Medical and Surgical Discharge Rates (1992-2015)

<h2>Overview</h2>
<p>The Dartmouth Institute for Health Policy and Clinical Practice (TDI) has created a publicly available source of data that provides researchers, payers, regulators, and innovators with metrics that quantify temporal and regional patterns of health care spending and utilization in the United States. Using CMS Medicare claims data (mostly for age >64 enrollees), Atlas researchers built cohorts (“denominators”) and numerous measures or events (“numerators”) which were then used to calculate rates either by geography or for patients assigned to specific hospitals. These rates, which are calculated consistently across time and place, provide researchers with opportunities to evaluate spatial and temporal variation/trends. </p>

<p>This entry contains a wide variety of medical and surgical discharge rates for fee-for-service (FFS) Medicare beneficiaries, age 65 and older, discharged from hospitals for medical and surgical conditions. Examples of rates include discharges for hypertension, asthma, COPD, diabetes, gastroenteritis, hip fracture, back surgery, hip replacement, radical prostatectomy, and valve replacement. Rates are provided at the state, county, hospital referral region (HRR), and hospital service area (HSA) levels, and all rates have been adjusted for age, sex, and race. For the 2008-2014 period, the rates provided for each geographic area include overall annual rates, rates stratified by race (black and non-black), and rates stratified by gender (male and female). For 1992-2007 and 2015, only the overall annual rates are provided.</p>

<p>In addition, this entry provides national and region-specific (nine regions) rate data for FFS Medicare beneficiaries for treatments related to eight different “preference-sensitive conditions”: early-stage breast cancer, stable angina, low back pain, arthritis of the knee or hip, carotid artery disease, gallstones, enlarged prostate, and early-stage prostate cancer. Ten of the treatment rates involve inpatient surgery, and one focuses on PSA testing. Rates are provided at the state, HRR, and HSA levels, and all rates have been adjusted for age, sex, and race as appropriate. The national rates are based on 2003-2008 data, while rates for the nine regions are based on 2008-2010 data.<p>

<p> Users downloading data should review the methods sections of the related publications for context as well as for information about any temporal changes in methods. All reports in the Dartmouth Atlas of Health Care series are available from the National Library of Medicine
<a href="https://www.ncbi.nlm.nih.gov/books/NBK584737/">https://www.ncbi.nlm.nih.gov/books/NBK584737/</a>
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<p> Note that for the general Dartmouth Atlas rate datasets, which span multiple decades, the author list includes all Dartmouth staff (programmers, analysts, supervisors, etc.) involved in generating all types of Atlas rates across all years. We do not attempt to assign individuals to specific datasets or years. <p>