Statistics from the HCUP-3 Nationwide Inpatient Sample for 1993: Diagnosis-Related Groups

Overview

The Healthcare Cost and Utilization Project (HCUP-3) is a Federal-State-industry partnership to assemble health care data for use in health services research and health policy analysis. The information presented here is based on data from the HCUP-3 Nationwide Inpatient Sample (NIS) Release 2, which contains all discharge records from a 20-percent sample of U.S. community hospitals from 17 States. Unlike other commonly used databases, the HCUP-3 database includes all payers.

HCUP-3 Nationwide Inpatient Sample

The NIS sample of hospitals is a stratified probability sample of community hospitals, with sampling probabilities proportional to the number of U.S. community hospitals in each stratum. Strata were defined based on five characteristics: region (Northeast, South, Midwest, West); location (urban, rural); teaching status; ownership/control (government, non-Federal; private, not-for-profit; private, investor-owned) and bed size (small, medium, large, varying by location and teaching status). The frame is limited to community hospitals, as defined by the American Hospital Association Annual Survey of Hospitals, from States participating in HCUP-3.

Sampling weights were used to obtain national estimates for the measures presented here—discharges, average length of stay, and average total charges. Comparisons between the NIS and the National Hospital Discharge Survey demonstrated that the number of discharges and lengths of stay were essentially the same when considered on a national or regional basis. Comparisons between the NIS and the Medicare Provider Analysis and Review (MEDPAR) data for enrollees not covered by health maintenance organizations demonstrated that the number of discharges was essentially the same.

Definitions

DRGs: Diagnosis-related groups (DRGs) are a classification of hospital case types into groups expected to have similar hospital resource use. Medicare uses this classification to pay for inpatient hospital care. The groupings are based on diagnoses, procedures, age, sex, and the presence of complications or comorbidities (CC, defined later). The DRGs in this report were assigned using the HCFA Grouper Version 10.0 (effective for the Medicare program October 1992). Comparisons among different DRG versions should be done with caution as criteria are revised periodically.

MEAN LOS: Mean length of stay (LOS) is calculated by dividing the sum of inpatient days by the number of patients within the DRG category. Inpatient days are calculated by subtracting day of admission from day of discharge, so persons entering and leaving a hospital on the same day have a length of stay of zero. Only 0.1 percent of records in the HCUP-3 NIS had missing LOS. We used a hot-deck procedure to impute LOS for these cases, controlling for diagnosis-related group (DRG) and hospital characteristics (geographic region, ownership, urban/rural location, size, and teaching status).

MEAN TOTAL CHARGE: Mean total charge is calculated by dividing the sum of patient charges by the number of patients within the DRG category. Total charges represent the dollar amount charged for the hospitalization rather than the amount paid or the actual costs to provide the care. Physician payments are not included. Although capitation and negotiated discounts have made total charges an imprecise measure of reimbursements, charges still represent one of the only ways to approximate costs of hospital care. Only 2.9 percent of records had missing total charges with a majority of missing cases concentrated among three States (Kansas, California, and Washington). We used a hot-deck procedure to impute total charges for these cases, controlling for DRG, HMO payer status (important for California and Washington), a hospital characteristics (geographic region, ownership, urban/rural location, size, and teaching status).

CC (Complications, Comorbidities): Patients who are more seriously ill tend to require more hospital resources than patients who are less seriously ill, even though they are admitted to the hospital for the same reason. Recognizing this, the DRG grouper splits certain DRGs based on the presence of secondary diagnoses for specific complications or comorbidities (CC).

For information about the HCUP-3 databases, contact:

Healthcare Cost and Utilization Project (HCUP-3)
Phone: 866-290-HCUP (4287) toll-free
E-mail: hcup@ahrq.gov


Table of Contents
[Note: Subject areas correspond to Major Diagnostic Categories (MDCs)]

