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    URSA-PHF-043: 90-Day Post-Op All-Cause Hospital IP Admission
    • 17 Jul 2025
    • 7 Minutes to read
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    URSA-PHF-043: 90-Day Post-Op All-Cause Hospital IP Admission

    • Updated on 17 Jul 2025
    • 7 Minutes to read
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    Article summary

    Measure Description

    Among surgery encounters, the percentage with a hospital inpatient admission within 90 days of discharge.

    Metadata

    • Measure Type: Rate Measure
    • Temporal Structure: Event
    • Component Class: Normal-Form
    • Denominator Case Field: Surgery Encounter ID
    • Target Direction: Down

    Denominator Description

    One per surgery encounter for living plan members; excluding surgery encounters with discharge status indicating the patient expired, was transferred to inpatient status at another hospital, or had a planned readmission.

    Numerator Description

    Hospital inpatient admissions within 90 days of the surgery encounter end date.

    Published Fields

    • Data Model Keys

      • Surgery Encounter ID
      • Surgery Patient ID
      • Surgery Encounter Primary Payor ID
      • Surgery Encounter Primary Plan ID
      • Surgery Facility Provider ID
      • Surgery Attending Provider ID
      • Surgery Primary HCPCS Procedure Provider ID
      • Patient ID
      • Primary Plan Attributee Provider ID
      • Empirical Attributee Primary Care Individual Provider ID
      • Empirical Attributee Primary Care Provider Group Provider ID
      • Primary Payor ID
      • Primary Plan ID

    • Patient Fields

      • Is Patient Alive
      • Is Hospice in Last 12 Months
      • Patient Last Name
      • Patient Date of Birth
      • Patient Age Integer
      • Patient Age Category Tier 1
      • Patient Age Category Tier 2
      • Patient Sex Category
      • Is Patient Sex Female
      • Is Patient Sex Male
      • Count Hospital Inpatient Admissions in Last 12 Months
      • Count ED Visits Without Inpatient Admissions in Last 12 Months
      • PCP Attribution Category
      • Primary Care Engagement Category
      • Count Primary Care Visits in Last 36 Months
      • Specialty Care Engagement Category
      • Count Specialty Care Office Visits in Last 36 Months
      • Primary or Specialty Care Engagement Category
      • Count Clinician Office Visits in Last 3 Years
      • Patient ZIP Code 5-Digit
      • Primary Plan Employer Description

    • Encounter Fields

      • Surgery Is Observation Stay Parent Encounter
      • Surgery Surgery Encounter Setting Category
      • Surgery Is Patient Discharged Home or Home with Home Health
      • Surgery Is Hospital Inpatient Admission Encounter
      • Surgery Is Ambulatory Surgical Center Encounter
      • Surgery Is Hospital Outpatient Surgery Encounter
      • Surgery Is Emergency Department Parent Encounter
      • Surgery Is MSK Related Encounter

    • Date Fields

      • Surgery Encounter LOS in Elapsed Midnights
      • Surgery Is Same Day Discharge
      • Surgery Encounter Start Date
      • Surgery Encounter End Date
      • Period Start Date
      • Period End Date
      • Current Continuous Primary Payor Membership Episode Start Date
      • Current Continuous Primary Payor Membership Episode 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)

    • Numerator Fields

      • Hospital IP Encounter ID
      • Hospital IP Encounter Start Date
      • Hospital IP Encounter End Date
      • Is Hospital IP Emergency Department Visit Parent Encounter
      • Is Hospital IP Observation Stay Parent Encounter
      • Hospital IP Facility Provider Description
      • Hospital IP Attending Provider Description
      • Hospital IP Primary HCPCS Procedure HCPCS Code
      • Hospital IP Principal Discharge Diagnosis ICD-10-CM Code
      • Hospital IP Principal Discharge Diagnosis ICD-10-CM Description
      • Hospital IP MS-DRG Code
      • Hospital IP MS-DRG Description
      • Hospital IP Primary Plan Allowed Amount
      • Hospital IP Primary Plan Paid Amount
      • Hospital IP Total Plan Paid Amount from All Plans
      • Hospital IP Patient Paid Amount
      • Elapsed Days from Surgery to IP Admission
      • Hospital IP Facility Provider ID
      • Hospital IP Encounter Patient Inpatient Status Start Date
      • Hospital IP Ursa Hospital Admission Condition-Treatment Type Tier 1 Category
      • Hospital IP Inpatient LOS Category Tier 1
      • Is Hospital IP Inpatient LOS < 2 Midnights
      • Hospital IP Inpatient LOS in Elapsed Midnights
      • Hospital IP Inpatient LOS in Distinct Calendar Days
      • Is Hospital IP Discharge Status Home or Home with Home Health
      • Hospital IP Primary HCPCS Short Description
      • Hospital IP Discharge Diagnosis AHRQ CCS Multi-Level Diagnosis Category Tier 2 Code
      • Hospital IP Discharge Diagnosis AHRQ CCS Multi-Level Diagnosis Category Tier 2 Description
      • Hospital IP Facility Provider State Abbreviation
      • Hospital IP APR-DRG Code
      • Hospital IP APR-DRG Description
      • Hospital IP APR-DRG MDC Code
      • Hospital IP APR-DRG MDC Description

