The measure estimates a hospital-level 30-day risk-standardized mortality rate (RSMR), defined as death from any cause within 30 days after the index admission date, for patients discharged from the hospital with either a principal discharge diagnosis of COPD or a principal discharge diagnosis of respiratory failure with a secondary discharge diagnosis of acute exacerbation of COPD. CMS annually reports the measure for patients who are 65 years or older and enrolled in fee-for-service (FFS) Medicare and hospitalized in non-federal hospitals or are patients hospitalized in Veterans Health Administration (VA) facilities.
The outcome for this measure is 30-day all-cause mortality. We define mortality as death from any cause within 30 days from the date of admission for patients hospitalized with either a principal diagnosis of COPD or a principal diagnosis of respiratory failure with a secondary diagnosis of acute exacerbation of COPD.
Denominator
1.15 Denominator
This claims-based measure is used for a cohort of patients aged 65 years or older.
The cohort includes admissions for patients aged 65 years and older discharged from the hospital with a principal discharge diagnosis of COPD and with a complete claims history for the 12 months prior to admission. The measure is publicly reported by CMS for those patients 65 years and older who are Medicare FFS or VA beneficiaries admitted to non-federal or VA hospitals, respectively.
Additional details are provided in S.7 Denominator Details.
Exclusions
Exclusions
The mortality measures exclude index admissions for patients:
1. With inconsistent or unknown vital status or other unreliable demographic (age and gender) data; 2. Enrolled in the Medicare hospice program or used VA hospice services any time in the 12 months prior to the index admission, including the first day of the index admission; or 3. Discharged against medical advice (AMA).
For patients with more than one admission for a given condition in a given year, only one index admission for that condition is randomly selected for inclusion in the cohort for each year.
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