ICU Outcomes Comparison — Peer

The intention of this analysis is to provide members with benchmark information related to ICU metrics and ICU patients, to gain a better understanding of ICU LOS, Returns to the ICU, and ICU Mortality (both patients that died in the ICU, and patients that died after being in the ICU). You can use the analysis to identify opportunities for improvement relative to peer performance.

Note: A billing file is required to be submitted for data to return on this report.

Please see ICU Risk Adjustment for additional details.

Notes

  • All results listed for Cases in the "Show Items" actually reflect Total ICU Cases, not overall cases

  • There is no Population Count button because this report is based on a subset of the total inpatient population and totals would not line up

  • As with other analyses, there is a 50,000 Row Limit. If a report returns more than 50,000 rows, an error message is displayed. You will then need to adjust your report criteria

Select Population Tab:

There are 4 required prompts that you must select before running this analysis.

Required Prompts:

  • Facilities
  • Time (1 year is selected by default)
  • Inpatient/Outpatient (Inpatient is selected by default)
  • Peer (You must choose at least five facilities in order for peer data to appear on the analysis)

Optional Prompts:

  • Diagnoses (ICD-10)
  • Procedures (ICD-10)
  • Inlier/Outlier
  • Patient Types
  • Patient Demographics
  • Patient Origination
  • Patient
  • Practitioners
  • Patient Visits
  • Resources
  • Facility Payers
  • Standard Primary Payers
  • Standard Secondary Payers
  • Patient Qualifications

Set Up Analysis Tab:

There is 1 required prompt that you must select before running this analysis.

Required Prompt

  • Row Header (MS-DRG Family is selected by default. However, you can select any attribute you want. Only one selection is allowed)

    Note: All results listed for Cases in the "Show Items" actually reflect Total ICU Cases, not overall cases

Optional Prompts:

  • Column Groupings (Only one selection is allowed)

Report Structure

The report includes a combination of grid and graph visualizations across three tabs:

Top 10- ICU Comparison Tab

  • Includes a section that returns the Top 10 MS-DRG Family by volume (based on total ICU cases calculated at the episode level) that resulted in an ICU stay

Top 10 MS-DRG Family Within ICU Comparison (based on total ICU cases) Example:

  • Includes a separate section that returns the Top 10 MS-DRG Family that is looking at your ICU patients full hospital stay. These metrics are calculated at the patient level

Top 10 MS-DRG Family Total Patient Stay Example:

  • Includes graphs for the "Top 10 MS-DRG Families"

1st graph is an Outcome Comparison

2nd graph is an age by race breakout for the patients that died in the ICU with a supplemental grid that includes the facility denominator, observed, and O/E values and peer O/E

Analytics View-Within ICU Tab

  • Includes all MS-DRG Family and all ICU outcome metrics for the "Within ICU Comparison" grid

  • This view is calculated at the episode level

  • Includes full drill maps from the grid row header

Analytics View-Total Patient Stay Tab

  • Includes all MS-DRG Family and all ICU outcome metrics for the "Total Patient Stay (ICU Patients)" grid

  • This view is calculated at the patient level

  • Includes full drill maps from the grid row header

Default Metrics - Peer

MS-DRG (ICD-10) are sorted by the highest "Total ICU Cases" in descending order on the report. The metric list below is sorted alphabetically and does not match the order of display on the report.

