1.59 New Mexico 0.49 0.59 0.63 0.81 0.80 0.91 0.86 0.72 0.72 0.62 0.72 New York 0.40 0.42 0.46 0.55 0.62 0.74 0.78 0.88 1.06 1.16 1.25 North Carolina 0.59 0.63 0.69 0.91 1.02 1.15 1.10 1.24 1.38 1.20 1.36 North Dakota 0.53 0.49 0.65 0.54 0.69 0.67 0.62 0.83 0.66 0.64 0.71 Ohio 0.52 0.55 0.64 0.76 1.00 1.27 1.34 1.27 1.35 1.28 1.38 Oklahoma 0.91 0.84 1.03 1.12 1.20 1.37 1.37 1.42 1.36 1.27 1.43 Oregon 0.37 0.49 0.53 0.57 0.70 0.71 0.60 0.62 0.67 0.63 0.78 Pennsylvania 0.52 0.55 0.60 0.68 0.90 1.00 1.05 1.12 1.11 1.07 1.11 Rhode Island 0.80 0.66 0.48 0.49 1.01 1.05 1.15 1.26 1.26 1.01 1.15 South Carolina 0.52 0.50 0.56 0.70 0.96 0.94 1.06 1.09 1.28 1.19 1.33 South Dakota 0.29 0.29 0.40 0.35 0.46 0.55 0.54 0.59 0.56 0.46 0.57


B.3-16


(rate per 1,000 beneficiaries) Tennessee 0.73 0.83 0.90 1.12 1.27 1.44 1.65 1.76 1.53 1.44 1.61 Texas 0.54 0.63 0.77 0.92 1.11 1.38 1.27 1.31 1.27 1.21 1.33 Utah 0.38 0.52 0.44 0.78 0.90 1.03 1.01 0.93 0.82 0.84 0.95 Vermont 0.39 0.35 0.56 0.55 0.48 0.69 0.65 0.66 0.90 1.00 1.05 Virginia 0.55 0.69 0.72 0.97 1.20 1.44 1.44 1.60 1.50 1.35 1.49 Washington 0.50 0.66 0.72 0.83 0.99 1.03 1.02 1.04 1.05 1.07 1.10 West Virginia 0.69 0.76 0.75 0.99 1.16 1.62 1.62 1.42 1.83 1.70 1.82 Wisconsin 0.37 0.39 0.41 0.43 0.50 0.54 0.60 0.56 0.61 0.58 0.65 Wyoming * 0.50 0.50 0.52 0.58 0.54 0.90 0.73 0.77 0.99 0.91 Puerto Rico/Virgin Islands 0.26 0.27 0.27 0.37 0.43 0.45 0.47 0.54 0.57 0.55 0.50



B.3-17

Table B.3-6. Age/sex Adjusted Average Length of Stay for Respiratory Failure Hospitalizations, 1992-2001 Year

Beneficiary Characteristics 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 Average Length of Stay (days) All Enrollees 16.76 15.01 14.71 13.4 12.78 12.46 12.35 12.24 12.55 12.63 12.35 Gender

Male 16.03 14.73 14.41 13.03 12.6 12.29 12.24 12.03 12.57 12.66 12.37 Female 17.33 15.23 14.94 13.69 12.89 12.58 12.43 12.42 12.54 12.58 12.32

Age Group 0–54 18.44 17.16 16.76 15.28 15.43 14.36 13.98 13.82 14.49 14.15 13.59 55–64 17.72 16.35 15 14.23 13.17 13.53 13.32 12.44 12.98 13.27 13.26 65–69 17.44 15.82 15.21 13.97 13.05 12.6 12.77 12.64 12.94 12.9 12.85 70–74 17.26 15.33 15.38 13.77 13.13 12.79 12.52 12.6 12.85 12.77 12.4 75–79 17.04 15.09 14.85 13.41 12.67 12.45 12.31 12.11 12.28 12.56 12.43 80–84 14.93 13.48 13.44 12.4 11.9 11.55 11.58 11.69 11.77 12 11.68 85–89 15.3 12.42 12.19 11.06 10.62 10.79 10.88 10.73 11.09 11.3 10.8 90–94 11.78 10.86 10.83 10.08 9.25 9.88 9.3 9.43 9.99 9.96 9.6 95+ 12.32 9.86 10.73 9.05 9.01 8.37 7.89 8.7 9.15 9.99 8.48

Race White 16.47 14.77 14.52 13.17 12.55 12.22 12.04 11.92 12.24 12.32 11.99 Black 20.82 17.63 17.21 15.57 14.88 14.42 14.93 14.35 14.65 14.65 14.42 Other 17.33 15.47 14.13 13.99 14.51 13.93 13.64 13.78 14.39 14.32 14.99 Unknown 15.63 15.33 14.49 16.9 10.06 12.2 12 12.58 11.07 14.67 10.89




Census Region Northeast 22.33 19.96 19.89 17.99 16.94 16.49 15.49 15.13 15.32 15.27 15.04 Midwest 16.39 14.86 14.28 13.13 12.37 12.07 11.76 11.53 12.07 11.73 11.55 South 15.86 14.49 14.01 12.63 12.05 11.74 11.79 11.8 11.87 12.19 11.92 West 13.47 11.5 11.74 11.05 10.72 10.58 11.02 11.1 11.43 11.62 11.4 Puerto Rico/Virgin Islands 15.38 14.01 13.78 16.22 18.33 18.02 17.24 14.7 16.36 16 15.51

State Alabama 16.21 13.65 13.54 12.47 12.78 11.82 12.43 11.72 11.91 12.01 12.25 Alaska * * * * * * 11.77 14.28 13.07 15.89 11.75


B.3-18


Arizona 11.24 10.18 10.39 9.54 9.5 8.78 8.97 8.65 9.72 9.53 8.91 Arkansas 14.01 12.98 12.22 11.27 10.66 10.57 10.25 10.85 11.04 11.45 11.91 California 14.27 11.8 12.12 11.47 11.08 10.97 11.48 11.75 12.29 12.41 12.08 Colorado 13.39 11.24 10.26 10.64 10.31 9.61 10.24 9.69 10.33 10.41 9.26 Connecticut 22.53 20.22 17.86 15.84 14.13 13.85 14.09 12.45 12.35 12.22 12.21 Delaware 18.01 21.05 15.63 12.58 12.38 13.41 13.19 13.76 15.67 14.08 12.33 District of Columbia * 20 31.19 18.07 20.02 19.57 14.86 17.36 19.64 15.54 16.35 Florida 14.63 13.9 13.12 12.15 11.16 10.84 11.27 11.07 11.08 11.78 11.73 Georgia 14.81 14.38 13.38 12.14 11.7 11.86 11.27 12.27 11.46 11.93 10.85 Hawaii * 21.16 20.02 21.66 20.66 26.1 17.91 21.99 17.19 20.2 21.69 Idaho 9.16 8.75 8.47 8.61 8.27 8.01 9.21 11.6 9.57 9.93 9.4 Illinois 16.25 14.76 13.38 13.61 13.05 12.3 11.09 10.8 11.36 11.55 10.82 Indiana 15.5 14.15 13.33 11.44 11.63 11.65 10.68 11.35 11.1 10.34 10.61 Iowa 14.25 12.21 12.64 13.52 11.1 10.69 11.03 9.71 10.54 10.52 10.7 Kansas 13.25 13.65 12.04 10.83 9.53 10.61 10.49 10.21 11.69 11.29 10.87 Kentucky 15.41 13.75 14.55 12 10.98 10.51 9.91 11.11 10.81 10.58 10.39 Louisiana 15.11 13.81 13.6 10.96 11.32 10.85 11.87 11.42 10.3 11.69 11.74 Maine 14.32 14.47 12.89 14.05 11.11 10.34 13.54 9.94 9.99 9.79 9.33 Maryland 18.64 14.79 14.72 13.36 13.71 13.22 11.98 11.89 11.7 11.52 11.29 Massachusetts 17.65 15.7 15.5 12.89 12.63 12.95 11.32 11.49 12.55 12.22 13.81 Michigan 17.16 15.28 14.44 13.68 12.71 12.91 13.93 12.96 13.16 13.54 13.48 Minnesota 12.61 9.93 12.17 10.83 10.42 10.1 9.35 9.47 10.93 11.41 10.34 Mississippi 13.57 15.29 14.63 12.29 13.17 13.24 11.76 10.82 11.39 12.89 12.76 Missouri 14 13.82 13.46 11.66 11.43 11.26 10.26 10.55 11.3 10.78 10.62 Montana 10.78 9.49 9.53 11 11.02 10.42 9.34 9.19 8.84 11.83 10.19 Nebraska 16.14 11.89 11.45 12.64 11.69 9.79 12.39 10.81 12.09 11.79 11.49 Nevada 15.12 13 14.28 11.44 11.37 10.77 10.53 11.19 10.7 12.34 12.3 New Hampshire 19.94 10.79 12.25 12.17 10.95 10.14 11.07 9.63 12.84 9.5 14.29 New Jersey 24.88 23.52 22.45 20.94 18.34 19.49 17.01 16.37 16.23 16.8 16.55 New Mexico 10.77 10.41 10.87 8.64 8.46 9.37 10.56 8.47 9.3 11.06 11.56 New York 26.8 24.05 25.54 23.78 21.43 19.87 19.21 19.08 18.99 19.04 17.87 North Carolina 16.54 15.37 14.33 13.3 11.72 12.25 12.66 13.43 12.78 12.62 11.43 North Dakota 14.01 14.97 12.12 14.05 10.47 12 14.05 10.47 15.91 11.59 14.05 Ohio 18.78 15.55 15.79 13.36 11.99 11.48 11.35 11.05 11.43 11.01 10.97 Oklahoma 13.75 12.4 12.51 10.71 10.05 10.33 10.81 9.95 10.98 11.58 12.09 Oregon 9.08 9.42 7.91 8.51 8.58 8.43 9.84 10.25 9.6 8.73 10.65 Pennsylvania 18.88 16.11 15.9 13.92 14.04 12.9 12.8 12.28 11.86 11.66 11.21 Rhode Island 18.92 19.47 16.95 16.98 15.03 14.21 13.55 11.7 12.34 15.92 14.15 South Carolina 17.19 14.14 12.94 12.92 14.18 13.63 12.95 12.67 12.65 13.37 13.27 South Dakota 15.78 17.87 14.31 12.24 14.88 13.34 12.56 11.43 12.43 13.18 12.22


