Value, 2009

State of Kentucky—Cabinet for Health and Family Services

March 2009

The State of Kentucky's Cabinet for Health and Family Services uses AHRQ's Inpatient Quality Indicators (IQIs) and Prevention Quality Indicators (PQIs) to create state-based reports that are available on the State's Web site. This allows Kentucky-specific data to be compared against national data.

Chandra Venettozzi, Health Data Administrator in the Office of Health Policy, states, "AHRQ represents a well-respected, validated source of data to increase the usefulness of the Kentucky data."

According to Venettozzi, Kentucky led the nation in legislation mandating the study of health care resource utilization. In the late 1990s, the legislature passed a law requiring hospitals and ambulatory surgery centers to report all admission and discharge diagnoses. She says, "The purpose of the bill was to allow us to collect data on where our citizens were going for health care and what type of care they were receiving. The legislation facilitating the reporting of health care utilization helped the State increase health care transparency. This has helped empower consumers to be able to examine quality issues when making health care choices and decisions."

The data used to develop the IQI reports are standardized administrative information submitted by Kentucky hospitals to bill for their services. This includes procedure codes, diagnosis codes, facility charges and patient demographic information. To fairly report on the quality of inpatient care, the data are "risk-adjusted" to account for the difference in patient severity levels for each facility.

For the Kentucky IQIs, the following reporting format is used on the Web site to easily identify hospitals performing above average, below average, or average for any given indicator:

• Green: If a hospital's risk-adjusted rate is better than the national average for an indicator, the rate is displayed in green. For most indicators, lower rates represent better quality.
• Red: If a hospital's risk-adjusted rate is worse than the national average, the value is displayed in red.
• Black: If the risk-adjusted rate is not statistically different from the national average, the indicator is displayed in black.

The PQI reports on the Kentucky Web site are used to identify ambulatory care-sensitive conditions—conditions for which good outpatient care can potentially prevent the need for hospitalization, complications, or more severe disease. Kentucky's Web site uses the following format to identify areas performing above average, below average, or average for any given prevention quality indicator:

• Green: If an area's risk-adjusted rate (considering a margin of error) is lower than the national average for an indicator, the area is displayed in green.
• Yellow: If an area's risk-adjusted rate (considering a margin of error) is comparable to the national average for an indicator, the area is displayed in yellow.
• Red: If an area's risk-adjusted rate (considering a margin of error) is higher than the national average for an indicator, the area is displayed in red.

The Kentucky Cabinet for Health and Family Services oversees most of the State's human services and health care programs. The Office of Health Policy, operating within its goals to coordinate efficient and cost-effective policy research, charges a nominal fee for commissioned searches of the databases. All proceeds are reinvested in database development and data collection on the State level. Kentucky has a population of 4.2 million, with over 30 percent of the population relying on government-sponsored health care programs. An additional 14 percent remain uninsured.

The Kentucky Inpatient Quality Indicator and Prevention Quality Indicator reports can be found at http://chfs.ky.gov/ohp/healthdata/IQI.htm and http://chfs.ky.gov/ohp/healthdata/pqis.htm.

Impact Case Study Identifier: CDOM 09-05
AHRQ Product(s): Healthcare Cost & Utilization Project—Prevention Quality Indicators, Inpatient Quality Indicators (HCUP-PQIs, IQIs)
Topic(s): Quality
Scope: Kentucky

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