Skip Navigation U.S. Department of Health and Human Services www.hhs.gov
Agency for Healthcare Research Quality www.ahrq.gov
Archive print banner

Hands-on Tool Training: Preventable Hospitalization Costs: A County-Level Mapping Tool

This information is for reference purposes only. It was current when produced and may now be outdated. Archive material is no longer maintained, and some links may not work. Persons with disabilities having difficulty accessing this information should contact us at: https://info.ahrq.gov. Let us know the nature of the problem, the Web address of what you want, and your contact information.

Please go to www.ahrq.gov for current information.


On January 18, 2008, Melanie Chansky provided Hands-on Tool training for the Preventable Hospitalization Costs: A County-Level Mapping Tool at the State Healthcare Quality Improvement Workshop. This is the text version of the event's slide presentation. Please select the following link to access the slides: (PowerPoint® File, 1.0 MB; PDF File, 220 KB; PDF Help).

Slides: 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 | 11 | 12 | 13 | 14 | 15


Slide 1: Preventable Hospitalization Costs: A County-Level Mapping Tool

State Healthcare Quality Improvement Workshop:
Tools You Can Use to Make a Difference
January 17-18, 2008

Melanie Chansky, MAA
Battelle Centers for Public Health Research and Evaluation.

On the top of the slide are the logos for the Department of Health & Human Services and the AHRQ logo. The Department of Health & Human Services logo is an artistic image of an eagle with the outlined profile of faces. The AHRQ logo reads, "AHRQ — Agency for Healthcare Research and Quality: Advancing Excellence in Health Care, www.ahrq.gov."

This presentation uses a template with a blue background and a header with the AHRQ and Department of Health & Human Services logos on the left.

Top of Page


Slide 2: AHRQ Quality Indicators (QIs)

  • Use existing hospital discharge data, based on readily available data elements.
  • Incorporate severity adjustment methods (APR-DRGs, comorbidity groupings and hierarchical modeling).
  • Five modules: Inpatient, Patient Safety, Prevention, Pediatric, and Neonatal.

Top of Page


Slide 3: Preventable Hospitalization Costs: A County-Level Mapping Tool

The PHC tool is a new QI software application designed to help organizations to:

  • Better understand geographical patterns of potentially preventable hospital admission rates for selected health problems.
  • Allocate resources more effectively by calculating potential cost savings if admission rates are reduced.

Top of Page


Slide 4: Main Functions of the PHC Tool

  • Creation of maps that show the rates of hospital admission for selected health problems on a county-by-county basis.
  • Calculation of potential cost savings that may occur if the number of hospital admissions for selected health problems in each county is reduced.
  • Ability to place additional information about local populations onto maps to indicate the number of persons who are at greatest risk for those health problems in each county.

Top of Page


Slide 5: It processes all Prevention QIs...

  • PQI 1 Diabetes Short-term Complications Admission Rate.
  • PQI 2 Perforated Appendix Admission Rate.
  • PQI 3 Diabetes Long-term Complications Admission Rate.
  • PQI 5 Chronic Obstructive Pulmonary Disease Admission Rate.
  • PQI 7 Hypertension Admission Rate.
  • PQI 8 Congestive Heart Failure Admission Rate.
  • PQI 9 Low Birth Weight Rate.
  • PQI 10 Dehydration Admission Rate.
  • PQI 11 Bacterial Pneumonia Admission Rate.
  • PQI 12 Urinary Tract Infection Admission Rate.
  • PQI 13 Angina without Procedure Admission Rate.
  • PQI 14 Uncontrolled Diabetes Admission Rate.
  • PQI 15 Adult Asthma Admission Rate.
  • PQI 16 Lower-extremity Amputation Rate among Diabetic Patients.

There is no longer a PQI 4 and PQI 6.

Top of Page


Slide 6: and all area-level Pediatric QIs

  • PDI 14 Asthma Admission Rate.
  • PDI 15 Diabetes Short-term Complications Admission Rate.
  • PDI 16 Gastroenteritis Admission Rate.
  • PDI 17 Perforated Appendix Admission Rate.
  • PDI 18 Urinary Tract Infection Admission Rate.

Top of Page


Slide 7: Applying the QIs

  • To calculate area rates it was necessary to have access to the state and county data.
  • The software produces observed and risk-adjusted rates for all PQIs and PDIs.
  • Output converted to rates
      — Rates expressed either per 100 population and per 10,000 population.

Top of Page


Slide 8: Uncontrolled Diabetes Admission

This slide shows a map of uncontrolled diabetes admission (2001, PQI14) in California. The map is broken down by county and is color-coded to show different categories of rates per 10,000 people. The first category is 0.02-0.36, the second category is 0.4-0.74, the third category is 0.77-1.97, the fourth category is 2.46-8.68, and the fifth category is 8.69-144.21. The southern part of California has the lowest rate (0.02-0.36). The eastern part of the state has the highest rate (8.69-144.21). The map also uses an indicator shaped like a person to show the number of people age 18 and over in a given area. The size of the person indicates the number of people in an area. The smallest person indicator represents 55-143 people. The next indicator represents 145-224 people. The largest person indicator represents 231-445 people.

There appears to be no relationship between population size and rate of uncontrolled diabetes admission. For example, one county with a small population has a high admission rate and another has a low rate.

Top of Page


Slide 9: Map Interpretation - Example

This slide contains a map of congestive heart failure admission rate (PQI 8), 2002 in the state of Michigan. The map is broken down by county and is color-coded to show different categories of rates per 100,000 population. This slide shows how to interpret this kind of map. At the top of the map will be the name of the indicator and the data year in the map title. Beside the state map will be a map key indicating the data quintiles and what colors are used to represent each quintile. Sometimes on the maps, symbols in the shape of a person are used to indicate the number of people in an area. The larger the person symbol, the more people are indicated in that area.

Top of Page


Slide 10: Data Interpretation

This slide contains a screen shot of a printout of all AHRQ PQIs by county for the state of Michigan. The printout shows how you can compare each county's rate to the overall state rate and how you can also look at the upper and lower confidence intervals for each county.

Top of Page


Slide 11: Cost Data Interpretation

This slide contains a screenshot of an Excel spreadsheet. At the top of the spreadsheet is the QI Name. In this case, it is Chronic Obstructive Pulmonary Disease (PQI 5). Below it is the county number, county name, mean cost for the QI specified, total number of cases, and total cost. Next to these data is the potential cost savings if the number of admissions were reduced by a specific percentage. In this case, the percentages used were 10%, 20%, 30%, 40%, and 50%.

Top of Page


Slide 12: Where to Download

Download the PHC mapping tool (SAS and Windows versions) and all technical documentation at:
http://www.qualityindicators.ahrq.gov/mappingtool.htm

Top of Page


Slide 13: Technical Support

If you have technical questions of any kind while using the PHC tool, contact the QI team at: Support@qualityindicators.ahrq.gov
or 1-888-512-6090.

Top of Page


Slide 14: Questions?

This slide shows a map of the United States that is color-coded by unknown categories.

Top of Page


Slide 15: Contact Information

My contact information:
Melanie Chansky
chanskym@battelle.org
703-248-1659

Return to Contents

The information on this page is archived and provided for reference purposes only.

 

AHRQ Advancing Excellence in Health Care