Abstract
We want to examine the treatment of patients with diabetes, and the reasons these patients are in the hospital. In order to do this, we must consider a cohort of patients who have diabetes and who are treated with medication and with insulin. We also need to know the extent to which compliance with monitoring is related to disease progression. Do patients with organ failure have greater, or less compliance with monitoring? There is so much involved in the treatment of diabetes, that it may be difficult to investigate all aspects of the treatment in one analysis. Therefore, at some point, it becomes important to focus on some one aspect of the disease. Then, you can add a second aspect followed by a third or fourth aspect of the disease.
TopInpatient Data
As discussed in Chapter 1, there are several different datasets available through CMS:
two data sets were used: one is Inpatient_base_claims, including 244,299 data about the claim information for the year 2004; the other is the Beneficiary_summary_file, covering 358,709 observations about the beneficiary information for the year 2004. The variables used are as follows:
BENE_ID: Encrypted 723 Beneficiary ID
BENE_SEX_IDENT_CD: Sex
BENE_RACE_CD: Beneficiary Race Code
BENE_AGE_AT_END_REF_YR: Age
BENE_ESRD_IND: End Stage Renal Disease indicator
ICD9_DGNS_CDn: Claim Diagnosis Code
CLM_TOT_CHRG_AMT: Claim Total Charge Amount
CLM_UTLZTN_DAY_CNT: Claim Utilization Day Count
NCH_DTNT_STATUS_IND_CD: NCH Patient Status Indicator Code
ICD9: AN abbreviation for the 9th edition of the International Classification of Diabetes and Related Health Problems.
We want to start looking at the beneficiary file so that we can define the denominator of occurrence. As shown previously, we can find the most frequently occurring procedure codes as well as the most frequently occurring diagnosis codes (Table 1). The most common procedures performed are given in Table 2.
Table 1. Most frequent diagnosis codes
| Primary ICD-9 | Description | COUNT | PERCENT |
| 4280 | Congestive Heart Failure | 17843 | 7.303755 |
| 486 | Pneumonia, Organism of unspecified type | 10363 | 4.241933 |
| 41401 | Coronary Atherosclerosis; of Native Coronary Artery | 10196 | 4.173574 |
| V5789 | Other specified rehabilitation procedure | 5957 | 2.438405 |
| 49121 | Obstruction Chronic Bronchitis with acute exacerbation | 5643 | 2.309874 |
| 41071 | Subendocardial Infarction, Initial | 5169 | 2.11585 |
| 5990 | Urinary Tract Infection of unspecified type | 4689 | 1.919369 |
| 5849 | Acute Renal Failure of unspecified type | 3539 | 1.448635 |
| 43491 | Cerebral Artery occlusion, unspecified with Infarction | 3491 | 1.428987 |
| 2765 | Hypovolemia | 3447 | 1.410976 |
| 78659 | Chest Pain of unknown type | 3396 | 1.3901 |
| 0389 | Septicemia of unspecified type | 3292 | 1.347529 |
| 42731 | Atrial Fibrillation | 2931 | 1.199759 |
| 51881 | Respiratory Failure | 2872 | 1.175609 |
| 5070 | Food Vomit Pneumonitis | 2554 | 1.04544 |
| 25080 | Diabetes of unspecified type with other specified manifestations | 2302 | 0.942288 |
| 7802 | Syncope and Collapse | 2207 | 0.903401 |
| 6826 | Cellulitis of Leg | 2161 | 0.884572 |
| 4359 | Unspecified transient cerebral ischemia | 1831 | 0.749491 |
| 71536 | Osteoarthrosis, localized, not specified whether primary or secondary | 1814 | 0.742533 |