The Centers for Medicare & Medicaid Services (CMS) publishes a set of data every quarter covering several measures for process of care for blood clot and stroke. This data is submitted to CMS by the hospitals using clinical chart data.
For more information visit the CMS Hospital Compare Web site.
Readmission rates includes patients readmitted to a hospital within 30 days of discharge from a previous hospital stay for heart attack, heart failure, or pneumonia. Readmission rates are reported for Medicare patients only. Readmissions rates displayed on this site reflect 3 years of data. For more information, visit the CMS Hospital Compare Web site.
CMS 30-day mortality rates take into account deaths within 30 days from all causes after an initial hospitalization with a principal diagnosis of heart attack, heart failure, or pneumonia. Mortality rates are reported for Medicare patients only. Mortality rates displayed on this site reflect 3 years of data. For more information, visit the CMS Hospital Compare Web site.
The inpatient quality indicators (IQIs) are a set of measures that can be used with hospital inpatient discharge data to provide a perspective on quality. Mortality indicators for inpatient procedures include procedures for which mortality has been shown to vary across institutions and for which there is evidence that high mortality may be associated with poorer quality of care. Utilization indicators examine procedures whose use varies significantly across hospitals and for which questions have been raised about overuse, underuse, or misuse.
Discharge data submitted by the hospitals are entered by IDPH into software provided by the Agency for Healthcare Research and Quality (AHRQ). The measures of care listed are authored by AHRQ.
AHRQ Version 5.0.3 software is utilized with risk adjustment as appropriate. For additional information about AHRQ measures and risk adjustment, read about the Quality Indicators at http://www.qualityindicators.ahrq.gov/.
The Pediatric Quality Indicators (PDIs) are a set of measures that reflect quality of care inside hospitals and identify potentially avoidable hospitalizations among children (PDI). They focus on potentially preventable complications and iatrogenic events for pediatric patients treated in hospitals, and on preventable hospitalizations among pediatric patients.
Discharge data submitted by the hospitals are entered by IDPH into software provided by the Agency for Healthcare Research and Quality (AHRQ). The measures of care listed are authored by AHRQ.
AHRQ Version 5.0.3 software is utilized with risk adjustment as appropriate. For additional information about AHRQ measures and risk adjustment, read about the Pediatric Quality Indicators at http://www.qualityindicators.ahrq.gov/.
The National Healthcare Safety Network (NHSN), a secure, Internet-based surveillance system managed by the Division of Healthcare Quality Promotion at the Centers for Disease Control and Prevention, is used by all Illinois hospitals with adult, pediatric and neonatal intensive care units to collect data on central line-associated bloodstream infections.
The reporting criteria and methods required by NHSN and a summary of the national level data are detailed on the NHSN Web site.
While the data collection methodology is identical in adult and pediatric intensive care settings, in neonatal intensive care unit (NICU) locations (level III or level II/III), data on central line-associated bloodstream infections are collected for each of five birth-weight categories (<750 g, 751-1000 g, 1001-1500 g, 1501-2500 g, and >2500 g) and for catheter type (central line and umbilical). The risk of bloodstream infections in neonates varies by birth-weight and type of catheter.
NHSN 2015 Baseline
Statewide Trends in Methicillin-Resistant Staphylococcus aureus (MRSA) and Clostridium difficile based on Hospital Discharge Data
Methicillin-Resistant Staphylococcus aureus (MRSA) Trends in Illinois
Analysis in these sections was conducted using hospital discharge data, which are routinely collected and provided to the Illinois Department of Public Health for all acute care hospitals in Illinois. The unit of analysis is the hospital discharge, not the person or patient. If a person is admitted to the hospital multiple times during the course of a year, that person will be counted each time as a separate "discharge" from the hospital.
Up to 25 diagnosis codes for each discharge can be included in the analysis.
C. difficile Trends in Illinois
Analysis in these sections was conducted using hospital discharge data, which are routinely collected and provided to the Illinois Department of Public Health for hospitals in Illinois. The unit of analysis is the hospital discharge, not the person or patient. A person admitted to the hospital multiple times during the course of a year will be counted each time as a separate "discharge" from the hospital.
Up to 25 diagnosis codes for each discharge can be included in the analysis.
The patient safety indicators (PSIs) are a set of measures that screen for adverse events that patients experience as a result of exposure to the health care system. These events are likely amenable to prevention by changes at the system or provider level.
