Hosp 09

Delaware Hospital
Discharge Summary
Report 2009
Acknowledgments
This report was prepared by Barbara Gladders, Health Statistics Administrator of the
Delaware Health Statistics Center, Division of Public Health, Department of Health &
Social Services. Ed Ratledge, of the University of Delawares Center for Applied
Demography and Survey Research, created the hospital discharge research file and
provided technical advice.
We gratefully acknowledge the Delaware Healthcare Association for gathering the
hospital profiles and the hospitals for providing the data that make this report possible.
Summer, 2011
For more information, contact:

Delaware Health Statistics Center
Division of Public Health
417 Federal Street
Dover, DE 19901
(302)744-4541
Fax: (302)739-4784
Or visit our website at:
http://www.dhss.delaware.gov/dhss/dph/hp/healthstats.html
T ABLE OF C ONTENTS
Executive Summary .....................................................................................................................................1

Patient Characteristics..................................................................................................................................3
Why Patients Were Hospitalized ..................................................................................................................7
Why Patients Were Hospitalized Injuries ....................................................................................................9
Why Patients Were Hospitalized Procedures ...........................................................................................11
Hospitalizations of Delaware Residents .....................................................................................................14
How Patients Were Admitted......................................................................................................................18
Hospital Charges and Billing ......................................................................................................................20
How Patients Were Discharged..................................................................................................................24
Hospital Specific Data ................................................................................................................................28
Appendix A .................................................................................................................................................34
Appendix B .................................................................................................................................................40
Appendix C .................................................................................................................................................41
Appendix D .................................................................................................................................................46
Appendix E .................................................................................................................................................47
Appendix F .................................................................................................................................................48
Appendix G .................................................................................................................................................49
Appendix H .................................................................................................................................................50
Hospital Profiles and Location Maps ..........................................................................................................51
Technical Notes ..........................................................................................................................................75
References .................................................................................................................................................79
EXECUTIVE SUMMARY
This report describes:
Patient Characteristics
Most Frequent Reason for Hospitalizations
Patient Admission Source
Hospital Charges and Billing Patterns
Patient Discharge Status
Patient Distribution
Data in this report will present 2009 Delaware hospital discharge data, as well as trend data for
selected characteristics. Hospitalization or hospital discharge, refers to any discharge from a non
-federal, short-stay, acute-care hospital in Delaware. Hospitalizations are expressed as numbers
of discharges, not as unduplicated patients; as a result, a single patient with multiple
hospitalizations can be counted more than once. Delaware hospital discharge data are based on
inpatient hospitalizations and do not include outpatient, clinic, or emergency room data. Unless
otherwise specified, the data presented represent discharges from the following hospitals and
systems: Alfred I. duPont, St. Francis Hospital, Christiana Care Health System (which consists of
Wilmington Hospital and Christiana Care), Bayhealth Medical Center (which consists of Kent
General and Milford), Beebe Medical Center, and Nanticoke Memorial Hospital 1.
More information on how annual files are created, as well as definitions of terms used in this
report, can be found in the Technical Notes.
Key findings:
After two years of declining numbers, the number of hospital discharges increased slightly
from 2008 to 2009. Despite two years with fewer discharges, aggregate hospital charges
continued their steady increase.
Women accounted for 58 percent of all discharges. In the 20 to 34 year age group, four out
of every five discharges were women.
Inpatient hospitalizations in 2009 generated total charges of 2.53 billion; nearly half of that
total (1.16 billion) was billed to Medicare.
In 2009, the average length of stay (ALOS) was 4.7 days and the mean charge for a
hospitalization was $22,410.
The most frequent reasons for hospitalization fell under the category of diseases of the
circulatory system, and included congestive heart failure, coronary artery disease, and
cardiac dysrhythmias (irregular heart beat).
Over half of all hospital stays in 2009 were admitted through the emergency department.
Thirteen percent of all discharges from Delaware hospitals were non-residents, most of whom
came from Pennsylvania, Maryland, and New Jersey.
See the Hospital Profiles at the end of this report for details about each of Delawares acute care hospitals.
Delaware Hospital Discharge Report 2009
EXECUTIVE SUMMARY
Hospital stays for liveborn infants varied by type of delivery and plurality.
The ALOS for infants delivered by cesarean section was 5.1 days, versus 2.7 days for infants
delivered vaginally.
The ALOS for infants who were part of a plural birth was more than three times that of singleton births
(11 days versus 3 .3 days).
Three-quarters of patients underwent a procedure while hospitalized; 21 percent had only 1 procedure, 18
percent had 2, and 37 percent had 3 or more procedures during their stay.
Patients who were uninsured and those covered by Medicare were more frequently admitted through the
emergency department (ED) than any other route; 74.2 percent of uninsured patients and 71.3 percent of
Medicare patients were admitted through the ED in 2009.
Medicare and private insurers were the primary payers in 38 and 33 percent of all hospital discharges in 2009.
Medicaid was the primary payer in 24 percent of all hospital stays, and uninsured hospitalizations accounted
for 3 percent of the total stays. The remaining 2 percent of hospitalizations were covered by other specified or
unknown programs.
PATIENT CHARACTERISTICS
Patients under 1 year old accounted for 13 percent of all discharges in 2009; the majority of these discharges were
infants hospitalized by virtue of being born in the hospital. Patients 65 and older were responsible for 32 percent of
all discharges in 2009.
Hospital Discharges by Age Group
Delaware Hospitals, 2009
25,000
Number of Discharges
20,000
15,000
10,000
5,000
<1
1-4
5-9
10-14
15-19
20-24
25-34
35-44
45-54
Age Group
55-64
65-74
75+
Source: Delaware Health Statistics Center
Males made up the majority of discharges in the age groups under 15. For nearly all age groups 15 and higher,
females made up the majority of discharges, and in the 20 to 34 year age range, four out of every five discharges
were women. In 2009, 57.7 percent of all discharges were women.
Distribution of Discharges by Sex and Age Group
90
Male
Female
Percent of Discharges
80
70
60
50
40
30
20
10
0
<1
1-4
5-9
10-14
15-19
20-24
25-34
35-44
45-54
55-64
65-74
75+
Age Group
Thirteen percent of all discharges from Delaware hospitals were non-residents, most of whom came from
Pennsylvania, Maryland, and New Jersey. With nearly half of their patients coming from out-of-state, A.I. duPont
Hospital had the largest proportion of non-resident patients.
Distribution of Non-resident Discharges by State of Residence and Hospital
30
25
20
PA
MD
NJ
Other
15
10
A I DUPONT
HOSPITAL
BAYHEALTH
MEDICAL CENTER
BEEBE MEDICAL
CENTER
CHRISTIANA CARE
HEALTH SYSTEM
NANTICOKE
MEMORIAL
HOSPITAL
SAINT FRANCIS
HOSPITAL
Though A.I. duPont, Christiana Care, and Bayhealth experienced small increases in the number of discharges
from 2008 to 2009, overall, the number of discharges declined or remained static between 2007 and 2009 . St.
Francis and Nanticoke experienced the largest percentage decreases.
Number of Discharges by Hospital System and Year of Discharge
Delaware, 2007-2009
65,000
2007
2008
1.4% decrease
2009
52,000
39,000
26,000
.4% decrease
13,000
2.7% decrease
5.1% decrease
13.7% decrease
18.7% decrease
0
A I DUPONT HOSPITAL BAYHEALTH MEDICAL
CENTER
BEEBE MEDICAL
CENTER
CHRISTIANA CARE
HEALTH SYSTEM
NANTICOKE
MEMORIAL HOSPITAL
SAINT FRANCIS
HOSPITAL
Between 1995 and 2002, distribution in ALOS shifted toward shorter hospital stays; as the ALOS decreased, the
percent of patients staying three or fewer days increased. ALOS has decreased slightly since 2002, and in 2009,
61 percent of patients stayed three or fewer days in the hospital.
Percent Distribution of Hospital Discharges by Average Length of Stay (ALOS)
Delaware, Selected Years 1995-2009
100%
Mean LOS
4.7 days
Mean LOS
5.2 days
Mean LOS
5.0 days
6.0
5.1
4.6
11.6
10.3
9.4
23.9
24.8
90%
80%
70%
25.3
60%
15+ days
8-14 days
4-7 days
<=3 days
50%
40%
30%
61.2
57.1
60.7
1995
2002
Year of Discharge
20%
10%
0%
2009
As patient age increased, the percent who stayed 3 days or less decreased; while 83 percent of patients under 1
had stays of 3 days or less, only 44 percent of patients 65 and older had stays of 3 days or less.
Distribution of Discharges by LOS Categories and Age Group

<=3 days
4-7 days
20%
40%
8-14 days
15+ days
60%
80%
65+
Age Group
45-64
18-44
1-17
Under 1
0%
100%
Percent
Between 1995 and 2009, ALOS for male and female patients declined 10 and 8 percent respectively. When
female obstetrical patients were excluded from the calculation of average length of stay, male and female patients
had very similar ALOS figures in all time periods. The only increase in ALOS from 1995 to 2009 was seen in
female obstetrical patients, whose length of stay increased 35 percent.
Mean Length of Stay by Patient Type

Delaware Hospitals, 1995-2009
6
Length of Stay in Days
0
1995
2002
Males
Females
Non-obstetric females
2009
Obstetric females
WHY PATIENTS WERE HOSPITALIZED

Most frequent reasons for hospitalization by primary diagnosis and body system 2:
In 2009, diseases of the circulatory system accounted for 15 percent of the total discharges and represented the
most common reasons for hospitalization; some of the most common diagnoses in that category were congestive
heart failure, coronary artery disease, irregular heart beat, heart attack, and stroke. Pregnancy and childbirth
comprised 12 percent of the total discharges, and 11 percent of all discharges were related to diseases of the
respiratory system, which included pneumonia, chronic obstructive pulmonary disease, asthma, and respiratory
failure. Together, these three categories accounted for 38 percent of all hospitalizations.
Number of Discharges by Body System and Discharge Year
20,000
18,000
2001
2005
2009
16,000
14,000
12,000
10,000
8,000
6,000
4,000
2,000
0
Circulatory
diseases
Pregnancy &
childbirth
Respiratory
diseases
Liveborn
Digestive
diseases
Injury and
poisoning
Musculoskeletal Genitourinary
diseases
diseases
Neoplasms
Endocrine,
nutritional &
metabolic
diseases, &
immunity
disorders
Diagnoses Grouped by Body System

Although hospitalizations due to infections and parasitic diseases did not occur frequently enough for them to
appear in the graph above, the largest percent increase (117) in hospitalizations from 2001 to 2009 occurred in
that category. The increase was driven primarily by a rise in the number of septicemia hospitalizations, which
represented 71.1 percent of all hospitalizations for infections and parasitic diseases in 2009. Diseases of the skin
and subcutaneous tissue also demonstrated a large percentage increase (61.8) from 2001 to 2009, and at 53.7
percent, the third largest increase in hospitalizations was due to certain conditions originating in the perinatal
period.
See Appendix A for details about the primary diagnoses and body system classifications.
WHY PATIENTS WERE HOSPITALIZED

Most frequent reasons for hospitalization by sex (excluding liveborn infants):
Specific diagnoses varied by sex, though much of that was a result of the large number of women hospitalized due
to pregnancy and delivery related conditions; 4 out of the top 10 diagnoses for women were related to pregnancy
and childbirth. Both men and women experienced high numbers of discharges due to pneumonia, osteoarthritis,
and congestive heart failure. The following table shows the most frequent diagnoses for both men and women, by
number, percent, and rank of discharges by gender.
Most Frequent Diagnoses (CCS Defined) for Hospitalizations by Gender, Delaware, 2009
CCS Principal Diagnosis
All diagnoses
Pregnancy and childbirth
Liveborn
Pneumonia
Osteoarthritis
Congestive heart failure
Coronary atherosclerosis (artery disease)
Septicemia
Cardiac dysrythmias (irregular heart beat)
Skin and subcutaneous tissue infections
Chronic obstructive pulmonary disease and bronchiectasis
Rehabilitation care; fitting of prostheses; and adjustment of devices
Asthma
Acute myocardial infarction (heart attack)
Complication of device; implant or graft
Acute cerebrovascular disease (stroke)
#
47677
--6052
1645
1285
1332
1576
1046
1085
1043
864
833
907
1089
902
835
MALE
%
100
--12.7
3.5
2.7
2.8
3.3
2.2
2.3
2.2
1.8
1.7
1.9
2.6
1.9
1.8
Rank
--1
2
5
4
3
8
7
9
12
15
10
6
11
14
#
65155
13023
5706
1859
1754
1311
892
1292
1017
948
1074
1040
931
734
878
909
FEMALE
%
100
20.0
8.8
2.9
2.7
2.0
1.4
2.0
1.6
1.5
1.6
1.6
1.4
1.1
1.3
1.4
Rank
1
2
3
4
5
14
6
10
11
8
9
12
21
17
13
Note: Clinical Classifications Software (CCS) is diagnostic classification system developed by the Agency for Healthcare Research and Quality (AHRQ).
See Appendix A for more information.
Most frequent reasons for hospitalization by age groups:

Excluding liveborn infants, patients under 1 were hospitalized most often for bronchitis, other perinatal
conditions (including respiratory conditions, infections, and conditions involving temperature regulation), and
pneumonia.
For those ages 1 to 17, asthma, pneumonia, and fluid and electrolyte disorders made up the top three
diagnoses.
For those ages 18 to 44, all of the top 10 diagnoses were associated with pregnancy and childbirth. If
pregnancy and childbirth were excluded, skin and subcutaneous tissue infections, diabetes, and mood
disorders became the three most common reasons for hospitalization.
For those ages 45 to 64, osteoarthritis, coronary artery disease, and pneumonia comprised the top three
diagnoses.
For those over 65, congestive heart failure, osteoarthritis, and pneumonia were the top three diagnoses.
Though the most common reasons for hospitalization differed by age, pneumonia appeared in the 10 most
frequent diagnoses for all five age groups.
WHY PATIENTS WERE HOSPITALIZEDINJURIES

Injury hospitalizations:
Injury hospitalizations accounted for 8 percent of the total number of discharges and $241 million in aggregate
charges in 2009. The majority of patients were admitted through the ED and the average charge for an injury stay
ranged from $12,838 for poisoning by psychotropic agents to $62,288 for spinal cord injuries, with an overall
average charge of $26,749 (see Appendix A ).
The most common primary diagnosis for an injury hospitalization in 2009 was complication of device, implant, or
graft, which accounted for 19.7 percent of injury hospitalizations. Complications of surgical procedures or medical
care were responsible for another 15.3 percent of injury hospitalizations, followed by intracranial injury, hip
fractures, and lower limb fractures.
Most Frequent Injury Diagnoses, 2009

Complications of surgical
procedures or medical
care, 15.3
Complication of device;
implant or graft, 19.7
Intracranial injury, 9.7
Fracture of lower limb, 8.3

All other injuries and
conditions due to external
causes, 20.4
Fracture of neck of femur
(hip), 8.3
Fracture of upper limb, 4.6

Poisoning by o ther
medications and d rugs, 5.5
Other fractures, 8.2
Falls were the most frequently specified external cause of injury (as defined by the Ecode listed on the discharge
record); they accounted for 89 percent of hip fractures, 68 percent of upper limb fractures, 52 percent of
intracranial injuries, and 65 percent of spinal cord injuries. Motor vehicle accidents were responsible for 28 percent
of intracranial injuries and 24 percent of spinal cord injuries. Unintentional poisonings accounted for 6 percent of
all injuries.
WHY PATIENTS WERE HOSPITALIZEDINJURIES

The number of injury hospitalizations was split almost equally between males and females, though the distribution
varied by specific injury type. Women were more likely to have been hospitalized for hip fractures and other
unspecified fractures, poisoning by other medications and drugs, and complications of surgical procedures or
medical care. Men were more likely to have been hospitalized for crushing or internal injuries, open wounds of
head, neck, and trunk, skull and face fractures, open wounds of extremities, and intracranial injuries.
Selected Primary Injury Diagnoses by Gender

80
Male
Female
70
Percent of Injuries
60
50
40
30
20
10
0
Complications
of surgical
procedures or
medical care
Intracranial
injury
Fracture of neck Other fractures Poisoning by Crushing injury Skull and face Open wounds ofOpen wounds of
of femur (hip)
other
or internal injury fractures
head; neck; and extremities
medications and
trunk
drugs
CCS Injury Categories
10
WHY PATIENTS WERE HOSPITALIZED PROCEDURES

Most frequent reasons for hospitalization by procedure:
In 2009, 75 percent of discharges had at least one associated procedure. Of the 84,928 hospital stays with an
accompanying procedure, 28 percent had only a principal procedure performed; the remaining 72 percent had 2 or
more procedures. Each discharge can have up to 6 procedures; it is this total number of procedures, or the alllisted procedures, that will be examined in this report.
The most common types of all-listed procedures were miscellaneous diagnostic and therapeutic, cardiovascular,
obstetric, and musculoskeletal. Miscellaneous diagnostic and therapeutic procedures accounted for nearly half of
the total procedures and included injections, vaccinations and prophylactic inoculations, CT scans, diagnostic
ultrasounds, respiratory intubation and mechanical ventilation, and blood transfusions.
Overall, the most frequently performed all-listed procedures were diagnostic cardiac catheterization; coronary
arteriography, other procedures to assist delivery, and computerized axial tomography (CT) scans of the head.
Most Frequent All-listed Inpatient Procedures, 2009
CCS Procedure
Diagnostic cardiac catheterization; coronary arteriography
Other procedures to assist delivery
Computerized axial tomography (CT) scan head
Respiratory intubation and mechanical ventilation
Blood transfusion
Diagnostic ultrasound of heart (echocardiogram)
Prophylactic vaccinations and inoculations
Other vascular catheterization; not heart
Other diagnostic ultrasound
Fetal monitoring
# of All-listed
Procedures
12,100
9,737
8,374
7,753
7,511
7,283
6,761
6,650
6,414
6,310
% of Discharges
with a Procedure
14.2
11.5
9.9
9.1
8.8
8.6
8.0
7.8
7.6
7.4
Note: All-listed procedures refer to all procedures performed during a hosptial stay: excludes other therapeutic
procedures.
Males most frequently underwent diagnostic cardiac catheterization, circumcision, and respiratory intubation and
mechanical ventilation, while females most frequently underwent other procedures to assist delivery, fetal
monitoring, and diagnostic cardiac catheterization. Four of the 10 most commonly performed procedures on
females were related to pregnancy and childbirth; together they accounted for 17 percent of the total procedures
performed on females.
See the definition of Procedure Classes in the Definitions section of the Technical Notes.
11
WHY PATIENTS WERE HOSPITALIZEDPROCEDURES

