URSA-PHU-R02: Potentially Preventable Hospital Encounters

Measure Description

One row per encounter for each high probability avoidable ED visit or potentially preventable hospital inpatient admission; the latter includes ambulatory care sensitive admissions and admissions following a prior related encounter.

Metadata

• Measure Type: Registry
• Temporal Structure: Event
• Component Class: Normal-Form
• Denominator Case Field: Encounter ID
• Target Direction: None

Published Fields

• Data Model Keys

  • Encounter ID
  • Patient ID
  • Facility Provider ID
  • Prior Admission Facility Provider ID
  • Prior ED Visit Facility Provider ID
  • Prior SNF Stay Facility Provider ID

• Date Fields

  • Encounter Start Date
  • Encounter End Date
  • Segment Start Date -- The start date of the reporting segment. (See also [URSA-CORE] Reporting Segment)
  • Segment End Date -- The end date of the reporting segment. (See also [URSA-CORE] Reporting Segment)

• Encounter Fields

  • PPHE Category
  • Is ACS Hospital Inpatient Admission
  • Is Hospital Inpatient Admission with Prior Related Encounter
  • Is High Probability Preventable ED Visit with Inpatient Admission
  • Is High Probability Preventable ED Visit without Inpatient Admission
  • ACS Admission PQI Category
  • Prior Encounter Scenario Category
  • Preventable ED Visit Scenario Category
  • Encounter LOS in Elapsed Midnights
  • Is Encounter LOS < 2 Midnights
  • Encounter LOS Category Tier 1
  • Encounter LOS in Distinct Calendar Days

• Provider Fields

  • Facility Provider NPI
  • Facility Provider Description
  • Facility Provider NUCC Taxonomy Code
  • Facility Provider Primary NUCC Provider Taxonomy Description
  • Facility Provider State Abbreviation
  • Facility Provider ZIP Code 5-Digit
  • Prior Admission Facility Provider Description
  • Prior ED Visit Facility Provider Description
  • Prior SNF Stay Facility Provider Description

• Diagnosis Fields

  • Principal Discharge Diagnosis ICD-10-CM Code
  • Principal Discharge Diagnosis ICD-10-CM Description
  • Principal Diagnosis AHRQ CCS Single-Level Diagnosis Category Code
  • Principal Diagnosis AHRQ CCS Single-Level Diagnosis Category Description
  • Principal Diagnosis WHO ICD-10 Block Description
  • Principal Diagnosis WHO ICD-10 Chapter Description
  • Principal Diagnosis AHRQ CCS Multi-Level Diagnosis Category Tier 1 Code
  • Principal Diagnosis AHRQ CCS Multi-Level Diagnosis Category Tier 1 Description
  • Principal Diagnosis AHRQ CCS Multi-Level Diagnosis Category Tier 2 Code
  • Principal Diagnosis AHRQ CCS Multi-Level Diagnosis Category Tier 2 Description

• Financial Fields

  • Primary Plan Allowed Amount
  • Primary Plan Paid Amount
  • Total Plan Paid Amount from All Plans
  • Patient Paid Amount

• Measure Fields

  • Denominator