B.3-19


Tennessee 16.92 15.34 14.42 13.22 12.2 11.9 11.31 10.42 12.08 11.76 11.48 Texas 13.93 13.22 12.57 10.74 10.86 10.5 10.96 10.91 11.46 11.68 11.7 Utah 9.48 8.68 9.69 8.69 8.12 8.83 10.11 9.52 9.84 10.07 9.24 Vermont 13.86 10 17.54 9.18 15.75 13.01 13.58 13.95 12.64 10.87 10.65 Virginia 17.35 14.62 15.48 14.55 12.58 12.88 12.85 12.74 11.74 13.01 12.21 Washington 12.6 9.38 9.99 8.48 8.16 8.88 8.12 8.12 8.93 8.92 9.48 West Virginia 16.96 14.22 14.5 13.44 11.83 10.97 11.31 11.39 11 11.96 10.82 Wisconsin 14.44 14.09 13.51 11.54 11.49 11.29 11.46 11.94 11.83 10.27 10.64 Wyoming * * * * * * 9.72 8.1 11.89 11.56 11.43 Puerto Rico/Virgin Islands 15.17 15.29 13.27 14.53 17.29 17.66 16.16 15.17 17.24 16.36 15.81



B.3-20

Table B.3-7. Total Medicare Payments for Discharges for Respiratory Failure,1992-2002 Year

Beneficiary Characteristics 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 (in thousands of dollars) All Enrollees 294,663 340,677 409,087 482,637 587,258 678,300 688,667 700,537 747,695 822,427 931,917 Gender

Male 147,707 171,614 201,820 237,296 288,106 332,524 334,877 333,867 360,455 391,920 451,402 Female 146,956 169,063 207,267 245,341 299,152 345,776 353,790 366,670 387,239 430,507 480,516

Age Group 0–54 11,635 16,519 20,434 27,493 38,025 41,049 41,321 45,590 50,814 63,124 69,254 55–64 21,273 25,418 30,264 37,325 45,566 55,050 54,427 55,620 63,122 75,042 89,425 65–69 53,316 62,572 71,534 82,025 94,491 104,784 102,103 101,277 106,079 111,944 135,526 70–74 68,191 75,671 91,180 104,583 124,025 139,658 140,889 136,387 141,967 150,254 165,975 75–79 62,319 69,770 83,451 98,209 116,921 138,800 138,586 141,696 150,146 164,003 180,082 80–84 41,229 50,414 61,758 72,230 88,844 104,253 108,968 111,106 116,456 127,104 149,130 85–89 24,764 26,894 34,259 40,262 52,578 60,388 65,656 71,142 78,227 84,083 91,578 90–94 8,597 10,010 12,225 15,117 20,373 26,255 27,939 28,394 31,755 34,442 38,713 95+ 3,339 3,409 3,983 5,392 6,434 8,062 8,777 9,324 9,129 12,431 12,234






State Alabama 6,442 8,023 8,602 9,864 11,003 11,847 13,427 11,903 11,458 14,188 17,086 Alaska * * * * * * 540 960 947 907 730


B.3-21


Arizona 4,869 5,516 5,889 6,459 6,814 7,499 6,767 7,349 7,582 7,712 8,984 Arkansas 2,879 3,374 3,801 4,867 5,472 6,281 6,223 6,598 5,206 5,609 7,463 California 27,553 30,404 42,138 48,635 61,548 67,332 72,891 61,813 64,801 76,004 85,729 Colorado 2,846 3,140 3,199 5,103 5,189 5,880 6,406 5,466 4,949 5,218 6,581 Connecticut 5,429 5,165 6,865 8,603 11,584 11,877 12,037 11,266 12,843 14,445 17,208 Delaware 733 1,243 1,028 767 1,462 2,008 2,518 2,714 4,088 3,227 4,106 District of Columbia * 1,144 2,102 1,397 2,148 2,671 2,525 2,726 3,379 2,542 3,184 Florida 23,383 29,755 36,811 42,918 48,891 51,502 48,728 53,620 50,800 57,773 64,619 Georgia 8,653 8,703 11,161 12,498 14,937 18,237 17,939 19,988 19,176 20,493 22,790 Hawaii * 828 767 2,286 2,386 3,251 2,287 3,271 1,891 1,445 2,698 Idaho 246 637 591 781 901 1,268 857 1,372 1,214 1,381 1,781 Illinois 11,496 13,044 16,881 19,084 23,104 26,717 25,997 26,082 27,989 33,745 36,957 Indiana 7,031 8,598 8,647 10,342 14,292 16,329 17,006 17,965 17,984 16,329 18,208 Iowa 2,742 2,249 3,164 3,678 3,955 4,573 5,387 5,926 5,611 5,829 6,197 Kansas 2,201 2,937 3,095 3,833 3,698 4,822 4,965 4,120 4,805 4,979 6,094 Kentucky 5,426 7,107 7,902 9,602 11,735 14,233 13,812 15,234 15,879 18,912 21,972 Louisiana 4,311 5,871 7,122 8,548 10,288 11,427 10,185 8,571 7,836 9,894 11,484 Maine 926 1,113 1,364 1,810 1,848 1,901 4,162 2,478 2,568 3,535 3,577 Maryland 6,970 7,410 9,929 11,890 15,096 17,124 15,960 17,232 18,654 24,200 27,367 Massachusetts 7,868 8,631 10,615 13,435 16,179 18,575 16,528 15,322 18,496 17,771 20,119 Michigan 13,309 15,187 17,401 23,675 26,698 32,097 33,795 33,084 32,135 37,429 45,370 Minnesota 2,933 3,396 3,469 4,035 4,582 5,400 6,001 7,024 7,388 8,743 8,571 Mississippi 1,791 2,084 2,868 2,846 4,535 5,931 5,129 4,804 5,525 6,264 6,854 Missouri 7,639 9,586 10,606 12,735 15,022 19,489 19,621 19,929 20,823 20,602 23,984 Montana 614 566 851 1,095 1,206 1,366 1,689 1,477 1,020 1,674 1,281 Nebraska 1,080 958 1,006 2,242 2,844 1,977 2,115 2,644 3,017 3,788 4,005 Nevada 2,421 1,589 1,478 3,049 4,157 4,974 3,391 3,937 3,922 5,573 7,521 New Hampshire 720 531 733 1,021 1,090 1,423 2,018 1,555 2,079 2,499 3,520 New Jersey 10,166 13,666 14,735 19,150 24,168 33,974 35,449 41,803 48,413 53,970 54,069 New Mexico 816 957 1,074 1,379 1,597 1,952 2,141 1,284 1,509 1,946 2,520 New York 25,280 26,891 33,625 38,781 40,043 43,922 45,494 52,613 69,250 87,137 93,596 North Carolina 7,191 8,277 8,622 12,782 15,028 18,147 19,750 24,335 27,065 24,010 27,225 North Dakota 993 934 962 1,248 1,071 1,298 1,609 1,688 2,261 1,667 2,090 Ohio 13,560 14,772 20,149 21,666 28,032 33,102 33,527 30,869 33,896 31,400 36,692 Oklahoma 4,897 4,744 6,132 5,547 6,642 8,873 8,728 8,325 8,916 9,389 11,337 Oregon 1,669 1,876 1,668 2,398 2,728 3,033 2,834 3,089 3,212 3,183 5,484 Pennsylvania 19,976 22,624 24,621 22,852 31,501 31,824 34,031 31,696 32,377 32,011 37,011 Rhode Island 2,086 2,153 1,349 1,427 3,419 2,808 2,967 2,642 2,709 3,353 3,204 South Carolina 3,135 3,111 3,500 4,867 8,957 8,226 8,695 9,469 12,354 13,118 14,933 South Dakota 530 599 654 570 989 1,118 1,119 1,148 1,283 1,433 1,449