DRGs           Subject areas

1 - 35 1 Diseases and Disorders of the Nervous System 36 - 48 2 Diseases and Disorders of the Eye 49 - 74 3 Diseases and Disorders of the Ear, Nose, Mouth, 168 - 169 and Throat 185 - 187 75 - 102 4 Diseases and Disorders of the Respiratory System 475 103 - 108 5 Diseases and Disorders of the Circulatory System 110 - 145 478 - 479 146 - 167 6 Diseases and Disorders of the Digestive System 170 - 184 188 - 190 191 - 208 7 Diseases and Disorders of the Hepatobiliary System and Pancreas 209 - 256 8 Diseases and Disorders of the Musculoskeletal System 471 and Connective Tissue 491 257 - 284 9 Diseases and Disorders of the Skin, Subcutaneous Tissue, and Breast 285 - 301 10 Endocrine, Nutritional, and Metabolic Diseases and Disorders 302 - 333 11 Diseases and Disorders of the Kidney and Urinary Tract 334 - 352 12 Diseases and Disorders of the Male Reproductive System 353 - 369 13 Diseases and Disorders of the Female Reproductive System 370 - 384 14 Pregnancy, Childbirth, and the Puerperium 385 - 391 15 Newborns and Other Neonates with Conditions Originating in the Perinatal Period 392 - 399 16 Diseases and Disorders of the Blood and Blood Forming Organs and Immunological Disorders 400 - 414 17 Myeloproliferative Diseases and Disorders, and Poorly 473 Differentiated Neoplasms 492 415 - 423 18 Infectious and Parasitic Diseases (Systemic or Unspecified Sites) 424 - 432 19 Mental Diseases and Disorders 433 - 437 20 Alcohol/Drug Use and Alcohol/Drug Induced Organic Mental Disorders 439 - 455 21 Injuries, Poisonings, and Toxic Effects of Drugs 456 - 460 22 Burns 472 461 - 467 23 Factors Influencing Health Status and Other Contacts with Health Services 484 - 487 24 Multiple Significant Trauma 488 - 490 25 Human Immunodeficiency Virus Infections


Statistics from the Nationwide Inpatient Sample for 1993 Hospital Inpatient Stays


DRGs— Diagnosis-Related Groups, Total % of total Mean total Version 10 discharges discharges Mean LOS charges


