Overstay Predictor Diagnosis Code Used

Please see Overstay Predictor Diagnosis Code to algorithm mapping for a listing of these dxs and how they map into the color generating algorithm.

The Overstay Predictor Project uses a number of diagnoses as indicators whether a patient would be likely to overstay due to difficulty in discharging. The following diagnoses are included to accomplish this.

Diagnoses used in analysis and by CCMDB.mdb to generate chart colour

Admit Dxs

• 502 ICH
• 503 SAH
• 504 Brain Stem Hemorrhage
• 505-0 CVA
• 505-1 CVA post angio
• 505-2 CVA post op
• 505-3 CVA post trauma
• 505-4 CVA post anticoagulation therapy
• 505-5 CVA intra-op
• 505-6 CVA post partum
• 505-7 CVA super sagittal sinus
• 505-8 CVA brainstem
• 505-90 CVA 2nd to other PROCEDURES
• 506 Tentorial_Herniation
• 529 Post Traumatic Quadriplegia
• 537 Paraplegia, Hemiplegia due to any condition
• 599-4 Cerebral Infarct Cause NYD
• 599-5 Quadraparesis-Post OP
• 599-6 Traumatic Paralysis 2nd to Spinal Subdural Bleed
• 599-18 Spinal Cord Infarct
• 603 SAH - Subarachnoid - POST OP (see: 647 for NON POST OP)
• 609 C-spine trauma WITH cord injury
• 611 T-spine WITH cord injury
• 613 L-spine WITH cord injury
• 647 SAH Subarachnoid-NON POST OP
• 648 Brainstem Hemorrhage-NON POST OP craniotomy
• 695 Diffuse axonal injury (likely be in an ICU not med ward)
• 983 CVA (stroke) due to central line insertion

Other Codes used (admit and comorbid)

Generally we don't want comorbids for this analysis because it is assumed that the patient was able to cope with the condition from home. However, apparently dementia having progressed to a non-functioning level is often the reason why a patient is hard to discharge. Therefore, the following being present as either Admit or Comorbidity are also included:

• 526 Dementia
• 538 Violent 2nd to dementia

No Acquired Diagnoses!

No acquired diagnoses will be included in the analysis; acquire diagnoses would not be available at the time that we need to make this prediction. We need to exclude acquired dxs from the dataset given to Rodrigo and provide it again.

Other diagnoses that might cause overstay

The overstay team is aware that some other diagnoses might also cause discharge delays. If you come across some that we missed, please add them below, with a reason why they should be included. We will review the algorithm over time and might decide to include these at that time.

• e.g. diagnosis
  • e.g. reason to include

===discussion=== Pts who become ACPC and expire in hospital 3 days to one month after comfort care is ordered.

• I would like to know where this type of patients fits in. Example: a patient who has co- morbids and is admitted with pneumonia and does not improve or deteriorates. The decision is made to provide comfort care only (ACPC). This patient lives three days to one month in hospital and then dies. Does this patient need a transfer ready date?
  • I currently code pts who become ACPC and then die within 48 hours as D/C treatment and do not fill out the transfer ready space. If the patient lives longer than 48 hours I will code the patient as palliative and fill the transfer ready space when the order of ACPC is written. Many of my admitted pts come to the hospital to die and I'm not sure if these patients fit into the transfer/overstay predictor project. Please let me know how you code these cases.Judy Kublick 11:32, 2012 September 24 (CDT)~~