B.3-22


Tennessee 7,431 9,415 10,776 13,909 16,478 18,702 20,305 20,652 21,598 20,683 24,376 Texas 15,005 19,443 25,676 28,331 36,570 46,158 43,928 45,179 46,689 49,325 60,416 Utah 642 1,071 1,145 1,531 2,095 2,397 2,422 2,164 2,433 2,579 2,951 Vermont 331 390 837 525 827 1,048 1,086 910 1,654 1,831 1,976 Virginia 5,687 6,722 8,508 12,050 13,858 18,480 17,959 19,933 18,412 21,626 21,657 Washington 4,265 5,449 6,097 6,563 7,667 8,840 8,243 8,277 9,442 11,140 13,409 West Virginia 2,500 2,765 2,774 3,324 3,909 5,689 6,144 6,052 7,258 7,538 8,117 Wisconsin 3,143 4,110 4,393 4,267 5,816 6,881 7,227 8,064 8,004 7,130 8,381 Wyoming * * * * * * 928 521 644 1,332 765 Puerto Rico/Virgin Islands 1,196 1,211 1,266 1,719 2,426 2,878 3,173 3,394 4,250 3,921 4,217



B.3-23

Table B.3-8. Average Medicare Payments per Discharge with Respiratory Failure, 1992-2002 Year


Male 15,818 16,762 17,594 17,237 18,044 18,612 18,516 18,281 19,181 20,381 20,777 Female 16,660 16,593 17,764 17,537 17,627 18,072 18,030 17,905 18,523 19,844 19,889

Age Group 0–54 18,826 20,804 21,486 22,083 23,400 23,741 22,817 23,260 23,330 25,129 23,516 55–64 16,830 17,639 18,004 18,333 18,837 20,442 19,799 18,314 19,404 21,313 21,674 65–69 16,698 17,726 18,595 18,163 18,883 18,695 19,228 19,019 19,839 20,357 21,383 70–74 17,014 17,372 18,551 18,182 18,377 18,906 19,003 18,453 19,281 20,193 20,463 75–79 16,601 17,055 18,071 17,632 17,930 18,564 18,242 18,055 18,712 20,042 20,492 80–84 14,971 15,436 16,660 16,401 16,591 17,029 17,245 17,558 18,064 19,191 19,509 85–89 14,749 14,177 15,488 14,667 15,307 16,151 16,248 16,411 17,349 18,823 18,382 90–94 13,025 12,736 13,173 13,570 14,721 15,481 15,151 15,257 16,046 17,017 17,298 95+ 14,580 12,818 14,224 14,380 14,426 14,631 14,088 14,192 15,265 18,978 17,135



Medicare Eligibility Status Aged without ESRD 16,063 16,372 17,412 17,024 17,359 17,825 17,867 17,703 18,401 19,519 19,802 Disabled without ESRD 17,385 18,617 19,249 19,568 20,523 21,496 20,527 20,145 20,946 22,803 22,178 ESRD only 19,107 21,889 22,244 21,868 23,465 23,605 23,120 22,616 24,118 25,090 26,247



State Alabama 11,951 12,755 12,342 13,421 13,893 13,970 14,787 13,713 13,705 15,030 15,187 Alaska * * * * * * 17,996 28,235 33,824 34,898 23,563 Arizona 15,122 15,627 16,179 14,848 15,884 15,089 14,872 15,122 16,483 16,408 16,793


B.3-24


Arkansas 10,320 10,318 10,029 10,888 10,344 11,461 10,861 11,741 12,395 14,022 14,926 California 18,897 18,528 22,027 22,474 23,278 24,556 25,318 24,043 26,182 28,170 29,349 Colorado 13,363 12,077 13,614 15,054 17,833 16,657 20,797 17,133 18,535 18,905 18,434 Connecticut 24,237 23,693 23,673 23,964 23,689 24,591 24,366 21,500 22,105 21,819 22,406 Delaware 20,370 28,246 21,424 15,347 18,740 19,687 20,987 20,253 24,481 18,984 17,323 District of Columbia * 28,610 46,704 32,496 39,053 36,582 26,867 35,867 45,057 28,881 30,619 Florida 13,935 15,619 15,711 16,431 16,540 16,550 16,407 15,524 15,602 17,022 17,168 Georgia 13,521 13,859 14,533 14,499 15,823 16,746 16,765 18,072 16,660 18,495 16,881 Hawaii * 28,563 23,975 36,293 38,484 42,218 28,953 32,066 27,808 27,787 29,649 Idaho 9,108 9,366 8,321 10,853 10,122 12,934 13,609 16,933 14,277 13,535 14,244 Illinois 16,400 17,300 20,192 19,613 18,723 20,088 18,218 17,611 17,999 19,195 17,897 Indiana 15,659 16,347 15,836 14,924 16,004 17,501 15,953 16,377 16,014 14,912 15,916 Iowa 12,353 10,086 11,717 13,880 12,245 13,294 11,659 11,287 12,306 12,925 12,394 Kansas 11,230 13,111 13,754 14,857 11,776 14,183 15,420 14,206 16,017 17,110 17,118 Kentucky 11,280 11,985 13,280 12,820 12,646 12,021 11,979 13,065 12,942 12,787 13,463 Louisiana 15,019 14,976 16,113 14,687 17,739 17,499 18,058 17,006 15,579 17,956 19,799 Maine 10,519 11,358 13,374 15,470 13,393 13,200 20,203 14,577 14,034 14,429 13,812 Maryland 21,380 16,994 18,186 15,832 18,166 18,433 17,953 18,792 18,199 19,252 19,396 Massachusetts 19,237 19,750 21,188 19,992 20,689 22,061 19,331 20,240 22,311 22,784 25,794 Michigan 20,226 19,698 19,685 21,601 19,939 21,186 21,539 22,692 20,679 23,104 23,581 Minnesota 15,199 16,728 17,175 19,032 19,251 19,286 17,547 16,725 20,522 20,767 19,218 Mississippi 10,534 13,027 14,487 12,164 15,746 15,485 13,900 13,381 14,772 17,595 16,676 Missouri 13,617 14,202 15,151 14,878 15,519 15,988 15,116 15,533 15,871 16,146 15,779 Montana 10,070 11,097 11,196 13,033 12,964 14,693 14,562 13,187 12,438 16,407 16,428 Nebraska 14,997 14,293 13,598 15,900 20,026 14,539 15,905 15,645 18,742 21,159 19,825 Nevada 16,033 19,374 18,026 18,256 18,643 18,912 18,841 18,398 16,409 21,189 21,367 New Hampshire 16,749 10,830 13,580 14,385 14,733 13,953 18,014 16,905 19,078 18,105 26,463 New Jersey 21,958 26,796 24,037 23,908 22,031 26,235 23,839 24,779 26,499 31,017 29,514 New Mexico 10,740 9,965 10,738 10,611 12,674 13,745 15,624 11,167 14,793 18,537 20,321 New York 28,120 28,517 32,966 32,507 29,950 28,688 28,065 29,327 31,264 35,065 34,755 North Carolina 13,244 13,912 12,869 13,803 14,258 14,838 16,809 18,174 17,865 17,958 17,352 North Dakota 15,512 15,823 11,731 18,353 13,382 14,266 19,865 14,184 24,581 17,734 19,717 Ohio 17,385 17,400 20,352 18,630 17,901 17,971 17,655 17,761 17,626 17,130 18,291 Oklahoma 12,063 12,550 13,448 11,050 12,143 14,740 14,215 13,875 15,137 16,132 17,442 Oregon 12,270 12,028 10,760 13,546 13,373 15,091 17,174 17,551 17,084 16,323 20,932 Pennsylvania 20,056 20,756 21,044 17,715 19,627 19,125 19,671 17,907 18,501 18,085 19,930 Rhode Island 17,381 21,966 18,224 19,023 21,779 18,846 21,981 18,868 18,813 26,610 23,389 South Carolina 14,929 13,015 13,513 14,231 18,817 17,209 16,625 16,700 17,700 19,463 19,495 South Dakota 12,615 14,606 14,855 12,390 16,476 17,462 13,992 15,719 16,235 19,897 18,340 Tennessee 13,246 14,374 14,445 15,021 15,286 15,431 14,692 13,861 16,239 16,599 17,154 Texas 15,141 16,590 17,278 15,705 16,892 17,140 18,311 18,122 18,609 19,275 20,397


