MI Mortality

christine.butka@hmhn.orgchristine.butka@hmhn.org
in CDI Management
Regarding MI mortality measures, do hospitals get penalized for patients that expire with a primary or secondary diagnosis of MI? We don’t look to see what the index admission is for, we just hold everyone with these diagnoses to determine if the MI diagnosis is clinically valid because the thought is that these patients are included in the mortality measure. 

Comments

  • lprescott1lprescott1
    if you are referring to the 30 day mortality measure related to Hospital Value Based Purchasing, An index admission is triggered by the principal diagnosis of the MI. 
  • christine.butka@hmhn.orgchristine.butka@hmhn.org
    Our Quality Department is reviewing all patients who Expire with a Primary Diagnosis or Secondary Diagnosis of MI because they think that is what is driving the MI Mortality Measure. If a patient has a secondary diagnosis of MI that is not clinically valid, they are saying we are being penalized for MI mortality.  I think they are misunderstanding what is being measured (Index admission with PDX of MI that expires within 30 days) but before I bring that up to them I want to make sure I am correct.  
    Besides the 30 day mortality measure related to HVBP, is there any other quality indicator that penalizes a hospital for a patient dying (during the same admission) with a primary or secondary diagnosis of MI?   
  • lprescott1lprescott1
    there are many registries that hospitals may report to for a number of different measures. I would encourage you to ask the quality department to further define what mortality index they are referring to. Together you might be able to understand the methodology, and risk adjustment applied. I do find in my travels, many make assumptions about the CMS measures that are not actually true. Education is key to assure you understand.
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