Entity Acute Claim Measures

DescriptionThe analysis of mortality rates and readmission rates in the context of specific medical conditions such as acute myocardial infarction (AMI), heart failure, and pneumonia as well as the utilization of related key diagnostic services and therapeutic treatments.

Attributes
Calendar DkCalendar Dk
Claim DkClaim Dk
Encounter DkEncounter Dk
MORT 30 AMI 30 Day MortalityMORT 30 AMI 30 Day Mortality
MORT 30 HF 30 Day MortalityMORT 30 HF 30 Day Mortality
MORT 30 PN 30 Day MortalityMORT 30 PN 30 Day Mortality
OP 10 Abdomen CT Use Of Contrast MaterialOP 10 Abdomen CT Use Of Contrast Material
OP 11 Thorax CT Use Of Contrast MaterialOP 11 Thorax CT Use Of Contrast Material
OP 13 Preoperative Cardiac ImagingOP 13 Preoperative Cardiac Imaging
OP 14 Simultaneous Use Of Brain And Sinus CTOP 14 Simultaneous Use Of Brain And Sinus CT
OP 15 Brain CT In ED For Atraumatic HeadacheOP 15 Brain CT In ED For Atraumatic Headache
OP 8 MRI Lumbar Spine For Low Back PainOP 8 MRI Lumbar Spine For Low Back Pain
OP 9 Mammography Follow Up RatesOP 9 Mammography Follow Up Rates
Patient DkPatient Dk
Point Of Care Location DkPoint Of Care Location Dk
Practitioner DkPractitioner Dk
Provider DkProvider Dk
READM 30 AMI 30 Day ReadmissionREADM 30 AMI 30 Day Readmission
READM 30 HF 30-Day ReadmissionREADM 30 HF 30-Day Readmission
READM 30 PN 30 Day ReadmissionREADM 30 PN 30 Day Readmission

Relationship
Acute Claim Measures_Encounter Dimension_FKAcute Claim Measures_Encounter Dimension_FK
Acute Claim Measures_Calendar_FKAcute Claim Measures_Calendar_FK
Acute Claim Measures_Claim Dimension_FKAcute Claim Measures_Claim Dimension_FK
Acute Claim Measures_Point Of Care Location Dimension_FKAcute Claim Measures_Point Of Care Location Dimension_FK
Acute Claim Measures_Provider Dimension_FKAcute Claim Measures_Provider Dimension_FK
Acute Claim Measures_Practitioner Dimension_FKAcute Claim Measures_Practitioner Dimension_FK
Acute Claim Measures_Patient Dimension_FKAcute Claim Measures_Patient Dimension_FK

Primary Key
Acute Claim Measures PKAcute Claim Measures PK

Dependencies
 NONE

Reverse Dependencies
 

Attribute Details

 Calendar Dk
DescriptionA numeric surrogate key used to uniquely identify entities in the dimensional model.
Data TypeStandards - Data Domains.ddm/Data Domains/Surrogate Key Large [LONG]
Is Part Of PrimaryKeytrue
Is Requiredtrue
Is Derivedfalse
Is Surrogate Keyfalse



 Claim Dk
DescriptionA numeric surrogate key used to uniquely identify entities in the dimensional model.
Data TypeStandards - Data Domains.ddm/Data Domains/Surrogate Key Large [LONG]
Is Part Of PrimaryKeytrue
Is Requiredtrue
Is Derivedfalse
Is Surrogate Keyfalse



 Encounter Dk
DescriptionA numeric surrogate key used to uniquely identify entities in the dimensional model.
Data TypeStandards - Data Domains.ddm/Data Domains/Surrogate Key Large [LONG]
Is Part Of PrimaryKeytrue
Is Requiredtrue
Is Derivedfalse
Is Surrogate Keyfalse



 MORT 30 AMI 30 Day Mortality
DescriptionThe measure estimates a hospital-level risk-standardized mortality rate (RSMR) for patients discharged from the hospital with a principal diagnosis of Acute Myocardial Infarction [AMI].
Data TypeStandards - Data Domains.ddm/Data Domains/Rate [FLOAT(5)]
Is Part Of PrimaryKeyfalse
Is Requiredfalse
Is Derivedfalse
Is Surrogate Keyfalse