B.3-25


Utah 10,190 12,904 14,499 11,690 13,780 13,853 14,504 11,763 14,066 14,251 14,050 Vermont 12,269 12,576 20,416 13,113 19,232 18,389 18,722 19,369 20,936 19,279 21,475 Virginia 15,206 13,470 15,554 16,110 14,790 15,795 15,233 14,920 14,601 17,932 16,030 Washington 15,233 14,118 14,871 13,616 14,017 15,900 15,209 15,076 16,536 17,461 19,433 West Virginia 13,020 13,168 12,439 11,828 11,565 11,928 12,263 13,272 12,037 13,295 14,044 Wisconsin 12,474 14,422 14,992 13,676 16,022 17,420 17,085 19,432 18,108 17,519 17,174 Wyoming * * * * * * 18,195 12,411 16,089 23,366 18,217 Puerto Rico/Virgin Islands 10,051 9,842 9,661 9,446 11,335 12,848 12,540 12,080 13,845 12,899 15,620



B.3-26

Table B.3-9. Total Beneficiary Deductible and Coinsurance Payments for Discharges for Respiratory Failure, 1992-2002 Year

Beneficiary Characteristics 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 (in thousands of dollars)

All Enrollees 15,215 15,288 17,536 20,044 22,993 25,371 25,683 26,361 27,271 29,201 33,535 Gender

Male 6,982 7,443 8,546 9,660 11,089 12,202 12,364 12,196 12,802 13,594 16,143 Female 8,233 7,845 8,990 10,384 11,903 13,169 13,319 14,165 14,469 15,607 17,392

Age Group 0–54 636 707 849 1,045 1,496 1,388 1,311 1,586 1,801 2,063 2,397 55–64 1,158 1,135 1,184 1,580 1,640 1,960 1,992 2,048 2,388 2,603 3,256 65–69 2,769 2,835 3,078 3,351 3,689 3,957 3,824 3,678 3,892 4,194 5,009 70–74 3,323 3,479 4,021 4,161 4,793 5,444 5,141 5,200 5,005 5,161 6,103 75–79 3,318 3,004 3,646 4,134 4,665 5,000 5,267 5,325 5,609 5,865 6,525 80–84 1,926 2,161 2,416 3,001 3,459 3,839 4,218 4,183 4,380 4,696 5,081 85–89 1,372 1,295 1,505 1,789 2,115 2,432 2,522 2,819 2,686 2,927 3,269 90–94 443 468 611 691 856 1,037 1,045 1,093 1,147 1,272 1,452 95+ 269 204 226 292 280 315 362 429 361 420 443

Race White 12,783 13,124 15,321 17,039 19,624 21,922 21,760 22,123 22,712 24,349 27,754 Black 1,719 1,647 1,843 2,232 2,485 2,378 2,815 2,962 3,352 3,647 4,237 Other 401 283 292 617 723 945 990 1,128 1,111 1,138 1,478 Unknown 313 234 80 155 161 126 118 148 97 67 65


Medicare Eligibility Status Aged without ESRD 13,342 13,355 15,317 17,260 19,611 21,758 22,196 22,500 22,868 24,034 27,303 Disabled without ESRD 1,654 1,744 1,902 2,405 2,843 2,986 2,940 3,252 3,821 4,241 5,052 All with ESRD 219 188 317 380 539 628 547 609 583 926 1,180



State Alabama 426 406 452 551 569 678 645 613 500 696 789 Alaska * 13 * * * * 33 16 18 24 17


B.3-27


(in thousands of dollars) Arizona 149 167 187 217 242 258 232 243 232 250 292 Arkansas 204 187 203 319 295 331 342 360 240 294 358 California 883 947 1,070 1,239 1,506 1,593 1,840 1,683 1,778 1,956 2,170 Colorado 123 149 119 217 162 194 153 182 169 177 198 Connecticut 297 231 269 294 486 394 380 351 505 451 545 Delaware 37 46 33 35 51 76 80 126 143 141 179 District of Columbia * 25 89 44 44 54 127 92 163 57 103 Florida 1,027 1,224 1,388 1,521 1,695 1,800 1,828 1,984 1,857 1,935 2,414 Georgia 383 396 460 494 572 687 591 825 702 717 808 Hawaii * 28 43 100 139 173 88 186 75 112 105 Idaho 18 34 34 48 50 57 54 49 49 54 66 Illinois 576 449 624 745 1,073 1,025 903 940 1,024 1,152 1,367 Indiana 338 315 377 376 528 571 559 659 544 697 633 Iowa 166 156 135 193 238 205 280 311 319 269 358 Kansas 110 145 129 176 158 245 207 204 208 184 240 Kentucky 329 365 476 411 526 667 647 641 723 881 921 Louisiana 199 259 263 368 315 381 336 345 283 369 425 Maine 72 55 61 102 119 78 166 84 118 232 125 Maryland 356 289 392 527 628 584 598 637 681 858 1,061 Massachusetts 309 346 459 397 495 504 511 415 605 597 600 Michigan 572 654 647 849 929 1,105 1,517 1,034 1,140 1,358 1,899 Minnesota 140 97 146 101 139 198 222 269 236 320 271 Mississippi 148 133 136 149 191 270 227 235 295 205 315 Missouri 366 461 411 470 516 658 727 756 746 669 851 Montana 31 28 45 74 78 48 58 73 48 71 36 Nebraska 46 38 52 83 98 94 87 106 119 126 117 Nevada 123 63 64 82 143 146 102 116 120 168 244 New Hampshire 33 44 29 49 46 64 91 55 97 88 143 New Jersey 864 830 996 1,290 1,329 1,641 1,513 1,647 2,026 2,074 2,385 New Mexico 41 75 85 70 70 74 88 61 80 77 87 New York 1,914 1,764 2,067 2,284 2,058 2,034 1,866 2,190 2,292 2,966 2,704 North Carolina 429 455 550 666 641 775 781 963 955 900 996 North Dakota 25 27 58 41 34 35 44 71 81 59 90 Ohio 627 612 784 828 996 1,101 1,117 995 1,119 1,088 1,225 Oklahoma 236 257 276 332 368 353 366 339 364 402 437 Oregon 65 80 91 128 129 149 108 106 114 112 214 Pennsylvania 890 930 1,013 950 1,273 1,079 1,157 1,211 1,168 1,078 1,223 Rhode Island 141 73 111 51 116 113 95 84 89 143 74 South Carolina 251 149 172 208 349 325 368 420 494 474 629 South Dakota 18 32 26 15 27 39 35 40 49 27 38