    • Provider Fields

      • Surgery Facility Provider Description
      • Surgery Facility Provider Primary NUCC Provider Taxonomy Code
      • Surgery Facility Provider Primary NUCC Provider Taxonomy Description
      • Surgery Facility Provider Practice Address State Abbreviation
      • Surgery Facility Provider Practice Address ZIP Code 5-Digit
      • Surgery Attending Provider Description
      • Surgery Attending Provider Primary NUCC Provider Taxonomy Code
      • Surgery Attending Provider Primary NUCC Provider Taxonomy Description
      • Primary Plan Attributee Provider Description
      • Primary Plan Attributee Primary NUCC Provider Taxonomy Description
      • Empirical Attributee Primary Care Individual Provider Description
      • Empirical Attributee Primary Care Individual Primary NUCC Provider Taxonomy Description
      • Empirical Attributee Primary Care Provider Group Provider Description
      • Empirical Attributee Primary Care Provider Group Primary NUCC Provider Taxonomy Description
      • Count Visits with Attributee Individual Primary Care Provider in Last 36 Months
      • Count Visits with Attributee Primary Care Provider Group in Last 36 Months

    • Location Fields

      • UW HIP Area Deprivation Index National Percentile
      • UW HIP ADI Quintile Category
      • CDC SVI Overall Quintile Category
      • CDC SVI Socioeconomic Quintile Category
      • CDC SVI Household / Disability Quintile Category
      • CDC SVI Minority / Language Quintile Category
      • CDC SVI Housing / Transportation Quintile Category

    • Insurance Fields

      • Surgery Encounter Primary Payor Description
      • Surgery Encounter Primary Plan Description
      • Surgery Encounter Primary Plan Financial Class Description
      • Is Any Current Plan Membership
      • Count Active Plan Memberships
      • Primary Payor Description
      • Primary Plan Description
      • Primary Plan Financial Class Description
      • Is Primary Plan Financial Class Commercial
      • Is Primary Plan Financial Class Medicare Advantage
      • Is Primary Plan Financial Class Medicare FFS
      • Is Primary Plan Financial Class Medicaid
      • Is Primary Plan Financial Class Other

    • Diagnosis Fields

      • Surgery Principal Discharge Diagnosis ICD-10-CM Code
      • Surgery Principal Discharge Diagnosis ICD-10-CM Description
      • Surgery Is Principal Discharge Diagnosis Musculoskeletal System
      • Surgery Principal Discharge Diagnosis AHRQ CCS Single-Level Diagnosis Category Code
      • Surgery Principal Discharge Diagnosis AHRQ CCS Single-Level Diagnosis Category Description
      • Surgery Principal Discharge Diagnosis AHRQ CCS Multi-Level Diagnosis Category Tier 1 Code
      • Surgery Principal Discharge Diagnosis AHRQ CCS Multi-Level Diagnosis Category Tier 1 Description
      • Surgery Principal Discharge Diagnosis AHRQ CCS Multi-Level Diagnosis Category Tier 2 Code
      • Surgery Principal Discharge Diagnosis AHRQ CCS Multi-Level Diagnosis Category Tier 2 Description
      • CCW Count Category
      • Count CCW Conditions
      • Is CCW Acquired Hypothyroidism
      • Is CCW Acute Myocardial Infarction
      • Is CCW ADHD, Conduct Disorders, and Hyperkinetic Syndrome
      • Is CCW Alzheimers Disease
      • Is CCW Alzheimers Disease and Related Disorders or Senile Dementia
      • Is CCW Anemia
      • Is CCW Anxiety Disorders
      • Is CCW Asthma
      • Is CCW Atrial Fibrillation
      • Is CCW Autism Spectrum Disorder
      • Is CCW Benign Prostatic Hyperplasia
      • Is CCW Bipolar Disorder
      • Is CCW Blindness and Visual Impairment
      • Is CCW Breast Cancer
      • Is CCW Cataract
      • Is CCW Cerebral Palsy
      • Is CCW CKD
      • Is CCW Colorectal Cancer
      • Is CCW COPD and Bronchiectasis
      • Is CCW Cystic Fibrosis and Other Metabolic Disorder
      • Is CCW Deafness and Hearing Impairment
      • Is CCW Depression
      • Is CCW Depressive Disorders
      • Is CCW Diabetes
      • Is CCW Endometrial Cancer
      • Is CCW Epilepsy
      • Is CCW Fibromyalgia and Chronic Pain and Fatigue
      • Is CCW Glaucoma
      • Is CCW Heart Failure
      • Is CCW Hip or Pelvic Fracture
      • Is CCW Hyperlipidemia
      • Is CCW Hypertension
      • Is CCW Intellectual Disability
      • Is CCW Ischemic Heart Disease
      • Is CCW Learning Disability
      • Is CCW Leukemia
      • Is CCW Lung Cancer
      • Is CCW Migraine and Chronic Headache
      • Is CCW Mobility Impairment
      • Is CCW Multiple Sclerosis
      • Is CCW Muscular Dystrophy
      • Is CCW Obesity
      • Is CCW Osteoporosis
      • Is CCW Other Developmental Delay
      • Is CCW Personality Disorder
      • Is CCW Pressure or Chronic Ulcer
      • Is CCW Prostate Cancer
      • Is CCW PTSD
      • Is CCW PVD
      • Is CCW Rheumatoid Arthritis or Osteoarthritis
      • Is CCW Schizophrenia
      • Is CCW Schizophrenia or Other Psychotic Disorders
      • Is CCW Stroke or Transient Ischemic Attack
      • CCW Systems Category
      • Count CCW Systems
      • Is CCW System Behavioral Health
      • Is CCW System Cardiovascular
      • Is CCW System Congenital
      • Is CCW System Endocrine/Metabolic
      • Is CCW System Genitourinary
      • Is CCW System Hematologic
      • Is CCW System Musculoskeletal
      • Is CCW System Neurological
      • Is CCW System Oncologic
      • Is CCW System Ophthalmologic
      • Is CCW System Pulmonary
      • Is CCW System Other

