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Congestive Heart Failure Rate (PQI 08)

CBE ID
0277
Project
Prevention and Population Health
Endorsed
New or Maintenance
Maintenance
Endorsement and Maintenance (E&M) Cycle
Fall 2017
Is Under Review
No
Measure Description

Admissions with a principal diagnosis of heart failure per 100,000 population, ages 18 years and older. Excludes cardiac procedure admissions, obstetric admissions, and transfers from other institutions.

[NOTE: The software provides the rate per population. However, common practice reports the measure as per 100,000 population. The user must multiply the rate obtained from the software by 100,000 to report admissions per 100,000 population.]

  • Measure Type
    Process
    Electronic Clinical Quality Measure (eCQM)
    No
    Level Of Analysis
    Health Plan
    Integrated Delivery System
    Care Setting
    Emergency Department and Services
    Inpatient/Hospital
    Outpatient Services
    Numerator

    Discharges, for patients ages 18 years and older, with a principal ICD-9-CM or ICD-10-CM diagnosis code
    for heart failure.

    [NOTE: By definition, discharges with a principal diagnosis of heart failure are precluded from an assignment of MDC 14 by grouper software. Thus, obstetric discharges should not be considered in the PQI rate, though the AHRQ QITM software does not explicitly exclude obstetric cases.]

    Denominator

    Population ages 18 years and older in metropolitan area† or county. Discharges in the numerator are assigned to the denominator based on the metropolitan area or county of the patient residence, not the metropolitan area or county of the hospital where the discharge occurred.

    † The term “metropolitan area” (MA) was adopted by the U.S. Census in 1990 and referred collectively to metropolitan statistical areas (MSAs), consolidated metropolitan statistical areas (CMSAs) and primary metropolitan statistical areas (PMSAs). In addition, “area” could refer to either 1) FIPS county, 2) modified FIPS county, 3) 1999 OMB Metropolitan Statistical Area or 4) 2003 OMB Metropolitan Statistical Area. Micropolitan Statistical Areas are not used in the QI software.

    Exclusions

    Not applicable.

    Testing Data Sources
    Claims Data
    Electronic Health Records: Electronic Health Records
  • Most Recent Endorsement Activity
    Measure Retired and Endorsement Removed Prevention and Population Health Fall Cycle 2017
    Initial Endorsement
    Endorsement Status
    Endorsement Removed
    Last Updated
    Removal Date