Statistics From the HCUP-3 Nationwide Inpatient Sample for 1994: 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 3, 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) to facilitate comparisons with published tables for 1992. Comparisons among different DRG versions should be done with caution since 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 0.2 percent of records in the HCUP-3 NIS had missing LOS. A hot-deck procedure was used 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 2.5 percent of records had missing total charges, with a majority of missing cases concentrated among three States (Kansas, California, and Washington). A hot-deck procedure was used to impute total charges for these cases, controlling for DRG, health maintenance organization (HMO) payer status (important for California and Washington), and 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 1994 Hospital Inpatient Stays

Diagnosis-related groups Total % of total Mean total DRGs (Version 10) discharges discharges Mean LOS charges

Total 34,622,215 100.00 5.55 10,275

1 Craniotomy age >17 89,319 0.26 10.76 32,594 except for trauma 2 Craniotomy for trauma 16,624 0.05 12.26 37,427 age >17 3 Craniotomy age 0-17 21,043 0.06 9.26 31,002 4 Spinal procedures 24,034 0.07 8.49 24,699 5 Extracranial vascular 107,788 0.31 4.68 13,981 procedures 6 Carpal tunnel release 1,959 0.01 2.20 5,688 7 Peripheral & cranial 17,269 0.05 13.07 21,671 nerve & other nervous system procedures w/ CC 8 Peripheral & cranial 14,116 0.04 2.99 9,643 nerve & other nervous system procedures w/o CC 9 Spinal disorders 7,537 0.02 12.23 15,721 & injuries 10 Nervous system 46,461 0.13 7.67 11,334 neoplasms w/ CC 11 Nervous system 9,011 0.03 4.69 7,677 neoplasms w/o CC 12 Degenerative nervous 49,158 0.14 13.56 12,950 system disorders 13 Multiple sclerosis 23,548 0.07 7.62 7,933 & cerebellar ataxia 14 Specific cerebro- 534,507 1.54 8.24 11,514 vascular disorders except transient ischemic attack 15 Transient ischemic 212,653 0.61 4.52 6,510 attack & precerebral occlusions 16 Nonspecific cerebro- 18,323 0.05 8.04 10,578 vascular disorders w/ CC 17 Nonspecific cerebro- 7,135 0.02 4.24 6,360 vascular disorders w/o CC 18 Cranial & peripheral 43,488 0.13 7.11 8,782 nerve disorders w/ CC 19 Cranial & peripheral 22,604 0.07 4.33 5,502 nerve disorders w/o CC 20 Nervous system 33,646 0.10 10.09 18,928 infection except viral meningitis 21 Viral meningitis 28,044 0.08 4.18 7,141 22 Hypertensive 4,962 0.01 4.81 7,750 encephalopathy 23 Nontraumatic stupor 11,589 0.03 4.97 7,909 & coma 24 Seizure & headache 132,220 0.38 5.47 8,485 age >17 w/ CC 25 Seizure & headache 89,053 0.26 3.35 5,024 age >17 w/o CC 26 Seizure & headache 65,809 0.19 3.00 5,691 age 0-17 27 Traumatic stupor & 21,865 0.06 5.35 13,713 coma, coma >1 hour 28 Traumatic stupor & 27,432 0.08 6.55 11,116 coma, coma <1 hour age >17 w/ CC 29 Traumatic stupor & 19,294 0.06 4.47 7,001 coma, coma <1 hour age >17 w/o CC 30 Traumatic stupor & 21,385 0.06 2.51 5,674 coma, coma <1 hour age 0-17 31 concussion age >17 w/ CC 12,819 0.04 3.70 6,873 32 Concussion age >17 16,017 0.05 2.01 4,038 w/o CC 33 Concussion age 0-17 11,730 0.03 1.45 3,267 34 Other disorders of 35,647 0.10 8.08 11,651 nervous system w/ CC 35 Other disorders of 17,281 0.05 4.99 6,121 nervous system w/o CC 36 Retinal procedures 34,414 0.10 1.59 5,806 37 Orbital procedures 9,053 0.03 3.52 10,218 38 Primary iris procedures 671 0.00 1.96 3,957 