U.S. Department of Health and Human Services Office of Disease Prevention and Health Promotion

Reduce the rate of hospital admissions for urinary tract infections among older adults — OA‑07 Data Methodology and Measurement

On this page:  About the National Data  |  Methodology

About the National Data

Data

Data Sources:  Healthcare Cost and Utilization Project - National (Nationwide) Inpatient Sample (HCUP-NIS), Agency for Healthcare Research and Quality (AHRQ); Population Estimates, Census

Baseline: 551.3 hospital admissions for urinary tract infections per 100,000 adults aged 65 years and over occurred in 2016

Target: 496.2 per 100,000

Numerator
Number of discharges from community, non-rehabilitation hospitals for adults aged 65 and over with a principal diagnosis of urinary tract infection.

Based on ICD-10 codes: N10 (Acute tubulo-interstitial nephritis, N2885 (Pyeloureteritis cystica), N119 (Chronic tubulo-interstitial nephritis, unspecified), N2886 (Ureteritis cystica, N12 (Tubulo-interstitial nephritis, not specified as acute or chronic), N3000 (Acute cystitis without hematuria), N151 (Renal and perinephric abscess), N3001 (Acute cystitis with hematuria), N159 (Renal tubulo-interstitial disease, unspecified), N3090 (Cystitis, unspecified without hematuria), N16 (Renal tubulo-interstitial disorders in diseases classified elsewhere), N3091 (Cystitis, unspecified with hematuria), N2884 (Pyelitis cystica), N390 (UTI, site unspecified).
Denominator
Number of adults aged 65 years and over.
Target-setting method
Percent improvement
Target-setting method details
10 percent improvement from the baseline.
Target-setting method justification
Trend data were not available for this objective. A 10 percent improvement from the baseline was used to calculate a target. This method was used because it was a statistically significant improvement from the baseline.

Methodology

Methodology notes

The indicator is designed to capture community acquired urinary tract infections (UTIs) including cystitis, pyelonephritis and nephritis, that progress and result in hospitalization. While uncomplicated cystitis does not typically result in hospitalization, progression to pyelonephritis, or nephritis may require hospitalization. When a physician documents "urosepsis" without any further specificity it is included in this indicator.

The population denominator is estimated using the US Census Data. Using a population denominator assumes a population health perspective. In the case of UTIs, the choice of denominator assumes that all older individuals are at risk for developing UTIs, and that access to quality care can minimize the likelihood of UTIs progressing to severity or complications that would require hospitalization.

Exclusions include:

  • transfer from a hospital (different facility)
  • transfer from a Skilled Nursing Facility (SNF) or Intermediate Care Facility (ICF)
  • transfer from another health care facility
  • with any-listed ICD-10-CM diagnosis code for kidney/urinary tract disorder
  • with any-listed ICD-10-CM diagnosis codes or any-listed or ICD-10-PCS procedure codes for immunocompromised state
  • with missing gender, age, quarter, year, principal diagnosis

Discharges with a disposition indicating that the patient was transferred to an acute care hospital are excluded. Community hospitals are defined by the American Hospital Association (AHA) as "non-Federal, short-term, general, and other specialty hospitals, excluding hospital units of institutions." The specialty hospitals included in the AHA definition of community hospitals include: obstetrics-gynecology, ear-nose-throat, orthopedic, and pediatric institutions. The AHA also groups public hospitals and academic medical centers with community hospitals.

The population estimates used to track this measure are based on estimates produced by the U.S. Census Bureau. Nielsen, a vendor that compiles and adds value to the Census estimates using intra-census methods to estimate household and demographic statistics for geographic areas by year, provided the denominator data.