A major component of obstetrical procedures are related to cesarean delivery of newborn infants. Since 1994,
annual cesarean delivery rates increased for every hospital in Delaware; by 2009, 34.8 of every 100 deliveries
were cesarean. Milford, Kent, and Nanticoke hospitals showed the greatest increases, rising 108, 89, and 79
percent respectively. In 2009, Milford and Christiana Care had the highest rates, at 41.3 and 36.6 cesareans per
100 deliveries.
Annual Cesarean Delivery Rates by Hospital
Delaware Hospitals, 1994 and 2009
45
1994
2009
Cesareans per 100 Deliveries
40
35
30
25
20
15
10
5
0
BEEBE MEDICAL
CENTER
CHRISTIANA
HOSPITAL
KENT GENERAL
HOSPITAL
MILFORD MEMORIAL
NANTICOKE
HOSPITAL
MEMORIAL HOSPITAL
Discharge Year
SAINT FRANCIS
HOSPITAL
Gender
In 2009, obstetrical procedures accounted for one in five all-listed procedures performed on females, and
included other procedures to assist delivery, fetal monitoring, cesarean sections, repair of current obstetrical
laceration, and artificial rupture of membranes.
Operations on the cardiovascular system accounted for 21 percent of the total procedures performed on males,
and included diagnostic cardiac catheterization, other vascular catheterization, not heart, and percutaneous
transluminal coronary angioplasty (PTCA).
The following procedures were present in the 10 most commonly performed procedures for both males and
females (excluding unspecified miscellaneous diagnostic and therapeutic procedures):
diagnostic cardiac catheterization,

CT scans,
blood transfusion,
diagnostic ultrasound of heart, and
respiratory intubation and mechanical ventilation.
12
WHY PATIENTS WERE HOSPITALIZEDPROCEDURES

Age
For patients under 1, prophylactic vaccinations and inoculations, ophthalmologic and otologic diagnosis and
treatment, and circumcision were the most common procedures.
For patients ages 1 to 17, other therapeutic procedures on muscles and tendons, other OR therapeutic
procedures on bone, and other vascular catheterization; not heart were the most frequently performed
procedures.
Obstetric procedures, specifically other procedures to assist delivery, fetal monitoring, and cesarean section,
were the most common procedures for those ages 18-44.
Diagnostic cardiac catheterization, CT scans, and other OR procedures on vessels other than head and neck
were the most frequently performed procedures for those 45-64.
The most commonly performed principal procedures on patients 65 and older were diagnostic cardiac
catheterization, CT scans, and echocardiograms.
13
HOSPITALIZATIONS OF DELAWARE RESIDENTS

Hospital stays for Delaware residents were based on inpatient discharges from Delaware hospitals only; as such,
information about residents who went out of state for hospital care are not represented in the following statistics.
Discharge rates of Delaware residents under the age of 1 were higher than the rates of all other age groups except
those 65 and older. Discharge rates decreased with each increase in age group between those patients under 1
and those ages 10-14; the trend reversed at the 15-19 age group and other than a slight dip in the rates for those
35-54, rates rose steadily with each older age group. Male and female discharge rates were similar for age groups
under 15 and over 44; females in 15-44 age groups had discharge rates 1.8 to 5.8 times that of males.
Resident Discharge Rates* by Sex and Age
4000
3500
Discharges per 1,000
3000
2500
2000
1500
1000
Females
500
Males
0
<1*
1-4
5-9
10-14
15-19
20-24
25-34
35-44
45-54
55-64
65-74
75+
Age Group
*This rate excludes all infants <1 who were admitted
by virtue of being born in the hospital.
In 2009, Delawareans were

discharged most frequently for
diseases of the circulatory system,
which accounted for 15.4 percent of
all resident hospital stays. The
most common diagnoses for
diseases of the circulatory system
included heart failure, coronary
artery disease, and irregular heart
beat. Pregnancy and childbirth, and
newborn infants were the second
and third most common reasons for
resident hospital stays, followed by
diseases of the respiratory system,
which included pneumonia, COPD
(chronic obstructive pulmonary
disease), and asthma, and diseases
of the digestive systems, which
included biliary tract disease,
gastrointestinal hemorrhage, and
intestinal obstruction.
100%
Percent Distribution of Resident Discharges for Hospitalizations by

Body System
Diseases of the circulatory system
80%
Complications of pregnancy, childbirth, &

the puerperium
Liveborn
60%
Diseases of the respiratory system

Diseases of the digestive system
Injury and poisoning
40%
Other
20%
0%
Discharges
14

Hospitalization Rates by Body System
Delaware Residents, 2009
Infections and parasitic diseases
33.6
Neoplasms
44.9
Endocrine, nutritional & metabolic diseases, & immunity
40.4
Disease of the blood and blood forming organs
13.7
Mental disorders
23.9
Diseases of the nervous system and sense organs
27.9
171.1
120.0
105.8
Diseases of the genitourinary system
53.0
Diseases of the skin and subcutaneous tissue
22.3
Diseases of the musculoskeletal system and connective tissue

Congenital anomalies
62.8
3.4
Certain conditions originating in the perinatal period
5.1
83.8
Discharges per 10,000 population
* Excluding hospitalizations related to pregnancy and liveborn infants.
High hospital discharge rates in 2009 were not necessarily indicative of large rate increases over the previous 10
years. In some categories, like diseases of the circulatory system, high 2009 rates were maintained in spite of
declines over the prior 10 year period. In others, such as diseases of the skin, and infectious and parasitic diseases,
2009 rates were comparatively low, though both had exhibited significant rate increases over the prior ten year
period.
Percent Change in Hospitalization Rates by Body System*
Delaware Residents, 1999 versus 2009
9.4
21.2
-14.1
41.7
67.3
7.6
6.2
13.2
-16.0
39.9
Mental disorders
-22.3
23.1
Endocrine, nutritional & metabolic diseases, & immunity disorders
6.7
Neoplasms
-22.6
118.5
-25
50
75
100
125
Percent Change from 1999 to 2009
*Excluding hospitalizations related to pregnancy and liveborn infants.

25
15

When the specific diagnoses that comprise each body system were examined, the following twenty principal
diagnoses had the highest discharge rates of Delaware residents in 2009.
Top 20 CCS Diagnoses with the Highest Hospital Discharge Rates* for Delaware Residents
1999
2004
CCS Diagnosis
Number Rate Number Rate
Pneumonia
2871
37.0
2949
35.5
Osteoarthritis
954
12.3
1978
23.8
2566
33.1
2933
35.3
Septicemia
568
7.3
1210
14.6
Coronary atherosclerosis and other heart disease
2524
32.6
2741
33.0
Cardiac dysrhythmias
1537
19.8
1578
19.0
1397
18.0
1536
18.5
827
10.7
1368
16.5
Rehabilitation care; fitting of prostheses; and adjustment of devices 2099
27.1
2272
27.4
Asthma
1311
16.9
1310
15.8
Acute cerebrovascular disease
1425
18.4
1365
16.4
Urinary tract infections
1058
13.7
1349
16.3
Acute myocardial infarction
1748
22.6
1636
19.7
1031
13.3
1323
15.9
Spondylosis; intervertebral disc disorders; other back problems
1395
18.0
1580
19.0
Respiratory failure; insufficiency; arrest (adult)
595
7.7
987
11.9
Diabetes mellitus with complications
1076
13.9
1387
16.7
Fluid and electrolyte disorders
1452
18.7
1345
16.2
Acute and unspecified renal failure
268
3.5
798
9.6
Complications of surgical procedures or medical care
818
10.6
1315
15.8
2009
Number Rate
3091
34.9
2686
30.3
2433
27.5
2179
24.6
2062
23.3
1876
21.2
1838
20.8
1709
19.3
1696
19.2
1562
17.6
1551
17.5
1551
17.5
1491
16.8
1485
16.8
1453
16.4
1441
16.3
1410
15.9
1311
14.8
1236
14.0
1166
13.2
% Difference from
1999 to 2009
-5.7
146.5
-17.0
235.9
-28.5
6.9
15.2
80.9
-29.3
4.3
-4.7
28.4
-25.3
26.1
-8.8
112.0
14.7
-20.9
303.8
24.8
*Hospitalization rate per 10,000, ranked by 2009 figures. Excluding pregnancy-related discharges and liveborn infants.
Diseases of the circulatory system accounted for 5 of the 20 conditions with the highest hospitalization rates; these
included:
congestive heart failure,
coronary atherosclerosis and other heart disease (coronary artery disease),
cardiac dysrhythmias (irregular heartbeat),
acute cerebrovascular disease (stroke), and
acute myocardial infarction (heart attack).
Three of the circulatory conditions listed above showed significant decreases in their rates since 1999, heart
failure, coronary artery disease, and heart attack.
Hospitalization rates for renal failure, septicemia, and osteoarthritis demonstrated the greatest increases between
1999 and 2009.
16

DE Resident Discharge Rates by Body System and Gender
200
180
160
Male
140
Female
120
100
80
60
40
20
0
Circulatory
Respiratory
Digestive
Injury & poisoning Musculoskeletal
Genitourinary
Cancer
Endocrine &
metabolic
Infections &
parasitic diseases
Nervous system
Women's higher discharge rate for diseases of the digestive system was due in large part to their higher discharge
rates of biliary tract disease and intestinal infection. Likewise, osteoarthritis and pathological fractures contributed to
the female to male disparity in hospitalization rates for diseases of the musculoskeletal system. The largest
difference between men and women occurred in the diseases of genitourinary system and was driven primarily by
women's higher rate of stays for urinary tract infections. Males had higher discharge rates for heart attack and
coronary artery disease, which resulted in their higher overall hospitalization rates for circulatory diseases.
Annual Discharge Rates of Delaware Residents by Gender and Selected Primary Diagnoses
40
Male
Female
35
30
25
20
15
10
0
Acute myocardial
infarction
Coronary
Intestinal infection Biliary tract disease
atherosclerosis and
other heart disease
CCS Diagnosis
17
Urinary tract
infections
Osteoarthritis
Pathological fracture
HOW PATIENTS WERE ADMITTED

Source of admissions:
Routine admissions and admissions from the ED accounted for 94 percent of all hospital discharges in 2009. The
remaining hospital admissions came from other short-term hospitals, long-term care facilities, and other sources.
Source of Admissions
Routine, 39.7
Other, 3.2
Other short-term
hospital, 1.6
Long-term care
facility, 1.0
ED, 54.4
Between 1995 and 2009, the distribution of admission source shifted from the majority of patients being routinely
admitted to the majority coming from the ED. In 1995, routine and ED admissions accounted for 57 and 39 percent
of all admissions. By 2009, the proportion of routine admissions had decreased 30 percent and the proportion of
ED admissions had risen by 41 percent.
Proportion of Hospital Discharges by Source of Admissions, Routine vs. ED
60
50
40
30
20
Routine
ED
10
0
1995
2002
Discharge Year
18
2009
HOW PATIENTS WERE ADMITTED

Though all primary payers experienced an increase in the percent of discharges coming from the ED, uninsured
patients had the largest proportion of their stays originating in the ED. In 2009, 74 percent of uninsured
admissions, 71 percent of Medicare admissions, 43 percent of private admissions, and 42 percent of Medicaid
admissions were admitted through the ED.
Percent of each Payer's Discharges Originating in the ED
Delaware, 1995-2009
80
Uninsured
Medicare
70
60
50
Private
Medicaid
40
30
20
10
0
1995
2001
Discharge Year
2009
The most common diagnoses of patients admitted through the emergency department were pneumonia, heart
failure, and septicemia.
2009 ED Admissions - Most Common Diagnoses
Pneumonia
Congestive heart failure; nonhypertensive
Septicemia
Chronic obstructive pulmonary disease and bronchiectasis (COPD)
Acute cerebrovascular disease (Stroke)
Cardiac dysrhythmias (Irregular heart beat)
Asthma
Acute myocardial infarction (Heart attack)
Frequency
Percent 1
3035
2309
2134
1767
1627
1606
1604
1600
1599
1527
4.9
3.8
3.5
2.9
2.6
2.6
2.6
2.6
2.6
2.5
1. Refers to the percent of discharges that originated in the ED.
The 10 most common diagnoses originating in the emergency department changed little from 2008 to
2009; the most notable difference was that asthma moved into the top 10 and respiratory failure was no
longer listed.
Four of the 10 most common ED diagnoses were related to circulatory conditions: heart failure, stroke,
heart attack, and irregular heart beat.
Another four of the most common ED diagnoses were primarily due to infections: pneumonia, skin
infections, septicemia, and urinary tract infections.
19
HOSPITAL CHARGES AND BILLING

Inpatient charges:
The total charges for a hospitalization represent the total amount billed for that particular stay. These charges
include accommodations, ancillary services (e.g. pharmacy, lab, radiology and anesthesiology), and services of
resident physicians. In this report, hospital charges for care are reported, not the actual costs of providing the care
or what the hospitals were reimbursed.
In 2009, total aggregate charges for all hospitalizations in Delaware equaled $2.53 billion, more than double the
aggregate charges in 2001. During the same time period, the number of discharges rose from 100,681 to 112,832,
a 12.1 percent increase.
Number of Discharges and Total Aggregate Charges by Year
140,000
$3,000,000,000
Aggregate Charges
Total Discharges
120,000
$2,500,000,000
100,000
80,000
$1,500,000,000
60,000
$1,000,000,000
Aggregate Charges
$2,000,000,000
40,000
$500,000,000
20,000
$1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
The average charge for a hospital stay rose again in 2009, to $22,410; the median charge per stay was $12,661.
The diagnostic groups with the highest average charges per hospital stay were congenital anomalies, perinatal
conditions, and infections and parasitic diseases, with average charges ranging from $36,619 to $108,056. These
three diagnostic groups also had the longest average stays, ranging from 8.3 to 11.4 days.
Looking at specific diagnoses within groups showed that the most expensive diagnoses were cardiac and
circulatory birth defects, leukemias, other CNS infections, and other birth defects. However, the 10 most
expensive diagnoses occurred relatively rarely and accounted for just under two percent of all discharges in 2009.
In comparison, the 10 diagnoses that occurred most frequently accounted for 30 percent of the total discharges in
2009 (see Appendix E for more information).
20

From 1999 to 2009, the average charges rose for each of the 10 highest volume diagnoses. The highest volume
diagnoses whose average charges increased the most were:
coronary atherosclerosis and other heart disease (205%),
cardiac dysrhythmias (138%).
septicemia (137%).
Average Hospital Charges for Highest* Volume CCS Diagnoses
$50,000
1999
2004
2009
$45,000
$40,000
Average Charge
$35,000
$30,000
$25,000
$20,000
$15,000
$10,000
$5,000
$-
Liveborn
Pneumonia
Osteoarthritis
Congestive
heart failure
Coronary
OB-related
atherosclerosis
trauma to
and other heart perineum and
disease
vulva
Septicemia
Cardiac
dysrhythmias
Skin and
subcutaneous
tissue infections
Chronic
obstructive
pulmonary
disease and
bronchiectasis
CCS Diagnosis
*Based on ten most common diagnoses in 2009.

Though the average charges of the high volume diagnoses increased over time, the proportion of total aggregate
charges represented by them experienced very little growth.
In 1999, the aggregate charges for 2009s highest volume diagnoses totaled $215.6 million and
accounted for 24 percent of the total aggregate charges for all diagnoses.
By 2009, the aggregate charges for those same diagnoses had more than tripled, to $645.7 million,
which accounted for 25.5 percent of the total aggregate charges.
In 2009, the 10 conditions with the highest total billed charges accounted for 32 percent of the total aggregate
charges. Coronary atherosclerosis incurred the largest aggregate charges of any diagnosis, resulting in a total
hospital bill of $111.1 million. Although hospital stays for newborns had relatively low average charges, their high
frequency resulted in liveborn infants having the 5th highest aggregate charges (see Appendix E for more
information).
21

Insurance status:
The following payer sources are listed in this report:
Medicare
Medicaid
Private insurance carriers, such as:
Blue Cross Blue Shield
HMOs
Commercial Insurance
Uninsured
Patients who have no insurance and self pay
Other types of insurance, such as:
Workmans compensation
CHAMPUS (Civilian Health and Medical Program of the Uniformed Services)
Other government sponsored programs
In 2009, 62 percent of hospitalizations were billed to Medicare (38) and Medicaid (24), 33 percent were billed to
private insurance, and the remaining 5 percent were billed to other types of coverage or to the patient.
Patients whose care was primarily billed to Medicare had both the highest average charges and the greatest
aggregate charges.
In 2009, Beebe had the highest percent of charges billed to Medicare. A.I. DuPont had the highest percentage
billed to both privately insured and Medicaid covered patients, and St. Francis had the highest percent of charges
with no coverage. Though 11.5 percent of St. Francis discharges were uninsured, they accounted for 8.5 percent
of its total hospital bill.
Percent of Hospital System's Total Charges
Distribution of Total Charges by Primary Payer Type and Hospital System

Delaware, 2009
100
90
80
Other
70
Uninsured
60
Private
Medicaid
50
Medicare
40
30
20
10
0
A I DUPONT
HOSPITAL
BAYHEALTH
MEDICAL
CENTER
BEEBE MEDICAL CHRISTIANA

CENTER
CARE HEALTH
SYSTEM
NANTICOKE
MEMORIAL
HOSPITAL
SAINT FRANCIS
HOSPITAL
Hospital System
22

Medicare:
From 1995 to 2009, the percent of hospital stays whose primary payer was Medicare increased from 34 to 38
percent. Over the same time period, the proportion of aggregate charges billed to Medicare remained at 46
percent.
Four of the 10 most frequent diagnoses for Medicare patients were related to diseases of the circulatory system;
together they accounted for 14.6 percent of Medicare hospitalizations. The three most frequent diagnoses for
Medicare patients in 2009 were7:
congestive heart failure; nonhypertensive,

osteoarthritis, and
pneumonia (except that caused by TB or STD).
Medicaid:
From 1995 to 2009, Medicaid covered hospitalizations increased from 16.4 to 24 percent. Over the same time
period, the proportion of aggregate charges billed to Medicaid rose from 13.8 to 19.9 percent.
Six of the 10 most frequent diagnoses for Medicaid patients were related to pregnancy and childbirth, and
accounted for 35.6 percent of Medicaid stays. The three most frequent diagnoses for Medicaid patients in 2009
were7:
liveborn infants,
OB-related trauma to perineum and vulva, and
other complications of pregnancy.
Private Insurers:
From 1995 to 2009, privately insured stays decreased from 42.3 to 32.7 percent. Over the same time period, the
proportion of aggregate charges billed to private insurance decreased from 34.1 to 29.4 percent.
Four of the 10 most frequent diagnoses for patients whose primary payer was private insurance were related to
pregnancy and childbirth, and accounted for 22.3 percent of all stays covered by private insurers . The three
most frequent diagnoses for privately insured patients in 2009 were7:
liveborn infants,
OB-related trauma to perineum and vulva, and
osteoarthritis.
Uninsured:
From 1995 to 2009, uninsured hospitalizations decreased from 5.7 to 3.1 percent. Over the same time period,
the proportion of aggregate charges billed to uninsured patients decreased from 4.2 to 2.6 percent.
The three most frequent diagnoses for uninsured patients in 2009 were 7:
liveborn infants,
skin and subcutaneous tissue infections, and
diabetes mellitus with complications.
See Appendix F for the top 10 principal diagnoses by payer type.
23
HOW PATIENTS WERE DISCHARGED

Patient discharge status:
A patients discharge status refers to how a person is discharged from the hospital, and includes discharges to
home, long-term care and other non-acute care facilities, other short-term hospitals, patients who left against
medical advice, and patients who died while in the hospital. The majority of patients (67 percent) in 2009 were
discharged to their homes, less than 3 percent of patients died in the hospital, and fewer than 1 percent left against
medical advice.
Percent of Discharges by Discharge Status

Expired in hospital
2.4%
Home health care

17.0%
Against medical advice

0.7%
Other
0.9%
Long-term care
10.0%
Another short-term hosp ital

2.2%
Routine - home
66.9%
Expired patients:
Patients who died during their hospital stay contributed to the in-hospital mortality figures. Data about in-hospital
mortality are expressed as either numbers of deaths, or percentages of deaths. Both the frequencies and
percentages are presented, as each statistic provides a different perspective for reviewing the data.
Frequencies
Patients with the following diagnoses experienced the highest numbers of in-hospital mortality:
septicemia,
respiratory failure, and
acute cerebrovascular disease (stroke).
24

