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

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Calculating & Reporting Healthcare Statistics

Second Edition

Chapter 8

Morbidity and Other Miscellaneous Rates

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  • 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

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  • 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

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  • Nosocomial Infection Rate Formula

    • Total number of nosocomial infections for a period X 100 / Total number of discharges, including deaths, for the same period

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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

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Infection Rate

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

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Infection Rate

  • Formula

    • Total number of infections x 100/ Total number of discharges (including deaths) for the period

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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

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Postoperative Infections

  • 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

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Postoperative Infections

  • A surgical operation

    • One or more surgical procedures performed at one time for one patient via a common approach or for a common purpose

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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

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Postoperative Infection Rate

  • Formula

    • Number of infections in clean surgical cases for a period x 100/Number of surgical operations for the period

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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

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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

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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

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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)

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  • 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

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Consultation Rate

  • Formula

    • Total number of patients receiving a consultation x 100/Total number of patients discharged

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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

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Other Rates

  • Formula

    • Number of times something occurred x 100/Number of times something could have occurred

©2006 All rights reserved.