39 Lens procedures w/ 8,479 0.02 1.61 4,760 or w/o vitrectomy 40 Extraocular procedures 5,828 0.02 2.91 6,819 except orbit age >17 41 Extraocular procedures 2,044 0.01 1.93 6,446 except orbit age 0-17 42 Intraocular procedures 30,312 0.09 2.22 6,145 except retina, iris & lens 43 Hyphema 2,206 0.01 3.82 3,382 44 Acute major eye 11,764 0.03 3.90 4,560 infections 45 Neurological eye 7,117 0.02 3.77 5,823 disorders 46 Other disorders of 7,733 0.02 5.18 7,551 the eye age >17 w/ CC 47 Other disorders of 6,059 0.02 3.11 4,010 the eye age >17 w/o CC 48 Other disorders of 5,046 0.01 3.29 5,421 the eye age 0-17 49 Major head & neck 7,960 0.02 5.22 17,629 procedures 50 Sialoadenectomy 12,490 0.04 1.92 7,052 51 Salivary gland 1,274 0.00 2.61 7,165 procedures except sialoadenectomy 52 Cleft lip & palate repair 6,936 0.02 1.96 6,926 53 Sinus & mastoid 18,433 0.05 2.67 8,751 procedures age >17 54 Sinus & mastoid 2,913 0.01 2.82 10,999 procedures age 0-17 55 Miscellaneous ear, nose, 14,665 0.04 2.36 8,426 mouth & throat procedures 56 Rhinoplasty 6,519 0.02 1.71 6,413 57 T&A procedures, except 9,680 0.03 2.86 6,381 tonsillectomy & adenoidectomy only, age >17 58 T&A procedures, except 8,268 0.02 2.24 5,655 tonsillectomy & adenoidectomy only, age 0-17 59 Tonsillectomy &/or 5,060 0.01 1.59 4,071 adenoidectomy only, age >17 60 Tonsillectomy &/or 16,177 0.05 1.39 3,678 adenoidectomy only, age 0-17 61 Myringotomy w/ tube 959 0.00 4.02 9,798 insertion age >17 62 Myringotomy w/ tube 5,160 0.01 2.58 7,489 insertion age 0-17 63 Other ear, nose, mouth 46,391 0.13 3.12 11,774 & throat OR procedures 64 Ear, nose, mouth & 8,942 0.03 9.36 13,790 throat malignancy 65 Dysequilibrium 61,985 0.18 3.25 4,501 66 Epistaxis 13,739 0.04 3.59 5,041 67 Epiglottitis 3,244 0.01 3.15 6,439 68 Otitis media & upper 33,065 0.10 4.10 5,628 respiratory infection age >17 w/ CC 69 Otitis media & upper 22,481 0.06 2.90 3,686 respiratory infection age >17 w/o CC 70 Otitis media & upper 59,206 0.17 2.91 3,928 respiratory infection age 0-17 71 Laryngotracheitis 20,209 0.06 1.86 2,926 72 Nasal trauma & deformity 3,224 0.01 2.68 6,008 73 Other ear, nose, mouth 17,010 0.05 4.43 6,439 & throat diagnoses age >17 74 Other ear, nose, mouth 9,747 0.03 3.19 6,777 & throat diagnoses age 0-17 75 Major chest procedures 90,845 0.26 10.74 29,592 76 Other respiratory 70,794 0.20 13.65 24,603 system OR procedures w/ CC 77 Other respiratory 7,882 0.02 4.99 10,798 system OR procedures w/o CC 78 Pulmonary embolism 54,467 0.16 8.00 12,149 79 Respiratory infections 273,007 0.79 10.00 15,589 & inflammations age >17 w/ CC 80 Respiratory infections 16,627 0.05 6.97 9,023 & inflammations age >17 w/o CC 81 Respiratory infections 12,218 0.04 7.80 14,597 & inflammations age 0-17 82 Respiratory neoplasms 125,795 0.36 7.74 12,187 83 Major chest trauma w/ CC 18,507 0.05 5.47 9,042 84 Major chest trauma w/o CC 7,249 0.02 2.59 5,757 85 Pleural effusion w/ CC 29,534 0.09 7.24 10,973 86 Pleural effusion w/o CC 3,290 0.01 4.52 7,406 87 Pulmonary edema & 83,571 0.24 7.52 12,239 respiratory failure 88 Chronic obstructive 511,064 1.48 6.29 8,784 pulmonary disease 89 Simple pneumonia & 614,655 1.78 7.11 9,727 pleurisy age >17 w/ CC 90 Simple pneumonia & 99,772 0.29 4.60 5,800 pleurisy age >17 w/o CC 91 Simple pneumonia & 197,214 0.57 3.64 5,414 pleurisy age 0-17 92 Interstitial lung 21,563 0.06 7.14 10,926 disease w/ CC 93 Interstitial lung 4,061 0.01 4.69 7,093 disease w/o CC 94 Pneumothorax