This study assessed the implications of CAH inpatient hospitalizations and transfers from CAHs to other hospitals for national quality measurement and reporting. The assessment would also help inform the development of quality indicators for CAHs focused on the transfer process. Through the use of discharge data from nine states via AHRQ’s Healthcare Cost and Utilization Project, the Flex Monitoring Team found the top 20 CAH diagnostic related groupings account for over half of inpatient admissions during 2001-2004, including pneumonia, heart failure, chest pain, and chronic obstructive pulmonary disease – respiratory and cardiac conditions that are common among the elderly.

These results confirm the importance of pneumonia and heart failure as CAH conditions to be assessed by national quality measures. In addition, they indicate that labor/delivery and newborn care remain important CAH diagnoses, and suggest that quality measures focused on those diagnoses would be relevant for CAHs that provide obstetrical care.