Mortality/Morbidity Definitions

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Unless otherwise specified, all number and rates pertain to place of residence (not occurrence).

Age-Adjusted Rates
A weighted average of the age-specific mortality rates, where the weights are the proportions of persons in the corresponding age groups of a standard population. The calculation of an Age-Adjusted Rate uses the year 2000 U.S. standard million. Age-Adjusted Rates currently on OASIS are: Age-Adjusted Death Rates (AADR), Age-Adjusted Discharge Rates (AADR), Age-Adjusted Deduplicated Discharge Rates (AADDR), Age-Adjusted Emergency Room Visit Rates (AAERVR) and Age-Adjusted Deduplicated Emergency Room Visit Rates (AADERVR). Benefit: Controls for differences in age structure so that observed differences in rates across areas such as counties are not due solely to differences in the proportion of people in different age groups in different areas. Rates that use Census Population Estimates in the denominator are unable to be calculated when the selected population is Unknown.
Cause of Death
Reported causes of death are based on the underlying cause of death. The underlying cause of death is defined by the World Health Organization as the disease or injury that initiated the sequence of events leading directly to death or as the circumstances of the accident or violence that produced the fatal injury.
Cause of Discharge
Causes are based on the principal diagnosis, except in cases where an External (E-code) cause supersedes the principal diagnosis. All discharges having external causes (injuries) are assigned their appropriate valid External Cause of Injury Code (E-Code) in accordance with STIPDA (State and Territorial Injury Prevention Directors Association) 2003 guidelines. The standards can be found at: http://www.stipda.org.
Crude Death Rate
Formula = [Number of Deaths / Population] * 100,000. Rates that use Census Population Estimates in the denominator are unable to be calculated when the selected population is Unknown.
Death/Discharge/ER Combined Rates
The total number of deaths, deduplicated discharges, and deduplicated emergency room visits added together. Note that deduplicated discharges and ER visits exclude those discharged dead, as well as readmissions of the same person with the same condition in a calendar year. The intent is to give a measure of total number of people affected by a given condition, by providing a single summary count that minimizes duplicate records.
Formula = [Number of Deaths+Deduplicated Discharges+Deduplicated ER Visits / Population] * 100,000.
Deduplicated Discharges
The number of persons discharged live from non-Federal acute-care inpatient facilities (Hospitals) for illness. Only discharges of Georgia residents who were seen in a Georgia facility are included. Persons are counted only once if readmitted for the same chronic condition during a calendar year. Causes are based on the principal diagnosis, except in cases where an External (E-code) cause supersedes the principal diagnosis. Deduplicated Discharges also excludes people discharged dead, healthy newborn infants, and healthy mothers giving birth to newborn infants. Since the number and rate are derived only from hospitalizations, they do not include all existing cases (prevalence) or new cases (incidence) among residents of Georgia.
All hospital discharges having external causes (injuries) were assigned their appropriate valid External Cause of Injury Code (E-Code) in accordance with STIPDA (State and Territorial Injury Prevention Directors Association) 2003 guidelines. The standards can be found at: http://www.stipda.org.  
Deduplicated Discharge Rate
Formula = [Number of Deduplicated Discharges / Population] * 100,000 (formerly used as Morbidity Rate on OASIS). Rates that use Census Population Estimates in the denominator are unable to be calculated when the selected population is Unknown.
Discharges
The number of inpatients discharged from non-Federal acute-care inpatient facilities. Only discharges of Georgia residents who were seen in a Georgia facility are included. Persons can be counted more than once if readmitted. Causes are based on the principal diagnosis, except in cases where an External (E-code) cause supersedes the principal diagnosis. Discharges include people both living and who have died.
All hospital discharges having external causes (injuries) were assigned their appropriate valid External Cause of Injury Code (E-Code) in accordance with STIPDA (State and Territorial Injury Prevention Directors Association) 2003 guidelines. The standards can be found at: http://www.stipda.org.  
Discharge Rate
Formula = [Number of Discharges / Population] * 100,000. Rates that use Census Population Estimates in the denominator are unable to be calculated when the selected population is Unknown.
International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM)
A statistical classification system, in use since 1979, that arranges diseases and injuries into groups according to established criteria. It is used to improve comparability of cause of death statistics reported by different governmental entities. Most ICD-9-CM codes are numeric and consist of three, four or five numbers and a description. The codes are revised approximately every 10 years by the World Health Organization and annual updates are published by the Health Care Financing Administration (HCFA), now the Center for Medicare, Medicaid Services.
International Classification of Diseases, 10th Revision, (ICD-10)
An alphanumeric coding scheme that replaces ICD-9, and used for mortality data since 1999. ICD-10 codes were developed by the World Health Organization Collaborating Centres for Classification of Diseases.
Non-Rural
Any county with 35,000 or more total population per year 2000 Census.
Premature Death Rate (Years of Potential Life Lost 75 (YPLL 75))
YPLL 75 represents the number of years of potential life lost due to death before age 75, as a measure of premature death. The Premature Death Rate (YPLL 75 Rate) is the years of potential life lost before age 75 that occur per 100,000 population less than 75 years of age. Formula = [Total Years of Life Lost before age 75 / Population less than 75 years old] * 100,000. YPLL can be age- and cause-specific. Rates that use Census Population Estimates in the denominator are unable to be calculated when the selected population is Unknown. This method of YPLL calculation uses the actual age at death and therefore is more precise as compared with the pre-defined age range methodology used by NCHS. Please note: The number above the Dials is not the number of deaths but rather the sum of YPLL for the age group chosen (<75 by default).
Race
Per the Federal Office of Management and Budget, Directive 15 (1997),
Note: Rates for years prior to year 2000 use population estimates for the denominator that adhere to a different Federal standard for race: White, Black, Asian or Other Pacific Islander, American Indian and Alaska Native. So, unlike years 2000 and after, Multiracial is not included. Also, Asian by itself is not available because it was grouped with Pacific Islander (After 1999 Asian is separate from Native Hawaiian or Other Pacific Islander).

