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. Author manuscript; available in PMC: 2013 Jul 1.
Published in final edited form as: Med Care. 2012 Jul;50(7):569–577. doi: 10.1097/MLR.0b013e31824e319f

Table 1.

High Referral Rate Procedures: Volumes and Referral Rate

Procedure Category # procedures in study period Average referral rate, % # Individual procedures in category Individual procedures (% share of category volume)
Musculoskeletal 80,688 95% 4 Knee arthroplasty (40%), Spinal fusion (31%), Hip replacement (22%) and Partial excision bone (7%)
Urinary/Genital 51,088 95% 6 Hysterectomy (32%), Oophorectomy (32%), Repair of cystocele and rectocele (12%), Transurethral resection of prostate (12%), Genitourinary incontinence procedures (8%) and Nephrectomy (2%)
Nervous 29,372 88% 1 Laminectomy (100%)
Cardiovascular 20,914 80% 4 Heart valve procedures (34%), Endarterectomy (32%), Peripheral vascular bypass (19%) and Aortic resection (15%)
Digestive 19,845 73% 2 Colorectal resection (98%) and Gastrectomy (2%)
All procedures 201,907 90% 17

Notes:

  1. Procedures are categorized by ICD-9-CM Procedure Chapters. No eye, ear and nose/throat procedures met the high referral rate criteria. Urinary, male genital and female genital system procedures have been combined into one category.
  2. Study period comprises pre- and post-reform periods (10/1/2004 – 6/30/2006 and 1/1/2008 – 9/30/2009 respectively)
  3. # procedures indicates the state-wide volume performed during hospitalization stays in the pre- and post-reform periods.
  4. Average referral rate indicates the % of hospitalizations (during which procedure was performed) based on outpatient referral.