Estimates days spent in acute care (i.e. time spent in emergency department, unplanned readmission and observation stays) within 30 days of discharge from an inpatient hospitalisation for pneumonia.

Count of the number of days the patient spends in acute care within 30 days of discharge from an eligible index pneumonia hospitalisation (i.e. days spent in an ED, admitted to an observation unit, or admitted as an unplanned readmission for any cause to a short-term acute care hospital).Each Emergency Department treat-and-release visit = 0.5 days. Observation stays are rounded up to the nearest half-day. Each readmission day is counted as one full day (1 day). Counts all eligible outcomes occurring in the 30-day period, even if they are repeat occurrences.

Admissions for patients that meet all of the following inclusion criteria: 1. Discharged from the hospital with diagnosis coding that meets one of the two following requirements: a. Principal discharge diagnosis of pneumonia; or b. (i). Principal discharge diagnosis of sepsis (that is not severe); and (ii). A secondary diagnosis of pneumonia coded as present on admission; and (iii). No secondary diagnosis of sepsis that is both severe and coded as present on admission 2. Aged 65 or over 3. Discharged alive 4. Not transferred to another acute care facility.

Index admissions that are: Pneumonia admissions within 30 days of discharge from a prior pneumonia index admission; Discharged against medical advice; principal diagnosis code of COVID-19 or with a secondary diagnosis code of COVID-19 coded as present on admission on the index admission claim.

Age, sex, comorbid diseases, and indicators of patient frailty to adjust for case-mix differences among hospitals based on the clinical status of the patient at the time of the index admission.

Medicare administrative claims and enrolment information.

Hospital Inpatient Quality Reporting Program (CMS and Providers) CMS Provider Compare and CMS Care Compare - Hospitals (Publicly reported) Contributes to Overall Hospital Star Quality Rating.

Wadhera RK, Joynt Maddox KE, Desai NR, Landon BE, Md MV, Gilstrap LG, Shen C, Yeh RW. Evaluation of Hospital Performance Using the Excess Days in Acute Care Measure in the Hospital Readmissions Reduction Program. Ann Intern Med. 2021 Jan;174(1):86-92. doi: 10.7326/M20-3486. Epub 2020 Oct 13. PMID: 33045180; PMCID: PMC8165741. cmit.cms.gov/cmit/#/MeasureView/?variantId=1996&sectionNumber=1 data.cms.gov/provider-data/topics/hospitals/measures-and-current-data-collection-periods data.cms.gov/provider-data/topics/hospitals/overall-hospital-quality-star-rating

www.cms.gov/medicare/quality/initiatives/hospital-quality-initiative/measure-methodology