Rates that use Census Population Estimates in the denominator are not calculated when a selected race is not available in the denominator, or zero.

Nevertheless, selections available in OASIS' Race query box reflect the 1997 Race classifications described above. Most of the numerators used in indicators in Oasis *do* have the year 2000 race selections. Therefore, selections of multiple years that span <2000 and 2000+ will return a *number(count)* for all race selections, but the *rates* may be limited by the change in racial classifications the federal government used as noted above. In these cases you will see NA1 in the output cell (NA1 therefore by definition will only show up in rates for the years before 2000).

In some cases, the numerator's race classification may be more precise, or up to date, than the Census population estimate counterpart used in the denominator. You may find that there are a number of births of a given race for a county/age-group selection, but no count of population estimated for the denominator. In such cases where the race selection was available for both the numerator and the denominator, but the denominator's estimate was zero, you will see a NA2. If the numerator was greater than the denominator, but the denominator was > 0, you will see a NA3 returned.
Rate
Both Numerator and Denominator can be Place, Race, Age, Time, Ethnicity, and Sex-specific:
Rate = [ N PRATES-M / D PRATES ] * 100,000
where
M - Measure(s) (e.g. Deaths to Males aged 45-59)
N - Number of Deaths
D - Population (e.g. Males aged 45-59)
Rates that use Census Population Estimates in the denominator are unable to be calculated when the selected population is Unknown.
Rural
Any county with less than 35,000 total population per year 2000 Census.
Sex-Specific Cancer Mortality rates
PLEASE NOTE: Unless a sex is specifically selected, Breast, Ovarian, Cervical, Uterine, Prostate and Testes cancer will have both males and females in the numerator and denominator. Note that usually (e.g. as reported in the Vital Statistics Report), Breast, Ovarian, Cervical and Uterine have only females in both the numerator and denominator, while Prostate and Testis have only males in both the numerator and denominator. Rates that use Census Population Estimates in the denominator are unable to be calculated when the selected population is Unknown.
Standard Mortality Ratio (SMR) / Standard Deduplicated Discharge Ratio (SDDR)
A statistical calibrator of confidence level in the mortality (or deduplicated discharge) rates of populations. It is indicative whether a mortality (or deduplicated discharge) rate is within the "normal" range of estimated values or significantly higher/lower to such estimates. Mortality (or deduplicated discharge) rates are compared to those for Georgia as a whole. State rates are the standard against which local rates are compared, in order to forecast the number of likely deaths (or deduplicated discharges), if a local area were to experience mortality (or deduplicated discharge) the same as the State. It is a statistic indicating significance at the 95% confidence level. Note that an SMR is not shown for the state as a whole - an N/A will be shown instead. For counties, N/A means Not Applicable due to zero events. Standard deduplicated discharge ratios use deduplicated discharges not discharges.
Result of 95% statistical significance test of ratios. Higher: Significantly higher ratio than expected based on the State ratio. Expected: No significant difference as compared to the State. Lower: Significantly lower ratio as compared with the State. Rates that use Census Population Estimates in the denominator are unable to be calculated when the selected population is Unknown.
Years of Potential Life Lost 75 (YPLL 75)
YPLL 75 represents the number of years of potential life lost due to death before age 75, as a measure of premature death. The YPLL 75 Rate is the years of potential life lost before age 75 that occur per 100,000 population less than 75 years of age. Formula = [Total Years of Life Lost before age 75 / Population less than 75 years old] * 100,000. YPLL can be age- and cause-specific. Rates that use Census Population Estimates in the denominator are unable to be calculated when the selected population is Unknown.This method of YPLL calculation uses the actual age at death and therefore is more precise as compared with the pre-defined age range methodology used by NCHS.

* Note: All hospital discharges having external causes (injuries) were assigned their appropriate valid External Cause of Injury Code (E-Code) in accordance with STIPDA (State and Territorial Injury Prevention Directors Association) 2003 guidelines. The standards can be found at: http://www.stipda.org.

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