B.3-28


(in thousands of dollars) Tennessee 411 472 485 606 642 756 811 829 816 788 995 Texas 731 704 906 969 1,240 1,640 1,518 1,455 1,550 1,511 2,095 Utah 35 47 41 72 76 107 115 115 99 122 118 Vermont 28 13 47 31 46 59 83 79 62 49 88 Virginia 390 323 350 494 627 834 838 1,085 922 1,010 1,130 Washington 179 244 266 239 291 307 315 326 317 343 403 West Virginia 182 146 121 185 241 332 324 265 347 365 360 Wisconsin 185 201 202 214 220 279 297 271 321 252 307 Wyoming * 11 16 15 23 17 35 27 42 48 44 Puerto Rico/Virgin Islands 65 93 63 118 156 168 177 193 227 207 240



B.3-29

Table B.3-10. Average Number of Pneumonia-Related Discharges Per Beneficiary Discharged With Respiratory Failure, 1992-2002


Male 1.03 1.03 1.03 1.03 1.04 1.04 1.04 1.04 1.05 1.05 1.05 Female 1.02 1.02 1.03 1.03 1.03 1.04 1.04 1.03 1.04 1.05 1.04

Age Group 0–54 1.05 1.05 1.06 1.05 1.05 1.06 1.05 1.05 1.06 1.06 1.07 55–64 1.04 1.06 1.06 1.05 1.06 1.06 1.06 1.06 1.07 1.08 1.07 65–69 1.04 1.04 1.03 1.04 1.05 1.05 1.05 1.05 1.06 1.06 1.06 70–74 1.03 1.03 1.03 1.04 1.04 1.05 1.05 1.04 1.05 1.05 1.05 75–79 1.02 1.02 1.03 1.03 1.03 1.04 1.04 1.03 1.04 1.05 1.05 80–84 1.02 1.02 1.02 1.03 1.03 1.03 1.03 1.03 1.03 1.04 1.04 85–89 1.02 1.01 1.01 1.02 1.02 1.02 1.02 1.02 1.02 1.03 1.03 90–94 1 1.01 1.02 1.02 1.02 1.02 1.02 1.01 1.01 1.02 1.02 95+ 1.01 1.01 1.02 1.01 1.01 1.01 1.01 1.01 1.01 1.02 1.02





Census Region Northeast 1.02 1.02 1.03 1.02 1.04 1.04 1.04 1.03 1.04 1.05 1.05 Midwest 1.03 1.03 1.03 1.03 1.03 1.04 1.04 1.04 1.05 1.05 1.05 South 1.03 1.03 1.03 1.04 1.04 1.04 1.04 1.04 1.05 1.05 1.05 West 1.03 1.03 1.03 1.04 1.03 1.04 1.04 1.04 1.03 1.04 1.04 Puerto Rico/Virgin Islands 1.04 1 1.02 1.01 1.02 1 1.03 1 1.02 1.01 1.02

State Alabama 1.05 1.03 1.02 1.03 1.04 1.04 1.04 1.03 1.03 1.04 1.06 Alaska * * * * * * 1.03 1 1 * 1.03


B.3-30


Arizona 1.04 1.03 1.03 1.03 1.02 1.02 1.06 1.04 1.03 1.04 1.05 Arkansas 1.04 1.02 1.03 1.03 1.05 1.04 1.03 1.04 1.03 1.03 1.03 California 1.03 1.04 1.03 1.05 1.04 1.05 1.04 1.04 1.04 1.05 1.04 Colorado 1.02 1.04 1.01 1.04 1.02 1.04 1.03 1.06 1.04 1.04 1.04 Connecticut 1.01 1.01 1.02 1.03 1.05 1.06 1.04 1.04 1.06 1.06 1.04 Delaware 1 1.07 1 1 1.03 1.03 1.05 1.04 1.05 1.08 1.02 District of Columbia * 1 1 1.05 1.06 1.03 1.08 1.01 1.06 1.03 1.01 Florida 1.03 1.03 1.02 1.04 1.04 1.04 1.03 1.04 1.04 1.04 1.05 Georgia 1.04 1.03 1.04 1.03 1.04 1.03 1.03 1.03 1.04 1.04 1.04 Hawaii * 1 1.03 1.03 1.03 1.01 1.04 1.01 1.01 1 1.07 Idaho * 1.05 1.01 1.06 1.05 1.05 1.03 1.03 1 1.04 1.05 Illinois 1.02 1.03 1.02 1.02 1.02 1.04 1.04 1.03 1.03 1.05 1.06 Indiana 1.03 1.03 1.03 1.05 1.05 1.04 1.04 1.04 1.05 1.05 1.04 Iowa 1.02 1.04 1.03 1.02 1.04 1.02 1.05 1.04 1.05 1.05 1.05 Kansas 1.04 1.02 1.03 1.04 1.05 1.04 1.03 1.03 1.02 1.03 1.05 Kentucky 1.03 1.06 1.04 1.05 1.04 1.06 1.06 1.05 1.07 1.06 1.07 Louisiana 1.04 1.02 1.03 1.04 1.02 1.04 1.04 1.03 1.02 1.03 1.04 Maine 1.04 1.03 1.04 1.04 1.05 1.06 1.07 1.06 1.02 1.05 1.05 Maryland 1.01 1.03 1.05 1.05 1.05 1.04 1.06 1.06 1.06 1.06 1.05 Massachusetts 1.02 1.03 1.03 1.03 1.03 1.06 1.04 1.03 1.05 1.04 1.04 Michigan 1.02 1.02 1.03 1.02 1.03 1.03 1.04 1.02 1.04 1.05 1.04 Minnesota 1.02 1.03 1.03 1.01 1.04 1.04 1.04 1.03 1.03 1.03 1.04 Mississippi 1.04 1.01 1.02 1.03 1.02 1.03 1.02 1.05 1.04 1.04 1.06 Missouri 1.03 1.03 1.03 1.04 1.03 1.04 1.05 1.04 1.05 1.05 1.05 Montana 1.02 1 1.03 1.04 1.02 1.02 1.03 1.02 1.05 1.03 1.03 Nebraska 1.03 1 1 1.01 1.02 1.03 1.07 1.04 1.05 1.06 1.06 Nevada 1.02 1.01 1.02 1.02 1.02 1.02 1.03 1.02 1.03 1.04 1.04 New Hampshire 1.02 1.02 1.02 1 1 1.01 1.04 1.01 1.01 1.02 1.03 New Jersey 1.02 1.02 1.02 1.02 1.05 1.05 1.03 1.03 1.05 1.06 1.07 New Mexico 1.03 1.04 1.04 1.06 1.02 1.01 1.02 1.03 1.01 1.01 1.02 New York 1.02 1.02 1.03 1.01 1.03 1.03 1.03 1.03 1.03 1.04 1.04 North Carolina 1.03 1.03 1.04 1.03 1.04 1.04 1.03 1.03 1.03 1.05 1.04 North Dakota 1.02 1.04 1 1.03 1.01 1.06 1.05 1.09 1.03 1.03 1.03 Ohio 1.02 1.03 1.03 1.02 1.03 1.04 1.04 1.04 1.06 1.05 1.04 Oklahoma 1.04 1.03 1.02 1.02 1.04 1.03 1.03 1.02 1.03 1.05 1.03 Oregon 1.05 1.01 1.03 1.01 1.01 1.04 1.01 1.04 1.01 1.02 1.04 Pennsylvania 1.02 1.03 1.03 1.03 1.04 1.03 1.04 1.04 1.03 1.04 1.04 Rhode Island 1.02 1.01 1.01 1.03 1.04 1.04 1.05 1.02 1.01 1.02 1.02 South Carolina 1.03 1.04 1.03 1.03 1.03 1.04 1.02 1.04 1.04 1.04 1.04 South Dakota 1.11 1.05 1 1 1.07 1 1.03 1.03 1.01 1.06 1 Tennessee 1.03 1.05 1.04 1.06 1.04 1.05 1.05 1.06 1.05 1.05 1.07


