IT-2.29: Cellulitis Admission Rate

IT-2.29: Cellulitis Admission Rate

Measure Title / IT-2.29 Cellulitis Admission Rate /
Description / The rate of admissions due to cellulitis
NQF Number / Not applicable
Measure Steward / Measure modeled after Agency for Healthcare Research and Quality (AHRQ) Prevention Quality Indicators (PQI)
Link to measure citation / http://www.qualityindicators.ahrq.gov/Modules/PQI_TechSpec.aspx
Measure type / Standalone (SA)
Performance and Achievement Type / Pay-for-Reporting: Prior Authorization
DSRIP-specific modifications to Measure Steward’s specification / Modeled after AHRQ PQI measures to measure hospitalizations due to cellulitis conditions or complications
Denominator Description / Population ages 18 years and older in metropolitan area[1] or county.
Denominator Inclusions / Discharges in the numerator are assigned to the denominator based on the metropolitan area or county of the patient residence, not the metropolitan area or county of the hospital where the discharge occurred.
Denominator Exclusions / None
Denominator Size / Providers must report a minimum of 30 cases per measure during a 12-month measurement period (15 cases for a 6-month measurement period)
·  For a measurement period (either 6 or 12 months) where the denominator size is less than or equal to 75, providers must report on all cases. No sampling is allowed.
·  For a measurement period (either 6 or 12 months) where the denominator size is less than or equal to 380 but greater than 75, providers must report on all cases (preferred, particularly for providers using an electronic health record) or a random sample of not less than 76 cases.
·  For a measurement period (either 6 or 12-months) where the denominator size is greater than 380, providers must report on all cases (preferred, particularly for providers using an electronic health record) or a random sample of cases that is not less than 20% of all cases; however, providers may cap the total sample size at 300 cases.
Numerator Description / All discharges of age 18 years or older with a principle diagnosis code for cellulitis
Numerator Inclusions / All discharges of age 18 years or older with a principle diagnosis code for cellulitis
Numerator Exclusions / • Transfer from a hospital (different facility), Skilled Nursing Facility (SNF) or Intermediate Care Facility (ICF), or another health care facility
• Missing gender, age, quarter, year, principal diagnosis, or county
Setting / Inpatient
Data Source / Administrative Claims, Clinical Data, Electronic Health Records
Allowable Denominator Sub-sets / All denominator subsets are permissible for this outcome

09/24/14

[1] The term “metropolitan area” (MA) was adopted by the U.S. Census in 1990 and referred collectively to metropolitan statistical areas (MSAs), consolidated metropolitan statistical areas (CMSAs) and primary metropolitan statistical areas (PMSAs). In addition, “area” could refer to either 1) FIPS county, 2) modified FIPS county, 3) 1999 OMB Metropolitan Statistical Area or 4) 2003 OMB Metropolitan Statistical Area. Micropolitan Statistical Areas are not used in the QI software.