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<div class="pre-content"><div><div class="bk_prnt"><p class="small">NCBI Bookshelf. A service of the National Library of Medicine, National Institutes of Health.</p><p>Davies SM, Geppert J, McClellan M, et al. Refinement of the HCUP Quality Indicators. Rockville (MD): Agency for Healthcare Research and Quality (US); 2001 May. (Technical Reviews, No. 4.)</p></div><div class="iconblock clearfix whole_rhythm no_top_margin bk_noprnt"><a class="img_link icnblk_img" title="Table of Contents Page" href="/books/n/techrev4/"><img class="source-thumb" src="/corehtml/pmc/pmcgifs/bookshelf/thumbs/th-techrev4-lrg.png" alt="Cover of Refinement of the HCUP Quality Indicators" height="100px" width="80px" /></a><div class="icnblk_cntnt eight_col"><h2>Refinement of the HCUP Quality Indicators.</h2><a data-jig="ncbitoggler" href="#__NBK43841_dtls__">Show details</a><div style="display:none" class="ui-widget" id="__NBK43841_dtls__"><div>Technical Reviews, No. 4.</div><div>Davies SM, Geppert J, McClellan M, et al.</div><div>Rockville (MD): <a href="http://www.ahrq.gov/" ref="pagearea=page-banner&amp;targetsite=external&amp;targetcat=link&amp;targettype=publisher">Agency for Healthcare Research and Quality (US)</a>; 2001 May.</div></div><div class="half_rhythm"><ul class="inline_list"><li style="margin-right:1em"><a class="bk_cntns" href="/books/n/techrev4/">Contents</a></li></ul></div><div class="bk_noprnt"><form method="get" action="/books/n/techrev4/" id="bk_srch"><div class="bk_search"><label for="bk_term" class="offscreen_noflow">Search term</label><input type="text" title="Search this book" id="bk_term" name="term" value="" data-jig="ncbiclearbutton" /> <input type="submit" class="jig-ncbibutton" value="Search this book" submit="false" style="padding: 0.1em 0.4em;" /></div></form></div></div><div class="icnblk_cntnt two_col"><div class="pagination bk_noprnt"><a class="active page_link prev" href="/books/n/techrev4/A2040/" title="Previous page in this title">&lt; Prev</a><a class="active page_link next" href="/books/n/techrev4/A2209/" title="Next page in this title">Next &gt;</a></div></div></div></div></div>
<div class="main-content lit-style" itemscope="itemscope" itemtype="http://schema.org/CreativeWork"><div class="meta-content fm-sec"><h1 id="_NBK43841_"><span class="label">APPENDIX 8</span><span class="title" itemprop="name">Literature Tables for Utilization and ACSC Indicators</span></h1></div><div class="body-content whole_rhythm" itemprop="text"><p>This appendix summarizes the literature reviews for area utilization and ACSC
indicators in table format.</p><p>
<a class="figpopup" href="/books/NBK43841/table/A2139/?report=objectonly" target="object" rid-figpopup="figA2139" rid-ob="figobA2139">Table
1A</a>. Studies of appropriateness of specific procedures. This
table summarizes the studies used to identify area utilization indicators.</p><p>Tables
2A-6A.