Discharge data submitted by the hospitals, are entered by IDPH into software provided by the Agency for Healthcare Research and Quality (AHRQ). The measures of care listed are authored by AHRQ.
AHRQ Version 5.0.3 software is utilized with risk adjustment as appropriate. For additional information about AHRQ measures and risk adjustment, read about the Patient Safety Indicators at http://www.qualityindicators.ahrq.gov/.
The HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) survey is the first national, standardized, publicly reported survey of patients' perspectives of hospital care. HCAHPS (pronounced “H-caps”), also known as the CAHPS® Hospital Survey, is a standardized survey instrument and data collection methodology for measuring patients’ perceptions of their hospital experience.
The HCAHPS survey asks discharged patients 27 questions about their recent hospital stay. The survey contains 18 questions about critical aspects of patients’ hospital experiences (communication with nurses and doctors, the responsiveness of hospital staff, the cleanliness and quietness of the hospital environment, pain management, communication about medicines, discharge information, overall rating of hospital, and would they recommend the hospital). The survey also includes four items to direct patients to relevant questions, three to adjust for the mix of patients across hospitals, and two items that support Congressionally-mandated reports.
The HCAHPS survey is administered to a random sample of adult patients across medical conditions between 48 hours and six weeks following discharge; the survey is not restricted to Medicare beneficiaries. Participating hospitals may either use an approved survey vendor, or collect their own HCAHPS data (if approved by CMS to do so). To accommodate the needs of hospitals, HCAHPS can be implemented in four different survey modes: mail, telephone, mail with telephone follow-up, or active interactive voice recognition (IVR). Hospitals may either integrate HCAHPS with their own patient surveys, or use HCAHPS by itself. Hospitals must survey patients throughout each month of the year. The survey is available in official English, Spanish, Chinese, Russian and Vietnamese versions.
The survey itself, as well as detailed information on sampling, data collection and coding, and file submission, are contained in the HCAHPS Quality Assurance Guidelines, Version 4.0, found at the official HCAHPS Web site, https://www.medicare.gov/hospitalcompare/search.html.
Discharge data from the Illinois Department of Public Health is utilized to calculate information on utilization of services. Data on the number of inpatients, their length of stay and median charges includes the use of DRG grouping software from 3M to combine these discharge data records into the various listed conditions. The median stay and charges are then calculated by listed service for each facility. A patient’s length of stay for any listed condition will vary. Data on outpatient procedure volume and charges includes the use of clinical classification software (CCS) for clustering patient diagnoses and procedures into a manageable number of clinically meaningful categories. The CCS was developed by the Healthcare Cost and Utilization Project https://www.hcup-us.ahrq.gov/datainnovations/icd10_resources.jsp. Data on diagnostic procedure visit volume and charges includes the use of revenue codes from the discharge data set. Median charges shown for all displayed services are list prices that may be discounted and paid by health insurance companies.
Hospitals gather internal data related to the type and number of monthly nurse hours worked. They also gather data on the number of days patients spend within specific categories of service. This information is submitted quarterly to IDPH where the data is combined. In addition, hospitals submit annual data on the number of nurse staffing position vacancies and turnover rates.
The number of infection prevention and control staff, both total and those certified in infection control, is gathered from data submitted by hospitals to the Illinois Department of Public Health through the Annual Hospital Profile survey. The number of beds used in per 100 beds calculation reflects the total number of authorized beds established by certificate of need at the Illinois Department of Public Health.
The number of specially trained lactation consultants and the number of International Board Certified lactation consultants is gathered from data submitted by hospitals to the Illinois Department of Public Health through the Annual Hospital Profile survey. The number of live births for each hospital is calculated from hospital discharge data submitted by hospitals to the Illinois Department of Public Health.
The bed numbers refer to the number of authorized beds approved by the Health Facilities and Services Review Board. These bed numbers may change frequently as a result of the regular Board meetings, and will be updated regularly as other data is added to the site.
Hospitals gather data on the type and volume of insurance providers of the patients seen in their facility. This information is submitted to the Illinois Department of Public Health annually, as part of the Annual Hospital Questionnaire (AHQ). Data on patient volume by insurance type was extracted as submitted to provide the percentage of hospital visits by major categories of insurance provider, with private pay and charity included where no insurance coverage exists.