B.3-31


Texas 1.03 1.03 1.03 1.04 1.03 1.04 1.04 1.04 1.05 1.05 1.05 Utah 1.03 1.01 1.03 1.01 1.03 1.02 1.02 1.03 1.04 1.02 1.05 Vermont 1.04 1.07 1 1.05 1.02 1.04 1.02 1 1.01 1.06 1 Virginia 1.01 1.03 1.03 1.03 1.04 1.05 1.04 1.04 1.04 1.06 1.04 Washington 1.03 1.03 1.05 1.05 1.03 1.04 1.06 1.03 1.03 1.03 1.04 West Virginia 1.04 1.02 1.03 1.04 1.05 1.03 1.06 1.03 1.06 1.04 1.04 Wisconsin 1.03 1.02 1.02 1.04 1.02 1.04 1.02 1.02 1.03 1.03 1.03 Wyoming * * * * * * 1.04 1.08 1 1.02 1.02 Puerto Rico/Virgin Islands 1.04 1 1.02 1.01 1.02 1 1.03 1 1.02 1.01 1.02



B.3-32

Table B.3-11. Average Number of All Discharges Per Beneficiary Discharged With Respiratory Failure, 1992-2002 Year


Male 2.18 2.15 2.17 2.25 2.28 2.3 2.3 2.32 2.35 2.45 2.43 Female 2.1 2.12 2.16 2.23 2.25 2.31 2.27 2.3 2.37 2.47 2.46

Age Group 0–54 2.63 2.4 2.62 2.65 2.66 2.65 2.56 2.64 2.6 2.78 2.81 55–64 2.59 2.55 2.57 2.63 2.67 2.69 2.65 2.7 2.78 2.8 2.8 65–69 2.23 2.27 2.27 2.33 2.34 2.39 2.39 2.41 2.47 2.57 2.53 70–74 2.17 2.17 2.16 2.27 2.32 2.37 2.35 2.36 2.41 2.52 2.46 75–79 2.14 2.11 2.15 2.21 2.23 2.3 2.29 2.29 2.35 2.44 2.45 80–84 2.01 1.99 2.05 2.13 2.15 2.2 2.18 2.22 2.24 2.35 2.34 85–89 1.87 1.9 1.93 1.98 2.03 2.05 2.06 2.09 2.16 2.22 2.25 90–94 1.76 1.75 1.8 2.03 1.92 1.96 1.93 1.99 2.03 2.12 2.07 95+ 1.57 1.83 1.79 1.84 1.82 1.87 1.95 1.89 1.82 2 1.94






State Alabama 2.25 2.09 2.17 2.24 2.28 2.25 2.28 2.34 2.32 2.52 2.43 Alaska * * * * * * 1.93 2.03 2.5 * 2.1 Arizona 1.95 2.02 1.94 2.15 1.97 2.08 2.03 2.1 2.18 2.23 2.29


B.3-33


Arkansas 2.31 2.12 2.29 2.21 2.09 2.27 2.26 2.21 2.34 2.38 2.38 California 2.1 2.1 2.23 2.25 2.31 2.32 2.31 2.32 2.33 2.52 2.41 Colorado 2.03 1.92 1.86 1.91 2.05 2.04 2.01 2.14 2.28 2.22 2.2 Connecticut 1.95 2.01 2 2.02 2.15 2.16 2.28 2.25 2.27 2.39 2.37 Delaware 1.97 2.15 2.31 2.1 2.17 2.46 2.37 2.12 2.35 2.45 2.38 District of Columbia * 2.75 1.98 2.56 2.83 2.9 2.62 2.76 2.69 2.53 2.55 Florida 2.15 2.12 2.13 2.27 2.22 2.29 2.25 2.3 2.34 2.47 2.42 Georgia 2.35 2.3 2.18 2.33 2.25 2.29 2.29 2.34 2.35 2.37 2.3 Hawaii * 1.97 1.74 2.21 1.8 2.01 1.95 1.93 2.3 1.94 2.38 Idaho * 1.92 2.08 2.01 2.05 2.14 2.11 2.19 1.98 2.01 2.16 Illinois 2.16 2.31 2.32 2.4 2.36 2.44 2.42 2.41 2.46 2.67 2.71 Indiana 2.09 2.1 2.1 2.24 2.32 2.31 2.27 2.36 2.38 2.44 2.43 Iowa 2.12 1.86 2.24 1.96 2.13 1.97 2.16 2.08 2.11 2.17 2.08 Kansas 2.15 2.06 1.85 2.27 2.33 2.11 2.09 2.15 2.14 2.19 2.21 Kentucky 2.32 2.4 2.4 2.51 2.55 2.58 2.49 2.54 2.61 2.62 2.68 Louisiana 2.33 2.34 2.22 2.24 2.26 2.41 2.34 2.43 2.35 2.68 2.75 Maine 1.89 2.05 2.19 2.05 2.21 2.33 2.35 2.13 2.17 2.32 2.32 Maryland 2.35 2.21 2.53 2.58 2.54 2.5 2.47 2.46 2.7 2.7 2.74 Massachusetts 2.26 2.15 2.16 2.29 2.41 2.37 2.38 2.32 2.38 2.39 2.52 Michigan 2.1 2.15 2.17 2.2 2.28 2.39 2.34 2.31 2.42 2.54 2.55 Minnesota 2.03 2.33 1.98 2.28 2.27 2.21 2.26 2.19 2.25 2.3 2.4 Mississippi 2.23 2.33 2.14 2.36 2.26 2.49 2.33 2.43 2.43 2.54 2.5 Missouri 2.19 2.02 2.16 2.2 2.27 2.35 2.21 2.33 2.38 2.51 2.5 Montana 2.23 1.88 1.97 2.2 2.09 1.93 2.18 2.2 2.4 1.99 2.21 Nebraska 1.9 1.72 1.8 2.01 1.93 2.03 2.29 2.16 2.04 2.22 2.21 Nevada 2.19 1.8 2.22 2.15 2.02 2.18 2.11 2.23 2.19 2.36 2.18 New Hampshire 1.72 1.58 1.83 1.87 1.93 1.78 1.91 2 2.21 2.27 1.95 New Jersey 2.14 2.08 2.05 2.28 2.33 2.4 2.3 2.31 2.42 2.56 2.59 New Mexico 1.99 2.02 1.89 2.18 1.95 2.06 1.8 2.18 1.9 2.06 2.03 New York 1.96 1.97 2.01 2.08 2.15 2.19 2.22 2.29 2.32 2.38 2.46 North Carolina 1.99 2.05 2.08 2.08 2.15 2.23 2.16 2.28 2.27 2.31 2.28 North Dakota 1.81 1.81 2 2.44 1.73 2.13 2.09 2.01 2.16 2.45 2.24 Ohio 2.27 2.27 2.23 2.37 2.35 2.37 2.38 2.42 2.52 2.57 2.58 Oklahoma 2.16 2.15 2.05 2.12 2.24 2.24 2.15 2.19 2.27 2.37 2.31 Oregon 1.84 1.84 1.89 1.8 1.93 2.12 1.88 1.92 2.03 2.23 2.23 Pennsylvania 2.15 2.28 2.18 2.18 2.27 2.36 2.37 2.34 2.38 2.49 2.51 Rhode Island 2.11 1.97 1.9 2.75 2.34 2.47 2.49 2.26 2.23 2.7 2.49 South Carolina 2.11 2.07 2.19 2.11 2.23 2.22 2.24 2.17 2.28 2.37 2.33 South Dakota 2.08 2.13 2.18 2.35 2.14 2.13 2.1 2.08 2.12 2.62 2 Tennessee 2.27 2.34 2.38 2.37 2.39 2.4 2.36 2.44 2.46 2.61 2.55 Texas 2.13 2.14 2.13 2.31 2.25 2.33 2.38 2.34 2.39 2.43 2.44


B.3-34


Utah 2.05 1.6 1.75 1.81 2.06 1.98 1.92 1.84 2.13 2.03 2.13 Vermont 1.85 2.07 1.93 2.33 2.31 2.04 2.28 2.26 2.14 2.22 2.14 Virginia 1.97 2.17 2.31 2.19 2.26 2.24 2.25 2.23 2.32 2.41 2.33 Washington 2.15 1.94 1.95 2.05 2.05 1.99 2.1 2.03 2.12 2.18 2.1 West Virginia 2.39 2.4 2.6 2.45 2.64 2.45 2.59 2.7 2.57 2.52 2.62 Wisconsin 2 1.91 1.93 2.13 2.02 2.22 1.97 2.14 2.06 2.26 2.12 Wyoming * * * * * * 1.94 2.23 2.23 2.13 2.1 Puerto Rico/Virgin Islands 2.07 1.77 2.4 2.06 2.07 1.87 1.84 2.19 2.1 2.17 2.1