Total 34,714,497 100.00 5.79 9,833


1   Craniotomy age > 17       88,249         0.25       12.14       32,337 
    except for trauma	            
2   Craniotomy for trauma     16,931         0.05       12.72       37,119   
    age >17                         
3   Craniotomy age 0-17       23,139         0.07       10.07       30,422 
4   Spinal procedures         25,728         0.07        9.01       22,547 
5   Extracranial vascular     84,156         0.24        5.28       14,026   
    procedures                      
6   Carpal tunnel release      2,019         0.01        2.47        5,790 
7   Peripheral & cranial      15,130         0.04       13.70       22,421 
    nerve & other nervous 
    system procedures w/ CC                
8   Peripheral & cranial      15,446         0.04        3.03        8,472 
    nerve & other nervous 
    system procedures w/o CC  
9   Spinal disorders           8,225         0.02       11.90       14,318 
    & injuries
10  Nervous system neoplasms  47,824         0.14        8.84       11,844 
    w/ CC                           
11  Nervous system neoplasms  10,670         0.03        4.78        7,580 
    w/o CC                          
12  Degenerative nervous      45,969         0.13       13.90       12,717 
    system disorders                       
13  Multiple sclerosis &      26,717         0.08        7.07        7,734 
    cerebellar ataxia               
14  Specific cerebro-        495,397         1.43        8.75       11,139 
    vascular disorders except 
    transient ischemic attack                
15  Transient ischemic       198,870         0.57        4.73        6,237 
    attack & precerebral 
    occlusions         
16  Nonspecific cerebro-      17,660         0.05        8.05       10,354 
    vascular disorders w/ CC                 
17  Nonspecific cerebro-       6,906         0.02        4.08        5,904 
    vascular disorders w/o CC          
18  Cranial & peripheral      35,600         0.10        6.99        8,457 
    nerve disorders w/ CC
19  Cranial & peripheral      22,247         0.06        4.27        5,144 
    nerve disorders w/o CC 
20  Nervous system infection  34,407         0.10       10.45       18,188 
    except viral meningitis         
21  Viral meningitis          37,476         0.11        3.79        5,814 
22  Hypertensive               6,063         0.02        5.29        7,729 
    encephalopathy
23  Nontraumatic stupor       10,524         0.03        5.01        7,214 
    & coma
24  Seizure & headache       127,898         0.37        5.93        8,402 
    age >17 w/ CC             
25  Seizure & headache        92,563         0.27        3.36        4,598 
    age >17 w/o CC 
26  Seizure & headache        68,572         0.20        3.06        5,136 
    age 0-17
27  Traumatic stupor &        22,055         0.06        6.50       12,847 
    coma, coma >1 hour  
28  Traumatic stupor &        25,871         0.07        7.37       11,902
    coma, coma <1 hour 
    age >17 w/ CC 
29  Traumatic stupor &        20,838         0.06        4.00        6,611
    coma, coma <1 hour 
    age >17 w/o CC 
30  Traumatic stupor &        22,500         0.06        2.67        5,444 
    coma, coma <1 hour 
    age 0-17           
31  concussion age >17 w/ CC  13,641         0.04        3.95        6,945
32  Concussion age >17        20,015         0.06        2.08        4,126
    w/o CC
33  Concussion age 0-17       15,192         0.04        1.46        3,158 
34  Other disorders of        34,015         0.10        9.23       11,608 
    nervous system w/ CC
35  Other disorders of        17,290         0.05        5.16        6,233 
    nervous system w/o CC
36  Retinal procedures        41,674         0.12        1.72        5,554 
37  Orbital procedures        10,189         0.03        3.54        9,335 
38  Primary iris procedures      957         0.00        2.36        4,131 
39  Lens procedures w/ or w/o 10,375         0.03        1.70        4,812  
    vitrectomy                      
40  Extraocular procedures     6,810         0.02        2.91        6,286 
    except orbit age >17             
41  Extraocular procedures     2,069         0.01        2.00        5,149 
    except orbit age 0-17             
42  Intraocular procedures    33,477         0.10        2.30        5,692 
    except retina, iris & lens       
43  Hyphema                    2,833         0.01        3.56        2,843 
44  Acute major eye           12,080         0.03        4.30        4,557 
    infections
45  Neurological eye disorders 7,289         0.02        4.04        5,940 
46  Other disorders of         7,345         0.02        5.47        7,722
    the eye age >17 w/ CC
47  Other disorders of         5,910         0.02        3.43        4,129
    the eye age >17 w/o CC
48  Other disorders of         5,110         0.01        3.35        4,587
    the eye age 0-17
49  Major head & neck          8,418         0.02        5.95       17,239 