w/ CC 29,730 0.09 6.40 10,154 95 Pneumothorax w/o CC 18,657 0.05 3.95 5,349 96 Bronchitis & asthma 142,036 0.41 5.13 7,165 age >17 w/ CC 97 Bronchitis & asthma 133,722 0.39 3.45 4,883 age >17 w/o CC 98 Bronchitis & asthma 301,748 0.87 3.05 4,905 age 0-17 99 Respiratory signs & 53,678 0.16 3.47 6,439 symptoms w/ CC 100 Respiratory signs & 45,335 0.13 2.19 4,237 symptoms w/o CC 101 Other respiratory 41,189 0.12 5.20 8,426 system diagnoses w/ CC 102 Other respiratory 16,205 0.05 2.69 5,285 system diagnoses w/o CC 103 Heart transplant 1,836 0.01 37.67 172,494 104 Cardiac valve 44,972 0.13 14.78 70,490 procedures w/ cardiac catheterization 105 Cardiac valve 42,001 0.12 11.31 55,778 procedures w/o cardiac catheterization 106 Coronary bypass w/ 177,495 0.51 11.46 50,591 cardiac catheterization 107 Coronary bypass w/o 126,893 0.37 8.80 38,513 cardiac catheterization 108 Other cardiothoracic 23,960 0.07 12.01 59,995 procedures 109 No longer valid 110 Major cardiovascular 103,680 0.30 10.86 40,052 procedures w/ CC 111 Major cardiovascular 13,853 0.04 6.29 22,612 procedures w/o CC 112 Percutaneous cardio- 457,019 1.32 4.25 18,259 vascular procedures 113 Amputation for 58,577 0.17 16.01 27,692 circulatory system disorders except upper limb & toe 114 Upper limb & toe 14,270 0.04 9.97 14,744 amputation for circulatory system disorders 115 Permanent cardiac 15,173 0.04 11.22 32,921 pacemaker implant w/ acute myocardial infarction, heart failure or shock 116 Permanent cardiac 119,965 0.35 5.51 22,077 pacemaker implant or AICD lead or generator procedures 117 Cardiac pacemaker 6,759 0.02 4.46 11,496 revision except device replacement 118 Cardiac pacemaker 10,468 0.03 3.22 14,438 device replacement 119 Vein ligation & stripping 8,076 0.02 3.67 7,942 120 Other circulatory system 56,260 0.16 10.11 19,942 OR procedures 121 Circulatory disorders 259,595 0.75 7.29 14,333 w/ acute myocardial infarction & cardio- vascular complication, discharged alive 122 Circulatory disorders 203,709 0.59 4.81 10,223 w/ acute myocardial infarction w/o cardio- vascular complication, discharged alive 123 Circulatory disorders 63,462 0.18 4.58 13,812 w/ acute myocardial infarction, expired 124 Circulatory disorders 258,263 0.75 4.70 11,562 except acute myocardial infarction, w/ cardiac catheterization & complex diagnosis 125 Circulatory disorders 170,512 0.49 2.67 7,934 except acute myocardial infarction, w/ cardiac catheterization w/o complex diagnosis 126 Acute & subacute 13,550 0.04 15.12 25,708 endocarditis 127 Heart failure & shock 951,821 2.75 6.39 9,383 128 Deep vein thrombo- 39,984 0.12 6.76 7,001 phlebitis 129 Cardiac arrest, 7,962 0.02 3.44 11,587 unexplained 130 Peripheral vascular 147,829 0.43 7.16 8,809 disorders w/ CC 131 Peripheral vascular 59,543 0.17 5.60 5,845 disorders w/o CC 132 Atherosclerosis w/ CC 124,240 0.36 3.73 6,114 133 Atherosclerosis w/o CC 13,035 0.04 3.44 7,082 134 Hypertension 70,393 0.20 3.87 5,487 135 Cardiac congenital 13,025 0.04 5.31 8,438 & valvular disorders age >17 w/ CC 136 Cardiac congenital 4,362 0.01 5.88 17,234 & valvular disorders age >17 w/o CC 137 Cardiac congenital 5,390 0.02 6.56 22,469 & valvular disorders age 0-17 138 Cardiac arrhythmia & 315,311 0.91 4.46 6,999 conduction disorders w/ CC 139 Cardiac arrhythmia & 139,620 0.40 2.62 4,312 conduction disorders w/o CC 140 Angina pectoris 445,797 1.29 3.29 5,386 141 Syncope & collapse 122,955 0.36 4.32 6,342 w/ CC 142 Syncope & collapse 71,946 