**Agency for Healthcare Research and Quality**

**Inpatient Quality Indicators (IQIs)**

**Log of Revisions to IQI Documentation and Software**

**Updated September 4, 2003**

The following table summarizes all of the revisions made to the IQI
software, software documentation and the Guide to Inpatient Quality
Indicators (Guide) document since the original release of the version
2.1 software and documents in June 2002. The table lists the revision
number, the date the revision was made, the component(s) affected by the
change and a short summary of the changes that were made. For
convenience and ease of use, the changes are listed in reverse
chronological order with the most recent changes appearing first in the
table. This log of revisions is current as of the date noted above.

+-------+---------+----------+---------------------------------------+
| *     | ***     | ***Comp  | ***Changes***                         |
| **Rev | Date*** | onent*** |                                       |
| ision |         |          |                                       |
| numb  |         |          |                                       |
| er*** |         |          |                                       |
+=======+=========+==========+=======================================+
| 2     | Se      | Software | Implemented changes associated with   |
|       | ptember | (SAS and | ICD-9-CM coding updates from Fiscal   |
|       | 4, 2003 | SPSS)    | Year (FY) 2002 (effective 10-1-2001)  |
|       |         | and      | and FY 2003 (effective 10-1-2002).    |
|       |         | Guide    | See separate documentation on ICD-9   |
|       |         |          | coding updates for specific details.  |
+-------+---------+----------+---------------------------------------+
| 2     | Se      | Software | 1.  Congestive Heart Failure (CHF)    |
|       | ptember | (SAS and |     Mortality Rate: The denominator   |
|       | 4, 2003 | SPSS)    |     exclusion of patients undergoing  |
|       |         | and      |     a cardiac procedure was removed   |
|       |         | Guide    |     from CHF Mortality Rate. This     |
|       |         |          |     exclusion was unnecessary due to  |
|       |         |          |     the use of APR-DRGs for risk      |
|       |         |          |     adjustment and to provide         |
|       |         |          |     consistency across indicators     |
|       |         |          |     (e.g. AMI patients with these     |
|       |         |          |     procedures are not excluded).     |
|       |         |          |                                       |
|       |         |          | 2.  Bilateral Heart Catheterization   |
|       |         |          |     Rate: Codes 404.xx for            |
|       |         |          |     hypertensive heart disease were   |
|       |         |          |     added to the denominator          |
|       |         |          |     exclusion.                        |
|       |         |          |                                       |
|       |         |          | 3.  Pediatric Heart Surgery Volume    |
|       |         |          |     and Mortality Rate: The code 36.3 |
|       |         |          |     was added to numerator including  |
|       |         |          |     definition of pediatric heart     |
|       |         |          |     surgery (#2P) to reflect coding   |
|       |         |          |     before October 1, 1998.           |
|       |         |          |                                       |
|       |         |          | 4.  Mortality after Hip Replacement:  |
|       |         |          |     The code 716.69 was deleted from  |
|       |         |          |     the including definition of       |
|       |         |          |     osteoarthritis (the fifth digit   |
|       |         |          |     "9" indicating "multiple sites"   |
|       |         |          |     is not valid for 716.6x).         |
+-------+---------+----------+---------------------------------------+
| 2     | Se      | Software | 1.  All parameter text files were     |
|       | ptember | (SAS and |     renamed to refer specifically to  |
|       | 4, 2003 | SPSS)    |     the IQI module (e.g., use of IQ   |
|       |         |          |     in file name). These changes are  |
|       |         |          |     also reflected in the software    |
|       |         |          |     documentation.                    |
|       |         |          |                                       |
|       |         |          | 2.  All parameter files were rerun    |
|       |         |          |     using the updated software and    |
|       |         |          |     Year 2000 HCUP SID data.          |
|       |         |          |                                       |
|       |         |          | 3.  Population files for 2000, and    |
|       |         |          |     2001 were re-estimated using the  |
|       |         |          |     latest available census files     |
+-------+---------+----------+---------------------------------------+
| 2     | Se      | So       | The treatment of missing data by SPSS |
|       | ptember | ftware - | was changed to mirror the treatment   |
|       | 4, 2003 | SPSS     | of missing data by SAS, specifically  |
|       |         |          | the software requires confirmation    |
|       |         |          | for the assignment of a poor outcome  |
|       |         |          | or negative event. For instance, in   |
|       |         |          | order to be assigned as a death, each |
|       |         |          | case must actually be coded as a      |
|       |         |          | death. Missing data is considered     |
|       |         |          | neutral. Missing data for some        |
|       |         |          | elements results in the exclusion of  |
|       |         |          | that case from the denominator. For a |
|       |         |          | few other elements, the case is       |
|       |         |          | retained. Table 5 of the Software     |
|       |         |          | Documentation lists the impact of     |
|       |         |          | missing data for each data element.   |
+-------+---------+----------+---------------------------------------+