Mqms patient safety among medicare beneficiaries
This presentation is the property of its rightful owner.
Sponsored Links
1 / 18

MQMS: Patient Safety Among Medicare Beneficiaries PowerPoint PPT Presentation


  • 46 Views
  • Uploaded on
  • Presentation posted in: General

MQMS: Patient Safety Among Medicare Beneficiaries. Arnold Chen, M.D., M.Sc. (MPR) David Hunt, M.D. (CMS) Sheila Roman, M.D., M.P.H. (CMS) Lein Han, Ph.D. (CMS) Neil Gittings, M.A. (CMS) June 2004. Study Objectives.

Download Presentation

MQMS: Patient Safety Among Medicare Beneficiaries

An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -

Presentation Transcript


Mqms patient safety among medicare beneficiaries

MQMS: Patient Safety Among Medicare Beneficiaries

Arnold Chen, M.D., M.Sc. (MPR)

David Hunt, M.D. (CMS)

Sheila Roman, M.D., M.P.H. (CMS)

Lein Han, Ph.D. (CMS)

Neil Gittings,M.A. (CMS)

June 2004


Study objectives

Study Objectives

  • Describe rates of potentially preventable adverse events among hospitalized Medicare beneficiaries

    • Nationally

    • Within specific subgroups

  • Disaggregate selected complications

    • Explore internal validity

    • Targeting specific complications

  • Different ways of describing the relative importance of adverse events


Methods

Methods

  • Medicare hospital claims data: Fee-for-service beneficiaries 2000 and 2001

  • Adapt AHRQ Patient Safety Indicators for Medicare beneficiaries

    • Review of PSIs by CMS Workgroup: Select 12 measures

    • Specify measures for disaggregation

  • Excess LOS, charges, mortality attributable to PSIs: Zhan et al. 2003

    • Adapt to Medicare: convert to relative ratios


National rates of patient safety events per 1 000 discharges

National Rates of Patient Safety Eventsper 1,000 Discharges


Event rates vary with age

Event Rates Vary with Age


Rates vary with race

Rates Vary with Race


Rates vary with dual eligibility

Rates Vary with Dual Eligibility


Rates vary with reason for medicare eligibility

Rates Vary with Reason for Medicare Eligibility


Disaggregating postoperative septicemia specific diagnoses

Disaggregating Postoperative Septicemia: Specific Diagnoses


Postoperative septicemia specific procedures

Postoperative Septicemia: Specific Procedures


Postop septicemia rates per 1 000 by drg

Postop Septicemia: Rates per 1,000 by DRG

DRG


Postop hemorrhage or hematoma rates per 1 000 by drg

Postop Hemorrhage or Hematoma: Rates per 1,000 by DRG

DRG


Absolute numbers of events

Absolute Numbers of Events


Relative ratios for excess los and mortality

Relative Ratios for Excess LOS and Mortality

Zhan et al. JAMA, 2003; 290: 1868-1874


Conclusions

Conclusions

  • Decubitus ulcers, postoperative septicemia, postoperative respiratory failure

    • Occur commonly

    • Affect large numbers of people

  • Disparities in rates of patient safety events by age, dual eligibility, black ethnicity, and ESRD


Conclusions cont

Conclusions (cont.)

  • Exploration by disaggregation and by DRGs:

    • Mixed support for internal validity

    • DRGs may provide another way to target efforts


Policy implications

Policy Implications

  • MQMS PSIs: inexpensive, powerful means of tracking safety for Medicare beneficiaries in FFS program

  • Results suggest focusing attention on:

    • Decubitus ulcers, postoperative septicemia, and postoperative respiratory failure

    • Elderly, dually eligible, black, and ESRD beneficiaries


Policy implications cont

Policy Implications (cont.)

  • Potential considerations for targeting interventions

    • Rates

    • Absolute numbers

    • Impacts on LOS, (charges), mortality

  • Importance of surgical infections--Postoperative Sepsis, and Selected Infections

    • CMS-QIO Surgical Infection Project


  • Login