Use of Hospitals, Physician Visits, and Hospice Care During Last Six Months of Life Among Cohorts Loyal to Highly Respected Hospitals in the United States

<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 hospital-specific utilization rates for 1999-2000 for chronically ill fee-for-service (FFS) Medicare beneficiaries during the last six months of life. Rates are provided for 77 different academic medical centers and include number of physician visits, number of hospital days, number of intensive care unit (ICU) days, percentage of patients seeing ten or more physicians, percentage of patients dying in the hospital, percentage of patients with an ICU stay, and percentage of patients admitted to hospice. For two of these measures (hospital days and ICU days), rates are also provided for three specific chronic illness cohorts: patients with solid tumor cancers, patients with congestive heart failure (CHF), and patients with chronic obstructive pulmonary disease (COPD). All rates have been adjusted for age, sex, race, and type of chronic illness using Poisson regression models.<p>

<p> Users downloading data should review the methods sections of the related publications for context. 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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