Facility-level risk-standardised rate of acute, unplanned hospital visits within 7 days of an outpatient surgical procedure performed at a Rural Emergency Hospital among Medicare Fee-For-Service (FFS) patients aged 65 years and older. An unplanned hospital visit is defined as an emergency department (ED) visit, observation stay, or unplanned inpatient admission.

The outcome is all-cause, unplanned hospital visits, defined as 1) an inpatient admission directly after the surgery or 2) an unplanned hospital visit post discharge (emergency department [ED] visit, observation stay, or unplanned inpatient admission) occurring after discharge and within 7 days of the outpatient surgical procedure performed at a Rural Emergency Hospital. If more than one unplanned hospital visit occurs, only the first hospital visit within the outcome time-frame is counted in the outcome.

Outpatient same-day surgeries performed at Rural Emergency Hospital for Medicare FFS patients aged 65 years and older.

Denominator Exclusions: 1. Surgeries performed at Rural Emergency Hospitals, for patients without continuous enrolment in Medicare FFS Parts A and B in the 7 days after the surgery. 2. Surgeries performed at Rural Emergency Hospitals, for patients who have an ED visit on the same day but billed on a separate claim unless the ED visit has a diagnosis indicative of a complication of care. 3. Surgeries performed at Rural Emergency Hospitals, that are billed on the same hospital claim as an emergency department (ED) visit and that occur on the same calendar day unless the ED visit has a diagnosis indicative of a complication of care. 4. Surgeries performed at Rural Emergency Hospitals, that are billed on the same hospital outpatient claim and that occur after the ED visit. 5. Surgeries performed at Rural Emergency Hospitals, that are billed on the same outpatient claim as an observation stay.

Age minus 65 (years above 65) Cancer (CC 8-14) Diabetes and DM Complications (CC 17-19, 122, 123) Disorders of Fluid/Electrolyte/Acid-Base (CC 24) Intestinal Obstruction/Perforation (CC 33) Inflammatory Bowel Disease (CC 35) Bone/Joint/Muscle Infections/Necrosis (CC 39) Haematological Disorders Including Coagulation Defects and Iron Deficiency (CC 46, 48, 49) Dementia or Senility (CC 51-53) Psychiatric Disorders (CC 57-63) Hemiplegia, Paraplegia, Paralysis, Functional Disability (CC 70, 71, 73, 74, 103-105, 189, 190) Other Significant CNS Disease (CC 77-80) Cardiorespiratory Arrest, Failure and Respiratory Dependence (CC 82-84) Congestive Heart Failure (CC 85) Ischaemic Heart Disease (CC 86-89) Hypertension and Hypertensive Disorders (CC 94, 95) Arrhythmias (CC 96, 97) Vascular Disease (CC 106-109) Chronic Lung Disease (CC 111-113) UTI and Other Urinary Tract Disorders (CC 144, 145) Pelvic Inflammatory Disease and Other Specified Female Genital Disorders (CC 147) Chronic Ulcers (CC 157-161) Cellulitis, Local Skin Infection (CC 164) Prior Significant Fracture (CC 169-171) Morbid Obesity (CC 22) Work Relative Value Units Surgical Body System: Miscellaneous diagnostic and therapeutic procedures Cardiovascular Digestive Ear Endocrine Female Genitalia Hemic-Lymphatic Skin & Breast Male Genitalia Musculoskeletal Nervous Nose-Throat-Pharynx Respiratory Urinary.

Stratified by dual eligibility by The Within-Facility Disparity Method and The Across-Facility Disparity Method, reported confidentially to hospitals.

Claims Data Administrative Data.

Unclear but part of Cost and Efficiency Fall 2023.

Risk-standardized hospital visits within 7 days after hospital outpatient surgery. Last updated 28.12.2023. Accessed 8.04.2024. cmit.cms.gov/cmit/#/MeasureView?variantId=12917&sectionNumber=1

Targets population 65+

cmit.cms.gov/cmit/#/MeasureView?variantId=12917&sectionNumber=3

Risk adjustment models:

p4qm.org/measures/2687