Examining Post Acute Care Relationships in an Integrated Hospital System. 3.5.1 Prevalence and Rank Order of Hierarchical Condition Categories


Table 3-11 shows the top 20 most frequently occurring HCCs among PAC users in our sample. This table also shows the rankings of HCCs within the five most common DRGs for post-acute users and the percent of beneficiaries in the DRG with each of the HCC indicators. To populate this table, we generated a list of the top 20 HCCs in PAC users and listed them in order in the table. Then we indicated the ranking for those HCCs for the five most common DRGs for PAC users. Because these are the five most common DRGs in our sample, the same 20 HCCs were the most common HCCs across these DRGs (although in varying rankings).

Overall, CHF (HCC80) was the most prevalent HCC in our sample (22.9 percent), followed closely by Specified Heart Arrhythmias (HCC92; 21.4 percent) and COPD (HCC108; 20.4 percent). Diabetes without Complication (HCC19) and Renal Failure (HCC131) were also highly prevalent in our sample. These five HCCs were the only ones present in more than 10.0 percent of our sample.

The HCC rankings by DRG were generally similar to the rankings overall, with a few exceptions. CHF, heart arrhythmias, and COPD were the top three HCCs for DRG 089 (Pneumonia) and DRG 127 (Heart Failure & Shock). In fact, heart arrhythmia was at least the third most common HCC across all DRGs. CHF was the first or second most common HCC for two of the five most common DRGs (DRG 089 and DRG 127). HCC19 (Diabetes), one of the most common comorbid conditions in the elderly population, is the fourth or fifth most common comorbidity across the top four DRGs (DRG 014, DRG 089, DRG 127, and DRG 210) and was the most common HCC in DRG 544.

Not surprisingly, HCC158 (Hip Fracture/Dislocation) was among least prevalent conditions for most DRGs except DRG 210 (Hip & Femur Procedures) and DRG 544 (Joint and Limb Reattachment Procedures). This HCC was among the least prevalent HCCs in all other DRGs (although it was the seventh most prevalent HCC in the overall sample). Also not surprisingly, the least common HCC in our overall sample, Hemiplegia/Hemiparesis (HCC100), was the second most common HCC for DRG 014 (Stroke).

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