    • Financial Fields

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

    • Billing and Claims Fields

      • Surgery Ursa Hospital Admission Condition-Treatment Type Tier 1 Category
      • Surgery MS-DRG Code
      • Surgery MS-DRG Description
      • Surgery MS-DRG MDC Code
      • Surgery MS-DRG MDC Description
      • Surgery Is MS-DRG MDC Code Musculoskeletal System
      • Surgery APR-DRG Code
      • Surgery CMS Admit Type Code
      • Surgery CMS Admit Type Description
      • Surgery CMS Admit Source Code
      • Surgery CMS Admit Source Description
      • Surgery CMS Place of Service Description
      • Surgery CMS Place of Service Code
      • Surgery CMS Patient Discharge Status Code
      • Surgery CMS Patient Discharge Status Description

    • Clinical Services Fields

      • Surgery Primary HCPCS Procedure HCPCS Code
      • Surgery Primary HCPCS Short Description
      • Surgery Primary HCPCS Long Description
      • Surgery Is Primary HCPCS Procedure Surgical
      • Surgery Primary Surgical Procedure HCPCS Category
      • Surgery Is Primary HCPCS Surgical Procedure of Musculoskeletal System
      • Surgery Primary HCPCS MSK Surgical Procedure Category
      • Surgery Primary HCPCS AHRQ CCS Single-Level Procedure Category Code
      • Surgery Primary HCPCS AHRQ CCS Single-Level Procedure Category Description
      • Surgery Principal ICD Procedure ICD-10-PCS Code
      • Surgery Principal ICD Procedure ICD-10-PCS Description
      • Surgery Is Principal ICD-10-PCS Operation of Musculoskeletal System
      • Surgery Principal ICD-10-PCS AHRQ CCS Single-Level Procedure Category Code
      • Surgery Principal ICD-10-PCS AHRQ CCS Single-Level Procedure Category Description
      • Surgery Principal ICD-10-PCS AHRQ CCS Multi-Level Procedure Category Tier 1 Code
      • Surgery Principal ICD-10-PCS AHRQ CCS Multi-Level Procedure Category Tier 1 Description
      • Surgery Principal ICD-10-PCS AHRQ CCS Multi-Level Procedure Category Tier 2 Code
      • Surgery Principal ICD-10-PCS AHRQ CCS Multi-Level Procedure Category Tier 2 Description
      • Surgery Surgery Encounter Hip-Knee Category

    • Validation Only Fields

      • Surgery Is Any Total Hip or Knee Replacement
      • Surgery Is MSDRG for Hip or Knee Replacement
      • Surgery Is Principal ICD-10 PCS AHRQ CCS Single Level Category Total Knee
      • Surgery Is Principal ICD-10 PCS AHRQ CCS Single Level Category Total Hip
      • Surgery Is Primary HCPCS AHRQ CCS Single Level Category Total Knee
      • Surgery Is Primary HCPCS AHRQ CCS Single Level Category Total Hip

    • Measure Fields

      • Denominator
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