Calculating & Reporting Healthcare Statistics Second Edition Chapter 8 Morbidity and Other...

Calculating & Reporting Healthcare Statistics

Second Edition

Chapter 8Morbidity and Other Miscellaneous Rates

©2006 All rights reserved.

Infections

• Morbidity– State of being diseased or the number of sick persons

or cases of disease in relation to a specific population– May be infectious or have other causes

• For example, the presence of concomitant (taking place at the same time) chronic (of long duration) conditions may constitute comorbidity

• Moreover, morbidity may be – preexisting (prior to admission to the hospital) or

– iatrogenic, or occurring because of the patient’s treatment


Infections

• Nosocomial Infections– Acquired in the hospital

• Can be attributable to– Specific patient care units (PCUs)– Specific operations– Patients with specified disease– Medical staff units– Individual physicians– Hospital employees


Infections

• Nosocomial Infection Rate Formula– Total number of nosocomial infections for a

period X 100 / Total number of discharges, including deaths, for the same period


Infection Rate

• May be calculated separately for specific infections such as – Surgical wound infections– Puerperal infections, which occur immediately after childbirth– Infections of the respiratory tract, urinary tract, bloodstream, and

so on– Complications that may results from an infection– Other types of complications that require special attention by

medical staff and administration include• Wound disruptions• Decubitus ulcers• Postoperative hemorrhages• Adverse drug reactions


Infection Rate

• Ratio of all infections to the number of discharges including deaths


Infection Rate

• Formula– Total number of infections x 100/ Total

number of discharges (including deaths) for the period


Postoperative Infections

• May be difficult to determine as it is not always evident if the patient entered the hospital with an infection or acquired one because of the surgical techniques used– The medical staff should provided guidance to

the HIM practitioner and the infection control committee on what constitutes a clean surgical case and which infection should be considered a postoperative infection



• Two terms need to be considered – A surgical procedure

• Any single, separate, systematic process upon or within the body that can be complete in itself

– Normally is performed by a physician, dentist, or other licensed practitioner

– Can be performed with or without instruments– Performed to restore disunited or deficient parts, remove

diseased or injured tissues, extract foreign matter, assist in obstetrical delivery, or aid in diagnosis



• A surgical operation– One or more surgical procedures performed

at one time for one patient via a common approach or for a common purpose


Postoperative Infection Rate

• Ratio of all infections in clean surgical cases to the number of surgical operations– Clean surgical case is one in which no

infection existed prior to surgery


Postoperative Infection Rate

• Formula– Number of infections in clean surgical cases

for a period x 100/Number of surgical operations for the period


Cesarean Section

• Most hospitals determine the percentage of deliveries that are performed by Cesarean Section (commonly called C-section) as compared to spontaneous or vaginal deliveries

• There has been much attention given to high C-section rates by specific physicians, hospitals and areas of the country because of concerns about adverse effects to the mother and child

• Additionally, it may be necessary to report C-section rates to accrediting agencies or the AMA for such reasons as residency programs


Cesarean Section

• Delivery– The process of delivering a liveborn infant or

dead fetus (and placenta) by manual, instrumental, or surgical means

• A pregnant mother who delivers has one delivery, however, she may have multiple births

– For example, a woman who delivers a liveborn infant is counted as one delivery and one live birth

– A woman who delivers liveborn twins is counted as one delivery and two live births

– A woman who delivers a stillbirth is counted as one delivery and one fetal death


Cesarean Section

• Delivery– A woman may be admitted to the hospital for

a condition of her pregnancy, however, she may not deliver her infant during that hospitalization

• For example, a patient who is admitted in labor but later discovered that this is an instance of false labor would be classified as an obstetrics patient, not delivered


Cesarean Section Rate

• Formula–Total number of C-sections performed in

a period x 100.

Total number of deliveries in the period (including C-sections)


Consultations

• The response by one healthcare professional to another healthcare professional’s request to provide recommendations and/or opinions regarding the care of a particular patient/resident– A patient’s attending physician may occasionally

request a consultant (another physician or health care practitioner) to examine a patient and give an opinion as to his/her condition

– A consultant will should also review the medical record and then prepare a consultation report that includes the findings of the examination and recommendations for treating the patient


Consultation Rate

– Formula• Total number of patients receiving a

consultation x 100/Total number of patients discharged


Other Rates

• These are reported according to individual healthcare facility needs

• May be reported for external agencies

• The best rule of thumb is to use the “other rates” formula


Other Rates

• Formula– Number of times something occurred x

100/Number of times something could have occurred

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