How to Calculate PQI 07: Hypertension Admission Rate

The heart pumps blood into the arteries with enough force to push blood to the far reaches of each organ from the top of the head to the bottom of the feet. Blood pressure can be defined as the pressure of blood on the walls of the arteries as it circulates through the body. Blood pressure is highest as its leaves the heart through the aorta and gradually decreases as it enters smaller and smaller blood vessels (arteries, arterioles, and capillaries). Blood returns in the veins leading to the heart, aided by gravity and muscle contraction.

It is known as the "silent killer" since it has no initial symptoms but can lead to long-term disease and complications.. High Blood Pressure a.k.a. Hypertension can be controlled by outpatient means by either medication or lifestyle change. When someone is admitted to a hospital due to complications from hypertension, then preventative measures could have failed. However, the cause of failure is not represented here, and that can include both patient and provider based causes.

Prevention is an important role for all healthcare providers. Hypertension is a controllable condition using outpatient care and drug therapy. Prevention Quality Indicators (PQIs) are a set of measures that help identify quality of care for outpatient and other non-hospital care.

How to Calculate PQI 07 Hypertension Admission Rate?

PQI #5: How to Calculate COPD or Asthma in Older Adults Admission Rate

Chronic Obstructive Pulmonary Disease (COPD) is an umbrella term used to describe progressive lung diseases including emphysema, chronic bronchitis, refractory (non-reversible) asthma, and some forms of bronchiectasis. This disease is characterized by increasing breathlessness.

COPD affects an estimated 30 million individuals in the U.S., and over half of them have symptoms of COPD and do not know it. Early screening can identify COPD before major loss of lung function occurs.

Most cases of COPD are caused by inhaling pollutants; that includes smoking (cigarettes, pipes, cigars, etc.), and second-hand smoke.

Fumes, chemicals and dust found in many work environments are contributing factors for many individuals who develop COPD.

Genetics can also play a role in an individual’s development of COPD—even if the person has never smoked or has ever been exposed to strong lung irritants in the workplace.

How To Calculate Chronic Obstructive Pulmonary Disease (COPD) or Asthma in Older Adults Admission Rate

Know About CCS Or Clinical Classifications Software

Clinical Classifications Software (CCS) is another commonly used term in health care sector. CCS collapses diagnosis and procedure codes from the ICD-9 Codes, which contains more than 14,000 diagnosis codes and 3,900 procedure codes.

This can be employed in many types of projects analyzing data on diagnoses and procedures. CCS can be used to identify populations for disease- or procedure-specific studies or to develop statistical reports providing information about relatively specific conditions.

Developed at the Agency for Healthcare Research and Quality (AHRQ), the Clinical Classifications Software (CCS) makes

CCS classification systems:
1.    Single-level
2.    Multi-level
Single-level :  Single-level CCS is most useful for ranking of diagnoses and procedures and for direct integration into risk adjustment and other software. This Single-level CCS lassifies all diagnoses and procedures into unique groups, has a total of 285 mutually exclusive categories.
Multi-level: Multi-level CCS is most useful when evaluating larger aggregations of conditions and procedures or exploring them in greater detail. The multi-level CCS expands the single-level CCS into a hierarchical system. The multi-level CCS groups single-level CCS categories into broader body systems or condition categories. It also splits single-level CCS categories to provide more detail. The multi-level system has four levels for diagnoses and three levels for procedures, which provide the opportunity to examine general groupings or to assess very specific conditions and procedures.

Use of CCS:

CCS can be used with all clinical data that are coded using ICD-9-CM codes.
•    Managed care plans utilize CCS to rank hospitalizations by type of condition. Managed care plan used CCS to examine numbers of cases, length of stay, and total costs, to better understand which conditions and procedures were associated with the highest resource use.
•    Insurers use CCS to develop clinically-based utilization profiles.
•    Researchers use CCS to explore the types of conditions and procedures that are most frequent in their study populations or to compare alternative treatments for similar conditions.
•    Researchers also use CCS in risk adjustment models and as a way to predict future health resource utilization.

it easier to quickly understand patterns of diagnoses and procedures so that health plans, policy makers, and researchers can analyze costs, utilization, and outcomes associated with particular illnesses and procedures.