B.3-35

Table B.1-12. Age-Sex Adjusted All-Cause Readmission Rates per 1,000 Beneficiaries Discharged with Respiratory Failure, 1992-2002 Year


Male 247.09 237.43 239.99 252.2 249.97 254.3 260.14 261.75 272.62 276.88 288.24 Female 216.45 212.31 224.21 225.95 225.92 242.64 237.92 243.72 239.83 270.1 272.67

Age Group 0–54 231.63 210.68 239.96 236.32 228.87 228.72 220.95 237.34 222.6 249.64 254.53 55–64 263.65 254 255.23 255.9 250.96 247.71 257.28 262.51 260.55 271.36 274.41 65–69 224.45 224.4 220.33 228.58 238.77 244.49 242.76 249.38 247.92 260.66 268.42 70–74 226.52 229.48 220.48 237.37 228.54 262.3 244.19 250.31 247.18 273.02 279.28 75–79 234.25 229.1 246.84 240.13 234.99 239.46 258.7 252.23 271.33 279.22 280.27 80–84 225.4 221.81 226.54 244.31 239.78 254.53 248.95 253.39 267.05 285.24 302.95 85–89 223.71 197.38 241.85 229.83 233.07 249.22 266.2 260.13 273.5 298.26 295.79 90–94 227.66 188.67 214.86 258.34 253.41 252.96 257.59 267 243.38 292.28 288.28 95+ * * 213.53 * 277.13 230.38 244.87 254.53 228.78 289.4 339.6

Race White 229.57 220.99 230.56 235.89 234.36 242.89 243.96 246.99 248.91 267.54 268.36 Black 242.98 237.89 241.08 257.41 254.68 277.87 262.92 288.47 284.53 305.01 345.33 Other 197.76 234.68 263.76 224.46 236.51 269.71 274.39 255.48 278.72 306.05 312.71 Unknown 230.77 281.98 * * 184.3 416.53 255.09 * * * *


Medicare Eligibility Statusa Aged without ESRD 232.03 244 253.25 260.39 265.57 260.06 264.72 265.75 269.87 287.6 294.31 Disabled without ESRD 243.53 229.18 237.5 239.28 234.36 226.27 230.45 240.9 236.59 248.99 252.74 All with ESRD 330.58 364.26 410.51 357.43 337.49 412.88 369.41 420 355.31 413.02 409.34


Census Region Northeast 244.35 243.91 230.94 248.14 261.06 281.24 267.28 273.15 268.2 283.22 300.49 Midwest 229.09 219.77 229.78 233.37 240.01 240.76 244.8 248.2 255.5 269.89 274.54 South 232.34 220.7 241.47 238.76 228.55 245.19 242.42 250.72 254.78 273.91 274.35 West 205.29 216.48 210.66 220.43 220.87 222.75 239 223.93 221.58 250.51 258.38 Puerto Rico/Virgin Islands * * * * 309.67 * * 250.42 291.56 276.05 323.3


B.3-36


Male 731.6 719.72 725.07 728.89 728.26 740.54 748.48 735.66 753.49 774.12 n.a. Female 706.62 693.93 696.39 709.02 713.03 733.76 716.37 724.91 731.63 757.58 n.a.

Age Group 0–54 708.11 676.25 696.03 681.47 693.47 705 668.98 701.51 714.17 737.3 n.a. 55–64 753.72 760.56 747.19 755.91 759.97 768.06 744.49 748.29 764.76 784.16 n.a. 65–69 703.1 698.48 682 681.39 701.08 724.61 724.46 708.92 724.44 746.19 n.a. 70–74 697.14 680.9 687.23 722.85 709.75 730.43 721.92 724.32 719.35 757.08 n.a. 75–79 734.03 732.19 730.2 736.14 725.51 739.17 746.84 731.43 753.6 771.7 n.a. 80–84 728.22 717.52 730.09 737.4 730.31 757.41 738.63 758.74 760.16 786.99 n.a. 85–89 735.04 687.16 722.4 734.43 739.96 748.13 756.47 749.84 790.84 795.31 n.a. 90–94 771.94 693.12 728.1 779.94 777.89 761.37 768.48 776.79 779.79 791.91 n.a. 95+ 654.05 808.79 837.73 675.39 792.84 796.07 822.81 783.37 774.23 796.99 n.a.







NOTES: Based on short-term hospitalizations among the full-year fee-for-service Medicare population. State and region are based on provider location. Rates are based on the first respiratory failure hospitalization for a beneficiary in a calendar year. All results reported at the national level are standardized to the age-sex distribution of the July 1999 Medicare FFS population using the direct method. Results reported at the state level are standardized using the indirect method. a Age-sex–adjusted rates are not comparable across aged and disabled groups.



B.3-37

Table B.3-13. Age-Sex Adjusted All-Pneumonia Readmission Rates per 1,000 Beneficiaries Discharged with Respiratory Failure, 1992-2002 Year


Male 71.1 75.45 68.61 75.05 77.37 79.49 78.03 80.01 81.91 84.48 85.34 Female 54.54 47.44 57.28 61.74 58.08 65.5 63.49 65.51 65.13 72.56 71.13

Age Group 0–54 80.44 62.38 70.13 77.12 68.78 58.13 52.32 58.25 57.12 62.89 58.04 55–64 59.05 73.92 69.3 77.3 69.39 69.7 76.79 65.84 78.78 76.33 80.08 65–69 55.91 54.32 55.1 64.52 59.27 63.64 68.49 72.14 62.46 70.09 74.95 70–74 54.79 53.66 61.63 66.6 61.35 80.39 67.54 74.39 72.98 74.14 70.39 75–79 61.95 65.29 66.08 62.7 70.15 67.79 69.93 72.09 85.05 80.67 79.37 80–84 71.82 67.15 66.73 72.84 70.92 74.47 74.77 72.75 78.51 88.33 88.11 85–89 59.22 55.84 58 60.58 70.93 82.73 81.04 83.71 77.54 95.06 97.11 90–94 * * * 70.92 79.98 87.95 86.41 80.42 66.29 86.94 88.13 95+ * * * * * * * * * * *

Race White 61.67 59.57 62.99 67.15 66.44 70.55 69.12 71.68 71.84 76.65 74.22 Black 59.11 58.74 52.87 69.04 65.95 74.72 65.24 73.34 71.6 78.66 98.33 Other * * * 75.91 75.56 67.04 82.72 69.63 74.15 85.05 86.39 Unknown * * * * * * * * * * *

Dual-Enrollment Status Not Dual 54.16 54.45 56.33 59.95 58.67 64.63 65.33 66.47 64.87 69.97 70.63 Dual 77.36 75.37 80 82.02 81.89 87.9 79.23 86.15 88.78 95.1 92.29

Medicare Eligibility Statusa Aged without ESRD 61.24 69.32 69.87 75.52 74.14 75.91 75.89 76.63 80.33 83.11 86.41 Disabled without ESRD 73.01 71.19 71.56 77.51 73.16 62.07 62.11 61.72 65.44 70.44 68.35 All with ESRD * * * * * 66.35 63.64 70.35 63.21 52.23 63.37


Census Region Northeast 74.44 61.77 62.12 73.25 67.18 79.67 78.79 75.82 78.62 87.45 80.18 Midwest 56.9 59.72 65.15 65.82 65.54 71.92 70.06 73.67 70.12 75.29 73.77 South 59.57 56.25 61.24 64.01 66.59 69.16 63.01 70.8 73.27 74.63 75.67 West 57.71 68.96 65.2 70.47 62.82 67.15 76.73 66.08 60.15 73.85 80.8 Puerto Rico/Virgin Islands * * * * * * * * * * *

Table B.3-13(cont’d)

B.3-38


Male 367.24 351.57 355.98 363.38 378.48 376.03 393.81 375.59 388.92 419.41 n.a. Female 288.65 281.19 292.51 303.42 308.96 325.34 316.2 321.24 332.21 360.72 n.a.