 MORT 30 HF 30 Day Mortality
DescriptionHospital 30-day, all-cause, risk-standardized mortality rate (RSMR) following heart failure (HF) hospitalization. The measure estimates a hospital-level risk-standardized mortality rate (RSMR) for patients discharged from the hospital with a principal diagnosis of HF.HF is the leading cause of hospitalization among Medicare beneficiaries and is associated with considerable risk of morbidity and mortality. Although HF is a progressive illness for which death may be an inevitable consequence rather than a marker of poor quality, clinical experience suggests that the care for these patients is highly variable and studies suggest gaps in quality of hospital care, particular in the transition to outpatient care. Moreover, there is substantial inter-hospital variation in the risk of death at 30 days that is not explained by differences in case mix. Many stakeholders, including patient organizations, are interested in outcomes measures for this common condition that could be used to assess the relative performance of a hospital and provide the opportunity for comparison with other institutions.
Data TypeStandards - Data Domains.ddm/Data Domains/Rate [FLOAT(5)]
Is Part Of PrimaryKeyfalse
Is Requiredfalse
Is Derivedfalse
Is Surrogate Keyfalse



 MORT 30 PN 30 Day Mortality
DescriptionHospital 30-day, all-cause, risk-standardized mortality rate (RSMR) following pneumonia hospitalization. The measure estimates a hospital-level risk-standardized mortality rate (RSMR) for patients discharged from the hospital with a principal diagnosis of pneumonia. Hospitalization for PN is common and is associated with considerable risk of morbidity and mortality. Although many current hospital interventions are known to decrease the risk of death within 30 days of hospital admission, current process-based performance measures cannot capture all the interventions that may influence outcomes. Risk-standardized mortality rates (RSMRs) can provide important additional information about quality of care that is not currently captured by the process measures. Variation in mortality, after adjusting for case mix, may reflect differences in hospitals' general environments (such as coordination of care, patient safety policies, and staffing) or variation in other care processes not measured in the current core measure set.
Data TypeStandards - Data Domains.ddm/Data Domains/Rate [FLOAT(5)]
Is Part Of PrimaryKeyfalse
Is Requiredfalse
Is Derivedfalse
Is Surrogate Keyfalse



 OP 10 Abdomen CT Use Of Contrast Material
DescriptionCalculates the ratio of abdomen studies that are performed with and without contrast out of all abdomen studies performed (those with contrast, those without contrast, and those with both). The measure is calculated based on a one-year window of claims data.
Data TypeStandards - Data Domains.ddm/Data Domains/Rate [FLOAT(5)]
Is Part Of PrimaryKeyfalse
Is Requiredfalse
Is Derivedfalse
Is Surrogate Keyfalse



 OP 11 Thorax CT Use Of Contrast Material
DescriptionCalculates the ratio of thorax studies that are performed with and without contrast out of all thorax studies performed (those with contrast, those without contrast, and those with both). The measure is calculated based on a one year window of claims data.
Data TypeStandards - Data Domains.ddm/Data Domains/Rate [FLOAT(5)]
Is Part Of PrimaryKeyfalse
Is Requiredfalse
Is Derivedfalse
Is Surrogate Keyfalse



 OP 13 Preoperative Cardiac Imaging
DescriptionCalculates the percentage of Stress Echocardiography, SPECT MPI or Stress MRI studies performed at a hospital outpatient facility in the 30 days prior to an ambulatory low-risk, non-cardiac surgery performed anywhere.
Data TypeStandards - Data Domains.ddm/Data Domains/Rate [FLOAT(5)]
Is Part Of PrimaryKeyfalse
Is Requiredfalse
Is Derivedfalse
Is Surrogate Keyfalse



 OP 14 Simultaneous Use Of Brain And Sinus CT
DescriptionCalculates the percentage of Brain CT studies with a simultaneous Sinus CT (i.e., Brain and Sinus CT studies performed on the same day at the same facility).
Data TypeStandards - Data Domains.ddm/Data Domains/Rate [FLOAT(5)]
Is Part Of PrimaryKeyfalse
Is Requiredfalse
Is Derivedfalse
Is Surrogate Keyfalse



 OP 15 Brain CT In ED For Atraumatic Headache
DescriptionCalculates the percentage of Emergency Department (ED) visits for headache with a coincident brain computed tomography (CT) study for Medicare beneficiaries.
Data TypeStandards - Data Domains.ddm/Data Domains/Rate [FLOAT(5)]
Is Part Of PrimaryKeyfalse
Is Requiredfalse
Is Derivedfalse
Is Surrogate Keyfalse



 OP 8 MRI Lumbar Spine For Low Back Pain
DescriptionCalculates the percentage of MRI of the Lumbar Spine studies with a diagnosis of low back pain on the imaging claim and for which the patient did not have prior claims-based evidence of antecedent conservative therapy. Antecedent conservative therapy may include:1)
Claim(s) for physical therapy in the 60 days preceding the Lumbar Spine MRI.Claim(s) for chiropractic evaluation and manipulative treatment in the 60 days preceding the Lumbar Spine MRI.Claim(s) for evaluation and management in the period 28 days and 60 days preceding the Lumbar Spine MRI
Data TypeStandards - Data Domains.ddm/Data Domains/Rate [FLOAT(5)]
Is Part Of PrimaryKeyfalse
Is Requiredfalse
Is Derivedtrue
Is Surrogate Keyfalse