The fine particulate matter measure comes from the U.S. County Health Rankings website (http://www.countyhealthrankings.org/app/illinois/2019/downloads) and is made available from the CDC WONDER program. CDC WONDER provides geographically aggregated daily measures of fine particulate matter in the outdoor air. Fine particulate matter, or PM 2.5 particles, are air pollutants with an aerodynamic diameter less than 2.5 micrometers. Data are available by place (combined 48 contiguous states plus the District of Columbia, region, division, state, county), time (year, month, day) and specified fine particulate matter (µg/m³) value. County-level and higher data are aggregated from 10 kilometer square spatial resolution grids. Further information about methodology is available on https://www.cdc.gov/air/default.htm.
Data from the Illinois Behavioral Risk Factor Surveillance System (Illinois BRFSS) was used to present prevalence of asthma. Asthma prevalence is defined as adults 18 years of age or older having "Current Asthma". "Current Asthma" means respondents to the BRFSS telephone survey indicated that asthma was current and active at the time of telephone interview. (See Behavioral Risk Factor Surveillance System).
Data from the Illinois Behavioral Risk Factor Surveillance System (Illinois BRFSS) was used to present prevalence of diabetes in Illinois counties. Diabetes prevalence is defined as adults, 18 years of age or older, who responded to the BRFSS telephone interview that they had been told they had diabetes (see Behavioral Risk Factor Surveillance System).
Data from the Illinois Behavioral Risk Factor Surveillance System (Illinois BRFSS) was used to present prevalence of obesity in Illinois counties. Obesity prevalence is defined as the percentage of adults age 18 or older with a body mass index greater than or equal to 30. Data on height and weight is collected through BRFSS telephone interview and used to calculate body mass index (see Behavioral Risk Factor Surveillance System).
Data from the Illinois Behavioral Risk Factor Surveillance System (Illinois BRFSS) was used to present information on the percentage of current smokers in Illinois counties. Respondents to the BRFSS telephone survey indicated their current smoking status (see Behavioral Risk Factor Surveillance System).
Data from the Illinois Behavioral Risk Factor Surveillance System (Illinois BRFSS) was used to present information on physical activity behaviors of residents of Illinois counties. Respondents to the BRFSS telephone survey were categorized as physically inactive if they reported no leisure time physical activity within the last thirty days (see Behavioral Risk Factor Surveillance System).
Data from the Illinois Behavioral Risk Factor Surveillance System (Illinois BRFSS) was used to present the percentage of the adult population (age 18 or older) who responded they had eight or more “poor mental health days” in the past 30 days. The data is collected through the BRFSS telephone interview and is based on responses to the question “Thinking about your mental health, which includes stress, depression, and problems with emotions, for how many days during the past 30 days was your mental health not good?”. Data is available at the Illinois county geographical level. For more information about the Illinois BRFSS see /contents/view/data_sources/#brfss.
Data from the Illinois Behavioral Risk Factor Surveillance System (Illinois BRFSS) was used to present prevalence of diagnosis of heart attack in Illinois counties. Heart attack prevalence is defined as adults, 18 years of age or older, who responded to the BRFSS telephone interview that they had been told they had heart attack (see Behavioral Risk Factor Surveillance System).
Data from the Illinois Behavioral Risk Factor Surveillance System (Illinois BRFSS) was used to present prevalence of diagnosis of angina (coronary heart disease) in Illinois counties. Angina prevalence is defined as adults, 18 years of age or older, who responded to the BRFSS telephone interview that they had been told they had angina (see Behavioral Risk Factor Surveillance System).
Data from the Illinois Behavioral Risk Factor Surveillance System (Illinois BRFSS) was used to present prevalence of diagnosis of stroke in Illinois counties. Stroke prevalence is defined as adults, 18 years of age or older, who responded to the BRFSS telephone interview that they had been told they had a stroke (see Behavioral Risk Factor Surveillance System).
The Clinical Classification Software (CCS) for ICD-10-CM was used to analyze the Behavioral Health hospitalization measures for Mood Disorders, Alcohol-related Disorders, Substance-related Disorders, and Anxiety in the adult population (18 years and older). The CCS was developed as part of the Healthcare Cost and Utilization Project sponsored by the Agency for Health Research and Quality. The software was developed for use with hospital discharge data. The CCS tool collapses the multitude of ICD-10-CM codes (over 68,000 diagnosis codes) into a number of smaller clinically meaningful categories. It is often used in descriptive analyses. The CCS includes Mental Health and Substance Use disorder categories.