Frequencies
Patients with the following diagnoses experienced the highest numbers of in-hospital mortality:
septicemia,
respiratory failure, and
acute cerebrovascular disease (stroke).
Diagnoses with the Greatest Numbers of In-Hospital Deaths
400
350
Number of Deaths
300
250
200
150
100
50
0
Septicemia
Respiratory
failure
Stroke
Pneumonia
Congestive heart Heart attack

failure;
nonhypertensive
Secondary
Acute and
Aspiration
malignancies unspecified renal pneumonitis;
failure
food/vomitus
Intracranial
injury
The most frequent causes of in-hospital mortality varied by age group. Low birthweight and prematurity accounted
for the largest number of deaths to those under one, while respiratory failure caused the highest number of deaths
to those ages 1-17. For patients 18 and older, septicemia accounted for the greatest number of deaths.
Patients ages 65 and older accounted for two-thirds of all in-hospital mortality (for more information see
Appendices G and H).
25

Percentages
Those diagnoses with the greatest percentages of in-hospital mortality were:
shock,
cardiac arrest and ventricular fibrillation,
malignant neoplasm without specification of site, and
coma; stupor; and brain damage.
CCS Diagnoses with the Greatest Percent of In-Hospital Mortality
Delaware Hospital, 2009
70
60
50
Percent
40
30
20
10
0
Shock
Cardiac arrest
and ventricular
fibrillation
Cancer; other
and unspecified
primary
Coma; stupor;
and brain
damage
Cancer of
pancreas
Septicemia
Primary Diagnosis
Secondary
malignancies
Malignant
Respiratory
neoplasm without failure; arrest
specification of
site
Cancer of liver
and intrahepatic
bile duct
Six of the ten diagnoses with the greatest percentages of in-hospital mortality were cancer-related, and included
pancreatic and liver cancer.
Patients who left against medical advice:

Less than one percent of patients left the hospital against medical advice. Males were twice as likely
than females to leave the hospital against medical advice; uninsured patients were more than 4 times
as likely to do so.
The three most frequent diagnoses of patients who left the hospital against medical advice were diabetes,
pancreatic disorders, and pneumonia.
For women, skin and subcutaneous tissue infections, diabetes, and COPD made up the top three.
For men, diabetes, pancreatic disorders, and pneumonia made up the top three.
26

Patients transferred to another facility:
The majority of patients discharged to another facility were transferred to a long-term care (LTC) facility. For those
65 and older, each 10 year increase in patient age nearly doubled the percent of those transferred to LTC facilities.
In 2009, less than 3 percent of those under 65 were discharged to long-term care facilities, compared to 15 percent
of those 65-74, 27 percent of those 75-84, and 44 percent of those 85 and older.
Distribution of Discharge Status by Age Group

100%
Other
90%
80%
70%
Expired in hospital
60%
Home health care
50%
Long-term care
40%
30%
Another short-term
hospital
20%
Routine - home
10%
0%
<65
65-74
75-84
85+
Age Group
In 2009, the most common diagnoses for patients discharged to LTC facilities were septicemia,
osteoarthritis, and hip fracture.
For patients under 65 (excluding liveborn infants), septicemia, complication of device, implant or graft,
and osteoarthritis were the three most common diagnoses.
For patients 65-74, osteoarthritis, septicemia, and respiratory failure were the three most common
diagnoses.
For patients 75-84, septicemia, osteoarthritis, and hip fracture were the three most common diagnoses.
For patients 85 and older, hip fracture, septicemia, and congestive heart failure were the three most
common diagnoses.
27
HOSPITAL SPECIFIC DATA

A.I. duPont Hospital for Children
2009 Discharge Distribution
Zip / State
PA
NJ
19805
19720
MD
19702
19802
19701
19808
19801
19709
19711
19713
19703
19901
19804
19803
Other state
19977
19810
19809
19904
19956
19947
19707
19963
19734
19973
19966
19952
19962
19934
19938
19807
19968
19806
19933
19943
19950
19958
19960
19953
19946
19945
19940
19706
19939
19971
19975
19970
19941
19964
19954
19899
Other DE
Invalid
Total
Number
2,762
1,301
605
547
535
419
327
279
256
250
244
214
211
166
163
145
139
135
127
127
114
112
80
77
77
75
64
63
58
54
52
45
41
39
37
37
31
29
27
23
21
14
14
14
13
13
10
9
8
8
6
5
5
5
22
2
10,256
%
26.9
12.7
5.9
5.3
5.2
4.1
3.2
2.7
2.5
2.4
2.4
2.1
2.1
1.6
1.6
1.4
1.4
1.3
1.2
1.2
1.1
1.1
0.8
0.8
0.8
0.7
0.6
0.6
0.6
0.5
0.5
0.4
0.4
0.4
0.4
0.4
0.3
0.3
0.3
0.2
0.2
0.1
0.1
0.1
0.1
0.1
0.1
0.1
0.1
0.1
0.1
0.0
0.0
0.0
0.2
0.0
100
Utilization Characteristics
2007
2008
Aggregate charges
Average charges
Average charge per day
Total All-listed Procedures1
Non-operating room procedures 2
Valid operating room procedures 2
Average Lenth of Stay
Primary Payer Distribution
Medicare
Medicaid
Private Insurance
Uninsured
Other
Admission Source Distribution
Routine
Other short-term hospital
Long-term care facility
ER
Other
Discharge Status Distribution
Routine
Another short-term hospital
Long-term care
Home health care
Expired
Other/Unknown
Sex
Male
Female
Age
<1
1-4
5-9
10-14
15-19
20-24
25-34
35-44
45-54
55-64
65-74
75+
$311,156,093
$29,527
$7,648
10,538
12,527
6,044
6,483
4.2
$341,657,933
$34,108
$7,795
10,017
11,361
5,642
5,719
4.6
2009
$372,061,971
$36,277
$7,811
10,256
10,423
5,368
5,055
4.6
0.1
39.5
58.0
0.8
1.6
0.2
38.8
57.8
0.8
2.4
0.2
41.1
55.4
1.5
1.9
31.8
6.7
4.2
56.2
1.1
29.4
7.2
2.9
59.7
0.7
25.4
10.1
0.7
62.9
0.9
93.4
0.7
0.9
4.3
0.3
0.0
0.4
92.7
0.6
1.1
4.9
0.4
0.1
0.3
93.0
0.6
0.5
4.6
0.4
0.1
0.7
54.9
45.1
55.4
44.6
55.5
44.5
24.2
27.0
17.5
18.3
12.5
0.4
0.0
0.0
0.0
0.0
0.0
0.0
23.2
27.8
17.3
17.2
14.0
0.4
0.0
0.0
0.0
0.0
0.0
0.0
23.6
27.6
17.6
17.8
12.8
0.5
0.0
0.0
0.0
0.0
0.0
0.0
Notes:
1. Total all-listed procedures represents the total number of procedures performed; up to 6 procedures may be
recorded per discharge, as a result the total number of all-listed procedures can exceed the total number of
discharges.
2. Procedures were classified using AHRQ's HCUP procedure class software. See AHRQ's website for more
information: http://www.hcup-us.ahrq.gov/toolssoftware/procedure/procedure.jsp.
3. Percentages may not sum to 100 due to rounding.
28

BayHealth Medical Center
Zip / State
19901
19904
19963
19977
19934
19943
19952
19962
19960
19938
19946
19950
19953
19947
MD
19968
19941
19966
19709
19933
Other state
19973
19734
19958
19954
19964
19971
19903
19979
19956
19936
19945
PA
19939
19980
19955
NJ
19720
19970
19951
19975
19902
19701
19702
19713
19961
19711
19940
19801
19930
19805
19808
19706
Other DE
Invalid
Total
Number
3,794
2,895
2,101
1,599
1,125
1,117
1,084
798
516
488
422
407
388
371
354
263
226
216
175
174
169
149
143
142
139
116
82
75
70
63
59
48
45
43
42
30
28
22
20
19
18
16
14
13
9
8
8
7
7
6
6
4
4
24
3
20,164
%
18.8
14.4
10.4
7.9
5.6
5.5
5.4
4.0
2.6
2.4
2.1
2.0
1.9
1.8
1.8
1.3
1.1
1.1
0.9
0.9
0.8
0.7
0.7
0.7
0.7
0.6
0.4
0.4
0.3
0.3
0.3
0.2
0.2
0.2
0.2
0.1
0.1
0.1
0.1
0.1
0.1
0.1
0.1
0.1
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.1
0.0
100
2007
2008
Aggregate charges
Average charges
Primary Payer Distribution3
Medicare
Medicaid
Private Insurance
Uninsured
Other
Routine
ER
Other
Routine
Long-term care
Home health care
Expired
Other/Unknown
Sex
Male
Female
Age
<1
1-4
5-9
10-14
15-19
20-24
25-34
35-44
45-54
55-64
65-74
75+
$355,152,301
$17,545
$4,424
20,242
22,725
14,530
8,195
5.1
$364,818,809
$18,914
$4,900
19,288
22,221
14,465
7,756
5.0
2009
$398,952,631
$19,785
$5,230
20,164
21,504
14,284
7,220
4.9
41.3
22.3
26.4
3.9
6.1
43.2
22.9
24.8
3.3
5.8
42.4
24.0
24.5
3.1
6.0
53.8
0.7
0.1
45.1
0.3
55.2
0.6
0.2
43.7
0.4
37.5
0.6
0.0
50.3
11.5
66.9
2.4
11.0
16.0
2.3
0.8
0.7
65.5
2.1
12.6
15.7
2.4
0.8
0.8
67.7
2.5
9.5
13.4
1.9
1.0
4.0
40.0
60.0
40.5
59.5
40.5
59.5
13.1
1.4
0.7
0.5
2.6
5.5
9.1
8.0
10.6
12.7
13.9
21.8
13.5
1.1
0.6
0.4
2.6
5.7
8.7
6.8
10.6
12.1
15.0
23.1
13.3
1.2
0.6
0.4
2.4
5.6
9.5
6.7
11.0
12.4
14.6
22.2
Notes:
discharges.
29

Beebe Medical Center
Zip / State
19966
19958
19971
19947
19968
19970
19945
19939
19975
19963
19973
MD
19956
Other state
19951
PA
19930
19960
19933
19950
19941
19943
19952
19901
19967
19904
19969
NJ
19944
19962
19934
19808
19804
19940
19977
19805
19701
19946
19711
19810
19720
19954
19734
19713
19709
19980
19964
19938
19809
19807
19803
19703
19706
Invalid
Other DE
Total
Number
2,221
1,851
944
912
717
425
376
329
236
229
170
153
143
138
137
131
117
115
111
68
64
43
41
33
32
27
25
19
17
14
10
10
10
8
7
7
7
6
6
5
5
4
4
4
4
3
3
3
3
3
3
3
2
1
5
9,964
%
22.3
18.6
9.5
9.2
7.2
4.3
3.8
3.3
2.4
2.3
1.7
1.5
1.4
1.4
1.4
1.3
1.2
1.2
1.1
0.7
0.6
0.4
0.4
0.3
0.3
0.3
0.3
0.2
0.2
0.1
0.1
0.1
0.1
0.1
0.1
0.1
0.1
0.1
0.1
0.1
0.1
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.1
100
2007
2008
Aggregate charges
Average charges
Medicare
Medicaid
Private Insurance
Uninsured
Other
Routine
ER
Other
Routine
Long-term care
Home health care
Expired
Other/Unknown
Sex
Male
Female
Age
<1
1-4
5-9
10-14
15-19
20-24
25-34
35-44
45-54
55-64
65-74
75+
$228,428,793
$21,765
$6,603
10,495
13,855
8,313
5,542
3.7
$252,061,080
$24,269
$7,383
10,386
15,247
9,495
5,752
3.8
2009
$269,338,839
$27,031
$8,466
9,964
15,457
9,916
5,541
3.8
50.3
18.0
27.7
2.9
1.0
50.5
18.1
27.8
2.6
5.8
51.4
18.4
26.2
2.9
6.0
40.3
0.1
2.3
57.2
0.1
34.4
0.0
9.9
55.6
0.0
33.1
0.0
9.5
57.4
0.0
61.8
2.6
12.5
19.8
2.0
0.7
0.6
59.6
1.8
14.9
20.3
2.3
0.6
0.5
61.3
1.5
13.5
18.5
1.9
0.6
2.7
44.0
56.0
43.1
56.9
44.1
55.9
10.0
0.6
0.2
0.2
1.9
4.2
7.0
6.3
9.4
13.4
19.8
27.0
10.7
0.4
0.2
0.2
1.6
3.8
7.5
6.2
9.5
13.6
19.4
26.9
10.0
0.5
0.2
0.1
1.5
3.4
7.0
5.0
9.9
13.7
20.7
28.0
Notes:
discharges.
30

Christiana Care Health System
Zip / State
19720
19702
19808
19805
19711
19713
MD
19701
19802
PA
19709
19804
19801
NJ
19810
19803
19707
19809
19703
19806
19977
19734
19807
Other state
19904
19901
19706
19938
19966
19958
19963
19973
19947
19934
19899
19943
19971
19956
19968
19962
19952
19953
19730
19933
19950
19960
19970
19946
19733
19731
19939
19964
19736
19945
19850
Other DE
Invalid
Total
Number
6,668
4,351
3,912
3,864
3,503
3,384
3,240
3,188
2,962
2,611
2,435
2,082
1,989
1,790
1,725
1,678
1,264
1,160
1,145
935
732
724
604
405
355
351
285
250
177
160
157
137
131
129
115
110
96
93
89
86
84
79
66
57
52
50
47
43
39
36
31
30
30
27
27
252
8
60,030
%
11.1
7.2
6.5
6.4
5.8
5.6
5.4
5.3
4.9
4.3
4.1
3.5
3.3
3.0
2.9
2.8
2.1
1.9
1.9
1.6
1.2
1.2
1.0
0.7
0.6
0.6
0.5
0.4
0.3
0.3
0.3
0.2
0.2
0.2
0.2
0.2
0.2
0.2
0.1
0.1
0.1
0.1
0.1
0.1
0.1
0.1
0.1
0.1
0.1
0.1
0.1
0.0
0.0
0.0
0.0
0.4
0.0
100
2007
2008
Aggregate charges
Average charges
Medicare
Medicaid
Private Insurance
Uninsured
Other
Routine
ER
Other
Routine
Long-term care
Home health care
Expired
Other/Unknown
Sex
Male
Female
Age
<1
1-4
5-9
10-14
15-19
20-24
25-34
35-44
45-54
55-64
65-74
75+
$1,094,875,751
$17,977
$4,382
60,904
165,861
134,969
30,892
5.1
$1,139,808,746
$19,455
$4,659
58,587
173,067
143,652
29,415
5.2
2009
$1,248,182,694
$20,793
$5,308
60,030
177,496
147,368
30,128
5.0
38.9
20.4
37.1
2.4
1.3
38.7
20.8
36.6
2.7
5.8
40.3
21.2
34.8
2.4
6.0
43.3
0.8
0.2
53.5
2.2
44.4
1.0
0.2
52.3
2.1
44.0
0.9
0.2
53.0
1.9
65.3
2.3
8.6
19.4
2.7
0.7
1.1
64.3
2.3
8.8
20.0
3.0
0.6
1.0
63.3
2.3
10.4
20.4
3.1
0.6
0.0
40.2
59.8
40.5
59.5
41.1
58.9
12.1
0.3
0.2
0.3
2.3
4.9
11.9
10.5
12.5
12.7
12.3
20.0
12.7
0.2
0.1
0.2
2.3
4.8
12.2
10.1
12.4
12.6
12.2
20.1
11.9
0.2
0.1
0.2
2.1
4.4
12.0
9.8
12.7
13.5
12.8
20.3
Notes:
discharges.
31

Nanticoke Memorial Hospital
Zip / State
19973
19956
19947
19933
19966
MD
19940
19950
19945
19975
19963
19939
19952
Other state
19968
19960
19931
19970
19941
19958
PA
NJ
19971
19954
19951
19946
19709
19977
19962
19943
19938
19934
19901
19967
19953
19808
19805
19801
19720
19703
19702
Total
Number
2,158
1,124
616
574
271
256
212
197
58
52
52
41
29
24
24
23
16
14
12
9
5
4
4
4
3
3
3
2
2
2
2
2
2
1
1
1
1
1
1
1
1
5,808
%
37.2
19.4
10.6
9.9
4.7
4.4
3.7
3.4
1.0
0.9
0.9
0.7
0.5
0.4
0.4
0.4
0.3
0.2
0.2
0.2
0.1
0.1
0.1
0.1
0.1
0.1
0.1
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
100
2007
2008
Aggregate charges
Average charges
Medicare
Medicaid
Private Insurance
Uninsured
Other
Routine
ER
Other
Routine
Long-term care
Home health care
Expired
Other/Unknown
Sex
Male
Female
Age
<1
1-4
5-9
10-14
15-19
20-24
25-34
35-44
45-54
55-64
65-74
75+
$95,103,262
$14,135
$3,626
6,728
13,936
11,850
2,086
4.1
$90,103,024
$14,752
$4,025
6,108
12,066
10,248
1,818
3.8
2009
$90,783,660
$15,631
$4,522
5,808
10,791
9,049
1,742
3.7
39.6
33.4
21.9
5.1
0.0
40.0
35.7
19.0
4.2
5.8
38.5
35.9
18.2
3.7
6.0
42.9
0.0
0.0
57.0
0.0
43.6
0.0
0.0
56.4
0.0
41.2
0.0
0.0
58.8
0.0
71.8
2.8
11.7
10.0
1.7
0.5
1.5
67.9
3.6
12.4
13.1
1.4
0.5
1.1
67.6
4.1
12.7
12.4
1.8
0.5
0.9
38.9
61.1
39.0
61.0
39.6
60.4
15.3
0.4
0.3
0.3
3.2
7.4
9.3
7.8
10.6
12.0
12.0
21.4
15.3
0.1
0.0
0.1
3.3
7.3
10.1
7.6
10.1
12.9
11.5
21.6
15.7
0.5
0.2
0.4
2.6
7.2
10.4
6.9
10.1
13.0
13.0
20.0
Notes:
discharges.
32

