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Data Element
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Categories
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Description
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Comments
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Primary Diagnostic Category
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Diagnosis codes from the ICD-9-CM classification system are used.
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The categories available for selection are derived from the principle diagnosis code.
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Diagnostic grouping is done using the clinical classificaton software (CCS) developed by
the Healthcare Cost and Utilization Project (HCUP).
The ICD-9-CM's diagnosis codes (more than 12,000)
are collapsed into a smaller number of
clinically meaningful categories that are sometimes more useful for
presenting descriptive statistics than are individual ICD-9-CM codes.
There are currently 259 separate categories of diagnosis codes in the CCS system.
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Primary Surgical Category
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Procedure (surgical) codes from the ICD-9-CM classification system are used.
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The categories available for selection are derived from the principle procedure (surgical) code.
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Surgical grouping is done using the clinical classificaton software developed by
the HCUP. The ICD-9-CM's procedure codes (more than 3,500)
are collapsed into a smaller number of
clinically meaningful categories that are sometimes more useful for
presenting descriptive statistics than are individual ICD-9-CM codes.
There are currently 231 separate categories of surgical procedures in the CCS system.
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Diagnosis Related Groups (DRGs)
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One of the most common categories used in the analysis and study of health care data.
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All possible principle diagnoses are divided into major diagnostic categories (MDCs) which are further divided
into smaller groups of clinically coherent categories of patients with treatments consuming generally consistent
amounts of resources.
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There are currently 25 MDCs and more than 500 DRGs with potential new categories evaluated each year.
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Major Diagnostic Categories (MDCs)
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Diagnoses in each MDC correspond to a single organ system or etiology and are generally associated
with a certain medical specialty. MDCs provide high order categories to focus on entire body systems.
There are currently 25 separate MDC categories.
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All possible principle diagnoses are divided into major diagnostic categories (MDCs) as the first step in
assigning a specific diagnosis related group (DRG) to the treatment received by each patient.
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There are certain conditions in which no MDC is assigned. These are organ transplants, conditions
involving tracheostomy, certain surgical procedures unrelated to the principle diagnosis,
principle diagnosis invalid as a discharge diagnosis and ungroupable
clinical data. The last two situations should rarely be found due to
exhaustive pre-editing of data received from Illinois hosptials.
You may wish to refer to other resources for additional information related to MDC assignments.
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Time Period
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Year and quarter
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Quarterly time frames are based on the date of discharge from the hospital.
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ZIP Code Category
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All ZIP code populations in Illinois were aggregated to the first four then the first three digits.
All groups with at least 20,000 residents in the population were retained, with all other
ZIP codes, along with unknown Illinois, out-of-state and foreign addresses were included in
category 0000 as unknown.
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ZIP code of patient residence at the time of hospitalization.
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Post office box addresses are considered unknown.
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Patient Residence Strata
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City of Chicago
Suburban Cook county
Metro collar counties
Urban counties
Rural counties
out-of-state/unknown
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Strata of patient residence at the time of hospitalization.
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Post office box addresses considered unknown.
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Patient Admit Type
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Emergency
Urgent
Elective
Newborn
Trauma center
Info not available
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Identifies the type of admission to the hospital.
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Patient Admit Source
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Physician referral
Clinical referral
HMO referral
Another hospital
Skilled nursing facility
Another health care
facility
Emergency department
Court/law
enforcement
Info not avail
Critical access
hospital
Newborn - normal
delivery
Newborn - premature
delivery
Newborn - sick baby
Newborn - extramural
birth
Newborn - info not
avail
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Identifies the source of admission to the hospital.
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Patient Discharge Status
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Routine discharge
Short-term general
hospital
Skilled nursing
facility
Intermediate care
facility
Another type of
institution
Home under care of
organized home
health service
Left against medical
advice
Home under the care
of home IV drug
therapy provider
Other
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Identifies the status of the patient at discharge from the provider.
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Length of Stay (days)
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Less than 7
7 - 13
14 - 29
30 and more
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The number of days a patient was hospitalized.
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Identifies the length of time that patients were
hospitalized, including outlier cases in which the
degree of severity of the condition within the
respective diagnosis related group (DRG) required
stays below or beyond the average length of stay.
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Hospital Charges
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Less than $ 3,500.00
$ 3,500.00-6,499.99
$ 6,500.00-11,999.99
$ 12,000.00-35,999.99
$ 36,000.00-99,999.99
$ 100,000.00 or more
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Identifies the hospital charges incurred during
hospitalization.
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Due to managed care contracting, payor discount
arrangements, Medicare and Medicaid payment plans,
and other agreements, charges reflect hospital billing
only, not necessarily actual consumer payment.
In addition, some services or items provided in the
hospital may not be reflected in each hospital's
charges due to contractual arrangements or limitations
with other clinical providers, e.g., anesthesia,
diagnostic testing, professional clinical services, etc.
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Payor
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Medicare
Medicaid
Insurance
Self pay
Other
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Indicates the primary source of expected payment for
the hospital charges. The final payment may vary from the initial charge for services.
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HMO and all commercial payers are combined as insurance.
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Age Group
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0
1 - 4
5 - 14
15 - 24
25 - 34
35 - 44
45 - 54
55 - 64
75 - 74
75 - 84
85 and older
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Age in years, based on the date of discharge from the hospital.
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Age values are, for the most part, provided in 10 year intervals.
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Gender
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Female
Male
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