Documentation

This MICA (Missouri Information for Community Assessment) database identifies the number of hospitalizations, the total charges billed for each hospitalization and the associated days of care (also called lengths of stay). Hospitalizations refers to hospital discharges of Missouri residents from non-federal and non-state acute care (average days of care less than 30 days) general and specialty hospitals whose facilities are open to the general public.

The diagnosis categories used in this MICA are based on the principal diagnosis, which is submitted as the first of 23 possible diagnoses coded on the discharge record. As defined by the Uniform Hospital Discharge Data Set (UHDDS), principal diagnosis represents the "condition established after study to be chiefly responsible for occasioning the admission of the patient to the hospital for care". Diagnoses associated with hospitalizations are classified in accordance with the Ninth Revision of the International Classification of Diseases (ICD-9). The diagnosis groupings used in this MICA are based on the Clinical Classification Software (CCS).

Charges are the total amount of billed charges for the hospital stay. Charges do not necessarily reflect costs of providing services or the final reimbursement amount. Charge data can be used to assess the relative impact of resources utilized between disease categories or geographical areas. Charge data should not be used to determine how much was spent on specific diseases. All negative or missing charge data are set to zero for the purpose of this MICA.

Days of care (DOC) are calculated as discharge date minus admission date. If these are the same date, then DOC is set to one. A DOC data point is set to a minimum value of one day per discharge if it is a missing, zero, or negative number in the discharge record. DOC was set for a maximum stay of 365 days.

Days of care and charges are reported as simple totals. No outlier analyses are performed on the DOC or charge data beyond that described previously. Thus, there may be days of care or charges that are serious outliers compared to the expected DOC or charge for a reported primary diagnosis category. As such, users should employ caution in attempting to calculate average days of care or average charges from these data.