0.21 2.75 4,558 w/o CC 143 Chest pain 430,976 1.24 2.22 4,366 144 Other circulatory 135,577 0.39 5.92 11,257 system diagnoses w/ CC 145 Other circulatory 23,643 0.07 3.13 6,413 system diagnoses w/o CC 146 Rectal resection w/ CC 15,810 0.05 10.62 23,128 147 Rectal resection w/o CC 3,748 0.01 7.20 15,676 148 Major small & large 274,508 0.79 13.03 29,696 bowel procedures w/ CC 149 Major small & large 43,790 0.13 7.12 14,507 bowel procedures w/o CC 150 Peritoneal adhesiolysis 50,944 0.15 10.79 22,036 w/ CC 151 Peritoneal adhesiolysis 20,232 0.06 5.26 10,482 w/o CC 152 Minor small & large 11,612 0.03 8.98 18,439 bowel procedures w/ CC 153 Minor small & large 8,414 0.02 5.66 10,709 bowel procedures w/o CC 154 Stomach, esophageal & 73,512 0.21 14.43 37,654 duodenal procedures age >17 w/ CC 155 Stomach, esophageal & 15,876 0.05 5.41 12,746 duodenal procedures age >17 w/o CC 156 Stomach, esophageal & 12,333 0.04 7.73 17,220 duodenal procedures age 0-17 157 Anal & stomal procedures 27,067 0.08 5.18 9,488 w/ CC 158 Anal & stomal procedures 30,188 0.09 2.43 5,101 w/o CC 159 Hernia procedures except 33,950 0.10 5.01 10,706 inguinal & femoral age >17 w/ CC 160 Hernia procedures except 34,948 0.10 2.65 6,481 inguinal & femoral age >17 w/o CC 161 Inguinal & femoral 24,269 0.07 4.12 8,922 hernia procedures age >17 w/ CC 162 Inguinal & femoral 23,062 0.07 1.85 5,162 hernia procedures age >17 w/o CC 163 Hernia procedures 8,803 0.03 2.68 8,148 age 0-17 164 Appendectomy w/ 28,216 0.08 8.22 17,118 complicated principal diagnosis w/ CC 165 Appendectomy w/ 36,659 0.11 5.00 10,128 complicated principal diagnosis w/o CC 166 Appendectomy w/o 29,472 0.09 4.23 9,532 complicated principal diagnosis w/ CC 167 Appendectomy w/o 129,530 0.37 2.44 6,214 complicated principal diagnosis w/o CC 168 Mouth procedures w/ CC 5,231 0.02 5.46 12,745 169 Mouth procedures w/o CC 5,464 0.02 2.69 7,679 170 Other digestive system 27,070 0.08 12.14 25,491 OR procedures w/ CC 171 Other digestive system 8,767 0.03 4.30 9,956 OR procedures w/o CC 172 Digestive malignancy 57,362 0.17 8.48 12,746 w/ CC 173 Digestive malignancy 5,110 0.01 5.49 6,224 w/o CC 174 Gastrointestinal 400,707 1.16 5.34 8,919 hemorrhage w/ CC 175 Gastrointestinal 55,879 0.16 3.27 4,747 hemorrhage w/o CC 176 Complicated peptic ulcer 28,646 0.08 5.87 9,429 177 Uncomplicated peptic 24,663 0.07 4.76 7,172 ulcer w/ CC 178 Uncomplicated peptic 14,667 0.04 3.20 4,975 ulcer w/o CC 179 Inflammatory bowel 46,213 0.13 6.41 9,117 disease 180 Gastrointestinal 134,080 0.39 5.97 8,274 obstruction w/ CC 181 Gastrointestinal 50,695 0.15 3.51 4,413 obstruction w/o CC 182 Esophagitis, gastro- 451,957 1.31 4.64 6,563 enteritis & miscellaneous digestive disorders age >17 w/ CC 183 Esophagitis, gastro- 250,847 0.72 2.90 4,346 enteritis & miscellaneous digestive disorders age >17 w/o CC 184 Esophagitis, gastro- 151,172 0.44 2.66 3,512 enteritis & miscellaneous digestive disorders age 0-17 185 Dental & oral disorders 18,278 0.05 3.80 7,471 except extractions & restorations age >17 186 Dental & oral disorders 7,368 0.02 2.96 4,876 except extractions & restorations age 0-17 187 Dental extractions & 4,512 0.01 3.34 6,849 restorations 188 Other digestive system 108,856 0.31 5.97 9,506 diagnoses age >17 w/ CC 189 Other digestive system 27,576 0.08 3.03 4,634 diagnoses age >17 w/o CC 190 Other digestive system 16,268 0.05 2.79 5,921 diagnoses age 0-17

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