Age Group 0–54 289.55 280.81 311.97 285.88 283.81 292.57 292.31 308.48 300.48 318.47 n.a. 55–64 388.79 352.27 342.01 355.39 363.89 353.39 367.74 355.33 374.58 387.23 n.a. 65–69 311.88 294.68 287.26 300.76 314.24 335.63 336.32 335.86 340.29 368.25 n.a. 70–74 306.03 293.07 292.15 330.4 339.97 342.68 342.28 344.14 346.68 369.53 n.a. 75–79 315.95 320.76 330.56 339.7 347.76 351.52 352.86 341 367.73 405.56 n.a. 80–84 343.51 343.64 362.56 355.74 355.2 375.19 372.65 369.16 378.05 420.21 n.a. 85–89 343.17 315.79 349.56 343.12 375.48 371.67 379.63 368.76 401.07 428.23 n.a. 90–94 400.67 364.55 361.54 410.12 418.13 391.24 400.94 371.24 398.61 457.54 n.a. 95+ * * 511.83 * 402.32 453.3 520.46 363.73 459.67 491.28 n.a.

Race White 319.04 310.1 318.29 327.43 335.35 344.16 343.36 342.29 352.21 380.07 n.a. Black 323.24 293.88 320.73 338.92 358.75 370.77 361.41 347.98 369.63 407.46 n.a. Other 349.23 407.7 371.57 347.21 351.77 331.86 414.75 359.23 407.45 447.46 n.a. Unknown 337.05 432.01 * * 456.74 * 374.81 * * * n.a.




Census Region Northeast 320.46 313.89 314.7 322.51 338.93 351.17 348.52 352.71 361.83 392.57 n.a. Midwest 330.15 303.48 318.78 329.02 347.32 353.36 347.58 349.47 364.72 377.83 n.a. South 318.8 310.18 313.68 322.67 329.72 339.22 341.99 339.39 347.32 381.44 n.a. West 309.18 305.12 338.71 342.01 340.59 348.95 361.55 333.73 350.73 393.73 n.a. Puerto Rico/Virgin Islands * * * * 410.57 * * 315.29 * * n.a.


NOTES: Based on short-term hospitalizations among the full-year fee-for-service Medicare population. State and region are based on provider location. Rates are based on the first respiratory failure hospitalization for a beneficiary in a calendar year. All results reported at the national level are standardized to the age-sex distribution of the July 1999 Medicare FFS population using the direct method. Results reported at the state level are standardized using the indirect method. a Age-sex–adjusted rates are not comparable across aged and disabled groups.



B.3-39

Table B.3-14. Age-Sex Adjusted All-Cause Mortality Rates per 1,000 Beneficiaries Discharged with Respiratory Failure, 1992-2002


(within 30-days from admission) All Enrollees 317.18 330.67 327.06 329.1 322.97 315.38 329.26 325.01 324.24 325.19 323.79 Gender

Male 345.94 358.79 358.02 358.95 346.45 347.7 358.24 352.49 348.97 351.52 350.16 Female 297.69 312.44 304.44 306.15 306.06 292.35 309.5 305.24 306.21 305.61 306.23

Age Group 0–54 227.56 190.58 177.89 189.24 171.95 170.99 187.52 174.77 161.39 166.56 156.09 55–64 203.62 227.56 215.35 214.56 217.53 202.83 226.37 218.96 199.52 207.45 202.49 65–69 229.24 250.53 261.78 259.5 259.37 259.25 261.21 264.33 262.3 261.2 264.6 70–74 298.13 315.37 296.93 303.94 300.21 291.72 314.58 296.04 302.49 303.85 306.72 75–79 349.69 367.96 368.1 364.37 354.68 345.83 356 358.95 355.74 358.76 357.94 80–84 416.33 434.48 433.54 432.89 418.77 412.07 424.34 428.09 435.66 431.95 422.28 85–89 477.94 506.71 507.24 501.57 489.59 479.47 507.51 494.6 492.05 487.67 502.23 90–94 560.29 588.67 539.22 553.39 583.87 544.71 574.46 569.33 585.44 578.68 571.41 95+ 672.13 619.92 615.55 622.83 640.84 622.32 616.6 621.62 614.33 626.82 642.51

Race White 323.06 329.4 330.04 331.73 325.38 317.31 331.48 326.01 325.03 328.19 325.11 Black 280.49 299.39 289.68 302.06 290.05 287.82 303.14 306.53 303.83 299.19 307.15 Other 267.3 391.48 306.33 335.14 339.13 335.8 340.18 336.13 351.68 321.02 338 Unknown 272.76 442.99 364.68 284.49 334.71 257.99 206.51 340.34 407.36 252.41 163.65

Dual-Enrollment Status Not Dual 326 339.1 336.57 338.32 332.21 322.29 337.93 333.64 334.39 336.1 335.79 Dual 286.03 310.32 304.31 311.61 304.54 299.94 307.49 309.71 305.55 301.82 303.4



Census Region Northeast 309.87 334.01 305.72 324.49 317.53 305.46 328.99 328.74 318.17 328.96 315.64 Midwest 319.09 325.16 344.17 339.02 326.4 314.41 335.18 323.95 319.67 328.95 312.12 South 314.16 321.8 320.12 321.1 318.47 309.86 320.4 319.49 322.72 316 325.56 West 324.15 352.3 342.18 335.84 335.61 337.07 340.42 335.26 343.12 341.26 349.08 Puerto Rico/Virgin Islands 442.1 547.85 450.88 477.68 327.37 540.09 470.05 422.19 465.63 493.12 407.85


B.3-40



Male 635.77 630.78 619.49 625.34 612.28 613.15 626.56 620.66 626.64 635.1 n.a. Female 580.45 568.07 560.8 549.68 547.33 553.48 554.04 557.26 560.44 571.4 n.a.



Dual-Enrollment Status Not Dual 600.71 594.28 583.09 582.64 573.71 572.29 579.27 581.57 583.71 597.46 n.a. Dual 607.27 602.96 597.01 593.15 588.02 594.11 602.02 599 606.78 609.22 n.a.


Urban/Rural Rural 588.38 577.84 562.46 571.09 551.31 551.37 565.22 565.9 563.67 579.4 n.a. Urban 606.98 598.12 592.78 587 584.04 588.07 592.29 591.07 597.81 606.47 n.a.

Census Region Northeast 631.66 616.82 597.4 604.96 590.87 595.18 612.44 602.27 596 611.38 n.a. Midwest 601.87 589.51 602.41 588.56 581.76 576.33 588.48 587.92 583.64 596.65 n.a. South 590.44 582.94 571.19 570.91 562.2 564.53 569.82 574.63 583.35 589.31 n.a. West 598.75 591.99 583.56 579.3 586.65 599.84 585.28 584.45 598.27 617.25 n.a. Puerto Rico/Virgin Islands 746.62 765.15 680.46 713.16 634.13 757.39 733.92 644.26 730.27 731.28 n.a.


NOTES: Based on short-term hospitalizations among the full-year fee-for-service Medicare population. State and region are based on provider location. Rates are based on each respiratory failure discharge for a beneficiary in a calendar year. All results reported at the national level are standardized to the age-sex distribution of the July 1999 Medicare FFS population using the direct method. Results reported at the state level are standardized using the indirect method. a Age-Sex–Adjusted rates are not comparable across aged and disabled groups.



A P P E N D I X C

I C D - 9 C O D E S F O R P N E U M O N I A C O H O R T S

PAGE IS INTENTIONALLY LEFT BLANK TO ALLOW FOR DOUBLE-SIDED COPYING

Cohort Principal Diagnosis Secondary diagnosis 1. Pneumonia Viral pneumonia 480.0-480.99 any Pneumococcal pneumonia 481.0-481.99 any Other bacterial pneumonia 482.0-482.99 any Pneumonia due to other specified organism 483.0-483.99 any Bronchopneumonia, organism unspecified 485.0-485.99 any Pneumonia, organism unspecified 486.0-486.99 any Influenza with pneumonia 487.0 any

2. Septicemia with pneumonia Septicemia 038.0-038.99 480.0-483.99;485.0-486.99; 487.0

3. Respiratory failure with pneumonia Acute respiratory failure 518.81 480.0-483.99;485.0-486.99; 487.0 Acute and chronic respiratory failure 518.84 480.0-483.99;485.0-486.99; 487.0

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