St. Francis Hospital
Zip / State
19805
19802
19801
19720
19806
19803
19810
19808
19703
19809
19804
19702
PA
19711
19701
19707
MD
19713
NJ
19709
Other state
19807
19977
19734
19899
19901
19904
19966
19958
19971
19962
19953
19934
19706
19943
19973
19963
19952
19938
19968
19947
19945
19850
19956
19946
19941
19940
19933
19736
19710
19979
19970
19961
19960
Total
Number
1,594
666
538
515
417
287
285
261
239
231
207
183
147
131
123
100
96
89
81
72
54
53
44
27
22
21
19
13
10
8
7
7
6
6
5
4
4
4
4
3
3
3
3
2
2
2
2
2
2
2
1
1
1
1
6,610
%
24.1
10.1
8.1
7.8
6.3
4.3
4.3
3.9
3.6
3.5
3.1
2.8
2.2
2.0
1.9
1.5
1.5
1.3
1.2
1.1
0.8
0.8
0.7
0.4
0.3
0.3
0.3
0.2
0.2
0.1
0.1
0.1
0.1
0.1
0.1
0.1
0.1
0.1
0.1
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
100
2007
2008
Aggregate charges
Average charges
Medicare
Medicaid
Private Insurance
Uninsured
Other
Routine
ER
Other
Routine
Long-term care
Home health care
Expired
Other/Unknown
Sex
Male
Female
Age
<1
1-4
5-9
10-14
15-19
20-24
25-34
35-44
45-54
55-64
65-74
75+
$182,792,252
$22,492
$7,150
8,127
9,535
5,976
3,559
4.3
$174,287,257
$23,313
$6,533
7,476
8,613
5,326
3,287
4.5
2009
$149,236,157
$22,577
$6,632
6,610
7,550
4,880
2,670
4.3
42.2
22.9
28.3
5.5
1.0
41.9
23.9
27.9
4.8
5.8
41.8
20.2
25.0
11.5
6.0
41.9
2.5
0.7
54.5
0.3
38.5
2.1
0.1
59.1
0.2
39.3
1.5
0.5
58.7
0.1
63.2
1.4
14.7
17.5
1.8
1.3
0.1
61.7
1.3
13.2
20.3
1.7
1.5
0.3
64.5
1.6
10.8
17.6
1.7
1.4
2.4
37.3
62.7
37.6
62.4
37.6
62.4
11.6
0.0
0.0
0.0
2.2
4.6
10.5
9.6
12.3
12.4
12.5
24.3
11.0
0.0
0.0
0.1
1.7
4.3
10.1
10.3
13.6
12.9
12.3
23.7
12.0
0.0
0.0
0.0
1.9
4.1
10.7
9.4
13.0
13.2
13.4
22.4
Notes:
discharges.
33
APPENDIX A
Clinical classification system:
Diagnoses and procedures were reported using the International Classification of Diseases, Ninth Revision,
Clinical Modification (ICD-9-CM). These codes were then aggregated into broader diagnostic categories according
to the Clinical Classification System (CCS) developed by the Agency of Healthcare Research and Quality (AHRQ).
The CCS diagnoses are used to categorize clinically similar diagnoses for ease in presentation and interpretation
of hospital discharge data. A complete listing of CCS diagnostic codes and selected corresponding measures are
presented below.
Number and Percent of Discharges, Mean Length of Stay, Mean Charges, Percent Expired, and Percent Admitted
from the ED by Principal Diagnosis
Clinical Classifications Software Categories and Chapter Headings

Tuberculosis
Septicemia (except in labor)
Bacterial infection; unspecified site
Mycoses
HIV infection
Hepatitis
Viral infection
Other infections; including parasitic
Sexually transmitted infections (not HIV or hepatitis)
Immunizations and screening for infectious disease
Neoplasms
Cancer of head and neck
Cancer of esophagus
Cancer of stomach
Cancer of colon
Cancer of rectum and anus
Cancer of liver and intrahepatic bile duct
Cancer of pancreas
Cancer of other GI organs; peritoneum
Cancer of bronchus; lung
Cancer; other respiratory and intrathoracic
Cancer of bone and connective tissue
Melanomas of skin
Other non-epithelial cancer of skin
Cancer of breast
Cancer of uterus
Cancer of cervix
Cancer of ovary
Cancer of other female genital organs
Cancer of prostate
Cancer of testis
Cancer of other male genital organs
Cancer of bladder
Cancer of kidney and renal pelvis
Cancer of other urinary organs
Cancer of brain and nervous system
Cancer of thyroid
Hodgkin`s disease
34
Number of Percent of
Discharges Discharges
3287
100.0
10
2338
23
90
242
92
360
119
12
2
4610
82
41
51
257
113
34
99
53
407
8
34
19
17
132
124
63
80
23
146
2
1
93
135
9
108
16
15
0.3
71.1
0.7
2.7
7.4
2.8
11.0
3.6
0.4
0.1
100.0
1.8
0.9
1.1
5.6
2.5
0.7
2.1
1.1
8.8
0.2
0.7
0.4
0.4
2.9
2.7
1.4
1.7
0.5
3.2
0.0
0.0
2.0
2.9
0.2
2.3
0.3
0.3
Mean
LOS
Mean Total Percent

Charges
Expired
8.3
$36,629
7.6
$ 24,150
9.2
$ 41,878
5.0
$ 22,597
7.8
$ 33,826
9.9
$ 36,730
4.5
$ 17,188
3.5
$ 14,657
5.1
$ 21,656
12.6
$ 27,321
1.0
$ 17,208
6.5
$34,575
8.9
$ 38,306
8.4
$ 35,237
8.4
$ 40,646
7.9
$ 36,405
8.3
$ 37,542
7.9
$ 44,883
8.0
$ 31,468
11.3
$ 51,895
7.5
$ 33,775
6.5
$ 27,673
10.9
$ 65,296
3.3
$ 18,293
6.8
$ 36,630
3.4
$ 22,787
4.6
$ 26,126
3.8
$ 18,756
7.9
$ 40,123
3.6
$ 17,471
3.1
$ 23,208
1.5
$ 13,360
1.0
$ 10,514
7.9
$ 38,915
5.3
$ 33,202
4.6
$ 19,748
7.3
$ 44,772
2.7
$ 23,093
7.9
$ 44,992
13.4
0.0
17.0
0.0
8.9
10.3
5.4
0.6
0.8
0.0
0.0
6.6
3.7
14.6
9.8
5.1
0.9
14.7
19.2
7.5
12.5
12.5
5.9
5.3
5.9
3.8
1.6
3.2
6.3
4.3
1.4
0.0
0.0
8.6
3.0
0.0
4.6
0.0
6.7
Percent
Admitted
from ED
88.6
40.0
91.3
65.2
86.7
89.7
79.3
79.2
83.2
66.7
0.0
28.9
22.0
29.3
51.0
29.6
31.0
47.1
52.5
37.7
51.4
62.5
17.6
0.0
17.6
12.1
14.5
17.5
22.5
17.4
7.5
0.0
0.0
36.6
17.8
22.2
55.6
6.3
60.0
APPENDIX A
Non-Hodgkin`s lymphoma
Leukemias
Multiple myeloma
Cancer; other and unspecified primary
Secondary malignancies
Malignant neoplasm without specification of site
Neoplasms of unspecified nature or uncertain behavior
Maintenance chemotherapy; radiotherapy
Benign neoplasm of uterus
Other and unspecified benign neoplasm
Endocrine, nutritional & metabolic diseases, & immunity disorders
Thyroid disorders
Diabetes mellitus without complication
Other endocrine disorders
Nutritional deficiencies
Disorders of lipid metabolism
Gout and other crystal arthropathies
Cystic fibrosis
Immunity disorders
Other nutritional; endocrine; and metabolic disorders
Deficiency and other anemia
Acute posthemorrhagic anemia
Sickle cell anemia
Coagulation and hemorrhagic disorders
Diseases of white blood cells
Other hematologic conditions
Mental disorders
Adjustment disorders
Anxiety disorders
Attention-deficit
Delirium
Developmental disorders
Disorders usually diagnosed in infancy
Impulse control disorders
Mood disorders
Personality disorders
Schizophrenia and other psychotic disorders
Alcohol-related disorders
Substance-related disorders
Screening and history of mental health and substance abuse codes
Miscellaneous disorders
Meningitis (except that caused by tuberculosis or STD)
Encephalitis (except that caused by tuberculosis or STD)
Other CNS infection and poliomyelitis
Parkinson`s disease
Multiple sclerosis
Other hereditary and degenerative nervous system conditions
Paralysis
Epilepsy; convulsions
Headache; including migraine
Coma; stupor; and brain damage
35
Number of Percent of Mean

Discharges Discharges LOS
130
117
60
18
604
20
117
443
514
425
4154
99
105
1578
116
32
1
62
1488
49
2
622
1388
545
59
377
161
232
14
2303
5
44
3
206
5
2
1
913
3
184
366
260
158
153
3050
134
25
18
34
90
132
64
893
269
29
2.8
2.5
1.3
0.4
13.1
0.4
2.5
9.6
11.1
9.2
100.0
2.4
2.5
38.0
2.8
0.8
0.0
1.5
35.8
1.2
0.0
15.0
100.0
39.3
4.3
27.2
11.6
16.7
1.0
100.0
0.2
1.9
0.1
8.9
0.2
0.1
0.0
39.6
0.1
8.0
15.9
11.3
6.9
6.6
100.0
4.4
0.8
0.6
1.1
3.0
4.3
2.1
29.3
8.8
1.0
10.5
16.8
9.8
7.6
7.2
7.7
7.3
5.9
2.5
5.0
4.5
5.6
2.6
5.2
5.4
9.8
6.0
5.1
3.8
8.7
3.5
3.6
4.6
3.9
4.2
5.7
3.7
5.1
5.4
6.0
1.4
3.4
2.7
8.0
2.6
22.5
1.0
6.4
6.7
9.3
4.9
4.3
6.9
2.8
4.2
4.4
10.8
16.4
5.9
5.3
6.2
4.5
3.4
2.7
7.0
Mean Total
Charges
$ 55,120
$ 101,495
$ 57,768
$ 52,437
$ 30,837
$ 34,090
$ 45,177
$ 42,427
$ 15,819
$ 25,858
$19,061
$ 22,280
$ 10,707
$ 19,383
$ 20,168
$ 32,755
$ 35,077
$ 14,675
$ 13,569
$ 65,559
$ 17,197
$ 28,121
$20,604
$ 18,073
$ 18,698
$ 17,910
$ 29,055
$ 24,755
$ 33,760
$13,672
$ 2,713
$ 11,229
$ 6,591
$ 16,194
$ 15,082
$ 46,338
$ 2,209
$ 9,514
$ 20,060
$ 14,014
$ 15,953
$ 18,038
$ 26,793
$ 8,922
$19,035
$ 20,656
$ 49,049
$ 91,183
$ 14,173
$ 20,768
$ 27,297
$ 36,189
$ 14,984
$ 11,552
$ 33,776
Percent
Percent Admitted
Expired from ED
13.8
12.8
11.7
22.2
15.6
15.0
2.6
1.8
0.0
0.7
1.4
2.0
0.0
0.7
1.7
3.1
0.0
0.0
2.1
0.0
0.0
1.8
1.6
2.4
0.0
0.3
1.9
1.7
7.1
2.3
0.0
0.0
0.0
3.4
0.0
0.0
0.0
1.9
0.0
0.0
2.2
2.7
8.2
0.0
1.6
0.0
8.0
0.0
2.9
2.2
3.0
1.6
1.1
0.0
20.7
45.4
42.7
45.0
50.0
55.0
60.0
44.4
0.5
3.3
20.2
73.2
53.5
90.5
84.9
84.5
62.5
100.0
90.3
82.6
18.4
50.0
22.0
71.0
72.1
88.1
84.6
53.4
55.2
57.1
76.3
60.0
90.9
100.0
93.7
100.0
100.0
0.0
61.9
100.0
81.5
97.3
84.6
92.4
46.4
78.9
87.3
80.0
66.7
82.4
71.1
56.1
29.7
82.2
88.5
72.4
APPENDIX A
Retinal detachments; defects; vascular occlusion; and retinopathy
Glaucoma
Blindness and vision defects
Inflammation; infection of eye (except that caused by tuberculosis or sexually transmitteddisease)
Other eye disorders
Otitis media and related conditions
Conditions associated with dizziness or vertigo
Other ear and sense organ disorders
Other nervous system disorders
Heart valve disorders
Peri-; endo-; and myocarditis; cardiomyopathy (except that caused by
tuberculosis or STD)
Essential hypertension
Hypertension with complications and secondary hypertension
Nonspecific chest pain
Pulmonary heart disease
Other and ill-defined heart disease
Conduction disorders
Cardiac arrest and ventricular fibrillation
Occlusion or stenosis of precerebral arteries
Other and ill-defined cerebrovascular disease
Transient cerebral ischemia
Late effects of cerebrovascular disease
Peripheral and visceral atherosclerosis
Aortic; peripheral; and visceral artery aneurysms
Aortic and peripheral arterial embolism or thrombosis
Other circulatory disease
Phlebitis; thrombophlebitis and thromboembolism
Varicose veins of lower extremity
Hemorrhoids
Other diseases of veins and lymphatics
Pneumonia (except that caused by tuberculosis or STD)
Influenza
Acute and chronic tonsillitis
Acute bronchitis
Other upper respiratory infections
Asthma
Aspiration pneumonitis; food/vomitus
Pleurisy; pneumothorax; pulmonary collapse
Lung disease due to external agents
Other lower respiratory disease
Other upper respiratory disease
36

10
1
24
0.3
0.0
0.8
79
20
69
178
49
932
17305
327
300
137
693
1823
2468
998
518
27
193
2102
62
2643
1744
437
51
526
55
656
301
140
458
493
11
77
65
12208
3504
275
165
974
376
1938
1838
605
391
1563
17
375
187
3.5
5.0
3.1
Percent
Mean Total Percent Admitted
Charges
Expired from ED
$ 14,757
$ 11,580
$ 10,672
0.0
0.0
0.0
60.0
0.0
87.5
2.6
0.7
2.3
5.8
1.6
30.6
100.0
1.9
5.3
$ 19,979
2.9
$ 14,211
2.3
$ 14,556
2.5
$ 10,506
2.6
$ 14,286
4.9
$ 22,350
4.7 $32,390
7.5
$ 76,516
1.3
0.0
0.0
0.6
2.0
2.3
3.7
0.9
74.7
85.0
58.0
93.8
65.3
79.1
72.9
22.9
1.7
0.8
4.0
10.5
14.3
5.8
3.0
0.2
1.1
12.1
0.4
15.3
10.1
2.5
0.3
3.0
0.3
3.8
1.7
0.8
2.6
2.8
0.1
0.4
0.4
100.0
28.7
2.3
1.4
8.0
3.1
15.9
15.1
5.0
3.2
12.8
0.1
3.1
1.5
6.8
$ 56,862
2.8
$ 13,174
5.4
$ 23,775
4.8
$ 47,207
3.5
$ 45,018
2.0
$ 13,147
5.7
$ 25,760
5.4
$ 43,665
4.7
$ 46,636
3.9
$ 23,977
8.5
$ 64,624
5.7
$ 24,639
6.8
$ 29,369
2.6
$ 22,369
3.5
$ 26,159
2.7
$ 13,625
5.0
$ 15,529
5.1
$ 37,103
6.8
$ 73,792
7.0
$ 45,215
3.9
$ 20,789
5.1
$ 20,417
5.5
$ 14,079
3.6
$ 13,249
8.2
$ 43,526
5.0 $22,236
5.3
$ 21,533
3.1
$ 17,078
2.1
$ 11,814
3.3
$ 16,257
2.3
$ 11,233
4.7
$ 16,389
2.6
$ 12,042
8.0
$ 31,711
7.2
$ 28,111
8.1
$ 44,976
5.5
$ 22,405
4.2
$ 23,655
5.2
$ 30,411
2.7
0.7
1.4
6.0
0.8
0.1
6.8
7.4
2.6
1.5
48.4
4.3
10.7
0.5
0.0
1.0
1.8
4.1
9.6
2.1
2.2
0.6
0.0
0.0
0.0
4.1
3.6
0.4
0.0
0.2
0.0
2.0
0.1
11.9
3.8
14.7
0.0
4.8
1.1
61.7
89.1
88.0
83.8
41.5
92.4
87.1
66.7
73.1
76.1
88.7
87.4
93.3
19.0
72.5
98.5
94.5
34.6
35.5
50.0
85.6
73.4
36.4
84.4
60.0
86.3
86.6
81.5
58.2
80.9
83.5
91.2
87.0
93.4
76.2
90.7
64.7
75.2
73.8
APPENDIX A
Intestinal infection
Disorders of teeth and jaw
Diseases of mouth; excluding dental
Esophageal disorders
Gastroduodenal ulcer (except hemorrhage)
Gastritis and duodenitis
Other disorders of stomach and duodenum
Appendicitis and other appendiceal conditions
Abdominal hernia
Regional enteritis and ulcerative colitis
Intestinal obstruction without hernia
Diverticulosis and diverticulitis
Anal and rectal conditions
Peritonitis and intestinal abscess
Biliary tract disease
Other liver diseases
Pancreatic disorders (not diabetes)
Gastrointestinal hemorrhage
Noninfectious gastroenteritis
Other gastrointestinal disorders
Nephritis; nephrosis; renal sclerosis
Chronic renal failure
Calculus of urinary tract
Other diseases of kidney and ureters
Other diseases of bladder and urethra
Genitourinary symptoms and ill-defined conditions
Hyperplasia of prostate
Inflammatory conditions of male genital organs
Other male genital disorders
Nonmalignant breast conditions
Inflammatory diseases of female pelvic organs
Endometriosis
Prolapse of female genital organs
Menstrual disorders
Ovarian cyst
Menopausal disorders
Other female genital disorders
Complications of pregnancy, childbirth, & the puerperium
Contraceptive and procreative management
Spontaneous abortion
Induced abortion
Postabortion complications
Ectopic pregnancy
Other complications of pregnancy
Hemorrhage during pregnancy; abruptio placenta; placenta previa
Hypertension complicating pregnancy; childbirth and the puerperium
Early or threatened labor
Prolonged pregnancy
Diabetes or abnormal glucose tolerance complicating pregnancy; childbirth; or the puerperium
37
Percent
Number of Percent of Mean Mean Total Percent Admitted
Charges
Expired from ED
10776
863
73
71
433
130
309
241
947
672
274
1010
917
111
85
1185
372
870
1009
450
754
5300
39
1327
36
1739
492
168
65
94
92
97
39
55
137
86
348
159
162
20
145
13023
3
33
15
5
61
1500
175
824
662
669
100.0
8.0
0.7
0.7
4.0
1.2
2.9
2.2
8.8
6.2
2.5
9.4
8.5
1.0
0.8
11.0
3.5
8.1
9.4
4.2
7.0
100.0
0.7
25.0
0.7
32.8
9.3
3.2
1.2
1.8
1.7
1.8
0.7
1.0
2.6
1.6
6.6
3.0
3.1
0.4
2.7
100.0
0.0
0.3
0.1
0.0
0.5
11.5
1.3
6.3
5.1
5.1
275
2.1
4.9 $22,488
5.1
$ 17,471
2.4
$ 12,685
4.0
$ 13,773
4.2
$ 21,222
5.0
$ 23,756
4.2
$ 16,068
5.8
$ 20,298
2.7
$ 18,982
5.0
$ 30,700
5.5
$ 20,824
6.2
$ 25,326
5.1
$ 21,715
4.6
$ 20,553
5.9
$ 26,761
4.2
$ 22,776
8.1
$ 42,260
5.6
$ 22,012
4.8
$ 21,986
3.2
$ 11,559
6.3
$ 26,004
4.4 $17,580
5.7
$ 25,218
6.3
$ 22,844
4.2
$ 35,201
4.9
$ 14,768
2.2
$ 12,482
4.0
$ 23,676
5.1
$ 26,180
3.5
$ 15,303
4.0
$ 17,401
3.8
$ 12,785
4.7
$ 25,043
3.5
$ 12,377
3.1
$ 13,965
2.5
$ 16,250
1.7
$ 17,032
2.5
$ 17,098
2.7
$ 15,590
2.8
$ 17,090
2.6
$ 16,178
2.9 $8,235
3.0
$ 15,063
2.0
$ 8,904
1.6
$ 6,237
1.8
$ 8,166
1.4
$ 12,490
2.5
$ 7,366
7.4
$ 13,025
4.0
$ 10,770
4.1
$ 7,899
2.7
$ 7,173
3.0
7,461
1.7
2.2
1.4
1.4
0.9
3.1
0.6
0.8
0.0
0.9
0.7
3.0
1.1
0.9
4.7
0.6
7.5
0.9
3.4
0.2
2.1
2.1
2.6
5.7
2.8
1.7
0.0
1.2
0.0
1.1
1.1
0.0
0.0
0.0
0.7
0.0
0.0
0.0
0.6
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.1
0.0
0.0
0.0
0.0
79.4
88.4
60.3
78.9
71.4
81.5
88.0
78.4
92.8
36.8
70.1
89.1
71.3
62.2
80.0
74.5
83.9
92.8
91.4
89.6
63.7
71.4
61.5
88.3
58.3
92.2
80.9
42.3
49.2
72.3
21.7
77.3
76.9
67.3
67.9
11.6
0.0
12.6
40.7
35.0
25.5
9.2
0.0
39.4
20.0
60.0
80.3
25.0
27.4
15.5
26.9
1.3
0.0
6.5
APPENDIX A
Malposition; malpresentation
Fetopelvic disproportion; obstruction
Previous C-section
Fetal distress and abnormal forces of labor
Polyhydramnios and other problems of amniotic cavity
Umbilical cord complication
OB-related trauma to perineum and vulva
Forceps delivery
Other complications of birth; puerperium affecting management of mother
Normal pregnancy and/or delivery
Other inflammatory condition of skin
Chronic ulcer of skin
Other skin disorders
Infective arthritis and osteomyelitis (except that caused by tuberculosis or
STD)
Rheumatoid arthritis and related disease
Osteoarthritis
Other non-traumatic joint disorders
Osteoporosis
Pathological fracture
Acquired foot deformities
Other acquired deformities
Systemic lupus erythematosus and connective tissue disorders
Other connective tissue disease
Other bone disease and musculoskeletal deformities
Cardiac and circulatory congenital anomalies
Digestive congenital anomalies
Genitourinary congenital anomalies
Nervous system congenital anomalies
Other congenital anomalies
Short gestation; low birth weight; and fetal growth retardation
Intrauterine hypoxia and birth asphyxia
Respiratory distress syndrome
Hemolytic jaundice and perinatal jaundice
Birth trauma
Other perinatal conditions
Joint disorders and dislocations; trauma-related
Fracture of neck of femur (hip)
Spinal cord injury
Skull and face fractures
Fracture of upper limb
Fracture of lower limb
Other fractures
Sprains and strains
Intracranial injury
38

