Hospital Discharge Data

Hospital discharge data is released each year by the Indiana Department of Health. Inpatient data aggregated by hospital, payer, APR-DRG (All Patients Refined Diagnosis Related Groups), MS-DRG (Medicare Severity Diagnosis Related Groups), principal diagnosis, and principal procedure is provided below by year. Inpatient, outpatient, and emergency department data are aggregated for specific conditions.

Data Definitions

Inpatient hospital discharges or hospitalizations generally refer to hospital discharges in which a patient was admitted to the hospital.

Outpatient hospital discharges generally refer to hospital discharges in which a patient received health services without being admitted to the hospital.

Emergency department visits refer to outpatient hospital discharges where emergency department services were provided. Inpatient hospitalizations may also involve emergency department services but are not included in counts of emergency department visits.

Data Source

All non-federal acute care hospitals are required to report inpatient and outpatient hospital discharges per IC 16-21-6-6. Long-term care, rehabilitation, and behavioral health hospitals may voluntarily report. Data are shared for all reporting hospitals, and the number of reporting hospitals varies by year.

Hospitals submit data monthly to the Indiana Hospital Association (IHA). IHA processes the records for accuracy, consistency and completeness, and requests resubmissions as necessary. Once finalized, the Indiana State Department of Health combines the data for annual release.

About the Public Inpatient Data Sets

The public inpatient data sets include all inpatient hospital discharges submitted by Indiana hospitals. Inpatient data are aggregated by hospital, primary payer, and:

APR-DRG and Severity: All Patients Refined Diagnosis Related Groups; classification of patients by reason for admission and severity of illness (minor to extreme) designed for all payers and patients of all ages

MS-DRG: Medicare Severity Diagnosis Related Groups; classification of patients by reason for admission and severity of illness (with or without complications or comorbidities) designed for Medicare patients

Principal Diagnosis: condition identified as chiefly responsible for the patient’s admission

Principal Procedure: procedure performed for definitive treatment or taking care of a complication, and most related to the principal diagnosis

Inpatient data are provided in four Access data files and seven Excel lookup tables.

Data Notes

Discharges are classified as inpatient or outpatient by each reporting hospital. The admission criteria distinguishing inpatient and outpatient visits may vary across hospitals. Billing procedures also vary by hospital, including the services provided and length of stay constituting one inpatient or outpatient discharge.

All counts reflect unique hospital discharge records. Counts do not necessarily reflect unique patients. Patients with more than one discharge from a hospital, for the same diagnosis, procedure, or condition in a year, are counted for each unique discharge record.

Hospitals transitioned from the use of ICD-9 to ICD-10 diagnosis and procedure codes on October 1, 2015. The ICD-10-CM and ICD-10-PCS codes offer greater specificity, significantly impacting the identification of health conditions. As such, please take the following into consideration:

• The crosswalk between ICD-9 and ICD-10 codes is not one-to-one. The code transition may have increased, decreased, or had no effect on the identification of various health conditions. When comparing data before and after 2015, real trends may be altered by the effects of the code transition. Considering and notating the ICD transition is recommended for any trend analysis or data sharing that includes hospital discharges before and after 2015.
• Both ICD-9 and ICD-10 codes should be utilized in the analysis of 2015 data. The diagnosis and procedure lookup tables for the 2015 public inpatient data sets include both code sets. The lookup tables also include a “Code_Timeframe” column to indicate whether the codes are ICD-9 (1/1/2015-9/30/2015) or ICD-10 (10/1/2015-12/31/2015).
• Updates to the ICD codes take effect at the beginning of each fiscal year on October 1. Beginning in 2016, the diagnosis and procedure lookup tables for the public inpatient data sets incorporate any code changes or additions. The “Code_Timeframe” column is included to indicate the applicable timeframe for each code, should any changes have been made.

Notes specific to the public inpatient data sets:

Discharges by APR-DRG and Severity are produced using proprietary computer software created, owned, and licensed by the 3M Company. All copyrights in and to the 3M^TM software (including the selection, coordination, and arrangement of all codes) are owned by 3M. All rights reserved.

The MS-DRG system emerged in October 2007, following drastic changes by the federal government to the former DRG system. Assignment to one of the MS-DRGs is intended to be more closely associated with the severity of the patient’s condition. There is no one-to-one crosswalk from the DRG system to the MS-DRG system.

Also in October 2007, the groupings for payers changed from those in prior years due to the adoption of the UB-04 billing form in place of the UB-92.