  • Facility Geometric LOS in Hospital (ICU Patients) Expected

  • Facility Geometric LOS in Hospital (ICU Patients) O/E

  • Facility Geometric LOS in Hospital (ICU Patients) Observed

  • Facility Geometric LOS in Hospital (ICU Patients) Opportunity

  • Facility Geometric LOS in Hospital (ICU Patients) Statistical Significance

  • Facility Geometric LOS in Hospital (ICU Patients) Variation

  • Facility Geometric LOS in ICU (per episode) Expected

  • Facility Geometric LOS in ICU (per episode) Observed

  • Facility Geometric LOS in ICU (per episode) O/E

  • Facility Geometric LOS in ICU (per episode) Opportunity

  • Facility Geometric LOS in ICU (per episode) Statistical Significance

  • Facility Geometric LOS in ICU (per episode) Variation

  • Facility Geometric LOS while in ICU Observed

  • Facility Hospitalization Mortality (ICU Patients) Expected

  • Facility Hospitalization Mortality (ICU Patients) O/E

  • Facility Hospitalization Mortality (ICU Patients) Observed

  • Facility Hospitalization Mortality (ICU Patients) Opportunity

  • Facility Hospitalization Mortality (ICU Patients) Statistical Significance

  • Facility Hospitalization Mortality (ICU Patients) Variation

  • Facility ICU Patient Ventilator Days Expected

  • Facility ICU Patient Ventilator Days O/E

  • Facility ICU Patient Ventilator Days Observed

  • Facility ICU Patient Ventilator Days Opportunity

  • Facility ICU Patient Ventilator Days Statistical Significance

  • Facility ICU Patient Ventilator Days Variation

  • Facility Mortality in ICU (Den)

  • Facility Mortality in ICU Expected

  • Facility Mortality in ICU O/E

  • Facility Mortality in ICU Observed

  • Facility Mortality in ICU Opportunity

  • Facility Mortality in ICU Statistical Significance

  • Facility Mortality in ICU Variation

  • Facility Returns to ICU (Den)

  • Facility Returns to ICU During Hospitalization Expected

  • Facility Returns to ICU During Hospitalization O/E

  • Facility Returns to ICU During Hospitalization Observed

  • Facility Returns to ICU During Hospitalization Opportunity

  • Facility Returns to ICU During Hospitalization Statistical Significance

  • Facility Returns to ICU During Hospitalization Variation

  • Facility Returns to ICU within 48 Hrs. Expected

  • Facility Returns to ICU within 48 Hrs. O/E

  • Facility Returns to ICU within 48 Hrs. Observed

  • Facility Returns to ICU within 48 Hrs. Opportunity

  • Facility Returns to ICU within 48 Hrs. Statistical Significance

  • Facility Returns to ICU within 48 Hrs. Variation

  • Facility Total ICU Cases

  • Facility Total ICU Episodes

  • Facility Total Mortalities in ICU

  • Facility Total Outcome Cases Directly Admitted to ICU

  • Facility Total Returns to ICU during Hospitalization

  • Facility Total Returns to ICU within 48 Hrs

  • Facility Total Ventilator (Den)

  • Peer Geometric LOS in Hospital (ICU Patients) Expected

  • Peer Geometric LOS in Hospital (ICU Patients) O/E

  • Peer Geometric LOS in Hospital (ICU Patients) Observed

  • Peer Geometric LOS in Hospital (ICU Patients) Statistical Significance

  • Peer Geometric LOS in Hospital (ICU Patients) Variation

  • Peer Geometric LOS in ICU Expected

  • Peer Geometric LOS in ICU Observed

  • Peer Geometric LOS in ICU O/E

  • Peer Geometric LOS in ICU Statistical Significance

  • Peer Geometric LOS in ICU Variation

  • Peer Geometric LOS while in ICU Observed

  • Peer Hospitalization Mortality (ICU Patients) Expected

  • Peer Hospitalization Mortality (ICU Patients) O/E

  • Peer Hospitalization Mortality (ICU Patients) Observed

  • Peer Hospitalization Mortality (ICU Patients) Statistical Significance

  • Peer Hospitalization Mortality (ICU Patients) Variation

  • Peer ICU Patient Ventilator Days Expected

  • Peer ICU Patient Ventilator Days O/E

  • Peer ICU Patient Ventilator Days Observed

  • Peer ICU Patient Ventilator Days Statistical Significance

  • Peer ICU Patient Ventilator Days Variation

  • Peer Mortality in ICU (Den)

