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2003 National Healthcare Quality Report

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Percent of patients with pneumonia who receive the initial antibiotic consistent with current recommendations.

Measure Source

CMS Health Care Quality Improvement Program (HCQIP) Quality Indicator.

Tables

1.78a Percent of patients with pneumonia who receive the initial antibiotic consistent with current recommendations, United States, 2000 – 2001.

1.78b Percent of patients with pneumonia who receive the initial antibiotic consistent with current recommendations, by state, 2000 – 2001.

Data Source

Centers for Medicare and Medicaid Services, Medicare Quality Improvement Organization Program. Data are from a systematic random sample of up to 750 inpatient records per state.

Denominator

Medicare discharges meeting either of the following criteria:

Principal diagnosis of pneumonia (ICD-9-CM codes of 480-483.8, 485-486, or 487.0).

Secondary diagnosis of pneumonia with a principal diagnosis of either septicemia (ICD-9-CM 038.XX) or respiratory failure (acute or chronic, ICD-9-CM code 518.81, 518.84).

Numerator

Pneumonia patients who received an initial antibiotic regimen consistent with current guidelines during the first 24 hours of their hospitalization.

Comments

Excludes patients transferred from another acute care or critical access hospital, patients who had no working diagnosis of pneumonia at the time of admission, patients who received comfort measures only, patients who did not receive antibiotics during the hospitalization or within 36 hours after arrival at the hospital, patients who were immunocompromised (based on comorbidities), patients who potentially had nosocomial pneumonia (index admission within 14 days of a previous admission), patients who had insufficient arrival or antibiotic timing data in their medical record.

See Medicare Priorities (HCFA Publication 10156) (also available as Pneumonia National Project Overview at www.nationalpneumonia.org) for a discussion of accepted antibiotic regimens for pneumonia.

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