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Description of IQIs used in the Hospital Performance Report

Acute Myocardial Infarction (AMI): According to the American Heart Association, if a heart attack victim gets to an emergency room fast enough, prompt care dramatically reduces heart damage. Timely and effective treatments for acute myocardial infarction
(AMI), which are essential for patient survival, include appropriate use of revascularization or thrombolytic therapy. The indicator is defined as the number of deaths per 100 patients with a principal diagnosis code (ICD-9-CM) of AMI (age 18 years and older). The following cases are excluded from the denominator: transferring to another short-term hospital (DISP=2); MDC 14 (pregnancy, childbirth, and puerperium); and cases with missing discharge disposition (DISP=missing), gender (SEX=missing), age (AGE=missing), quarter (DQTR=missing), year (YEAR=missing) or principal diagnosis (DX1=missing).

Congestive Heart Failure (CHF): CHF is one of the most common and severe heart diseases affecting Americans, and one of the most common reasons for hospitalization. Congestion is the presence of an abnormal amount of fluid in the tissues, usually
because of limitations in the body's ability to return the flow of blood from the arms or legs to the heart and lungs. Though CHF has many possible underlying causes, the end result is an inability of the heart muscle to function well enough to meet the demands of
the rest of the body. CHF mortality is influenced greatly by other medical problems, including lung disease, high blood pressure, cancer and liver disease. The mortality rate for this measure is defined as the number of deaths per 100 patients with principal (ICD-9-CM) diagnosis code of CHF (age 18 years and older). Transfer cases (DISP=2); MDC 14 (pregnancy, childbirth, and puerperium); and cases with missing information on discharge disposition (DISP=missing), gender (SEX=missing), age (AGE=missing), quarter (DQTR=missing), year (YEAR=missing) or principal diagnosis (DX1=missing); are excluded from rate calculation.

Acute Stroke: A stroke is a disruption in the blood supply to the brain. A stroke occurs when a blood vessel bringing oxygen and nutrients to the brain bursts, or is clogged by a blood clot or some other particle. Treatment for stroke must be timely and efficient to prevent brain tissue death, and differs significantly based on which of the two types of stroke a patient has suffered. For example, clot-busting drugs are appropriate for strokes caused by clots, but could be fatal in the case of a burst blood vessel. Mortality rates will vary based on the cause of the stroke, the severity of the stroke, other patient illnesses, speed of arrival at the hospital, and speed of diagnosis of the type of stroke. Moreover, clinical factors, including use of mechanical ventilation on the first day, may
vary by hospital and influence mortality. The mortality rate for Acute Stroke is defined as the number of deaths per 100 patients with principal (ICD-9-CM) diagnosis code of stroke (age 18 years and older). The following cases are excluded from consideration
for this rate calculation: transferring to another short-term hospital (DISP=2); MDC 14 (pregnancy, childbirth, and puerperium); and cases with missing discharge disposition (DISP=missing), gender (SEX=missing), age (AGE=missing), quarter (DQTR=missing),
year (YEAR=missing) or principal diagnosis (DX1=missing).

Pneumonia: Pneumonia involves an infection in the lungs. Pneumonia typically is treated with antibiotics, sometimes in an outpatient setting. However, death may occur even when the patient is in the hospital, especially in patients with weakened respiratory systems or other chronic health problems. There is a significant impact on outcomes from patient co-morbid factors as well as physician admitting practices (since there is variation in the criteria physicians use to admit patients for inpatient treatment). Inhospital pneumonia mortality rate is defined as deaths per 100 discharges with principal (ICD-9-CM) diagnosis code of pneumonia (age 18 years and older). Transfer cases (DISP=2); MDC 14 (pregnancy, childbirth, and puerperium); and cases with missing
information on discharge disposition (DISP=missing), gender (SEX=missing), age (AGE=missing), quarter (DQTR=missing), year (YEAR=missing) or principal diagnosis (DX1=missing); are excluded from rate calculation.

Inpatient Quality Indicators

Inpatient Quality Indicators (IQIs) are a set of measures that provide a perspective on hospital quality of care using administrative discharge data. Quality of care is measured using: 1) in-hospital mortality for certain procedures and medical conditions; 2) utilization of procedures for which there are questions of overuse, underuse, or misuse; and 3) volume of procedures for which there is some evidence that a higher volume of procedures is associated with lower mortality.

The Hospital Performance Report includes background information on the Agency for Healthcare Research and Quality's (AHRQ) Quality Indicator (QI) tools, how they are used to compare hospital performance, guides on interpreting IQI estimates, and definitions of each inpatient quality indicator.

The Department of Health reports on the following IQIs, detailed at left:

  • Acute Myocardial Infarction (AMI)
  • Congestive Heart Failure
  • Pneumonia
  • Acute Stroke

View IQIs for All NJ Hospitals

Last Reviewed: 8/17/2016