    procedures
50  Sialoadenectomy           13,348         0.04        1.99        6,594 
51  Salivary gland             1,461         0.00        2.59        6,578 
    procedures except
    sialoadenectomy
52  Cleft lip & palate repair  7,117         0.02        2.00        6,537
53  Sinus & mastoid           22,569         0.07        2.68        7,573 
    procedures age >17
54  Sinus & mastoid            3,412         0.01        3.08        8,647 
    procedures age 0-17
55  Miscellaneous ear, nose,  17,180         0.05        2.47        7,656 
    mouth & throat procedures
56  Rhinoplasty                9,111         0.03        1.73        5,918 
57  T&A procedures, except     8,600         0.02        2.79        5,587 
    tonsillectomy &/or 
    adenoidectomy only, 
    age >17
58  T&A procedures, except    11,220         0.03        1.86        4,234 
    tonsillectomy &/or 
    adenoidectomy only, 
    age 0-17
59  Tonsillectomy &/or         8,256         0.02        1.35        3,248 
    adenoidectomy only, 
    age >17
60  Tonsillectomy &/or        24,502         0.07        1.31        3,194 
    adenoidectomy only, 
    age 0-17
61  Myringotomy w/ tube        1,124         0.00        4.25        8,842 
    insertion age >17
62  Myringotomy w/ tube        4,467         0.01        2.97        6,882  
    insertion age 0-17
63  Other ear, nose, mouth    51,119         0.15        3.21       11,197 
    & throat OR procedures
64  Ear, nose, mouth &         9,229         0.03        8.30       12,244 
    throat malignancy
65  Dysequilibrium            61,763         0.18        3.32        4,145 
66  Epistaxis                 15,210         0.04        3.68        4,788 
67  Epiglottitis               3,367         0.01        3.21        5,665 
68  Otitis media & upper      36,055         0.10        4.21        5,398 
    respiratory infection 
    age >17 w/ CC
69  Otitis media & upper      25,602         0.07        3.01        3,553 
    respiratory infection 
    age >17 w/o CC
70  Otitis media & upper      70,307         0.20        2.95        3,528 
    respiratory infection 
    age 0-17
71  Laryngotracheitis         34,456         0.10        1.93        2,588 
72  Nasal trauma & deformity   3,593         0.01        2.40        4,774 
73  Other ear, nose, mouth    17,141         0.05        4.54        6,147 
    & throat diagnoses 
    age >17
74  Other ear, nose, mouth    10,009         0.03        3.47        5,904 
    & throat diagnoses 
    age 0-17
75  Major chest procedures    92,632         0.27       11.07       28,432 
76  Other respiratory system  70,817         0.20       12.72       23,448 
    OR procedures w/ CC             
77  Other respiratory system   9,421         0.03        4.93       10,116
    OR procedures w/o CC              
78  Pulmonary embolism        52,851         0.15        8.55       11,907 
79  Respiratory infections   250,844         0.72       10.60       15,232 
    & inflammations 
    age >17 w/ CC
80  Respiratory infections    18,363         0.05        8.23        8,866 
    & inflammations 
    age >17 w/o CC
81  Respiratory infections    12,392         0.04        8.01       13,868 
    & inflammations age 0-17
82  Respiratory neoplasms    126,478         0.36        8.22       11,902 
83  Major chest trauma w/ CC  17,983         0.05        5.57        8,901 
84  Major chest trauma w/o CC  7,679         0.02        2.80        5,250 
85  Pleural effusion w/ CC    28,512         0.08        7.69       10,956 
86  Pleural effusion w/o CC    3,748         0.01        4.31        6,154 
87  Pulmonary edema &         76,202         0.22        7.46       11,827 
    respiratory failure             
88  Chronic obstructive      504,477         1.45        6.63        8,699 
    pulmonary disease     
89  Simple pneumonia &       595,218         1.71        7.55        9,577 
    pleurisy age >17 w/ CC         
90  Simple pneumonia &       110,024         0.32        4.85        5,514   
    pleurisy age >17 w/o CC        
91  Simple pneumonia &       193,972         0.56        3.73        4,995   
    pleurisy age 0-17              
92  Interstitial lung         19,737         0.06        8.02       11,358 
    disease w/ CC                   
93  Interstitial lung          4,141         0.01        4.65        6,736 
    disease w/o CC                   
94  Pneumothorax w/ CC        27,973         0.08        7.05       10,224 
95  Pneumothorax w/o CC       19,041         0.05        4.07        5,171 
96  Bronchitis & asthma      161,179         0.46        5.40        7,094  
    age >17 w/ CC                  
97  Bronchitis & asthma      149,163         0.43        3.68        4,806   
    age >17 w/o CC                 
98  Bronchitis & asthma      329,801         0.95        3.13        4,529 
    age 0-17                       
99  Respiratory signs &       56,294         0.16        3.89        6,436  