Percent
Mean Total Percent Admitted
Charges Expired from ED
528
138
1540
618
597
490
2385
54
1748
703
2293
1991
49
202
51
6733
4.1
1.1
11.8
4.7
4.6
3.8
18.3
0.4
13.4
5.4
100.0
86.8
2.1
8.8
2.2
100.0
3.3
$ 10,448
2.8
$ 9,367
2.7
$ 9,958
3.2
$ 9,413
3.6
$ 8,850
2.3
$ 6,528
2.2
$ 6,126
2.3
$ 6,416
3.5
$ 9,200
2.1
$ 6,033
4.2 $13,682
3.9
$ 12,520
3.4
$ 10,425
7.6
$ 24,761
5.0
$ 18,320
3.7 $34,507
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.6
0.3
0.0
3.5
0.0
0.3
76.5
80.7
93.9
38.6
47.1
19.2
324
51
3039
183
1705
1
227
38
257
65
519
324
4.8
0.8
45.1
2.7
25.3
0.0
3.4
0.6
3.8
1.0
7.7
4.8
100.0
32.7
18.6
8.2
7.5
33.0
100.0
12.6
1.1
5.0
22.7
0.6
57.9
100.0
1.0
8.3
0.6
2.0
4.6
8.3
8.2
1.2
9.7
8.0
$ 31,226
3.9
$ 24,816
3.1
$ 31,630
4.1
$ 29,041
2.9
$ 34,205
2.0
$ 27,726
5.7
$ 27,119
3.1
$ 31,045
5.8
$ 84,878
4.2
$ 19,383
5.0
$ 23,543
3.7
$ 57,227
10.5 $108,056
15.8
$ 194,041
9.4
$ 69,963
3.5
$ 28,890
5.8
$ 45,905
8.6
$ 78,207
11.4 $58,206
26.5
$ 73,243
11.4
$ 51,433
15.2
$ 60,765
1.7
$ 4,189
3.8
$ 28,515
11.7
$ 76,297
5.0 $26,749
2.9
$ 20,713
5.8
$ 30,134
10.8
$ 62,288
3.0
$ 18,463
3.6
$ 21,310
4.9
$ 29,415
5.3
$ 24,762
2.9
$ 13,525
5.4
$ 28,045
0.9
0.0
0.1
0.0
0.2
0.0
2.2
0.0
0.8
1.5
0.8
0.3
1.0
2.7
0.8
0.0
0.0
0.0
1.3
3.8
14.3
3.2
0.0
0.0
0.8
2.1
1.1
2.0
11.8
1.1
0.7
0.9
1.5
0.0
6.9
51.9
49.0
1.7
45.9
22.7
0.0
65.6
2.6
1.9
69.2
64.2
13.3
16.8
7.2
53.2
19.6
11.8
6.3
36.1
5.1
14.3
0.0
37.1
25.0
46.1
76.7
52.9
95.4
92.2
94.4
82.2
88.0
89.1
82.7
97.3
679
222
126
56
51
224
618
78
7
31
140
4
358
9026
87
746
51
179
411
750
743
110
875
4.2
0.7
1.4
3.4
7.9
2.9
3.3
0.0
8.5
2.0
APPENDIX A
Crushing injury or internal injury
Open wounds of head; neck; and trunk
Open wounds of extremities
Superficial injury; contusion
Burns
Poisoning by psychotropic agents
Poisoning by other medications and drugs
Poisoning by nonmedicinal substances
Other injuries and conditions due to external causes
Liveborn
Liveborn
Other conditions
Syncope
Fever of unknown origin
Lymphadenitis
Gangrene
Shock
Nausea and vomiting
Abdominal pain
Malaise and fatigue
Allergic reactions
Administrative/social admission
Medical examination/evaluation
Other aftercare
Other screening for suspected conditions (not mental disorders or infectious disease)
Residual codes; unclassified
Unknown
Total
39
Percent
Number of Percent of Mean Mean Total Percent Admitted
Charges Expired from ED
369
129
99
1780
1380
162
36
261
498
51
309
11758
11758
4098
660
264
68
113
5
121
553
53
108
1873
2
2
10
4.1
1.4
1.1
19.7
15.3
1.8
0.4
2.9
5.5
0.6
3.4
100.0
100.0
100.0
16.1
6.4
1.7
2.8
0.1
3.0
13.5
1.3
2.6
45.7
0.0
0.0
0.2
6.5
$ 36,756
3.6
$ 19,748
4.4
$ 23,778
5.8
$ 37,372
5.4
$ 21,901
3.4
$ 14,258
5.6
$ 26,062
3.3
$ 12,838
3.0
$ 12,899
3.7
$ 15,948
4.3
$ 20,661
3.5 $6,661
3.5
$ 6,661
7.3 $19,361
2.7
$ 13,682
2.5
$ 10,696
2.4
$ 12,276
14.2
$ 62,376
5.4
$ 35,128
2.8
$ 11,114
3.0
$ 12,393
2.7
$ 10,625
2.7
$ 11,302
11.9
$ 24,076
7.0
$ 20,403
6.0
$ 12,325
4.4
$ 24,361
3.5
1.6
2.0
1.9
1.2
1.9
2.8
0.8
1.4
0.0
2.3
0.4
0.4
0.7
0.3
0.0
0.0
8.0
60.0
0.0
0.4
3.8
0.0
0.3
0.0
0.0
0.0
0.0
44.4
95.8
69.3
79.4
47.8
80.0
81.0
84.6
88.7
83.3
0.3
50.0
50.0
0.0
12
254
0.3
6.2
100.0
100.0
1.8
$ 6,759
3.5
$ 15,594
4.0 $20,587
4.7
$ 22,410
0.0
1.6
0.5
2.4
50.0
69.7
67.1
54.4
222
112832
97.3
93.8
81.8
43.7
58.6
92.6
88.9
94.3
91.2
94.1
89.0
0.0
APPENDIX B
Clinical classification system for Ecodes:
Ecodes are supplementary classifications of external causes of injury and poisoning. They provide additional
information regarding the nature of the condition, or to allow more detailed analysis of the external cause of the
diagnosis. Ecodes were coded according to the International Classification of Diseases, Ninth Revision, Clinical
Modification (ICD-9-CM). These codes were then aggregated into broader diagnostic categories using the Clinical
Classification System (CCS) developed by the Agency of Healthcare Research and Quality (AHRQ). The CCS
classification system for Ecodes is used to categorize clinically similar diagnoses for ease in presentation and
interpretation of hospital discharge data. A complete listing of CCS Ecodes and selected corresponding measures
are presented below.
Number and Percent of Discharges, Mean Length of Stay, Mean Charges, Percent Expired, and Percent Admitted
from the ED by Ecode
Number of Percent of
Discharges Discharges
166
1.6
10
0.1
3851
38.2
52
0.5
117
1.2
27
0.3
1099
10.9
78
0.8
7
0.1
110
1.1
178
1.8
101
1.0
778
7.7
309
3.1
67
0.7
961
9.5
1049
10.4
372
3.7
147
1.5
589
5.8
14
0.1
10082
100.0
Clinical Classifications Software Categories for Ecodes

E Codes: Cut/pierce
E Codes: Drowning/submersion
E Codes: Fall
E Codes: Fire/burn
E Codes: Firearms
E Codes: Machinery
E Codes: Motor vehicle traffic (MVT)
E Codes: Pedal cyclist; not MVT
E Codes: Pedestrian; not MVT
E Codes: Transport; not MVT
E Codes: Natural/environment
E Codes: Overexertion
E Codes: Poisoning
E Codes: Struck by; against
E Codes: Suffocation
E Codes: Adverse effects of medical care
E Codes: Adverse effects of medical drugs
E Codes: Other specified and classifiable
E Codes: Other specified; NEC
E Codes: Unspecified
E Codes: Place of occurrence
Total
40
Mean
LOS
4.9
1.9
5.7
8.0
6.7
4.6
6.2
3.1
4.1
3.2
4.3
4.6
3.6
4.0
11.4
11.0
6.0
7.4
6.7
7.0
3.7
6.2
Mean Total
Charges
$ 18,914
$ 13,377
$ 24,593
$ 34,755
$ 40,462
$ 27,089
$ 37,135
$ 17,876
$ 25,613
$ 19,789
$ 13,908
$ 22,274
$ 15,090
$ 19,277
$ 51,918
$ 88,926
$ 36,695
$ 32,500
$ 28,103
$ 32,721
$ 24,118
$ 33,277
Percent
Expired
1.2
0.0
3.8
1.9
10.3
3.7
2.1
0.0
0.0
1.8
0.6
2.0
0.8
1.0
10.4
1.7
2.7
2.7
2.0
2.9
0.0
2.8
Percent
Admitted
from ED
87.3
100.0
91.8
82.7
95.7
92.6
95.2
96.2
100.0
93.6
88.8
82.2
90.1
91.9
83.6
39.4
80.3
57.8
66.0
61.6
85.7
82.3
APPENDIX C
Number of All-listed Procedures Performed during the Inpatient Stay
by Procedure and Sex of Patient
Single level CCS Procedure Categories and Chapter Headings
Male
Operations on the nervous system

Incision and excision of CNS
Insertion; replacement; or removal of extracranial ventricular shunt
Laminectomy; excision intervertebral disc
Diagnostic spinal tap
Insertion of catheter or spinal stimulator and injection into spinal canal
Decompression peripheral nerve
Other diagnostic nervous system procedures
Other non-OR or closed therapeutic nervous system procedures
Other OR therapeutic nervous system procedures
Operations on the endocrine system
Thyroidectomy; partial or complete
Diagnostic endocrine procedures
Other therapeutic endocrine procedures
Operations on the eye
Lens and cataract procedures
Repair of retinal tear; detachment
Destruction of lesion of retina and choroid
Diagnostic procedures on eye
Other therapeutic procedures on eyelids; conjunctiva; cornea
Other intraocular therapeutic procedures
Other extraocular muscle and orbit therapeutic procedures
Operations on the ear
Tympanoplasty
Myringotomy
Mastoidectomy
Diagnostic procedures on ear
Other therapeutic ear procedures
Operations on the nose, mouth, and pharynx
Control of epistaxis
Plastic procedures on nose
Dental procedures
Tonsillectomy and/or adenoidectomy
Diagnostic procedures on nose; mouth and pharynx
Other non-OR therapeutic procedures on nose; mouth and pharynx
Other OR therapeutic procedures on nose; mouth and pharynx
Operations on the respiratory system
Tracheostomy; temporary and permanent
Tracheoscopy and laryngoscopy with biopsy
Lobectomy or pneumonectomy
Diagnostic bronchoscopy and biopsy of bronchus
Other diagnostic procedures on lung and bronchus
Incision of pleura; thoracentesis; chest drainage
Other diagnostic procedures of respiratory tract and mediastinum
Other non-OR therapeutic procedures on respiratory system
Other OR Rx procedures on respiratory system and mediastinum
Operations on the cardiovascular system
Heart valve procedures
Coronary artery bypass graft (CABG)
Percutaneous transluminal coronary angioplasty (PTCA)
Diagnostic cardiac catheterization; coronary arteriography
Insertion; revision; replacement; removal of cardiac pacemaker or cardioverter/defibrillator
Other OR heart procedures
Extracorporeal circulation auxiliary to open heart procedures
1918
183
67
647
545
115
19
24
76
242
76
21
9
46
97
0
1
1
1
56
10
28
165
2
92
4
7
60
607
55
35
130
82
31
87
187
2123
219
119
143
489
22
731
77
135
188
22525
272
955
1595
7237
927
470
720
41
Female
Total
1845
158
76
646
483
133
11
26
75
237
117
50
22
45
67
1
1
2
0
56
3
4
97
3
60
4
8
22
399
58
17
92
49
24
48
111
1766
154
115
118
430
14
648
56
105
126
16015
188
393
852
4863
646
326
382
3763
341
143
1293
1028
248
30
50
151
479
193
71
31
91
164
1
2
3
1
112
13
32
262
5
152
8
15
82
1006
113
52
222
131
55
135
298
3889
373
234
261
919
36
1379
133
240
314
38540
460
1348
2447
12100
1573
796
1102
APPENDIX C
Extracorporeal circulation auxiliary to open heart procedures
Endarterectomy; vessel of head and neck
Aortic resection; replacement or anastomosis
Other vascular catheterization; not heart
Peripheral vascular bypass
Other vascular bypass and shunt; not heart
Creation; revision and removal of arteriovenous fistula or vessel-to-vessel cannula for dialysis
Hemodialysis
Other OR procedures on vessels of head and neck
Embolectomy and endarterectomy of lower limbs
Other OR procedures on vessels other than head and neck
Other diagnostic cardiovascular procedures
Other non-OR therapeutic cardiovascular procedures
Operations on the hemic and lymphatic system
Bone marrow transplant
Bone marrow biopsy
Procedures on spleen
Other therapeutic procedures; hemic and lymphatic system
Operations on the digestive system
Injection or ligation of esophageal varices
Esophageal dilatation
Upper gastrointestinal endoscopy; biopsy
Gastrostomy; temporary and permanent
Colostomy; temporary and permanent
Ileostomy and other enterostomy
Gastrectomy; partial and total
Small bowel resection
Colonoscopy and biopsy
Proctoscopy and anorectal biopsy
Colorectal resection
Local excision of large intestine lesion (not endoscopic)
Appendectomy
Hemorrhoid procedures
Endoscopic retrograde cannulation of pancreas (ERCP)
Biopsy of liver
Cholecystectomy and common duct exploration
Inguinal and femoral hernia repair
Other hernia repair
Laparoscopy (GI only)
Abdominal paracentesis
Exploratory laparotomy
Excision; lysis peritoneal adhesions
Peritoneal dialysis
Other bowel diagnostic procedures
Other non-OR upper GI therapeutic procedures
Other OR upper GI therapeutic procedures
Other non-OR lower GI therapeutic procedures
Other OR lower GI therapeutic procedures
Other gastrointestinal diagnostic procedures
Other non-OR gastrointestinal therapeutic procedures
Other OR gastrointestinal therapeutic procedures
Operations on the urinary system
Endoscopy and endoscopic biopsy of the urinary tract
Transurethral excision; drainage; or removal urinary obstruction
Ureteral catheterization
Nephrotomy and nephrostomy
42
Male
720
201
214
3181
181
22
55
1290
93
128
3582
190
1212
606
42
165
35
364
7452
1
31
1359
248
67
84
22
136
541
114
466
3
607
20
33
113
387
99
286
52
401
30
274
32
37
276
269
274
472
92
260
366
1954
161
453
274
67
Female
382
139
73
3469
96
14
42
1147
59
75
2289
170
792
594
21
106
47
420
9470
0
31
1664
239
69
62
39
178
752
108
550
7
534
10
51
93
765
34
539
89
351
39
803
30
28
255
455
251
466
117
386
475
2518
306
375
470
75
Total
1102
340
287
6650
277
36
97
2437
152
203
5871
360
2004
1200
63
271
82
784
16922
1
62
3023
487
136
146
61
314
1293
222
1016
10
1141
30
84
206
1152
133
825
141
752
69
1077
62
65
531
724
525
938
209
646
841
4472
467
828
744
142
APPENDIX C
Male
Female
Total
Nephrectomy; partial or complete

Kidney transplant
Genitourinary incontinence procedures
Extracorporeal lithotripsy; urinary
Indwelling catheter
Procedures on the urethra
Other diagnostic procedures of urinary tract
Other non-OR therapeutic procedures of urinary tract
Other OR therapeutic procedures of urinary tract
Operations on the male genital organs
Transurethral resection of prostate (TURP)
Open prostatectomy
Circumcision
Diagnostic procedures; male genital
Other non-OR therapeutic procedures; male genital
Other OR therapeutic procedures; male genital
Operations on the female genital organs
Oophorectomy; unilateral and bilateral
Other operations on ovary
Ligation or occlusion of fallopian tubes
Other operations on fallopian tubes
Hysterectomy; abdominal and vaginal
Other excision of cervix and uterus
Abortion (termination of pregnancy)
Dilatation and curettage (D&C); aspiration after delivery or abortion
Diagnostic dilatation and curettage (D&C)
Repair of cystocele and rectocele; obliteration of vaginal vault
Other diagnostic procedures; female organs
Other non-OR therapeutic procedures; female organs
Other OR therapeutic procedures; female organs
Obstetrical procedures
Removal of ectopic pregnancy
Episiotomy
Cesarean section
Forceps; vacuum; and breech delivery
Artificial rupture of membranes to assist delivery
Other procedures to assist delivery
Diagnostic amniocentesis
Fetal monitoring
Repair of current obstetric laceration
Other therapeutic obstetrical procedures
Operations on the musculoskeletal system
Partial excision bone
Bunionectomy or repair of toe deformities
Treatment; facial fracture or dislocation
Treatment; fracture or dislocation of radius and ulna
Treatment; fracture or dislocation of hip and femur
Treatment; fracture or dislocation of lower extremity (other than hip or femur)
Other fracture and dislocation procedure
Arthroscopy
Division of joint capsule; ligament or cartilage
Excision of semilunar cartilage of knee
Arthroplasty knee
Hip replacement; total and partial
95
16
1
15
499
58
40
81
194
5199
117
129
4799
13
51
90
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
8318
481
9
71
111
417
395
295
22
24
14
976
893
97
1
203
13
558
12
27
181
200
0
0
0
0
0
0
0
4323
889
152
712
100
1163
122
6
56
30
289
69
98
637
28593
43
422
4036
747
3148
9737
21
6310
3834
295
9252
480
17
11
113
611
444
290
12
30
7
1456
1073
192
17
204
28
1057
70
67
262
394
5199
117
129
4799
13
51
90
4323
889
152
712
100
1163
122
6
56
30
289
69
98
637
28593
43
422
4036
747
3148
9737
21
6310
3834
295
17570
961
26
82
224
1028
839
585
34
54
21
2432
1966
43
APPENDIX C
Male
Female
Arthroplasty other than hip or knee

