Inpatient Quality Indicators Overview

The Inpatient Quality Indicators (IQIs) are a set of measures that provide a perspective on hospital quality of care using hospital administrative data. These indicators reflect quality of care inside hospitals and include inpatient mortality for certain procedures and medical conditions; utilization of procedures for which there are questions of overuse, underuse, and misuse; and volume of procedures for which there is some evidence that a higher volume of procedures is associated with lower mortality.

The IQIs are a software tool distributed free by the Agency for Healthcare Research and Quality (AHRQ). The software can be used to help hospitals identify potential problem areas that might need further study and which can provide an indirect measure of inhospital quality of care. The IQI software programs can be applied to any hospital inpatient administrative data. These data are readily available and relatively inexpensive to use.

The IQIs are the second in a three-part set of AHRQ Quality Indicators (QIs) developed by investigators at Stanford University and the University of California, under a contract with AHRQ.

The AHRQ QIs expanded the original Quality Healthcare Cost and Utilization Project (HCUP) QIs. The Prevention Quality Indicators, the first set of AHRQ QIs, were released in November 2001.  The IQIs were released of in May 2002.  The third set, the Patient Safety Indicators, were released in March 2003.

IQI Facts

• Can be used to help hospitals identify potential problem areas that might need further study.
• Provide the opportunity to assess quality of care inside the hospital using administrative data found in the typical discharge record.
• Include 16 mortality indicators for conditions or procedures for which mortality can vary from hospital to hospital.
• Include 11 utilization indicators for procedures for which utilization varies across hospitals or geographic areas.
• Include 7 volume indicators for procedures for which outcomes may be related to the volume of those procedures performed.
• Are publicly available without cost.
• Are available for download.

The IQIs include the following 34 measures:

1. Mortality Rates for Medical Conditions (6 Indicators)
   • Acute myocardial infarction (AMI) (IQI 15)
   • AMI, Without Transfer Cases (IQI 32)
   • Congestive heart failure (IQI 16)
   • Stroke (IQI 17)
   • Gastrointestinal hemorrhage (IQI 18)
   • Hip fracture (IQI 19)
   • Pneumonia (IQI 20)
2. Mortality Rates for Surgical Procedures (9 Indicators)
   • Esophageal resection (IQI 8)
   • Pancreatic resection (IQI 9)
   • Pediatric heart surgery (IQI 10)
   • Abdominal aortic aneurysm repair (IQI 11)
   • Coronary artery bypass graft (IQI 12)
   • Percutaneous transluminal coronary angioplasty (IQI 30)
   • Carotid endarterectomy (IQI 31)
   • Craniotomy (IQI 13)
   • Hip replacement (IQI 14)
3. Hospital-level Procedure Utilization Rates (5 Indicators)
   • Cesarean section delivery (IQI 21)
   • Primary Cesarean delivery (IQI 33)
   • Vaginal Birth After Cesarean (VBAC), Uncomplicated (IQI 22)
   • VBAC, All (IQI 34)
   • Laparoscopic cholecystectomy (IQI 23)
   • Incidental appendectomy in the elderly (IQI 24)
   • Bi-lateral cardiac catheterization (IQI 25)
4. Area-level Utilization Rates
   • Coronary artery bypass graft (IQI 26)
   • Percutaneous transluminal coronary angioplasty (IQI 27)
   • Hysterectomy (IQI 28)
   • Laminectomy or spinal fusion (IQI 29)
5. Volume of Procedures (7 Indicators)
   • Esophageal resection (IQI 1)
   • Pancreatic resection (IQI 2)
   • Pediatric heart surgery (IQI 3)
   • Abdominal aortic aneurysm repair (IQI 4)
   • Coronary artery bypass graft (IQI 5)
   • Percutaneous transluminal coronary angioplasty (IQI 6)
   • Carotid endarterectomy (IQI 7)