    symptoms w/ CC                  
100 Respiratory signs &       51,381         0.15        2.34        4,016 
    symptoms w/o CC                 
101 Other respiratory system  40,906         0.12        5.38        8,055 
    diagnoses w/ CC                 
102 Other respiratory system  17,678         0.05        2.88        4,909 
    diagnoses w/o CC                
103 Heart transplant           2,179         0.01       42.00      179,522 
104 Cardiac valve             43,920         0.13       16.62       72,058 
    procedures w/ cardiac 
    catheterization
105 Cardiac valve             42,637         0.12       12.38       54,818 
    procedures w/o cardiac 
    catheterization
106 Coronary bypass w/       173,985         0.50       12.51       51,439
    cardiac catheterization
107 Coronary bypass w/o      129,742         0.37        9.72       38,477 
    cardiac catheterization
108 Other cardiothoracic      26,241         0.08       12.58       57,205 
    procedures
109 No longer valid                    
110 Major cardiovascular      97,658         0.28       11.49       38,821 
    procedures w/ CC                
111 Major cardiovascular      13,720         0.04        6.71       21,287 
    procedures w/o CC         
112 Percutaneous cardio-     449,306         1.29        4.59       17,702 
    vascular procedures
113 Amputation for            53,083         0.15       17.68       27,771 
    circulatory system 
    disorders except upper 
    limb & toe
114 Upper limb & toe          13,590         0.04       10.76       14,720 
    amputation for circulatory 
    system disorders
115 Permanent cardiac         13,627         0.04       12.18       32,243 
    pacemaker implant w/ 
    acute myocardial 
    infarction, heart failure 
    or shock
116 Permanent cardiac        112,358         0.32        5.99       21,787 
    pacemaker implant or 
    AICD lead or generator
    procedures
117 Cardiac pacemaker          6,385         0.02        4.46       10,514 
    revision except device 
    replacement
118 Cardiac pacemaker         10,916         0.03        3.29       14,023 
    device replacement
119 Vein ligation & stripping  9,392         0.03        3.70        8,134 
120 Other circulatory system  52,787         0.15       10.87       20,203 
    OR procedures                   
121 Circulatory disorders    251,712         0.73        7.93       14,122 
    w/ acute myocardial 
    infarction & cardio-
    vascular complication, 
    discharged alive
122 Circulatory disorders    205,229         0.59        5.20        9,869 
    w/ acute myocardial 
    infarction w/o cardio-
    vascular complication, 
    discharged alive
123 Circulatory disorders     66,939         0.19        4.77       13,430 
    w/ acute myocardial 
    infarction, expired
124 Circulatory disorders    256,495         0.74        4.95       11,137 
    except acute myocardial 
    infarction, w/ cardiac
    catheterization & 
    complex diagnosis
125 Circulatory disorders    195,022         0.56        2.72        7,326 
    except acute myocardial 
    infarction, w/ cardiac
    catheterization w/o 
    complex diagnosis
126 Acute & subacute          12,847         0.04       16.38       24,035 
    endocarditis
127 Heart failure & shock    943,275         2.72        6.83        9,254 
128 Deep vein thrombo-        39,459         0.11        7.22        6,818 
    phlebitis
129 Cardiac arrest,            8,764         0.03        3.65       12,133 
    unexplained
130 Peripheral vascular      133,807         0.39        7.48        8,777 
    disorders w/ CC                
131 Peripheral vascular       59,328         0.17        5.49        5,517 
    disorders w/o CC                
132 Atherosclerosis w/ CC     36,797         0.11        5.30        6,643 
133 Atherosclerosis w/o CC    10,708         0.03        3.75        5,192 
134 Hypertension              71,271         0.21        4.08        5,328 
135 Cardiac congenital &      12,226         0.04        5.95        8,446 
    valvular disorders age
    >17 w/ CC                       
136 Cardiac congenital &       4,485         0.01        3.11        5,200 
    valvular disorders
    age >17 w/o CC                   
137 Cardiac congenital &       5,264         0.02        6.02       14,550 
    valvular disorders
    age 0-17                         
138 Cardiac arrhythmia &     309,232         0.89        6.01        6,882 
    conduction disorders 
    w/ CC     
139 Cardiac arrhythmia &     143,110         0.41        2.79        4,120 
    conduction disorders 
    w/o CC    
140 Angina pectoris          550,938         1.59        3.52        5,304 
141 Syncope & collapse       121,194         0.35        4.65        6,245 
    w/ CC
142 Syncope & collapse        71,970         0.21        2.99        4,486 
    w/o CC
143 Chest pain               439,658         1.27        2.41        4,193 
144 Other circulatory        127,120         0.37        6.36       11,248