 OP 9 Mammography Follow Up Rates
DescriptionCalculates the percentage of patients with mammography screening studies that are followed by a diagnostic mammography or ultrasound of the breast in an outpatient or office setting within 45 days.
Data TypeStandards - Data Domains.ddm/Data Domains/Rate [FLOAT(5)]
Is Part Of PrimaryKeyfalse
Is Requiredfalse
Is Derivedfalse
Is Surrogate Keyfalse



 Patient Dk
DescriptionA numeric surrogate key used to uniquely identify entities in the dimensional model.
Data TypeStandards - Data Domains.ddm/Data Domains/Surrogate Key Large [LONG]
Is Part Of PrimaryKeytrue
Is Requiredtrue
Is Derivedfalse
Is Surrogate Keyfalse



 Point Of Care Location Dk
DescriptionA numeric surrogate key used to uniquely identify entities in the dimensional model.
Data TypeStandards - Data Domains.ddm/Data Domains/Surrogate Key Large [LONG]
Is Part Of PrimaryKeytrue
Is Requiredtrue
Is Derivedfalse
Is Surrogate Keyfalse



 Practitioner Dk
DescriptionA numeric surrogate key used to uniquely identify entities in the dimensional model.
Data TypeStandards - Data Domains.ddm/Data Domains/Surrogate Key Large [LONG]
Is Part Of PrimaryKeytrue
Is Requiredtrue
Is Derivedfalse
Is Surrogate Keyfalse



 Provider Dk
DescriptionA numeric surrogate key used to uniquely identify entities in the dimensional model.
Data TypeStandards - Data Domains.ddm/Data Domains/Surrogate Key Large [LONG]
Is Part Of PrimaryKeytrue
Is Requiredtrue
Is Derivedfalse
Is Surrogate Keyfalse



 READM 30 AMI 30 Day Readmission
DescriptionHospital, thirty-day all-cause risk-standardized readmission rate (RSRR) following acute myocardial infarction (AMI) hospitalization. The measure estimates a hospital-level, risk-standardized, all-cause 30 day readmission rate for patients discharged from the hospital with a principal discharge diagnosis of AMI. Readmission of patients who were recently discharged after hospitalization with AMI represents an important, expensive, and often preventable adverse outcome. The risk of readmission can be modified by the quality and type of care provided to these patients. Improving readmission rates is the joint responsibility of hospitals and clinicians. Measuring readmission will create incentives to invest in interventions to improve hospital care, better assess the readiness of patients for discharge, and facilitate transitions to outpatient status. This measure is also responsive to the call by the Medicare Payment Advisory Commission (MedPAC) to develop readmission measures, with AMI highlighted as one of seven conditions that account for nearly 30% of potentially preventable readmissions in the 15-day window after initial hospital discharge (MedPAC, 2007).
Data TypeStandards - Data Domains.ddm/Data Domains/Rate [FLOAT(5)]
Is Part Of PrimaryKeyfalse
Is Requiredfalse
Is Derivedfalse
Is Surrogate Keyfalse



 READM 30 HF 30-Day Readmission
DescriptionHospital thirty-day all-cause risk standardized readmission rate (RSRR) following heart failure (HF) hospitalization. The measure estimates a hospital-level, risk-standardized, all-cause 30 day readmission rate for patients discharged from the hospital with a principal discharge diagnosis of HF. Readmission of patients who were recently discharged after hospitalization with HF represents an important, expensive, and often preventable adverse outcome. The risk of readmission can be modified by the quality and type of care provided to these patients. Improving readmission rates is the joint responsibility of hospitals and clinicians. Measuring readmission will create incentives to invest in interventions to improve hospital care, better assess the readiness of patients for discharge, and facilitate transitions to outpatient status. This measure is also responsive to the call by the Medicare Payment Advisory Commission (MedPAC) to develop readmission measures, with HF highlighted as one of seven conditions that account for nearly 30% of potentially preventable readmissions in the 15-day window after initial hospital discharge (MedPAC, 2007).
Data TypeStandards - Data Domains.ddm/Data Domains/Rate [FLOAT(5)]
Is Part Of PrimaryKeyfalse
Is Requiredfalse
Is Derivedfalse
Is Surrogate Keyfalse



