| Dimensional Warehouse Model Data Model |
Description | The 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. |
Primary Key | |
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Dependencies | |
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Reverse Dependencies | |
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Attribute Details |
Description | A numeric surrogate key used to uniquely identify entities in the dimensional model. |
Data Type | Standards - Data Domains.ddm/Data Domains/Surrogate Key Large [LONG] |
Is Part Of PrimaryKey | true |
Is Required | true |
Is Derived | false |
Is Surrogate Key | false |
Description | A numeric surrogate key used to uniquely identify entities in the dimensional model. |
Data Type | Standards - Data Domains.ddm/Data Domains/Surrogate Key Large [LONG] |
Is Part Of PrimaryKey | true |
Is Required | true |
Is Derived | false |
Is Surrogate Key | false |
Description | A numeric surrogate key used to uniquely identify entities in the dimensional model. |
Data Type | Standards - Data Domains.ddm/Data Domains/Surrogate Key Large [LONG] |
Is Part Of PrimaryKey | true |
Is Required | true |
Is Derived | false |
Is Surrogate Key | false |
Description | The 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 Type | Standards - Data Domains.ddm/Data Domains/Rate [FLOAT(5)] |
Is Part Of PrimaryKey | false |
Is Required | false |
Is Derived | false |
Is Surrogate Key | false |
Description | Hospital 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 Type | Standards - Data Domains.ddm/Data Domains/Rate [FLOAT(5)] |
Is Part Of PrimaryKey | false |
Is Required | false |
Is Derived | false |
Is Surrogate Key | false |
Description | Hospital 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 Type | Standards - Data Domains.ddm/Data Domains/Rate [FLOAT(5)] |
Is Part Of PrimaryKey | false |
Is Required | false |
Is Derived | false |
Is Surrogate Key | false |
Description | Calculates 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 Type | Standards - Data Domains.ddm/Data Domains/Rate [FLOAT(5)] |
Is Part Of PrimaryKey | false |
Is Required | false |
Is Derived | false |
Is Surrogate Key | false |
Description | Calculates 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 Type | Standards - Data Domains.ddm/Data Domains/Rate [FLOAT(5)] |
Is Part Of PrimaryKey | false |
Is Required | false |
Is Derived | false |
Is Surrogate Key | false |
Description | Calculates 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 Type | Standards - Data Domains.ddm/Data Domains/Rate [FLOAT(5)] |
Is Part Of PrimaryKey | false |
Is Required | false |
Is Derived | false |
Is Surrogate Key | false |
Description | Calculates 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 Type | Standards - Data Domains.ddm/Data Domains/Rate [FLOAT(5)] |
Is Part Of PrimaryKey | false |
Is Required | false |
Is Derived | false |
Is Surrogate Key | false |
Description | Calculates the percentage of Emergency Department (ED) visits for headache with a coincident brain computed tomography (CT) study for Medicare beneficiaries. |
Data Type | Standards - Data Domains.ddm/Data Domains/Rate [FLOAT(5)] |
Is Part Of PrimaryKey | false |
Is Required | false |
Is Derived | false |
Is Surrogate Key | false |
Description | Calculates 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 Type | Standards - Data Domains.ddm/Data Domains/Rate [FLOAT(5)] |
Is Part Of PrimaryKey | false |
Is Required | false |
Is Derived | true |
Is Surrogate Key | false |
Description | Calculates 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 Type | Standards - Data Domains.ddm/Data Domains/Rate [FLOAT(5)] |
Is Part Of PrimaryKey | false |
Is Required | false |
Is Derived | false |
Is Surrogate Key | false |
Description | A numeric surrogate key used to uniquely identify entities in the dimensional model. |
Data Type | Standards - Data Domains.ddm/Data Domains/Surrogate Key Large [LONG] |
Is Part Of PrimaryKey | true |
Is Required | true |
Is Derived | false |
Is Surrogate Key | false |
Description | A numeric surrogate key used to uniquely identify entities in the dimensional model. |
Data Type | Standards - Data Domains.ddm/Data Domains/Surrogate Key Large [LONG] |
Is Part Of PrimaryKey | true |
Is Required | true |
Is Derived | false |
Is Surrogate Key | false |
Description | A numeric surrogate key used to uniquely identify entities in the dimensional model. |
Data Type | Standards - Data Domains.ddm/Data Domains/Surrogate Key Large [LONG] |
Is Part Of PrimaryKey | true |
Is Required | true |
Is Derived | false |
Is Surrogate Key | false |
