Healthcare Cost and Utilization Project
HCUP Research Note

Most Common Diagnoses and Procedures in U.S. Community Hospitals, 1996

Summary

This Research Note provides information on the most frequent diagnoses and procedures for U.S. hospital inpatients in 1996. Its analysis is based on data from the Nationwide Inpatient Sample of the Healthcare Cost and Utilization Project (HCUP). For each of the most common diagnoses and procedures, information on inhospital mortality and mean and median length of stay and total charges is provided. This information can be used to evaluate the variety of diagnoses associated with a given procedure and the variations in treatment for particular diagnoses.

Key information from the Research Note is summarized here. Select to access the full text of Most Common Diagnoses and Procedures in U.S. Community Hospitals, 1996. Print versions of the HCUP Research Note (AHCPR Publication No. 99-0046) are available from the AHCPR Publications Clearinghouse (P.O. Box 8547, Silver Spring, MD 20907, Telephone 800-358-9295). Electronic requests may be made to: ahrqpubs@ahrq.gov.

By Anne Elixhauser, Ph.D., and Claudia A. Steiner, M.D., M.P.H., Agency for Health Care Policy and Research

Information in this Research Note helps to answer questions such as:

• What are the most common reasons for hospitalization in the United States?
• Which procedures are most frequently performed?
• For what conditions is this procedure used?
• How is this condition treated?

The analysis is based on data for U.S. hospital inpatient stays in 1996 using the Healthcare Cost and Utilization Project's Nationwide Inpatient Sample.

For each of the 100 most frequently performed principal procedures, we list the 5 principal diagnoses most commonly recorded on the discharge abstract. Similarly, for each of the 100 most frequent principal diagnoses treated in hospitals, we list the 5 principal procedures most commonly performed. For each diagnosis-procedure combination, information on inhospital mortality and mean and median length of stay and total charges is provided.

These data can be used to evaluate the variety of diagnoses associated with a given procedure and the variations in treatment for particular diagnoses. In addition, it provides information on variations in length of stay, total charges, and inhospital mortality among diagnosis-procedure combinations.

Examples of findings include:

• Wide variations in length of stay and total charges for some conditions exist, depending on what specific treatments are provided. Hospital charges for coronary atherosclerosis treated without an invasive procedure are, on average, $5,000, compared with $19,000 for hospitalizations during which percutaneous transluminal coronary angioplasty is performed, and $44,000 for a hospitalization during which coronary artery bypass graft surgery is performed.
• Most procedures are performed for a wide range of conditions. One-third of all hysterectomies are used to treat benign neoplasm of the uterus, while prolapse of female genital organs accounts for 15 percent, endometriosis accounts for 12 percent, and menstrual disorders account for 11 percent of all hysterectomies.
• The major cause of amputation of the lower extremity is diabetes mellitus, accounting for 35 percent of the reasons for amputation. Gangrene is the next most common principal diagnoses (30 percent) followed by infective arthritis and osteomyelitis (6 percent).

This information can be used as a starting point for many analyses. Medical professionals can compare their own practices with a nationwide sample. Health plans and insurers can use the information as a starting point for examining the impact of payment policies on practice patterns. Health services researchers can use the information to generate hypotheses for future research on the treatment of specific conditions.

The data presented in this research note are organized using the Clinical Classifications Software (CCS), formerly called the Clinical Classifications for Health Policy Research (CCHPR). CCS collapses about 12,000 diagnosis codes and 3,500 procedure codes from the International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) into a smaller number of clinically meaningful, relatively homogenous clusters. Without the CCS tool, researchers have two relatively unsatisfactory alternatives: They may work directly with the ICD-9-CM coded data; but 12,000 diagnosis codes and 3,500 procedure codes are cumbersome and often too detailed to be useful. Or they may use software that was designed to bundle or aggregate procedures for purposes of payment, such as diagnosis-related groups (DRGs). However, these "reimbursement groupers" mask clinically important details about procedures that were performed. CCS, a "clinical grouper," makes ICD-9-CM data more amenable to clinically focused statistical analyses.

Select NIS data are now available through HCUPnet, an interactive data repository which can accommodate queries on number of discharges, length of stay, charges, and inhospital mortality for specific diagnoses and procedures. Select to access more information on NIS and other HCUP databases, tools, and publications.

We invite you to tell us how you are using HCUP data and tools and to share suggestions of how these products might be improved to better meet your needs. Please E-mail hcup@ahrq.gov.

Current as of October 1999

Send Questions & Comments to: hcup@ahrq.gov

Internet Citation:

Elixhauser A, Steiner CA. Most Common Diagnoses and Procedures in U.S. Community Hospitals, 1996, Summary. HCUP Research Note. Agency for Health Care Policy and Research, Rockville, MD. http://www.hcup-us.ahrq.gov/reports/natstats/commdx.htm

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