In this case, the Illinois Hospital Discharge data was utilized as the data source and includes hospitalization discharges with a billing code falling within one of the four CCS categories outlined above (for mood, alcohol, substance related disorders, and anxiety). Data includes only non-federal, acute care and behavioral health hospitals in Illinois. All Illinois Veterans Affairs and state run behavioral health hospitals are excluded.
Data for geographic areas (county, zip code, Cook County sub-regions and Illinois regions) and race/ethnicity categories with less than 20 discharges for the reporting period were suppressed due to statistical imprecision and patient confidentiality. Rates reported are average annual rates per 10,000 area population. Rate calculation for a given geographic area (zip/county/state region) or race/ethnicity category was suppressed when the combined population estimate was less than 1000.
Further information about the Clinical Classification Software can be found at: https://www.hcup-us.ahrq.gov/toolssoftware/ccs/CCSUsersGuide.pdf.
Interest in the study of emergency department utilization is growing rapidly. Emergency department (ED) visit volume has surged in recent years, and many people are using these services as a primary means of obtaining medical care. Along with demographic components such as age, sex, race and ethnicity, payer and income level, it is useful to look at the type of visit associated with emergency department use (necessary or unnecessary) and ED use for ambulatory care-sensitive conditions such as asthma and diabetes.
Asthma
Type II Diabetes
Emergency Department visits for hypertension were defined as visits with a primary diagnosis of hypertension and are based on the Agency for Health Research and Quality prevention quality indicator PQI 7 (for hypertension). Specifications exclude all obstetric-related visits, visits associated with cardiac procedures, Stage IV kidney disease, or transfers from other health care facilities. The data source was the Illinois discharge data collection system and includes all 2012, 2013, and 2014 outpatient discharges with an emergency department billing code. These data currently exclude those cases known to have resulted in admission to a hospital as an inpatient; however they do include cases where an outpatient surgery and/or observation care may have been given. Only patients aged 18 years or older were included in the analysis. Data for geographic areas (county, zip code, Cook County sub-regions and Illinois regions) and race/ethnicity categories with less than 20 discharges in 2012-2014 were suppressed due to statistical imprecision and patient confidentiality. Three-year average crude rates are reported per 10,000 area population. Rate calculation for a given geographic area (zip/county/state region) or race/ethnicity category was suppressed when the 2012-2014 combined population estimate was less than 1000.
The prevalence rate is determined using data reported to eHARS. To determine the prevalence rate, the number of persons living with diagnosed HIV disease whose last known address was in Illinois and who were last known to be alive as of 12/31/2018 and reported to eHARS by June 30th, 2019 was used as the numerator. The most recently reported address in eHARS was used to calculate county-level incidence rates; county HIV prevalence rates can be affected by the presence of correctional facilities in the county. Vintage 2018 U.S. Census county population estimates were used as the denominator to determine the HIV prevalence rate per 100,000 population..
The data source was the Illinois discharge data collection system and includes inpatient discharges based on ICD 10 CM codes. Hospital admissions with the principal diagnosis code indicating injury as the reason for hospitalization are included in this measure. The codes for all Injuries include traumatic brain injury (TBI), unintentional falls, motor vehicle traffic (MVT), assault, fire and firearms as well as all other causes of injury included in the external cause codes of the ICD 10 CM coding scheme.
The first-listed (or primary diagnosis) was used to identify the inpatient discharges for injuries. Guidance from the Council of State and Territorial Epidemiologists (CSTE) was used to define the indicator and sub-indicators and can be found here: GeneralInjuryIndicators - Injury_Surveillance_Methods_Toolkit (cste.org).
Injury Inpatient discharges were defined as follows:
Data for geographic areas (county, zip code, Cook County sub-regions and Illinois regions), age groups and race/ethnicity categories with less than 20 discharges in for the reporting period was suppressed due to statistical imprecision and patient confidentiality. Rates reported for pediatric, adult and senior populations are three-year average rates per 10,000 area population. Rate calculation for a given geographic area (zip/county/state region), age group or race/ethnicity category was suppressed when the data reporting period combined population estimate was less than 1000.
