Post-Acute Care

Total number of patients that have vest and/or limb restraint (upper or lower body or both) on the day of the prevalence measurement episode.

The average (geometric mean) hospital length of stay in days relative to the expected geometric mean length of stay of any well defined population of inpatients over a specified time interval

Percentage of discharges from an inpatient facility (eg, hospital inpatient or observation, skilled nursing facility, or rehabilitation facility) to home or any other site of care, of patients, regardless of age, for which a transition record was transmitted to the facility or primary physician or other health care professional designated for follow-up care within 24 hours of discharge

Total Cost of Care reflects a mix of complicated factors such as patient illness burden, service utilization and negotiated prices. Total Cost Index (TCI) is a measure of a primary care provider’s risk adjusted cost effectiveness at managing the population they care for. TCI includes all costs associated with treating members including professional, facility inpatient and outpatient, pharmacy, lab, radiology, ancillary and behavioral health services.

The Resource Use Index (RUI) is a risk adjusted measure of the frequency and intensity of services utilized to manage a provider group’s patients. Resource use includes all resources associated with treating members including professional, facility inpatient and outpatient, pharmacy, lab, radiology, ancillary and behavioral health services.

A Resource Use Index when viewed together with the Total Cost of Care measure (NQF-endorsed #1604) provides a more complete picture of population based drivers of health care costs.

Percentage of all pediatric (less than 18 years old) in-center hemodialysis, home hemodialysis, and peritoneal dialysis patients with hemoglobin less than 11.0 g/dL and in whom serum ferritin concentration was less than 100 ng/ml and TSAT less than 20% who received IV iron or were prescribed oral iron within the following three months.

Percentage of patients aged 18 years and older with a diagnosis of end stage renal disease (ESRD) with a catheter after 90 days on hemodialysis who are seen/evaluated by a vascular surgeon or other surgeon qualified in the area of vascular access for permanent vascular access at least once during the 12-month reporting period.

Percentage of end stage renal disease (ESRD) patients aged 18 years and older receiving hemodialysis during the 12-month reporting period and on dialysis >90 days who:

1. have a functional autogenous AVF (defined as two needles used or a single-needle device [NOT one needle used in a two-needle device]) (computed and reported separately);

2. have a functional AV graft (computed and reported separately); or

Percentage of patients aged 18 years and older with a diagnosis of community-acquired bacterial pneumonia with vital signs documented and reviewed