EXHIBIT 2.2 Most Frequent Principal Diagnoses by Age
PDFNumber of Discharges, Percent Distribution, and Growth of the Most Frequent Principal CCS Diagnoses for Inpatient Hospital Stays by Age, 1997 and 2007
| AGE GROUP AND PRINCIPAL CCS DIAGNOSIS |
NUMBER OF DISCHARGES IN THOUSANDS |
PERCENT OF AGE-SPECIFIC TOTAL DISCHARGES |
CUMULATIVE GROWTH |
| 1997 |
2007 |
1997 |
2007 |
1997-2007 |
| All ages, total discharges* |
34,679 |
39,542 |
|
|
14% |
| ‹ 1 year, total discharges |
4,426 |
5,125 |
100.0% |
100.0% |
16 |
| Liveborn (newborn infant) |
3,776 |
4,539 |
85.3 |
88.6 |
20 |
| Acute bronchitis |
108 |
92‡ |
2.4 |
1.8 |
-15 |
| Hemolytic jaundice and perinatal jaundice (infant jaundice following birth) |
33 |
43 |
0.7 |
0.8 |
31 |
| Pneumonia |
55 |
34 |
1.3 |
0.7 |
-39 |
| Short gestation, low birth weight, and fetal growth retardation (premature birth and low birth weight) |
22 |
25‡ |
0.5 |
0.5 |
12 |
| 1-17 years, total discharges |
1,821 |
1,658‡ |
100.0 |
100.0 |
-9 |
| Asthma |
159 |
114 |
8.7 |
6.9 |
-28 |
| Pneumonia |
135 |
109 |
7.4 |
6.6 |
-19 |
| Mood disorders (depression and bipolar disorder) |
64 |
81‡ |
3.5 |
4.9 |
27 |
| Appendicitis and other appendiceal conditions |
65 |
78 |
3.6 |
4.7 |
20 |
| Fluid and electrolyte disorders (primarily dehydration or fluid overload) |
64 |
61‡ |
3.5 |
3.7 |
-5 |
| 18-44 years, total discharges |
9,444 |
10,354 |
100.0 |
100.0 |
10 |
| Trauma to external female genitals (vulva) and area between anus and vagina (perineum) due to childbirth |
676 |
833 |
7.2 |
8.0 |
23 |
| Previous C-section |
270 |
558 |
2.9 |
5.4 |
107 |
| Mood disorders (depression and bipolar disorder) |
335 |
386‡ |
3.5 |
3.7 |
15 |
| Normal pregnancy and/or delivery |
511 |
299 |
5.4 |
2.9 |
-41 |
| Prolonged pregnancy |
§ |
264 |
§ |
2.6 |
§ |
| 45-64 years, total discharges |
6,496 |
9,135 |
100.0 |
100.0 |
41 |
| Coronary atherosclerosis (coronary artery disease) |
526 |
405 |
8.1 |
4.4 |
-23 |
| Non-specific chest pain |
242 |
381 |
3.7 |
4.2 |
57 |
| Osteoarthritis (degenerative joint disease) |
105 |
323 |
1.6 |
3.5 |
206 |
| Disorders of intervertebral discs and bones in spinal column (back problems) |
190 |
269 |
2.9 |
2.9 |
42 |
| Pneumonia |
199 |
261 |
3.1 |
2.9 |
31 |
| 65-84 years, total discharges |
10,121 |
10,277‡ |
100.0 |
100.0 |
2 |
| Congestive heart failure |
581 |
515 |
5.7 |
5.0 |
-11 |
| Coronary atherosclerosis (coronary artery disease) |
741 |
466 |
7.3 |
4.5 |
-37 |
| Pneumonia |
514 |
465 |
5.1 |
4.5 |
-9 |
| Osteoarthritis (degenerative joint disease) |
281 |
442 |
2.8 |
4.3 |
57 |
| Cardiac dysrhythmias (irregular heart beat) |
333 |
379 |
3.3 |
3.7 |
14 |
| 85+ years, total discharges |
2,362 |
2,953 |
100.0 |
100.0 |
25 |
| Congestive heart failure |
202 |
234 |
8.6 |
7.9 |
16 |
| Pneumonia |
197 |
193‡ |
8.3 |
6.5 |
-2 |
| Septicemia (blood infection) |
76 |
126 |
3.2 |
4.3 |
64 |
| Urinary tract infections |
75 |
118 |
3.2 |
4.0 |
58 |
| Fracture of neck of femur (hip fracture) |
125 |
117‡ |
5.3 |
4.0 |
-6 |
* Includes a small number of discharges (less than 41,000 or 0.1 percent) with missing age.