The data source was the Illinois discharge data collection system and includes outpatient discharges with an emergency department billing code. The most inclusive method (all diagnosis codes and reason for visit) was used to pull the data. The codes for NTDC are a subset of all oral and facial related codes and include caries, periodontal disease, erosion, occlusal anomalies, cysts, impacted teeth, teething, and all other non-traumatic conditions associated with the oral cavity. Diagnoses that are deemed due to trauma are excluded from this definition.
The first-listed (or primary diagnosis) was used to identify the ED discharges for NTDC. The data source was the Illinois discharge data collection system. and includes outpatient discharges with an emergency department billing code. These data include all NTCD diagnosis codes and reason for visit.
NTDC ED discharges were defined as follows:
Data for geographic areas (county, zip code, Cook County sub-regions and Illinois regions) and race/ethnicity categories with less than 20 discharges in for the reporting period was suppressed due to statistical imprecision and patient confidentiality. Rates reported for pediatric and adult populations are three-year average rates per 10,000 area population. Rate calculation for a given geographic area (zip/county/state region) or race/ethnicity category was suppressed when the data reporting period combined population estimate was less than 1000.
The data source was the Illinois County Behavioral Risk Factor Survey (ICBRFS). ICBRFS is a statewide telephone survey that collects county level health data on health-related risk behaviors, chronic health conditions, health care access, and use of preventative services. The ICBRFS uses a standardized questionnaire and procedures established by the Centers for Disease Control and Prevention (CDC) and used for the nationwide program known as Behavioral Risk Factor Surveillance System (BRFSS).
The IL BRFSS statewide data is available at: http://www.idph.state.il.us/brfss/statedata.asp
The interviews are conducted over a period of years and are referred to as a round. Round 6 started in 2015 with counties at the southernmost portion of the state and progressed north to the top of the state, completing all counties of Illinois in 2019. Round 6 included approximately 37,000 surveys across the state.
Because the ICBRFS respondents are randomly selected, measures of prevalence are subject to random sample errors. Each measure listed in the data tables includes the number of respondents (unweighted count), the estimated percent (weighted percentage), the 95% confidence interval (upper and lower limits), and the estimated population (weighted count).
Calculations are intentionally suppressed to reduce the possibility of making statements about the findings when the data is not strong enough to support any statistical conclusions. To provide high quality health information, prevalence estimates are suppressed when any of the following criteria are met: fewer than 6 respondents in the numerator (i.e. the number of respondents associated with the response categories, e.g. “Yes-No”), there are fewer than 50 respondents in the denominator (i.e. the total number of respondents to a question), the half-width of the confidence interval for the prevalence estimate is greater than 10. Additionally, not all survey questions are able to be analyzed for each county.
Weighted data are used in all calculations, so percentages shown in tables cannot be derived exactly from the numbers presented. ICBRFS data are weighted for the probability of selection of a telephone number, the number of adults in a household, and the number of phones in a household. The data is adjusted to reflect the demographic distribution of the county’s adult population (ages 18 and older). It is advised not to compare county data to state rates from the BRFSS due to the difference in the methodology to weigh the data. Additionally, comparisons to other Illinois counties should be made with caution as ICBRFS completes counties on a rotating basis and counties will be surveyed during different timeframes within the survey rotation.
Prevention Quality Indicators (PQIs), developed by the federal Agency of Healthcare Research and Quality (AHRQ), identify hospital admissions that evidence suggests could have been avoided, at least in part, through high-quality outpatient care. They represent hospital admission rates for ambulatory care sensitive conditions. Even though these indicators are based on hospital inpatient data, they provide insight into the community health care system or services outside the hospital setting. For Prevention Quality Indicators, lower rates usually represent better outpatient care.
PQIs used in this report consist of the following 13 ambulatory care sensitive conditions, which are measured as rates of admission to the hospital. They are presented as a rate among the adult population (>=18 years of age):
Both the observed and risk adjusted measures are reported. Risk adjustment is based on county specific age and sex distribution. Further details of the PQIs can be found at: http://www.qualityindicators.ahrq.gov/Modules/pqi_resources.aspx.
The PQIs are defined using AHRQ definitions and programs. The county level PQIs were created using AHRQ SAS QI 4.5a. As this software only defines the PQIs at the county level, the AHRQ SAS program was modified to allow for estimation of Illinois regions.
Race specific PQIs: The race specific PQI measures reflect crude, race-stratified rates. They are not risk adjusted. The rates are suppressed where case counts or populations are low.