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 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 ©2006 All rights reserved.

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 ©2006 All rights reserved.

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 ©2006 All rights reserved.

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 ©2006 All rights reserved.

Infection Rate Ratio of all infections to the number of discharges including deaths ©2006 All rights reserved.

Infection Rate Formula Total number of infections x 100/ Total number of discharges (including deaths) for the period ©2006 All rights reserved.

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 ©2006 All rights reserved.

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 ©2006 All rights reserved.

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 ©2006 All rights reserved.

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 ©2006 All rights reserved.

Postoperative Infection Rate Formula Number of infections in clean surgical cases for a period x 100/Number of surgical operations for the period ©2006 All rights reserved.

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 ©2006 All rights reserved.

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 ©2006 All rights reserved.

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 ©2006 All rights reserved.

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) ©2006 All rights reserved.

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 ©2006 All rights reserved.

Consultation Rate Formula Total number of patients receiving a consultation x 100/Total number of patients discharged ©2006 All rights reserved.

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 ©2006 All rights reserved.

Other Rates Formula Number of times something occurred x 100/Number of times something could have occurred ©2006 All rights reserved.