Arthrocentesis
Injections and aspirations of muscles; tendons; bursa; joints and soft tissue
Amputation of lower extremity
Spinal fusion
Other diagnostic procedures on musculoskeletal system
Other therapeutic procedures on muscles and tendons
Other OR therapeutic procedures on bone
Other OR therapeutic procedures on joints
Other non-OR therapeutic procedures on musculoskeletal system
Other OR therapeutic procedures on musculoskeletal system
Operations on the integumentary system
Breast biopsy and other diagnostic procedures on breast
Lumpectomy; quadrantectomy of breast
Mastectomy
Incision and drainage; skin and subcutaneous tissue
Debridement of wound; infection or burn
Excision of skin lesion
Suture of skin and subcutaneous tissue
Skin graft
Other diagnostic procedures on skin and subcutaneous tissue
Other non-OR therapeutic procedures on skin and breast
Other OR therapeutic procedures on skin and breast
Miscellaneous diagnostic and therapeutic procedures
Other organ transplantation
Computerized axial tomography (CT) scan head
CT scan chest
CT scan abdomen
Other CT scan
Myelogram
Mammography
Routine chest X-ray
Intraoperative cholangiogram
Upper gastrointestinal X-ray
Lower gastrointestinal X-ray
Intravenous pyelogram
Cerebral arteriogram
Contrast aortogram
Contrast arteriogram of femoral and lower extremity arteries
Arterio- or venogram (not heart and head)
Diagnostic ultrasound of head and neck
Diagnostic ultrasound of heart (echocardiogram)
Diagnostic ultrasound of gastrointestinal tract
Diagnostic ultrasound of urinary tract
Diagnostic ultrasound of abdomen or retroperitoneum
Other diagnostic ultrasound
Magnetic resonance imaging
Electroencephalogram (EEG)
Nonoperative urinary system measurements
Cardiac stress tests
Electrocardiogram
Swan-Ganz catheterization for monitoring
68
145
23
244
1557
158
891
509
253
697
65
2201
0
1
1
487
512
67
369
209
33
403
119
52108
5
3906
2116
2515
1501
1
1
0
40
171
1
4
143
359
990
882
926
3543
20
58
1824
2394
2294
493
3
473
13
36
83
81
30
131
1822
145
685
569
192
936
34
2230
17
28
80
421
424
119
204
173
31
425
308
60586
3
4468
2289
3402
1675
1
20
2
57
153
5
1
169
265
690
720
1109
3740
18
37
2387
4020
2896
503
4
485
13
29
44
Total
151
226
53
375
3379
303
1576
1078
445
1633
99
4431
17
29
81
908
936
186
573
382
64
828
427
112694
8
8374
4405
5917
3176
2
21
2
97
324
6
5
312
624
1680
1602
2035
7283
38
95
4211
6414
5190
996
7
958
26
65
APPENDIX C
Arterial blood gases
Microscopic examination (bacterial smear; culture; toxicology)
Radioisotope bone scan
Radioisotope pulmonary scan
Radioisotope scan and function studies
Other radioisotope scan
Therapeutic radiology for cancer treatment
Diagnostic physical therapy
Physical therapy exercises; manipulation; and other procedures
Traction; splints; and other wound care
Other physical therapy and rehabilitation
Respiratory intubation and mechanical ventilation
Other respiratory therapy
Psychological and psychiatric evaluation and therapy
Alcohol and drug rehabilitation/detoxification
Ophthalmologic and otologic diagnosis and treatment
Nasogastric tube
Blood transfusion
Enteral and parenteral nutrition
Cancer chemotherapy
Conversion of cardiac rhythm
Other diagnostic radiology and related techniques
Other diagnostic procedures (interview; evaluation; consultation)
Prophylactic vaccinations and inoculations
Nonoperative removal of foreign body
Other therapeutic procedures
Total
45
Male
Female
Total
7
0
107
375
244
74
71
38
400
210
856
4023
117
17
12
3284
107
3512
369
470
537
526
2
12
105
527
314
82
83
42
498
223
920
3730
175
32
4
3020
128
3999
379
352
375
516
9
12
212
902
558
156
154
80
898
433
1776
7753
292
49
16
6304
235
7511
748
822
912
1042
1976
3491
40
6533
105349
2225
3270
44
10368
137872
4201
6761
84
16901
243221
APPENDIX D
Annual Hospitalization Rates for 20 Most Frequent Diagnoses* of Males
0
10
15
20
25
30
35

Osteoarthritis

Rehabilitation care; fitting of prostheses; and adjustment of
Asthma


Gastrointestinal hemorrhage
*Excluding liveborn infants.
Annual Hospitalization Rates for 20 Most Frequent Diagnoses*of Females

0
10
15
20
25
30
35
40
45
50

Other complications of birth; puerperium affecting management of
Osteoarthritis
Previous C-section

Asthma

Hypertension complicating pregnancy; childbirth and the puerperium
*Excluding liveborn infants.
46
APPENDIX E
Conditions with the 10 Highest Total Charges 2009

Rank
CCS Principal Diagnoses
1
2
3
Osteoarthritis
4
5
Liveborn
6
7
8
9
10
Total for 10 most expensive conditions
Total aggregate charges for all discharges
$
$
$
$
$
$
$
$
$
$
$
$
Total Billed
Charges
111,105,399
97,910,578
96,123,170
86,057,713
78,320,501
75,451,368
70,297,866
66,522,477
65,120,227
58,320,156
805,229,454
2,528,555,952
% of Total
Charges
4.4
3.9
3.8
3.4
3.1
3.0
2.8
2.6
2.6
2.3
31.8
100.0
Number of
Discharges
2468
2338
3039
1823
11759
3504
1563
1780
2643
1705
32622
112,832
Discharges with Highest Mean Charges in 2009

All Discharges
Leukemias
Other CNS infection and poliomyelitis
Other acquired deformities
Heart valve disorders
Aortic; peripheral; and visceral artery aneurysms
Digestive congenital anomalies
Number Discharges
Percent Discharges
1999
2004
2009
1999
2004
2009
94,665 111,806 112,832 100.0 100.0 100.0
278
351
222
0.3
0.3
0.2
99
151
117
0.1
0.1
0.1
25
26
18
0.0
0.0
0.0
178
247
257
0.2
0.2
0.2
326
338
224
0.3
0.3
0.2
183
287
327
0.2
0.3
0.3
225
263
358
0.2
0.2
0.3
226
227
301
0.2
0.2
0.3
79
74
78
0.1
0.1
0.1
94
119
126
0.1
0.1
0.1
$
$
$
$
$
$
$
$
$
$
$
1999
9,495
52,912
49,672
36,704
28,212
21,290
36,703
20,702
30,003
31,972
16,792
Mean Charges
2004
2009
$ 15,222 $ 22,410
$ 89,126 $ 194,041
$ 51,877 $ 101,495
$ 40,293 $ 91,183
$ 49,845 $ 84,878
$ 27,672 $ 78,207
$ 57,197 $ 76,516
$ 43,426 $ 76,297
$ 44,248 $ 73,792
$ 83,823 $ 73,243
$ 29,973 $ 69,963
Number, Percent, and Mean Charges for the Highest Volume Discharges in 2009
Number Discharges
Percent Discharges
1999
2004
2009
1999
2004
2009
All Discharges
94,665 111,806 112,832
100.0
100.0
100.0
Liveborn
10,119 11,423 11,759
10.7
10.2
10.4
Pneumonia
3,111
3,211
3,504
3.3
2.9
3.1
Osteoarthritis
1,038
2,225
3,039
1.1
2.0
2.7
2,726
3,134
2,643
2.9
2.8
2.3
2,928
3,205
2,468
3.1
2.9
2.2
2,321
2,224
2,385
2.5
2.0
2.1
Septicemia
616
1,325
2,338
0.7
1.2
2.1
1,706
1,832
2,102
1.8
1.6
1.9
895
1,547
1,991
0.9
1.4
1.8
1,458
1,606
1,938
1.5
1.4
1.7
Mean Charges
1999
2004
2009
$ 9,495 $ 15,222 $ 22,410
$ 3,543 $ 4,201 $ 6,660
$ 11,051 $ 15,520 $ 21,533
$ 17,129 $ 23,638 $ 31,630
$ 11,267 $ 19,955 $ 24,639
$ 14,781 $ 27,246 $ 45,018
$ 2,727 $ 3,925 $ 6,126
$ 17,685 $ 28,604 $ 41,878
$ 10,067 $ 17,472 $ 23,977
$ 6,552 $ 9,696 $ 12,520
$ 9,145 $ 12,625 $ 16,389
47
APPENDIX F
2009 Delaware Hospitalizations
Top 10 Most Frequent Diagnoses for Medicare
Number of
Discharges
2128
1810
1783
1665
1487
1447
1434
1412
1220
1116
Percent of hospitalizations for this

condition billed to Medicare
5.0
4.2
4.2
3.9
3.5
3.4
3.3
3.3
2.8
2.6
Number of
Discharges
Liveborn
5814
958
899
828
Asthma
768
Previous C-section
722
697
Acute bronchitis
472
463
Normal pregnancy and/or delivery
424

condition billed to Medicaid
21.5
3.5
3.3
3.1
2.8
2.7
2.6
1.7
1.7
1.6
CCS Diagnosis
Osteoarthritis
Top 10 Most Frequent Diagnoses for Medicaid
CCS Diagnosis
Top 10 Most Frequent Diagnoses for Privately Insured

Number of
Discharges
Liveborn
5376
1271
Osteoarthritis
1052
844
832
763
Previous C-section
739
Asthma
726
680
628
CCS Diagnosis

condition billed to Private Insurers
14.6
3.4
2.9
2.3
2.3
2.1
2.0
2.0
1.8
1.7
Top 10 Most Frequent Diagnoses for Uninsured

Number of
Discharges
241
137
132
129
124
95
78
74
73
71
CCS Diagnosis
Liveborn
Mood disorders
Nonspecific chest pain
Asthma

condition billed to Uninsured Patients
7.0
4.0
3.8
3.7
3.6
2.7
2.3
2.1
2.1
2.1
48
APPENDIX G
Conditions with the Highest Number of In-Hospital Deaths by Age Group
Age Group in Years
Diagnosis
Under 1
14,967
All Discharges
Respiratory distress syndrome
Respiratory failure; insufficiency; arrest
Intracranial injury2
Other gastrointestinal disorders
Cardiac arrest and ventricular fibrillation
Crushing injury or internal injury
HIV infection
Mental disorders3
Other nervous system disorders
Secondary malignancies
Other liver diseases
Cancer of bronchus; lung
Aspiration pneumonitis; food/vomitus
23
19
8
7
5
4
1
1
1-17
9,151
1
5
3
1
2
2
1
1
1
18-44
26,437
45-64
25,873
65+
36,404
9
9
51
15
162
32
7
5
20
5
4
8
15
6
4
2
52
9
98
125
14
279
17
27
20
5
37
31
17
14
10
99
11
64
55
77
36
104
66
TOTAL
112,832
23
19
8
7
6
231
60
2
186
30
398
6
5
25
52
125
20
66
92
108
17
50
104
66
Notes:
1. Includes 51 cases where the secondary diagnosis was used in place of the general principal diagnosis of "liveborn infant".
2. 65 percent of intracranial injuries were due to falls.
3. 46 percent of these were delirium and mood disorders, 40 percent were alcohol-related, and 14 percent were drug-related.
49
APPENDIX H
Age Distribution of Patients who Died while Hospitalized

65-74, 18.9
75+, 48.2
55-64, 14.5
45-54, 9.0
<1, 2.8
35-44, 3.4
1-14, 0.7
25-34, 1.4
50
15-24, 1.1
HOSPITAL PROFILES
AND
HOSPITAL LOCATION
51
MAPS
Alfred I. duPont Hospital for Children Profile

Introduction:
Name
General Background
Accreditation
Alfred I. duPont Hospital for Children

Since our founding in 1940, the Alfred I. duPont Hospital for Children has
served thousands of children from across the country and around the world. In
2009, the Alfred I. duPont Hospital for Children was named one of Parents
Magazine's Top 25 Best Children's Hospitals.
The hospital is a division of Nemours, one of the nations largest pediatric
health systems. Nemours is dedicated to achieving higher standards in
childrens health. Nemours offers an integrated spectrum of clinical treatment
coupled with research, advocacy, and educational health and prevention
services extending to all families in the communities it serves.
Starting with Alfred I. duPonts bequest more than seventy years ago,
Nemours has grown into a multi-dimensional organization offering
personalized clinical and preventive care focused on children.
In addition to the Alfred I. duPont Hospital for Children, Nemours owns and
operates major childrens specialty clinics in Delaware (Wilmington), Florida
(Jacksonville, Orlando and Pensacola), Pennsylvania (Philadelphia,
Lancaster and Newtown Square) and New Jersey (Egg Harbor Township and
Voorhees). Nemours also operates primary care practices throughout
Delaware and in southeastern Pennsylvania.
Together the duPont Hospital and Nemours are the academic partner of
Thomas Jefferson University (Philadelphia) and Jefferson Medical College.
Mission Statement:
To provide leadership, institutions, and services to restore and improve the

health of children through care and programs not readily available, with one
high standard of quality and distinction regardless of the recipient's financial
status.
Ownership:
Nemours (Jacksonville, Fla.)
Medical Staff:
440 physicians, clinical psychologists, APNs and PAs
Services Offered:
The Nemours/Alfred I. duPont Hospital for Children offers all the specialties of
pediatric medicine, surgery, and dentistry in a spacious, comfortable, and
family-centered facility.
Number of Employees:
3,125 (in the Delaware Valley)
Licensed Beds:
Staffed Beds:
200
159
Location of Facilities:
1600 Rockland Road

Wilmington, Delaware 19803
52
Alfred I. duPont Hospital for Children

5.0 Miles
PA
92
Ardentown
Brandywine Creek State Park
Arden
202
100
Ardentown
Ardencroft
3
261
52
82
95
95
Twin Lakes
Hoopes Reservoir
Bellevue Lake
Bellevue State Park
Dupont Estate Pond
AI DuPont Hospital
Carriage Road Ponds
Porter Reservoir
13
Bellefonte
Fox Point State Park
100
48
3
141
38th St Reservoir
Wilmington Hospital
495
495
100
41
2
9
Brandywine Creek
Elsmere
Wilmington
NJ
Delaware River
Cherry Island Pond
62
9
Little Mill Creek
Shellpot Creek
95
Newport
Christina River Bank
295
NJ
Porter Reservoir
R
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Map Created by Delaware Health Statistics Center
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53
CARUTHERS
AN
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K
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1600 Rockland Rd
Wilmington, DE 19899
(302) 651-4000
www.nemours.org
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Contact Information:
RO
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Wilmington
PO
CA
S
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CONCOR
Newark
295
D
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ElsmereWilmington
Newport
1.5
Miles
Arden
Bellefonte
UN
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MP
3 22 322
0.5
BR
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I 95
Bayhealth Medical Center Profile

Introduction:
Name
Bayhealth Medical Center
General Background
Kent General Hospital, founded in 1927, and Milford Memorial Hospital,

founded in 1907, merged in January of 1997. The combined
organization, Bayhealth Medical Center, is a not-for-profit health care
facility that includes Middletown Medical Center and numerous satellite
locations. Bayhealth is southern Delawares largest healthcare system
and is a member of the Premier Health Alliance.
Accreditation
Bayhealth Kent General Hospital and Milford Memorial Hospital Accredited by the Joint Commission.
Cancer Programs - The American College of Surgeons Community
Hospital Comprehensive Cancer Program.
Diagnostic Imaging and Womens Centers ACR Mammography
Accreditation, ACR Ultrasound Breast & Breast Biopsy Accreditation
and ACR Ultrasound & Vascular Accreditation.
Laboratory - The American Association of Blood Banks, Joint
Commission Pathology and Clinical Laboratory Services, and
Certification by the Healthcare Financing Administration.
Home Health Care - Skilled Home Health Agency License.
Pharmacy at Kent General - DEA Controlled Substance Certificate,
Certification with State of DE Division of Professional Regulation,
Uniform Controlled Substance Certificate and ASHP American
Society of Health System Pharmacists
Rehabilitation Services Council for the Accreditation of
Rehabilitation Facilities (CARF).
Bayhealth SleepCare Center at Kent - AASM American Academy of
Sleep Medicine
Mission Statement:
To improve the health status of all members of the Bayhealth community.
Ownership:
Bayhealth, Inc. is the non-profit and parent corporation of Bayhealth

Medical Center, Inc. and six other corporate entities, including the
Bayhealth Foundation.
Medical Staff:
The medical staff of Bayhealth totals 450 active, provisional active and
courtesy staff.
Services Offered:
Surgical Services
Cardiovascular Surgery and Intervention
Affiliated with Penn Cardiac Care
Major services include orthopedics, general and vascular surgery,
ophthalmology, urology, gynecology and plastic surgery.
Day Surgery Services
Endoscopic Suite
Incontinence Center
54
Services Offered:
Otolaryngology
Thoracic
Wound Care Center including Hyperbaric
Diagnostic Imaging (Digital)

PET/CT Scanning
Magnetic Resonance Imaging, including Open MRI
Digital PACS (Picture Archiving Communications System)
Magnetic Resonance Angiography
Computerized Tomography
Nuclear Medicine
Digital Vascular Imaging
Ultrasonography
Low-dose Mammography
General Radiography
Fluoroscopy
Stereotactic Breast Biopsy
Bone densitometry
Critical Care
Cardiovascular Surgical Intensive Care
Intensive Care, Intermediate Care & Dialysis Units
33 Additional Monitored Beds on new 4th Floor Unit
Emergency Services
24-hour emergency and trauma services
Kent General and Milford Memorial Emergency Departments
are designated trauma centers
Obstetric and Pediatric Services
Two-Floor Maternity and Womens Services unit at Kent
General featuring all private rooms, 10 delivery rooms, 15
neonatal intensive care beds, and a newborn nursery
LDRP Suites at Milford Memorial
Level II neonatal intensive care (KGH)
Perinatology (Maternal Fetal Medicine)
Pediatric Intermediate Care Unit (KGH)
Inpatient Pediatric Unit
Ronald Room (for families with a newborn in the NICU)
Cancer Services
Bayhealth Cancer Institute
Chemotherapy and Radiation Therapy
Affiliated with the Penn Cancer Network
Trilogy Technology
3 D imaging
Prostate Seed Implants
IMRT
Clinical Trials
Breast Care Coordinator
Care Coordinators
Nurse Navigators
55
Services Offered:
Rehabilitation Services
Inpatient Rehabilitation Center (MMH) CARF accredited
Physical and Occupational Therapy Services
Certified Speech Pathologists
Sports Medicine
Three-phase Cardiac Rehabilitation Services
Aquatic Therapy
Home Health Care
Other Services
Wound Care Center
Bayhealth Sleep Care Centers
Bariatric Surgery Program
WalkIn Medical Care - Milford
Community Related Services