These tables summarize studies of ACSC indicators. <a class="figpopup" href="/books/NBK43841/table/A2167/?report=objectonly" target="object" rid-figpopup="figA2167" rid-ob="figobA2167">Table 2A</a>
identifies the studies and designs. <a class="figpopup" href="/books/NBK43841/table/A2168/?report=objectonly" target="object" rid-figpopup="figA2168" rid-ob="figobA2168">Table 3A</a> lists the ACS
conditions examined in each study. Tables
4A-6A
list pediatric avoidable hospitalizations, infant discretionary hospitalizations,
and late hospitalization indicators examined by each study.</p><p>
<a class="figpopup" href="/books/NBK43841/table/A2168/?report=objectonly" target="object" rid-figpopup="figA2168" rid-ob="figobA2168">Table
3A</a> focuses on conditions for which the risk of
hospitalization can be reduced, either through better outpatient management of
chronic diseases (e.g., asthma, CHF, diabetes) or through more timely diagnosis and
effective treatment of acute conditions (e.g., pneumonia, UTI, cellulitis). This is
the best validated of the 4 constructs, and is the basis for all of our selected
indicators.</p><p>
<a class="figpopup" href="/books/NBK43841/table/A2169/?report=objectonly" target="object" rid-figpopup="figA2169" rid-ob="figobA2169">Table
4A</a> includes "conditions for which evidence exists that
specific ambulatory care modalities reduce hospitalization rates." This category
differs from #1 in that it is more sharply focused on defects in ambulatory care,
such as a lack of prior outpatient visits or antibiotic prescriptions. There is some
overlap between this list and #1 (e.g., asthma, gastroenteritis, DKA, severe ENT
infections, PID), although the definitions often differ slightly. Some of these
indicators cannot be implemented without linked outpatient claims.</p><p>
<a class="figpopup" href="/books/NBK43841/table/A2170/?report=objectonly" target="object" rid-figpopup="figA2170" rid-ob="figobA2170">Table
5A</a> focuses on conditions "for which the decision to admit
involves a substantial amount of physician judgment...have a wide range in severity
and are often managed at home." This concept seems somewhat less relevant to
discussions about quality of care.</p><p>
<a class="figpopup" href="/books/NBK43841/table/A2171/?report=objectonly" target="object" rid-figpopup="figA2171" rid-ob="figobA2171">Table
6A</a> focuses on conditions "whose advanced stages are presumed
to have a greater likelihood of reflecting untimely hospital admissions" (because
earlier admission would have prevented progression to the advanced stage). This
concept relates to the timeliness of hospitalization and the appropriateness of
inpatient care, more than to the timeliness and effectiveness of outpatient care.</p><p id="A2139"><a href="/books/NBK43841/table/A2139/?report=objectonly" target="object">Table 1A. Studies of appropriateness of specific procedures</a></p><p id="A2167"><a href="/books/NBK43841/table/A2167/?report=objectonly" target="object">Table 2A. Studies of ACSC indicators</a></p><p id="A2168"><a href="/books/NBK43841/table/A2168/?report=objectonly" target="object">Table 3A. Studies of ACSC indicators</a></p><p id="A2169"><a href="/books/NBK43841/table/A2169/?report=objectonly" target="object">Table 4A. Studies of ACSC Indicators- Pediatric Avoidable
Hospitalizations</a></p><p id="A2170"><a href="/books/NBK43841/table/A2170/?report=objectonly" target="object">Table 5A. Studies of ACSC Indicators-Discretionary Hospitalization of
Infants</a></p><p id="A2171"><a href="/books/NBK43841/table/A2171/?report=objectonly" target="object">Table 6A. Studies of ACSC Indicators- Late Hospitalization</a></p><dl class="temp-labeled-list"><dt>1.</dt><dd><div class="bk_ref" id="A2141">Wong JH, Findlay JM, Surez-Alamazor ME Regional performance of Carotid Endarterectomy. <span><span class="ref-journal">
<em>Stroke.</em>
. </span>1997;<span class="ref-vol">28</span>:891898.</span> [<a href="https://pubmed.ncbi.nlm.nih.gov/9158621" ref="pagearea=cite-ref&amp;targetsite=entrez&amp;targetcat=link&amp;targettype=pubmed">PubMed<span class="bk_prnt">: 9158621</span></a>]</div></dd><dt>2.</dt><dd><div class="bk_ref" id="A2142">Matchar DB, et al <span class="ref-title">Influence of projected complication rates on
estimated appropriate use rates for carotid endarterectomy </span><span class="ref-journal">
<em>HSR.</em>
</span> 199732(3):325342. [<a href="/pmc/articles/PMC1070194/" ref="pagearea=cite-ref&amp;targetsite=entrez&amp;targetcat=link&amp;targettype=pmc">PMC free article<span class="bk_prnt">: PMC1070194</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/9240284" ref="pagearea=cite-ref&amp;targetsite=entrez&amp;targetcat=link&amp;targettype=pubmed">PubMed<span class="bk_prnt">: 9240284</span></a>]</div></dd><dt>3.</dt><dd><div class="bk_ref" id="A2143">Chassin MR, et al Does inappropriate use explain geographic variations in the
use of health care services: A study of three procedures. <span><span class="ref-journal">
<em>JAMA.</em>
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