‡ 2007 discharges are not statistically different from 1997 discharges at p‹0.05.
§ Consistent data are not available for this diagnosis due to coding changes that took place between 1997 and 2007.
Source: AHRQ, Center for Delivery, Organization, and Markets, Healthcare Cost and Utilization Project, Nationwide Inpatient Sample, 1997 and 2007. |
The principal diagnoses for hospitalizations generally varied by age, although some conditions were frequent among all ages.
Infants, children and young adults:
- Pregnancy, childbirth, and newborns:
- In 2007, most discharges for children under one year old (89 percent) were for liveborn infants, which increased 20 percent between 1997 and 2007.
- Bronchitis accounted for another 1.8 percent and jaundice for another 0.8 percent of infant stays. Jaundice stays in infants increased 31 percent between 1997 and 2007.
- Among 18-44 year olds, previous C-sections more than doubled between 1997 and 2007, while normal pregnancy and/or delivery fell 41 percent.
- Asthma among children 1-17 declined by 28 percent between 1997 and 2007.
- Appendicitis, also a common reason for hospital stays for children 1-17 in 2007, accounted for 5 percent of discharges in this age group, increasing 20 percent between 1997 and 2007.
- Depression and bipolar disorders (mood disorders) were the 3rd most common diagnoses for children 1–17 and adults 18–44.
Older adults:
- Cardiovascular conditions were the most common diagnoses for adults over 44 years old. However, specific diagnoses differed somewhat between age groups for older adults:
- Coronary atherosclerosis (coronary artery disease) accounted for 4 percent of all discharges for adults 45-64; these stays declined by 23 percent between 1997 and 2007. This condition also ranked 2nd for 65-84 year olds (4.5 percent of stays in 2007), with stays declining 37 percent between 1997 and 2007.
- Hospitalizations for non-specific chest pain in 45-64 year olds increased 57 percent between 1997 and 2007 and comprised 4 percent of stays in 2007.
- Congestive heart failure (CHF) was the most common condition for adults 65-84 and 85 and older. In 2007, CHF accounted for 5 percent of all stays among adults 65-84 and 8 percent of all stays among adults 85 and older.
- Irregular heart beat was the reason for 379,000 hospitalizations (3.7 percent) in 2007 among 65-84 year olds, an increase of 14 percent since 1997.
- Among adults 85 and older, hospitalizations for septicemia (up 64 percent) and urinary tract infections (up 58 percent) increased at more than twice the rate of all hospitalizations for this age group between 1997 and 2007.
- Musculoskeletal conditions:
- Degenerative joint disease (osteoarthritis) more than tripled among adults 45-64 and increased 57 percent among adults 65-84.
- Back problems increased 42 percent for 45-64 year olds between 1997 and 2007.
- Hospital stays for hip fractures changed very little between 1997 and 2007 for patients 85 and older.
All patients:
- Pneumonia was a top five condition for all age groups except 18-44 year olds:
- Hospital stays for pneumonia declined among children (a drop of 39 percent for children less than one and a 19-percent decline for children 1-17 years).
- Pneumonia stays rose among adults 45-64 years (31 percent), but fell among adults 65-84 years (down 9 percent).
- Stays remained relatively stable for adults 85 years and older.
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