Community based outpatient laboratory services
Planetree Affiliate
Occupational Health Programs
Consumer Health Education Programs
Diabetes Care Centers
Support Groups
Health Fair and Health Screenings
STEPS Program for Seniors
Guest Relations Program
High School-based Wellness Centers at Milford, Smyrna,
Caesar Rodney and Woodbridge
2,900
Licensed Beds:
Staffed Beds:
389
336
Oncology Services
793 S. Queen Street, Dover, DE 19904
21 W. Clarke Avenue, Milford, DE 19963
640 S. State Street, Dover, DE 19901
Lifestyles Fitness Centers
1255 S. State Street
21 W. Clarke Avenue
Outpatient Rehabilitation Services at KGH
560 S. Governors Avenue, Dover, DE 19904
Outpatient Rehabilitation Services at MMH
21 W. Clarke Avenue, Milford, DE 19963
Outpatient Services Center at KGH
Hope Street, Dover, DE 19901
Dover Outpatient Imaging Center
Outpatient Services Center at MMH
Kings Highway, Milford, DE 19963
56
Womens Center at KGH

Womens Center at MMH
Medical Arts Building, Suite 3, Milford, DE 19963
Harrington Outpatient Services
201 Shaw Avenue, Harrington, DE 19952
Middletown Medical Center
209 E. Main Street, Middletown, DE 19709
Milford Outpatient Imaging Center
1020 Mattlind Way, Milford, DE
Milton Outpatient Services
632 Mulberry Street, Milton, DE 19968
Smyrna-Clayton Medical Services
315 N. Carter Road, Smyrna, DE 19977
High School Wellness Centers
Caesar Rodney High School
Smyrna High School
Milford High School
Woodbridge High School
WalkIn Medical Care
301 Jefferson Avenue, Milford, DE 19963
Bayhealth Outpatient Imaging Center
Eden Hill Medical Center
200 Banning Street, Suite 140, Dover, DE 19904
57
Milford Memorial Hospital

BayHealth Medical Center
5.0 Miles
McCauley Pond
15
Mispillion River
Tubmill Pond
14
Milford Air Park
Houston
Griffiths Lake Haven Lake
Silver Lake
Milford
Milford Memorial
Marshal Millpond
Blairs Pond
Abbotts Pond
Cedar Creek
36
36
Swiggetts Pond
Cubbage Pond
30
Clendaniel Pond
113
Hudson Pond
Georgetown
Seaford
ST
IA
PL
HW
PO
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WI
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Rehoboth Beach
KIN
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www.bayhealth.org/about/milford.asp
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21 West Clarke Avenue

Milford, DE 19963
(302) 422-3311
Miles
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MilfordSlaughter Beach
Bridgeville
1.5
Silver Lake
Farmington
Greenwood Ellendale
Milton
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Harrington
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PLUM ST
WALNU
T ST
J ST
Hartly
DoverLittle Creek
Wyoming
Camden
Woodside Bowers Beach
Viola
FeltonFrederica
0.25
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Kent General Hospital

Bayhealth Medical Center
Green Creek
5.0 Miles
Cheswold
42
Delaware Bay
13
1
Silver Lake
9
Dover
Silver Lake Park
Little Creek
Kent County Aeropark
Saint Jones Lake

15
S Little Creek Road

Dover Air Force Base
Moores Lake Isaac Lake
Wyoming Lake
113
Wyoming
St Jones River
13
Camden
Cypress Pond
10
13
Voshell Pond
Derby Pond
FeltonFrederica
Milford
1.5
2
Miles
T
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SOU
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LL T
SCU

HOPE ST
STATE ST
DOVER ST
ALLEY 304
www.bayhealth.org
0.5
ALLEY 299
MONROE TER
640 South State St.

Dover, DE 19901
(302) 674-4700
ALLEY 305
SUNSET TER
Smyrna
Clayton Leipsic
Cheswold
Dover
Hartly
Wyoming Little Creek
Camden
Viola Bowers Beach
0.25
BRADFORD ST
GOVERNORS AV
Middletown
Townsend
US
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Magnolia
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Woodside
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Beebe Medical Center Profile

Introduction:
Beebe Medical Center, in conjunction with its Medical-Dental Staff, provides

healthcare services in a variety of locations throughout eastern Sussex County.
Name
General Background
Beebe Medical Center is a community hospital system offering a broad spectrum

of services and facilities to serve people living in or visiting our service area.
Accreditation
Beebe Medical Center Joint Commission on the Accreditation of Healthcare

Organizations (JCAHO)
Beebe Home Health Agency Joint Commission on the Accreditation of
Healthcare Organizations (JCAHO)
Cancer Program The Commission on Cancer, the American College of Surgeons
Beebe School of Nursing National League for Nursing
Vascular Laboratory Intersocietal Commission for the Accreditation of Vascular
Laboratories
Laboratory The College of American Pathologists; American Association of
Blood Banks
Mammography The American College of Radiology
Ultrasonography The American College of Radiology
Mission Statement:
Beebe Medical Centers charitable mission is to encourage healthy living, prevent

illness, and restore optimal health with the people residing, working, or visiting in
the communities we serve.
Ownership:
Community owned, private, not-for-profit hospital, governed by a local Board of

Directors.
Medical Staff:
173 active staff doctors serving a variety of medical specialties.
Services Offered:
Tunnell Cancer Center, offering comprehensive, hospital-based diagnosis and

treatment, including medical oncology, radiation oncology, and surgical
oncology.
Comprehensive Cardiac Care, including cardiac catheterization, non-invasive
diagnostic testing, cardiac rehabilitation, and preventive care. Open Heart
Surgery in affiliation with Christiana Care Health System.
Physical Rehabilitation Therapy Services offering physical therapy,
occupational therapy, and speech therapy.
Women's Health Pavilion.
Diagnostic Imaging services including magnetic resonance imaging (MRI),
computed tomography (CT), nuclear imaging, Positron Emission Tomography
(PET), Electronic Bean Computed Tomogrpahy (EBCT) digital interventional
radiology, ultrasonography, mammography, stereotactic breast biopsy, bone
densitometry, fluoroscopy, and general radiography.
Beebe Lab Express.
Specialized programs such as:

Wound Care and Diabetes Management Center
Sleep Disorders Center
Integrative Health
24-hour Emergency Medicine Department in Lewes Level III Trauma
Designation
Millville Emergency Center (summer)
60
Services Offered:
Specialized programs such as:
Accredited Vascular Laboratory

Inpatient and Outpatient surgery
Home Health services
Beebe School of Nursing (RN to BSN option offered in conjunction with
Wilmington University, CAN program)

High School-based Wellness Centers (Cape Henlopen, Indian River and
Sussex Central High Schools)
Gull HouseAdult Day Care
1,600 employees
Licensed Beds:
Staffed Beds:
210 Beebe Medical Center

155 Beebe Medical Center

Lewes, DE
Beebe Medical Foundation
Lewes, DE
Beebe Health Campus
Rehoboth Beach, DE, Route 24
Diagnostic Imaging
Physical Therapy
Walk-in lab, x-ray, EKG, and blood draw
Tunnell Cancer Center
Beebe Physician Network Practices
Lewes, DE (Lewes Pulmonary)
Lewes, DE (Lewes Infectious Diseases)
Rehoboth Beach, DE (Surgical Oncology)
Lewes, DE (Interventional Cardiology)
Lewes, DE (Hospitalists)
Lewes, DE (Primary Care)
Lewes, DE (Beebe Gastroenterology)
Lewes, DE (Dr. Bhaskar Palekar)
Lewes, DE (Dr. Kathryn Grinnen)
Rehoboth DE (Beebe Health Center at Kmart)
Millville, DE (Millville Weekend Walk In Health Center) Labor Day through
Memorial Day)
Beebe Imaging
Georgetown, DE
Millville, DE
Rehoboth Beach, DE
Lewes, DE
Beebe Emergency Services
Lewes, DE
Millville, DE (summer only)
Gull House Adult Day Care Center
Rehoboth Beach, DE
Beebe Lab Express
Lewes, DE
Rehoboth Beach, DE
Georgetown, DE
Milton, DE
61
Millsboro, DE
Millville, DE
Long Neck, DE
Beebe Physical Rehabilitation Therapy
Lewes, DE
Rehoboth Beach, DE
Millsboro, DE
Millville, DE
Wellness Centers
Indian River High School
Cape Henlopen High School
Sussex Central High School
Wound Care and Diabetes Management
Long Neck, DE
Beebe Sleep Disorders Center
Rehoboth Beach, DE
62

5.0 Miles
Delaware Bay
Breakwater Harbor
Broadkill River
Holland Pond
Atlantic Ocean
Roosevelt Inlet
Lewes and Rehoboth Canal
Lewes

Cape Henlopen State Park
Red Mill Pond
1
Bookhammers Pond
Gordons Pond
Henlopen Acres
Goslee Mill Pond
Lake Gerar
Welches Pond
Rehoboth Beach
Hetty Fisher Pond

Silver Lake
24
Spring Lake
Ocean View
Dagsboro
Millville
Frankford South Bethany
ST
HW
KIN
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Bethel
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Georgetown
Seaford
Blades
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BE
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Rehoboth Beach
Dewey Beach
424 Savannah Rd.

Lewes, DE 19958
(302) 645-3300
2
Miles
RO
Bridgeville
Lewes
1.5
RA
IL
Milton
ST
Ellendale
Greenwood
Farmington
US
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Harrington
PA
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AR
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White Oak Creek

Dewey Beach
Johnson Branch Bald Eagle Creek
Head of0Bay
Cove
0.25 0.5
Love Creek Arnell Creek
Stockley CreekRehoboth Bay
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St. Francis Hospital Profile

Introduction:
Name
St. Francis Healthcare Services
General Background
The Sisters of St. Francis of Philadelphia established St. Francis Hospital in 1924.
Today, St. Francis Hospital is a member of Catholic Health East, the largest
Catholic healthcare system on the East Coast and operates under the identity of St.
Francis Healthcare Services. In addition to the hospital, St. Francis Healthcare
Services includes Franciscan Care Center at Brackenville, the Center of Hope, the
North Wilmington Womens Center the Womens Place, Women to Women OB/
GYN.
Accreditation
St. Francis Hospital is accredited by the Joint Commission on Accreditation of

Healthcare Organizations. St. Francis Home Care is accredited by the Joint
Commission on Accreditation of Healthcare Services, and the Family Practice
Residency Program is accredited by the American Council on Graduate Medical
Education.
Mission Statement:
Our Mission
St. Francis Healthcare Services, a member of Catholic Health East, under the
sponsorship of Hope ministries, is a compassionate, healing presence in our
community, providing state-of-the-art, person-centered health services that enable
those we care for to achieve their optimal quality of life, and those who serve to
achieve their highest potential.
Our Vision
Committed to our Mission, our Faith, and our Core Values, St. Francis Healthcare
Services will achieve excellence in all we do.
Our Core Values
Reverence for each person
We believe that each person is a manifestation of the sacredness of human life.
Community
We demonstrate our connectedness to each other through inclusive and

compassionate relationships.
Justice
We advocate for a society in which all can realize their full potential and achieve the
common good.
Commitment to those who are poor
We give priority to those whom society ignores.
Stewardship
We care for and strengthen the ministry and all resources entrusted to us.
Courage
We dare to take the risks our faith demands of us.
Integrity
Ownership:
We keep our word and are faithful to who we say we are.

Not for profit Catholic healthcare system
64
Medical Staff:
679 members of the medical staff and 131 allied health professionals. With
retirees, we have 803 members of the medical staff.
Services Offered:
24-Hour Emergency Services - Level IV Trauma Designation

Ambulatory Rehabilitation
Bariatric Surgery Center of Excellence
daVinci@ Surgical System
Emergency Medical Services Basic Life Support and transport.
Home Care Services
Imaging Services, including x-ray, CT, nuclear medicine, ultrasound, MRI, digital
mammography, R2 ImageChecker System (computerized detection unit that
assists the radiologist in locating abnormalities depicted in mammograms)
GI Lab
Inpatient and Outpatient Cardiac Catheterization Lab
Level II Neonatal Nursery
Maternity and Family Birthplace
Minimally Invasive Surgery Center
Orthopaedics/joint replacement
Neurodiagnostics/Sleep Center
Franciscan Care Center at Brackenville
North Wilmington Womens Center
Physical Medicine Rehabilitation
The Womens Place
St. Francis Family Practice Center
St. Francis Heart Center
St. Francis OB/GYN Centers
St. Francis Pain Center
Women to Women OB/GYN
900
Licensed Beds:
Staffed Beds:
395
110
St. Francis Hospital, Wilmington, DE

Franciscan Care Center at Brackenville, Hockessin, DE
St. Francis Home Care, Wilmington, DE
St. Francis Pain Center, Wilmington, DE
St. Francis Family Practice Center, Wilmington, DE
St. Francis OB/GYN Center
North Wilmington Womens Center, Wilmington, DE
Henderson OB/GYN, Wilmington, DE
St. Francis Imaging
North Wilmington Womens Center
The Womans Place
St. Francis Rehabilitation
Inpatient only St. Francis Hospital, Wilmington, DE
Cardiac Rehabilitation, Wilmington, DE
St. Clare Medical Outreach Program (providing medical care to the uninsured, in
partnership with the Ministry of Caring), Wilmington, DE
Center of Hope (providing medical care to all people immigrants and citizens,
insured and uninsured), Newark, DE
Tiny Steps (providing prenatal and postpartum care to low-income women)
Wilmington (Family Practice Center) and Newark (Center of Hope), DE
65

5.0 Miles
92
92
Ardentown
Arden
Ardentown
Ardencroft
Red Clay Creek
261
100
82
202
52
95
Twin Lakes
Hoopes Reservoir
AI DuPont Hospital
Bellevue State ParkBellevue Lake
Dupont Estate Pond
Carriage Road Ponds

Porter Reservoir
Bellefonte
100
48
3
141
13
38th St Reservoir
Wilmington Hospital
495
41
100
9
Elsmere
Shellpot Creek
Brandywine Creek
Wilmington
2
Delaware River
Cherry Island Pond
62
9
Little Mill Creek
95
Newport
295
NJ

Gracelawn Memorial Park Cem
202
295
95
202
1
141
New Castle
0.25
0.5
1.5
2
Miles
0
e4
New Castle
40
3R
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ST
ST
5T
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BR
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www.stfrancishealthcare.org/
Delaware City
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CL
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LA
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Newark
7th and Clayton Streets

(302) 421-4100
295
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ElsmereWilmington
Newport
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Christiana Care Health System Profile

Introduction:
Name
General Background
Christiana Care Health System is one of the countrys largest health care providers,
serving more than 500,000 patients yearly, placing it as the 14th leading hospital in
the nation and 9th on the East Coast in terms of admissions. A not-for-profit
teaching hospital affiliated with Thomas Jefferson Medical College, Christiana Care
is recognized as a regional center for excellence in cardiology, cancer and women's
health services, as well as for its Level-I trauma care and Level-3 neonatal intensive
care (both highest capability).
Christiana Hospital is the only Level I trauma center between Philadelphia and
Baltimore. Christiana Care includes two hospitals with 1,100 patient beds, a home
health care service, preventive medicine, rehabilitation services, a network of
primary care physicians and an extensive range of outpatient services.
With more than 10,000 employees, Christiana Care is the largest private employer
in Delaware and the 10th largest employer in the Philadelphia region. In 2008
Christiana Care had more than $1.7 billion in total patient revenue and provided the
community with $37.7 million of free care and medicine. Find more information at
www.christianacare.org
Accreditation
In the 2007 survey, Christiana Care was accredited by the Joint Commission.
Mission Statement:
Christiana Care Health System is dedicated to improving the health of all

individuals in the communities we serve through health care services, education,
and research.
Ownership:
Christiana Care is a not-for-profit, private teaching health system operated by the

Board of Directors of the Christiana Care Corporation. The Board represents a
cross-section of business and community leaders.
Medical Staff:
Christiana Care's Medical-Dental Staff includes more than 1,400 community

physicians, surgeons and dentists representing every medical practice and
specialty.
Services Offered:
Christiana Hospital, Christiana Care's flagship tertiary care facility, is the state's
designated Level I (highest capability) trauma center. The Christiana Hospital
campus is also home to Christiana Care's:
Helen F. Graham Cancer Center a state-of-the-art outpatient facility, which
serves as headquarters for our regionally acclaimed cancer program. The
Cancer Program emphasizes improving prevention and early detection and
improving survival and quality-of-life. Selected by the National Cancer Institute
as a community clinical oncology program, Christiana Care provides access to
todays most promising cancer research clinical trials.
Center for Heart and Vascular Health the programs comprehensive services
include open heart surgery (more than 800 cardiovascular surgeries each year),
diagnostic and interventional cardiac catheterization, dedicated
electrophysiology lab, noninvasive studies, research, lipid program,
rehabilitation and primary and secondary heart disease prevention.
Women's health program one of the busiest (more than 7,200 births a year),
most advanced maternity services in the nation, including a Level III (highest
capability) neonatal intensive care unit.
67
The Eugene du Pont Preventive Medicine & Rehabilitation Institute features a full
range of medically supervised preventive and alternative/complementary health
services including nutrition and fitness, stress reduction and smoking cessation,
adolescent pregnancy prevention, and special programs for arthritis, asthma,
cancer, cardiovascular disease, diabetes weight management and osteoporosis.
Wilmington Hospital includes an inpatient rehabilitation facility, joint replacement
center, outpatient surgical facility, psychiatry services, speech and hearing
services and an accredited sleep disorders center.
10,487 full and part-time, system-wide
Licensed Beds:
Wilmington Hospital -- 241

Christiana Hospital -- 906
Wilmington and Christiana - 1,147
Staffed Beds:
Throughout the state of Delaware, in southern New Jersey and southeastern

Pennsylvania. The major facilities are:
Wilmington Hospital, Wilmington, DE
Christiana Hospital, Newark, DE
Eugene du Pont Preventive Medicine & Rehabilitation Institute, Wilmington,
DE
Helen F. Graham Cancer Center, Newark, DE
Christiana Care Visiting Nurse Association, New Castle, DE
Primary Care/Internal Medicine Offices
HealthCare Center at Christiana, Newark, DE
Springside Plaza, Glasgow, DE
68
Wilmington Hospital
5.0 Miles
92
Ardentown
Arden
Ardentown
Ardencroft
3
261
100
202
52
82
95
Twin Lakes
AI DuPont Hospital
Hoopes Reservoir
Bellevue State ParkBellevue Lake

Dupont Estate Pond
Carriage Road Ponds

Porter Reservoir
Bellefonte
13
100
48
3
141
38th St Reservoir
495
Wilmington Hospital
100
41
2
Elsmere
Shellpot Creek
Brandywine Creek
Wilmington
Delaware River
Cherry Island Pond
62
9
Little Mill Creek
NJ
95
Newport
295

202
295
95
202
141
New Castle
0.25
0.5
1.5
2
Miles
ST
Bellefonte
WA
S
DR
13
T
12
T
HS
T
HS
T
KIN
G
HS
T
ST
11
T
HS
T
AV
E
PAR
K
HS
T
OR
AN
GE
S
T
10
T
TS
T
40
MA
DIS
ON
S
Ro
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E
AV
0
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New Castle
Brandywine Creek
14
T
E
AR
Newark
ut
Ro
US
NJ U
501 W. 14th St.