    system diagnoses w/ CC
145 Other circulatory         25,421         0.07        3.27        5,763 
    system diagnoses w/o CC
146 Rectal resection w/ CC    15,765         0.05       11.29       22,468 
147 Rectal resection w/o CC    4,575         0.01        7.70       15,669 
148 Major small & large      268,465         0.77       13.78       29,087 
    bowel procedures w/ CC
149 Major small & large       47,729         0.14        7.49       14,110 
    bowel procedures w/o CC
150 Peritoneal adhesiolysis   47,409         0.14       11.41       21,589 
    w/ CC
151 Peritoneal adhesiolysis   21,151         0.06        5.61       10,645 
    w/o CC
152 Minor small & large       11,315         0.03        8.98       15,963
    bowel procedures w/ CC
153 Minor small & large        9,211         0.03        5.84       10,289 
    bowel procedures w/o CC
154 Stomach, esophageal &     70,329         0.20       15.62       37,420 
    duodenal procedures 
    age >17 w/ CC
155 Stomach, esophageal &     14,400         0.04        6.53       13,389
    duodenal procedures 
    age >17 w/o CC
156 Stomach, esophageal &     13,106         0.04        7.65       16,507 
    duodenal procedures 
    age 0-17
157 Anal & stomal procedures  27,713         0.08        5.48        9,230 
    w/ CC                           
158 Anal & stomal procedures  38,100         0.11        2.47        4,680 
    w/o CC                          
159 Hernia procedures except  33,295         0.10        5.35       10,348 
    inguinal & femoral 
    age >17 w/ CC
160 Hernia procedures except  37,284         0.11        2.76        6,008 
    inguinal & femoral 
    age >17 w/o CC
161 Inguinal & femoral        26,221         0.08        4.34        8,431
    hernia procedures 
    age >17 w/ CC
162 Inguinal & femoral        29,694         0.09        1.88        4,916 
    hernia procedures 
    age >17 w/o CC
163 Hernia procedures         11,044         0.03        2.83        8,255 
    age 0-17
164 Appendectomy w/           26,063         0.08        8.78       17,063 
    complicated principal 
    diagnosis w/ CC
165 Appendectomy w/           37,126         0.11        5.20        9,584 
    complicated principal 
    diagnosis w/o CC
166 Appendectomy w/o          27,635         0.08        4.62        9,498 
    complicated principal 
    diagnosis w/ CC
167 Appendectomy w/o         129,920         0.37        2.60        5,908 
    complicated principal 
    diagnosis w/o CC
168 Mouth procedures w/ CC     5,305         0.02        5.24       11,502 
169 Mouth procedures w/o CC    5,923         0.02        2.61        7,155 
170 Other digestive system    27,422         0.08       12.31       24,617  
    OR procedures w/ CC             
171 Other digestive system     9,679         0.03        4.22        8,778  
    OR procedures w/o CC          
172 Digestive malignancy      58,314         0.17        9.15       12,717 
    w/ CC
173 Digestive malignancy       6,313         0.02        5.15        6,883 
    w/o CC
174 Gastrointestinal         378,983         1.09        6.75        8,710 
    hemorrhage w/ CC
175 Gastrointestinal          61,509         0.18        3.31        4,652 
    hemorrhage w/o CC
176 Complicated peptic ulcer  26,873         0.08        6.38        9,232 
177 Uncomplicated peptic      23,625         0.07        5.03        6,920 
    ulcer w/ CC
178 Uncomplicated peptic      16,427         0.05        3.36        4,734 
    ulcer w/o CC
179 Inflammatory bowel        44,680         0.13        6.82        8,928 
    disease
180 Gastrointestinal         125,131         0.36        6.48        8,237 
    obstruction w/ CC
181 Gastrointestinal          52,945         0.15        3.67        4,370 
    obstruction w/o CC
182 Esophagitis, gastro-     439,252         1.27        4.91        6,375
    enteritis & miscellaneous 
    digestive disorders 
    age >17 w/ CC
183 Esophagitis, gastro-     265,033         0.76        2.99        4,091 
    enteritis & miscellaneous 
    digestive disorders 
    age >17 w/o CC
184 Esophagitis, gastro-     166,164         0.48        2.76        3,294
    enteritis & miscellaneous 
    digestive disorders 
    age 0-17
185 Dental & oral disorders   19,913         0.06        3.84        6,791
    except extractions & 
    restorations age >17
186 Dental & oral disorders    8,037         0.02        3.23        4,903 
    except extractions & 
    restorations age 0-17
187 Dental extractions &       4,957         0.01        3.37        6,790 
    restorations
188 Other digestive system    97,105         0.28        6.31        9,242 
    diagnoses age >17 
    w/ CC
189 Other digestive system    29,522         0.09        3.23        4,461 
    diagnoses age >17 
    w/o CC
190 Other digestive system    16,237         0.05        3.08        5,278 
    diagnoses age 0-17 
Select for DRGs 191-492
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