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

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 It was current when produced and may now be outdated. Archive material is no longer maintained, and some links may not work.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 December 6, 2007, MaryBeth Farquhar made a presentation entitled Preventable Hospitalization Costs: A County-Level Mapping Tool. 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).

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
December 6-7, 2007

MaryBeth Farquhar, RN, MSN, CAGS

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."

Return to Top


Slide 2: AHRQ Quality Indicators (QIs)

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. The header and body of the slide are separated by a light blue horizontal line that traverses 80 percent of the slide from the left.

  • 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.

Return to Top


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.

Return to Top


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.

Return to Top


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.

Return to Top


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.

Return to Top


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.

Return to Top


Slide 8:

This slide shows a map of uncontrolled diabetes admission (2001, PQI14) in Maryland. The map is broken down by county and is color-coded to show different categories of rates per 10,000 people. The map also uses an indicator shaped like a person to show the average user population age 18 and over in a given area. The smallest person indicator represents 897 people. The next largest indicator represents 19,391 people. The largest person indicator represents 79,054 people. The highest rates were in Howard, Prince George's, St. Mary's, and Charles Counties and Baltimore City.

Data Source: Healthcare Cost and Utilization Project & Maryland Health Services Cost and Review Commission.

Return to Top


Slide 9: Map Interpretation - Example

This slide shows 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.

Return to Top


Slide 10: Data Interpretation

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

Return to Top


Slide 11: Cost Data Interpretation

This slide shows the printout 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%.

Return to Top


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

Return to Top


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

Return to Top


Slide 14: Questions?

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

Return to Top


Slide 15: Contact information

MaryBeth Farquhar, RN, MSN, CAGS
Senior Advisor, Quality Indicators Initiative
MaryBeth.Farquhar@ahrq.hhs.gov
301-427-1317

Return to Top

Return to Contents

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

 

AHRQ Advancing Excellence in Health Care