(302) 733-1000
www.christianacare.org/body.cfm?id=336
Newport
295
LA
DE
ElsmereWilmington
GL
E
ST
HIN
GT
ON
TA
TN
AL
LS
AM
AD
WE
S
30
T
HS
1
ou te
US R
T
17
Arden
Delaware City
BG 4.27.06
69
Christiana Hospital
52
48
5.0 Miles
100
41
141
100 Wilmington
72
Elsmere
White Clay Creek State Park
62
Little Mill Creek
Newport
495
95
295
202
896
Christiana Hospital
273
95
202
896
Newark
273
141
95
New Castle
Smalleys PondTalor Pond
Mill Creek
95
Delaware River
1
896
Whittingtons Pond
40
9
13
72
Four Seasons Lake

Becks Pond
Sunset Lake
Delaware Bay
71
0
0.25
0.5
1.5
2
Miles
Newark
New Castle
Delaware City
R
TD
u te 4 0
US Ro
E
OS
95
W
TO
Christiana Hospital
M
SA
MD
4755 Ogletown-Stanton Rd
Newark, DE 19718
(302) 733-1000
www.christianacare.org
N
TO
AN
T
S
LE
OG
CH
UR
CH
MA
NS
RD
NE
NT
AL
DR
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7
Bellefonte
295
ElsmereWilmington
Newport
NJ
RD
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NT
I
Arden
HW
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ST
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BG 4.27.06
70
Nanticoke Memorial Hospital Profile

Introduction:
Name
General Background
Nanticoke Memorial Hospital was originally incorporated in 1945 by a group of

citizens concerned by the lack of health care facilities in western Sussex County.
Over the years, involved citizens and a progressive administrative team have
continued to direct the course of Nanticoke Memorial Hospital, and its affiliates,
organized under the corporate title of Nanticoke Health Services. What started as
a 32-bed hospital in 1952 has grown to include extended care, business services,
outpatient services, cancer care services, medical centers across Sussex County
Delaware, and a host of preventative medicine and health programs.
Accreditation
Accreditation
Joint Commission on Accreditation of Healthcare Organizations
American Association of Blood Banks
Nuclear Regulatory Commission
American College on Radiology
Mammography Quality Standards Act
Mission Statement:
"We exist to positively impact our communities' quality of life through improved
health status."
Ownership:
Nanticoke Health Services, Inc. is the non-profit and parent corporation of

Nanticoke Memorial Hospital and four other corporate entities.
Medical Staff:
The medical staff of Nanticoke Memorial Hospital totals 139 active and consultant
staff members.
Services Offered:
Medical Services
Major services include acute inpatient care comprised of cardiology,
gastroenterology, infectious disease, neurology and pulmonology.
Nutrition Services
Cardiac Services including cardiac catherizations, echocardiography,
pacemakers, stress testing and telemetry
Cancer Services including radiation therapy, chemotherapy and pain
management
Surgical Services
Major services include general and vascular surgery, ophthalmology, urology,
gynecology, plastic/reconstructive surgery, otolaryngology (ENT), thoracic,
podiatry and laser
Day Surgery Services
Lithotripsy
Diagnostic Services
General radiology
Fluoroscopy
Magnetic resonance imaging
Computerized tomography
Nuclear medicine
Ultrasound
Endoscopy suite
EEG
Sleep disorder studies
Mammography
Stereotactic breast biopsy
71
Services Offered:
Critical Care
Multidisciplinary intensive care and progressive care unit
Hemodialysis
Peritoneal dialysis
Emergency Services
24-hour emergency services
Obstetric and Pediatric Services
Birthing suites
Ronald McDonald rooms
Rehabilitation Services
Physical and occupational therapy
Speech pathology
Cardiac rehabilitation services
Wound Care & Hyperbaric Chambers
Community Related Services
Laboratory courier services
Consumer health education programs
Support groups
Health Screenings: cholesterol, blood sugar monitoring, prostate cancer
screening, risk for stroke assessment, blood pressure checks
High school-based wellness centers
Nutrition counseling
1050
Licensed Beds:
139 Hospital Beds

110 Extended Care Beds
Acute Care
Nanticoke Memorial Hospital, Seaford, DE
Extended Care
LifeCare at Lofland Park, Seaford, DE
Off Campus Care
Mid-Sussex Medical Center, Millsboro, DE
Georgetown Medical Center
Seaford Medical Center
Wellness Centers
Seaford High School Wellness Center
Laurel High School Wellness Center
Delmar High School Wellness Center
Business Services
Nanticoke Occupational Health Services, Seaford, DE
Practice Management Associates, Seaford, DE
Affiliations:
Clinical rotations with various schools in nursing, radiology, laboratory, and

certified nursing assistant
Student intern program with Seaford and Laurel High School
72
Patient Mix:
Based on Discharges (FY07)

Medicare % 47
Medicaid % 23
Others (Commercial & Self Pay) % 30
Based on Patient Days (FY07)
Medicare % 60
Medicaid % 15
Others (Commercial & Self Pay) % 25
Uncompensated Care:
Charity Care & Bad Debt at cost (FY07) - $ 15,649,000
73

Bridgeville
404
5.0 Miles
Collins Pond
18
13
Hearns Pond
Seaford
Williams Pond
Concord Pond
Nanticoke Memorial
20
Blades
Fleetwood Pond
20
Nanticoke River
Laurel
Wileys Pond
Bethel
Chipman Pond
Broad Creek
9
Rehoboth Beach
Georgetown
Seaford
Blades
Bethel
US
Ro
u te
50
Laurel
Delmar
Millsboro
Ocean View
Dagsboro
Millville
Frankford
801 Middleford Rd.
Seaford, DE 19973
(302) 629-6611
www.nanticoke.org
3RD ST
KING ST
BRIDGEVILLE HWY
Bridgeville
Lewes
0.5
1.5
Williams Pond
MIDDLEFORD RD
E DR
RIVERSID
Greenwood Ellendale
Milton
US
Ro
u te
Farmington
MD
0.25
2
Miles
THOMPSON ST
NORTH ST
Harrington
RT
DI
RD
Selbyville
Nanticoke River

BG 4.27.06
74
TECHNICAL NOTES
Methods:
Hospital discharge data is recorded in the states uniform claims and billing database, which is maintained under
contract by the University of Delaware. Pursuant to the Uniform Health Data Act (16 Del Code, C.20) Delaware
hospitals must submit uniform claims and billing data each quarter. These quarterly submissions are checked for
data quality and completeness, and collated into an annual file by the University of Delaware. Each annual data
file is stored at the Delaware Health Statistics Center, which is responsible for all data analysis, reports, and
fulfilling of data requests.
Due to its status as a long-term care facility, Select Specialty in Wilmington is excluded from the data presented
in this report. Select Specialty is associated with St. Francis hospital. A short-stay hospital is one where the
average length of stay is less than 30 days.
Maps were created using ESRIs ArcView software.
Rate calculations and significance testing:
Hospital Discharge Rates were calculated using the Delaware Population Consortiums (DPC) October 2007
population projections, and were presented as the number of discharges per 10,000 population. Significance
testing for the difference between rates was performed using the following formula:
Rates - When the absolute value of the following statistic is greater than 1.96, then the difference between two
rates (R1 - R2) is considered statistically significant at the 95-percent confidence level.
R1
R2
R12
N1
R2
2
N2
where
R1 = first rate
R2 = second rate
N1 = first number of discharges
N2 = second number of discharges
Percents - When the absolute difference between two proportions is greater than the statistic in the formula
below, the difference is considered statistically significant at the 95-percent confidence level.
1.96
p(1 p) *
N1 N 2
where
N1 = first denominator
N1 = second denominator
p=
N1 * p1
N1
N 2 * p2
N2
p1=the first percent

p2=the second percent
75
TECHNICAL NOTES
Definitions:
Admission source - The source of the patients admission, e.g., emergency, another hospital, or long term care
facility, which describes how the patient was admitted.
Aggregate charges - The sum of all charges for all hospital stays.
Body System In this report, it represents the more generalized grouping of CCS categories that correspond with
ICD-9 CM chapter headings.
Clinical Classification System (CCS) This refers to the classification system developed at the Agency for
Healthcare Research and Quality (AHRQ) used to aggregate ICD-9-CM codes into broader, homogeneous
groups. In this report, the 2009 version of the single-level diagnosis classification scheme is used for both
diagnoses and procedures. Because CCS codes are based on ICD-9-CM diagnoses, they can be mapped to ICD
-9-CM chapter headings. Data in this report are presented by both CCS diagnoses and by ICD-9-CM chapters.
For more information, see http://www.ahrq.gov/data/hcup/.
Discharge - A completed inpatient hospitalization. A hospitalization may be completed by death or by releasing
the patient to his or her home, a long-term care facility, another hospital, or if the patient leaves against medical
advice.
Discharge Status - The disposition of a patient at discharge from the hospital into one of the following categories:
Home or routine discharge - patient returned to previous place of residence after discharge from the
hospital.
Long-term care facility - patient entered a nursing home including skilled nursing facilities, extended care
facilities, custodial care facilities, or other long term care placement upon discharge from the hospital.
Another short-term hospital - patient transferred to another short-term hospital at discharge, including shortterm maternity hospitals.
Against medical advice (AMA) patient left the hospital against medical advice.
Expired - patient who died during the inpatient stay.
Home health care patient discharge to home where care is provided by a home health care agency for the
purpose of promoting, maintaining, or restoring health, or for minimizing the effects of disability and illness,
including terminal illness.
Unknown - patient whose status was not entered.
Expected source of payment - The principal expected source of payment for the hospitalization.
Medicare - The health insurance program for the aged and disabled administered by the Centers for
Medicare and Medicaid Services (formerly the Health Care Financing Administration).
Medicaid - A jointly funded Federal-State health insurance program providing medical care to those unable
to afford it.
Workers compensation - A State or municipal disability insurance or industrial accident insurance.
Private health insurance- Includes HMO/PPO, Blue Cross/Blue Shield, and other private.
HMO/PPO - Any health maintenance organization (HMO) or preferred provider organization (PPO)
sponsored by consumers, communities, physicians, or hospitals.
Blue Cross/Blue Shield and other private - A private insurance plan not specified as an HMO/PPO. This
includes Blue Cross/Blue Shield plans, medical coverage provided by life insurance companies,
casualty insurance companies, health insurance companies, and independent plans such as employer/
union-sponsored plans and/or self-funded plans (partial or total).
Self-pay - The majority of the costs for the hospitalization were expected to be paid by the patient, spouse,
family, or next-of-kin.
Other government- Other Federal, State, or local government other than workers compensation, Medicare,
and Medicaid not listed separately including casualty insurance paid by the State, Federal or State medical
research grant.
76
TECHNICAL NOTES
No charge- Patients admitted with the understanding that payment would not be expected because the
medical services are free, e.g., charity patients or research or teaching patients.
Other and not stated.
Hospital charges - The amount the hospital charged for the entire hospital stay.
International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) - The official system of
assigning codes to diagnoses and procedures associated with hospital stays in the United States. The ICD-9-CM
is based on and is compatible with the World Health Organizations International Classification of Diseases, Ninth
Revision. ICD-9-CM is divided into 17 chapters and 2 supplemental classifications. Diagnoses are grouped under
chapters arranged primarily by body system. In addition, there are chapters for infectious and parasitic diseases;
neoplasms; endocrine, metabolic, and nutritional diseases; mental disorders; complications of pregnancy,
childbirth and puerperium; certain conditions originating in the perinatal period; congenital anomalies; and
symptoms, signs and ill-defined conditions. The two supplemental classifications are for factors influencing health
status and contact with health services and classification of external causes of injury and poisoning. More
information can be found online at www.cdc.gov/nchs/icd9.htm.
Length of stay - The number of nights the patient remained in the hospital for this stay.
Liveborn The term for the hospitalization that results from an infant being born in the hospital, also referred to as
newborn. They are identified by a specific range of ICD-9 CM codes on the discharge record. Records of infants
born in the hospital are separate and distinct from the mothers' discharge records, so excluding liveborn infants
does not remove the mother's discharge data from the analysis.
Long-term care facility A facility that provides a specific level of personal or medical care or supervision to
residents. Types of long-term care facilities include licensed nursing homes, skilled nursing facilities (SNF),
intermediate care facilities (ICF), hospice medical facilities, and other health care institutions, such as institutions
for the mentally retarded and developmentally disabled.
Mean length of stay - Average length of stay for discharges. It is calculated by dividing the total number of days of
care by the number of discharges.
Obstetric The branch of care that deals with the management of pregnancy, labor, and the puerperium.
Primary diagnosis - The diagnosis chiefly responsible for the admission of the patient to the hospital; it is the firstlisted diagnosis specified on the discharge summary of the medical record.
ProceduresUp to six procedures, the principal and five additional, may be recorded on a single hospital stay.
Principal procedure refers to the first-listed procedure, which is the procedure performed as a specific
treatment for the hospitalization, or the one most closely related to the principal diagnosis.
All-listed procedures refers to the principal plus any secondary procedures appearing on a single discharge
record/performed during a hospital stay. Because patients often receive more than one procedure, the number
of all-listed procedures usually exceeds the number of discharge with procedures.
Procedure classes Refers to AHRQ's HCUP classification system for procedures, which are categorized into four
general categories: minor diagnostic, minor therapeutic, major diagnostic, and major therapeutic. The two minor
categories are considered non-operating procedures and the two major categories are considered valid operating
procedures. This report uses the 2008 version of the classification system. More information can be found at:
http://www.hcup-us.ahrq.gov/toolssoftware/procedure/procedure.jsp.
Puerperium The period or state of confinement after labor and giving birth.
77
TECHNICAL NOTES
Rate - A rate is a measure of an event, disease, or condition in relation to a unit of population for a specified
time. For example, the five-year average discharge rate per 10,000 population is calculated as follows:
(Five-year total number of discharges / Five-year total population) *10,000
Short-stay Hospitals - A short-stay hospital is one where the average length of stay is less than 30 days. Due to
its status as a long-term care facility, Select Specialty in Wilmington was excluded from the data presented in
this report. Select Specialty is associated with St. Francis hospital.
Uninsured patients A term for those patients whose primary payer is listed as self-pay.
78
REFERENCES
CMS National Health Expenditure Data. Accessed 3/24/2006. http://www.cms.hhs.gov/
NationalHealthExpendData/02_NationalHealthAccountsHistorical.asp#TopOfPage
DeFrances CJ, Hall MJ, Podogornik MN. 2003 National Hospital Discharge Survey. Advance data from
vital and health statistics; no 359. Hyattsville, MD: National Center for Health Statistics. 2005.
DHSC Hospital Discharge Summary Report, 1992-2000. Division of Public Health, Delaware Health and
Social Services, Jan 2002. Doc. No. 350520-020106.
Elixhauser A, Steiner C, Palmer L. Clinical Classifications Software (CCS),2006. U.S. Agency for
Healthcare Research and Quality. Available: http://www.ahrq.gov/data/hcup/ccs.htm#download.
HCUPnet, Healthcare Cost and Utilization Project. Agency for Healthcare Research and Quality, Rockville,
MD. http://www.ahrq.gov/HCUPnet/
Levit K, Ryan K, Elixhauser A, Stranges E, Kassed C, Coffey R. HCUP Facts and Figures: Statistics on
Hospital-based Care in the United States in 2005. Rockville, MD: Agency for Healthcare Research and
Quality, 2007. http://www.hcup-us.ahrq.gov/reports.jsp
Merrill CT, Elixhauser A. Hospitalization in the United States, 2002. Rockville, MD: Agency for Healthcare
Research and Quality, 2005. HCUP Fact Book No. 6. AHRW Publication No. 05-0056. ISBN 1-58763-217
-9.
National Center for Health Statistics. Health, United States, 2005 with Chartbook on Trends in the Health
of Americans. Hyattsville, Maryland: 2005.
National Center for Health Statistics. National Trends in Injury Hospitalizations 1979-2001. Hyattsville,
Maryland: 2005.
National Health Expenditure Accounts: Definitions, Sources, and Methods Used in the NHEA 2004. http://
www.cms.hhs.gov/NationalHealthExpendData/downloads/dsm-04.pdf
Owens P, Myers M, Elixhauser A, Brach C. Care of Adults With Mental Health and Substance Abuse
Disorders in U.S. Community Hospitals, 2004. Agency for Healthcare Research and Quality, 2007. HCUP
Fact Book No.10. AHRQ Publication No.0 7-0008.I SBN 1-58763-229-2.
The National Association of Health Data Organizations. 2005. Public Health Data Dissemination
Guidelines: NAHDO Working Technical Paper Series.
79

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Delaware Hospital

For more information, contact:

Executive Summary .....................................................................................................................................1

Delaware Hospital Discharge Report 2009

Delaware Health Statistics Center

Delaware Hospital Discharge Report 2009

Delaware Health Statistics Center

Source: Delaware Health Statistics Center

Delaware Hospital Discharge Report 2009

Delaware Health Statistics Center

Source: Delaware Health Statistics Center

Source: Delaware Health Statistics Center

Delaware Hospital Discharge Report 2009

Delaware Health Statistics Center

Distribution of Discharges by LOS Categories and Age Group

Delaware Hospital Discharge Report 2009

Delaware Health Statistics Center

Mean Length of Stay by Patient Type

Length of Stay in Days

Delaware Hospital Discharge Report 2009

Delaware Health Statistics Center

WHY PATIENTS WERE HOSPITALIZED

Diagnoses Grouped by Body System

Delaware Hospital Discharge Report 2009

Delaware Health Statistics Center

WHY PATIENTS WERE HOSPITALIZED

Most frequent reasons for hospitalization by age groups:

Delaware Hospital Discharge Report 2009

Delaware Health Statistics Center

WHY PATIENTS WERE HOSPITALIZEDINJURIES

Most Frequent Injury Diagnoses, 2009

Intracranial injury, 9.7

Fracture of lower limb, 8.3

Fracture of upper limb, 4.6

Other fractures, 8.2

Source: Delaware Health Statistics Center

Delaware Hospital Discharge Report 2009

Delaware Health Statistics Center

WHY PATIENTS WERE HOSPITALIZEDINJURIES

Selected Primary Injury Diagnoses by Gender

Delaware Hospital Discharge Report 2009

Source: Delaware Health Statistics Center

Delaware Health Statistics Center

WHY PATIENTS WERE HOSPITALIZED PROCEDURES

Delaware Hospital Discharge Report 2009

Delaware Health Statistics Center

WHY PATIENTS WERE HOSPITALIZEDPROCEDURES

Cesareans per 100 Deliveries

Source: Delaware Health Statistics Center

diagnostic cardiac catheterization,

Delaware Hospital Discharge Report 2009

Delaware Health Statistics Center

WHY PATIENTS WERE HOSPITALIZEDPROCEDURES

Delaware Hospital Discharge Report 2009

Delaware Health Statistics Center

HOSPITALIZATIONS OF DELAWARE RESIDENTS

Discharges per 1,000

In 2009, Delawareans were

Delaware Hospital Discharge Report 2009

Source: Delaware Health Statistics Center

Percent Distribution of Resident Discharges for Hospitalizations by

Diseases of the circulatory system

Complications of pregnancy, childbirth, &