Know About Ambulatory-Care-Sensitive Admissions or PQI

Ambulatory-Care-Sensitive Admissions (ACSAs) are those that can be prevented. This is also commonly known as Prevention Quality Indicators or in short ‘PQI’.

The Agency for Healthcare Research and Quality (AHRQ) Quality Indicators (QIs) are
one Agency response to this need for a multidimensional, accessible family of quality indicators.
They include a family of measures that providers, policy makers, and researchers can use with
inpatient data to identify apparent variations in the quality of either inpatient or outpatient care.

The PQI composites provide:
-Provide assessment of quality and disparity
-Provide baselines to track progress
-Identify information gaps
-Emphasize interdependence of quality and disparities
-Promote awareness and change

What AHRQ PQI Composite Measure:
PQI #01 Diabetes Short-Term Complications Admission Rate
PQI #03 Diabetes Long-Term Complications Admission Rate
PQI #05 Chronic Obstructive Pulmonary Disease (COPD) or Asthma in Older Adults Admission Rate
PQI #07 Hypertension Admission Rate
PQI #08 Congestive Heart Failure (CHF) Admission Rate
PQI #10 Dehydration Admission Rate
PQI #11 Bacterial Pneumonia Admission Rate
PQI #12 Urinary Tract Infection Admission Rate
PQI #13 Angina without Procedure Admission Rate
PQI #14 Uncontrolled Diabetes Admission Rate
PQI #15 Asthma in Younger Adults Admission Rate
PQI #16 Rate of Lower-Extremity Amputation Among Patients With Diabetes

Acute Composite (PQI #91)
PQI #10 Dehydration Admission Rate
PQI #11 Bacterial Pneumonia Admission Rate
PQI #12 Urinary Tract Infection Admission Rate

Chronic Composite (PQI #92)
PQI #01 Diabetes Short-Term Complications Admission Rate
PQI #03 Diabetes Long-Term Complications Admission Rate
PQI #05 Chronic Obstructive Pulmonary Disease (COPD) or Asthma in Older Adults Admission Rate
PQI #07 Hypertension Admission Rate
PQI #08 Congestive Heart Failure (CHF) Admission Rate
PQI #13 Angina without Procedure Admission Rate
PQI #14 Uncontrolled Diabetes Admission Rate
PQI #15 Asthma in Younger Adults Admission Rate
PQI #16 Rate of Lower-Extremity Amputation Among Patients With Diabetes

What IS CCS Classification!!

Clinical Classifications Software (CCS) is a tool for clustering patient diagnoses and procedures into a manageable number of clinically meaningful categories. This was developed by Agency for Healthcare Research and Quality (AHRQ).

CCS is used to analyze costs, usage, and outcomes associated with patient diagnoses and procedures.

CCS is composed of diagnoses and procedures categories, which are organized in two related classification systems. The single-level system consists of 285 mutually-exclusive diagnosis categories, 231 mutually-exclusive procedure categories, and no hierarchical structure. The multi-level system uses the single-level categories and International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) codes in a hierarchical system consisting of four levels for diagnoses and three levels for procedures. This "clinical grouper" makes it easier to quickly understand patterns of diagnoses and procedures so that health plans, policy makers, and researchers can analyze costs, utilization, and outcomes associated with particular illnesses and procedures.

How Often id Updates?
CCS is updated annually.

How Is CCS Used?

Clinical Classifications Software can be used with all clinical data that are coded using ICD-9-CM codes. CCS is used in a variety of ways:

Managed care plans utilize CCS to rank hospitalizations by type of condition. One managed care plan used CCS to examine numbers of cases, length of stay, and total costs, to better understand which conditions and procedures were associated with the highest resource use.
Insurers use CCS to develop clinically-based utilization profiles. For example, one insurer integrated CCS into in-house software that develops profiles of patient populations and purchasers.
Researchers use CCS to explore the types of conditions and procedures that are most frequent in their study populations or to compare alternative treatments for similar conditions. In one study of differences in use of procedures among payers, CCS procedure categories provided a convenient grouping scheme.
Researchers also use CCS in risk adjustment models and as a way to predict future health resource utilization. Investigators in one study found that categorizing patients using CCS predicted more than 40 percent of the subsequent year's medical expenses.