Summary
Key Findings
- Hospital data can be used to assess health care received by residents of the U.S.-Mexico border.
- Access to health care: Hispanics in border counties had the highest rates of uninsurance.
- Hispanics in border counties had higher hospitalization rates than Hispanics in non-border counties for:
- Diabetes.
- Injuries.
- Maternal and neonatal care.
- COPD.
- Chronic kidney disease.
- Obesity.
- When hospitalized for diabetes in border hospitals, Hispanics were more likely than non-Hispanics to experience:
- Amputation.
- Renal failure.
- Peripheral vascular disease.
- Paralysis.
- When hospitalized for mental health or substance abuse in border hospitals, Hispanics were more likely than non-Hispanics to have:
- Liver disease.
- Hispanics in border counties were more likely to be hospitalized in non-border hospitals than non-Hispanics.
Definitions
Conditions of Interest
- Cancers: Any Dxv in CCS 24 (breast), 26 (cervix), 29 (prostate), or in range 140.x-149.x (oral).
- Cardiovascular: Any Dx in CCS 96-109.
- Diabetes: Any Dx in CCS 49-50.
- Lower-extremity amputation based on AHRQ PQI 16.
- HIV/AIDS: Any Dx in CCS 5.
- Maternal and Neonatal:
- Newborn: PDx in CCS 218 (normal) and CCS 219-224 (complicated).
- Neural tube defects: PDx in 756.17, 741.x.
- Delivery: PDx in CCS 196 (normal) and CCS 176-195 (complicated).
- Mental Health and Substance Use: Any Dx in CCS 650-659, 662-670 (mental health) and CCS 660-661 (substance use)
- Environmental health: Any Dx in CCS 128 (asthma), 127 (COPD), 131 (respiratory failure), 122 and 132 (other respiratory including pneumonia).
- Injuries: Any external cause of injury code indicating motor vehicle accident and unintentional injuries (screen based on CDC classification for injuries).
- Obesity: Any Dx of 278.00, 278.01, and V778 by age (18+ adults; 0-17 children).
- Renal Failure: Any Dx in CCS 157 (acute) or CCS158 (chronic).
Service Line and Comorbidities
- Service line:
- Maternal: PDx in CCS 176-196.
- Neonatal: PDx in CCS 218-224.
- Mental Health: PDx in 650-670.
- Injury: PDX in range 800-990.4, 909.9, 910-994.9, and 995 (with some exclusions).
- Surgical: Surgical diagnosis-related group.
- Medical: All other discharges.
- Every discharge is assigned to one of the hospital service lines, based on the following hierarchical order: maternal and neonatal, mental health, injury, surgical, and medical.
- Comorbidities:
- AHRQ indicators for 29 comorbidities.
- Severity index is based on a weighted sum of the individual comorbidity indicators with more severe comorbidities having a higher weight. For example, the weight for metastatic cancer is 13 and the weight for chronic pulmonary disease is 3.
v. Dx = diagnosis; CCS = Clinical Classifications Software; PQI = Prevention Quality Indicator; CDC = Centers for Disease Control and Prevention.