Description | A numeric surrogate key used to uniquely identify entities in the dimensional model. |
Data Type | Standards - Data Domains.ddm/Data Domains/Surrogate Key Large [LONG] |
Is Part Of PrimaryKey | true |
Is Required | true |
Is Derived | false |
Is Surrogate Key | false |
Description | Hospital, 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 Type | Standards - Data Domains.ddm/Data Domains/Rate [FLOAT(5)] |
Is Part Of PrimaryKey | false |
Is Required | false |
Is Derived | false |
Is Surrogate Key | false |
Description | Hospital 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 Type | Standards - Data Domains.ddm/Data Domains/Rate [FLOAT(5)] |
Is Part Of PrimaryKey | false |
Is Required | false |
Is Derived | false |
Is Surrogate Key | false |
Description | Hospital 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 Type | Standards - Data Domains.ddm/Data Domains/Rate [FLOAT(5)] |
Is Part Of PrimaryKey | false |
Is Required | false |
Is Derived | false |
Is Surrogate Key | false |
Relationship Details |
Is Identifying Relationship | true |
Child Table | Acute Claim Measures |
Child Multiplicity | ZERO_TO_MANY |
Child Referential Integrity: On Delete | NONE |
Child Referential Integrity: On Insert | NONE |
Child Referential Integrity: On Update | NONE |
Parent Table | Encounter Dimension |
Parent Multiplicity | ONE |
Parent Referential Integrity: On Delete | NONE |
Parent Referential Integrity: On Insert | NONE |
Parent Referential Integrity: On Update | NONE |
Is Identifying Relationship | true |
Child Table | Acute Claim Measures |
Child Multiplicity | ZERO_TO_MANY |
Child Referential Integrity: On Delete | NONE |
Child Referential Integrity: On Insert | NONE |
Child Referential Integrity: On Update | NONE |
Parent Table | Calendar Dimension |
Parent Multiplicity | ONE |
Parent Referential Integrity: On Delete | NONE |
Parent Referential Integrity: On Insert | NONE |
Parent Referential Integrity: On Update | NONE |
Is Identifying Relationship | true |
Child Table | Acute Claim Measures |
Child Multiplicity | ZERO_TO_MANY |
Child Referential Integrity: On Delete | NONE |
Child Referential Integrity: On Insert | NONE |
Child Referential Integrity: On Update | NONE |
Parent Table | Claim Dimension |
Parent Multiplicity | ONE |
Parent Referential Integrity: On Delete | NONE |
Parent Referential Integrity: On Insert | NONE |
Parent Referential Integrity: On Update | NONE |
Is Identifying Relationship | true |
Child Table | Acute Claim Measures |
Child Multiplicity | ZERO_TO_MANY |
Child Referential Integrity: On Delete | NONE |
Child Referential Integrity: On Insert | NONE |
Child Referential Integrity: On Update | NONE |
Parent Table | Point Of Care Location Dimension |
Parent Multiplicity | ONE |
Parent Referential Integrity: On Delete | NONE |
Parent Referential Integrity: On Insert | NONE |
Parent Referential Integrity: On Update | NONE |
Is Identifying Relationship | true |
Child Table | Acute Claim Measures |
Child Multiplicity | ZERO_TO_MANY |
Child Referential Integrity: On Delete | NONE |
Child Referential Integrity: On Insert | NONE |
Child Referential Integrity: On Update | NONE |
Parent Table | Provider Dimension |
Parent Multiplicity | ONE |
Parent Referential Integrity: On Delete | NONE |
Parent Referential Integrity: On Insert | NONE |
Parent Referential Integrity: On Update | NONE |
Is Identifying Relationship | true |
Child Table | Acute Claim Measures |
Child Multiplicity | ZERO_TO_MANY |
Child Referential Integrity: On Delete | NONE |
Child Referential Integrity: On Insert | NONE |
Child Referential Integrity: On Update | NONE |
Parent Table | Practitioner Dimension |
Parent Multiplicity | ONE |
Parent Referential Integrity: On Delete | NONE |
Parent Referential Integrity: On Insert | NONE |
Parent Referential Integrity: On Update | NONE |
Is Identifying Relationship | true |
Child Table | Acute Claim Measures |
Child Multiplicity | ZERO_TO_MANY |
Child Referential Integrity: On Delete | NONE |
Child Referential Integrity: On Insert | NONE |
Child Referential Integrity: On Update | NONE |
Parent Table | Patient Dimension |
Parent Multiplicity | ONE |
Parent Referential Integrity: On Delete | NONE |
Parent Referential Integrity: On Insert | NONE |
Parent Referential Integrity: On Update | NONE |
Primary Key Details |
Key Attribute | Provider Dk |
Key Attribute | Patient Dk |
Key Attribute | Encounter Dk |
Key Attribute | Claim Dk |
Key Attribute | Practitioner Dk |
Key Attribute | Point Of Care Location Dk |
Key Attribute | Calendar Dk |
| Dimensional Warehouse Model Data Model |