Risk-Standardised Hospital Visits Within 7 Days After Hospital Outpatient Surgery
Identifying Attributes
Care Settings
Country
Publishing Organisation
Type of Quality Indicator
IOM Quality Dimension
Domain
Defining Attributes
Definition
Facility-level, post-surgical risk-standardised hospital visit ratio of the predicted to expected number of all-cause, unplanned hospital visits within 7 days of a same-day surgery at a hospital outpatient department among Medicare fee-for-service patients aged 65 years and older.
Numerator
All-cause, unplanned hospital visits occurring after discharge from the hospital outpatient department and within 7 days of the outpatient surgery.
Denominator
Eligible same-day surgeries or cystoscopy procedures with intervention performed at hospital outpatient departments for Medicare fee-for-service patients aged 65 years and older.
Exclusions
Surgeries for patients without continuous enrolment in Medicare fee-for-service Parts A and B in the 7 days after the surgery; Surgeries for patients who have an Emergency Department visit on the same day but billed on a separate claim, unless the Emergency Department visit has a diagnosis indicative of a complication of care; Surgeries that are billed on the same hospital claim as an Emergency Department visit and that occur on the same calendar day, unless the Emergency Department visit has a diagnosis indicative of a complication of care; Surgeries that are billed on the same hospital outpatient claim and that occur after the Emergency Department visit; Surgeries that are billed on the same outpatient claim as an observation stay; eye surgeries and same day surgeries performed concurrently with high-risk procedures.
Use of Risk Adjustment
Risk Adjustments
The risk-adjustment model has 25 patient-level variables, including age, clinical comorbidities, and indicators of surgical complexity. Adjusts for surgical procedural complexity using the Work Relative Value Unit of the procedure; and it classifies each surgery into an anatomical body system group using the Agency for Healthcare Research and Quality Clinical Classification System.
Stratifications
Data Attributes
Type of Data Collection
Data Collection Methods
Medicare administrative claims and enrolment data.
Frequency of Data Collection
Frequency of Data Collection in Days
Reporting Methods
Hospital Outpatient Quality Reporting (CMS and Providers) CMS Care Compare - Hospitals and Provider compare (Publicly reported) Contributes to Overall Hospital Quality Star Rating.