 READM 30 PN 30 Day Readmission
DescriptionHospital thirty-day all-cause risk-standardized readmission rate (RSRR) following pneumonia hospitalization. The measure estimates a hospital-level, risk-standardized, all-cause 30 day readmission for patients discharged from the hospital with a principal discharge diagnosis of pneumonia (PN). Readmission of patients who were recently discharged after hospitalization with PN represents an important, expensive, and often preventable adverse outcome. The risk of readmission can be modified by the quality and type of care provided to these patients. Improving readmission rates is the joint responsibility of hospitals and clinicians. Measuring readmission will create incentives to invest in interventions to improve hospital care, better assess the readiness of patients for discharge, and facilitate transitions to outpatient status. This measure is also responsive to the call by the Medicare Payment Advisory Commission (MedPAC) to develop readmission measures, with PN highlighted as one of seven conditions that account for nearly 30% of potentially preventable readmissions in the 15-day window after initial hospital discharge (MedPAC, 2007).
Data TypeStandards - Data Domains.ddm/Data Domains/Rate [FLOAT(5)]
Is Part Of PrimaryKeyfalse
Is Requiredfalse
Is Derivedfalse
Is Surrogate Keyfalse

Relationship Details

 Acute Claim Measures_Encounter Dimension_FK
Is Identifying Relationshiptrue
Child TableAcute Claim Measures
Child MultiplicityZERO_TO_MANY
Child Referential Integrity: On DeleteNONE
Child Referential Integrity: On InsertNONE
Child Referential Integrity: On UpdateNONE
Parent TableEncounter Dimension
Parent MultiplicityONE
Parent Referential Integrity: On DeleteNONE
Parent Referential Integrity: On InsertNONE
Parent Referential Integrity: On UpdateNONE



 Acute Claim Measures_Calendar_FK
Is Identifying Relationshiptrue
Child TableAcute Claim Measures
Child MultiplicityZERO_TO_MANY
Child Referential Integrity: On DeleteNONE
Child Referential Integrity: On InsertNONE
Child Referential Integrity: On UpdateNONE
Parent TableCalendar Dimension
Parent MultiplicityONE
Parent Referential Integrity: On DeleteNONE
Parent Referential Integrity: On InsertNONE
Parent Referential Integrity: On UpdateNONE



 Acute Claim Measures_Claim Dimension_FK
Is Identifying Relationshiptrue
Child TableAcute Claim Measures
Child MultiplicityZERO_TO_MANY
Child Referential Integrity: On DeleteNONE
Child Referential Integrity: On InsertNONE
Child Referential Integrity: On UpdateNONE
Parent TableClaim Dimension
Parent MultiplicityONE
Parent Referential Integrity: On DeleteNONE
Parent Referential Integrity: On InsertNONE
Parent Referential Integrity: On UpdateNONE



 Acute Claim Measures_Point Of Care Location Dimension_FK
Is Identifying Relationshiptrue
Child TableAcute Claim Measures
Child MultiplicityZERO_TO_MANY
Child Referential Integrity: On DeleteNONE
Child Referential Integrity: On InsertNONE
Child Referential Integrity: On UpdateNONE
Parent TablePoint Of Care Location Dimension
Parent MultiplicityONE
Parent Referential Integrity: On DeleteNONE
Parent Referential Integrity: On InsertNONE
Parent Referential Integrity: On UpdateNONE



 Acute Claim Measures_Provider Dimension_FK
Is Identifying Relationshiptrue
Child TableAcute Claim Measures
Child MultiplicityZERO_TO_MANY
Child Referential Integrity: On DeleteNONE
Child Referential Integrity: On InsertNONE
Child Referential Integrity: On UpdateNONE
Parent TableProvider Dimension
Parent MultiplicityONE
Parent Referential Integrity: On DeleteNONE
Parent Referential Integrity: On InsertNONE
Parent Referential Integrity: On UpdateNONE



 Acute Claim Measures_Practitioner Dimension_FK
Is Identifying Relationshiptrue
Child TableAcute Claim Measures
Child MultiplicityZERO_TO_MANY
Child Referential Integrity: On DeleteNONE
Child Referential Integrity: On InsertNONE
Child Referential Integrity: On UpdateNONE
Parent TablePractitioner Dimension
Parent MultiplicityONE
Parent Referential Integrity: On DeleteNONE
Parent Referential Integrity: On InsertNONE
Parent Referential Integrity: On UpdateNONE



 Acute Claim Measures_Patient Dimension_FK
Is Identifying Relationshiptrue
Child TableAcute Claim Measures
Child MultiplicityZERO_TO_MANY
Child Referential Integrity: On DeleteNONE
Child Referential Integrity: On InsertNONE
Child Referential Integrity: On UpdateNONE
Parent TablePatient Dimension
Parent MultiplicityONE
Parent Referential Integrity: On DeleteNONE
Parent Referential Integrity: On InsertNONE
Parent Referential Integrity: On UpdateNONE

Primary Key Details

 Acute Claim Measures PK
Key AttributeProvider Dk
Key AttributePatient Dk
Key AttributeEncounter Dk
Key AttributeClaim Dk
Key AttributePractitioner Dk
Key AttributePoint Of Care Location Dk
Key AttributeCalendar Dk