  • Peer Mortality in ICU Expected

  • Peer Mortality in ICU O/E

  • Peer Mortality in ICU Observed

  • Peer Mortality in ICU Statistical Significance

  • Peer Mortality in ICU Variation

  • Peer Returns to ICU (Den)

  • Peer Returns to ICU During Hospitalization Expected

  • Peer Returns to ICU During Hospitalization O/E

  • Peer Returns to ICU During Hospitalization Observed

  • Peer Returns to ICU During Hospitalization Statistical Significance

  • Peer Returns to ICU During Hospitalization Variation

  • Peer Returns to ICU within 48 Hrs. Expected

  • Peer Returns to ICU within 48 Hrs. O/E

  • Peer Returns to ICU within 48 Hrs. Observed

  • Peer Returns to ICU within 48 Hrs. Statistical Significance

  • Peer Returns to ICU within 48 Hrs. Variation

  • Peer Total ICU Cases

  • Peer Total ICU Episodes

  • Peer Total Mortalities in ICU

  • Peer Total Outcome Cases Directly Admitted to ICU

  • Peer Total Returns to ICU during Hospitalization

  • Peer Total Returns to ICU within 48 Hrs

  • Peer Total Ventilator (Den)

Frequently Asked Questions

LOS in ICU is counted for each ICU stay separately. In the following example, the patient had two ICU episodes. The first episode had LOS in ICU as 3 days and the second as 2 days. In the encounter-based report, this patient’s total LOS in ICU is counted as 5 days.

 

Day count is calculated by ICU Room and Board by billing dates, and exact hours of day is unknown. Therefore, this metric is dependent on billing practice.

For example, in a case where a patient was admitted in ICU on 01/01 and transferred to another site of care in the sample hospital on 01/02, LOS in ICU would be counted as 1 day if ICU Room and Board was only billed only on 01/01. However, LOS in ICU would be counted as 2 days if ICU Room and Board was billed on both 01/01 and 01/02.

 

To be included in the ventilator days report, a patient’s record needs to have at least one ICU R&B charge, one mechanical ventilation charge, one ICD procedure code indicating mechanical ventilation. However, our calculation does not check the alignment of the date stamp of these three conditions. We recognized that these date stamps may not always be aligned due to imperfect data.

 

Bar Graphs

There are two columns of bar graphs.

  • The first column includes the Within ICU Stay- Top 10 MS-DRG Family Outcome Comparison graphs

  • The second column includes the Mortality in ICU- Top 10 MS-DRG Family Standard Age by Race graphs

Within ICU Stay- Top 10 MS-DRG Outcome Comparison

  • Shows the outcomes per MS-DRG Family for the Top 10 based on total ICU cases (facility and peer)

  • X-axis- O/E for each of the below "Within ICU Comparison" Outcomes"

  • Y-axis- "Within ICU Comparison" Outcomes

    • Mortality in ICU

    • Returns to ICU During Hospitalization

    • Returns to ICU within 48 Hrs.

    • ICU Patient Ventilator Days

Sample Graph

Mortality in ICU- Top 10 MS-DRG Family Standard Age by Race

  • The health equity view for the outcome and age by race grouping

  • Peer Grid

    • Row headers: Standard Age Grouping, Race

    • Columns: Facility Mortality in ICU (Den), Facility Mortality in ICU Observed, Facility Mortality in ICU O/E, Peer Mortality in ICU O/E

  • Peer Graph

    • This graph will be a mix of bar and line charts

    • The bar will represent the facility O/E

    • The line will represent the peer O/E

    • X-axis- Standard Age Groupings by all Race

    • Groupings:

    • Standard Age: 18 years through 64 years, 65 years through 74 years, 75 years and older

    • Race- all applicable race values

    • Y-axis- Mortality in ICU O/E

Sample Graph