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Data Collection and Measurement

Next Reply: Re:Mortality - Admit to Hospice on Day 1
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Post Mortality - Admit to Hospice on Day 1
Author: mdavis
Date: Jan 24, 2010 4:06 pm
A patient's death is excluded from the mortality calculation IF he/she was admitted to hospice in the 12 months preceding the hospital admission OR on the FIRST day of the hospital admission. It seems highly unlikely that a patient would be admitted to hospice on Day 1 of an acute admission to the hospital. The patient may be offered the GIP level of care if the hospital has a contract with a hospice to do so. This, too, is not likely to happen on day 1. Am I missing something? This was new for 2009 but doesn't seem to be much of an advantage due to it being a very rare circumstance.
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Re:Mortality - Admit to Hospice on Day 1 (by jbcassel on 02/10/2010)
Good question, and I am sorry for the delay in posting an answer. First, to clarify two things, the exclusion you are referring to is in effect only for CMS's own "Hospital Compare" mortality measurement, and technically they refer to this as hospice "enrollment" because the data source is the Medicare Enrollment Database. You're correct - CMS did add this "or on first day of hospital admission" exclusion in 2009, and it does indeed apply to only a small percentage of cases. While this may not seem significant numerically, it is an important way to recognize and take into account that such cases would not be appropriate for the equation of "more deaths = lower quality" in comparing hospitals. Currently only CMS has the ability to look at this data source, so it is the only one with the ability to make this exclusion. Let me know what you think.
- Brian Cassel, VCU Massey Cancer Center PCLC

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