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

2. 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
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3. 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
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4. 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
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5. 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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6. Infection Rate
Ratio of all infections to the number of discharges including deaths
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7. Infection Rate Formula
Total number of infections x 100/ Total number of discharges (including deaths) for the period
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8. 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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9. 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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10. 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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11. 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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12. 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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13. 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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14. 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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15. 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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16. 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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17. 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
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18. Consultation Rate Formula
Total number of patients receiving a consultation x 100/Total number of patients discharged
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19. 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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20. Other Rates
Formula
Number of times something occurred x 100/Number of times something could have occurred
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