Pneumonia Cohort

This cohort follows the specifications for the CMS Pneumonia Condition-Specific Readmission measure. It uses the same diagnosis and admission/discharge information.

To leverage this cohort:

  • Profile filters: In the Profile Editor, add the cohort as a profile filter. With this option, you can further customize the profile with additional filters.
  • Statistical Process Control: Add a Statistical Process Control section to a scorecard and select the cohort from the dropdown. Within this section, the cohort is not customizable and must be used as-is. When drilling into a chart in the SPC section, you can select to create a profile of the encounters you're drilling into so you can analyze and customize further.

Cohort inclusions

To be eligible for this cohort, the encounter must have:

  • A Principal Diagnosis for Pneumonia (one of: A481, J1000, J1001, J1008, J1100, J1108, J120, J121, J122, J123, J1281, J1289, J129, J13, J14, J150, J151, J1520, J15211, J15212, J1529, J153, J154, J155, J156, J157, J158, J159, J160, J168, J180, J181, J188, J189, or J690)

OR

  • A Principal Diagnosis for Sepsis (one of: A021, A227, A267, A327, A400, A401, A403, A408, A409, A4101, A4102, A411, A412, A413, A414, A4150, A4151, A4152, A4153, A4159, A4181, A4189, A419, A427, A5486, or B377) 
  • AND at least one POA Secondary Diagnosis of Pneumonia (one of: A481, J1000, J1001, J1008, J1100, J1108, J120, J121, J122, J123, J1281, J1289, J129, J13, J14, J150, J51, J1520, J15211, J15212, J1529, J153, J154, J155, J156, J157, J158, J159, J160, J168, J180, J181, J188, J189, or J690)
  • AND no Secondary Diagnoses for Severe Sepsis (one of: R6520 or R6521).

Cohort exclusions

Encounters transferred or discharged Against Medical Advice (AMA) are excluded.

Statistical Process Control (SPC) measures

The following measures pertain to this cohort in the Statistical Process Control section of scorecards.

Key measures

  • Length of Stay (LOS)
  • 1 to 30 Day Readmission Rate Forward
  • Charges - Pharmacy

Adverse events

These measures flag the encounter if the condition is present. The adverse events are aggregated in the Adverse Event bar chart.

  • Any PSI
  • Any HAC
  • AMI within 7 days of index admission
  • Pneumonia within 7 days of index admission
  • Sepsis within 7 days of index admission
  • Mortality within 30 days of admission
  • Unexplained Cardiac Arrest
  • Reaction to Anesthesia
  • Medical PE/DVT