AHRQ SAS Quality Indicators software was originally developed by the Agency for Healthcare
research and quality in the late 1990s version 6.0 was released in June 2016
there are three important software announcements
First, The ICD-10 SAS QI version 6.0
will not include risk adjustments because one full year of ICD-10 data is required in order to develop complete risk adjustment models
Second, The ICD-10 SAS QI version 6.0 package, will include all four modules in a single release in 2016
And Finally, The ICD-9 SAS QI software version 6.0, will be released by module incrementally throughout 2016
this tutorial will walk you through how to compute our quality indicators using SAS QI version 6.0 throughout the presentation we
will be referring to a few resource documents that are available for you to download
from the AHRQ website
The SAS packages are organized as four modules
providing Inpatient Quality Indicators, or IQIs
Pediatric Quality Indicators, or PDIs; Prevention Quality Indicators, or PQIs
Prevention Quality Indicators, or PQIs
Patient Safety Indicators, or PSIs
you can use the programs in these modules to produce observed and expected quality indicator rates, risk-adjusted quality indicator rates
MSX-smoothed rates and other, condition-specific rates. Now let's talk about the hospital discharge dataset that you will bring into sas
the input data file has to be a SAS dataset with required elements in specified formats
you may have to recode data elements to match what's expected by the SAS program
for instance the variable name for gender
has to be sex coded "1" for mail and "2" for female
you can find more details in section 5.1 of the Manual software input data
you'll also need to check the data dictionary in appendix C
table 27 specifies the format for each variable that will be used in each module
in addition diagnose season procedures must be coded in compliance with the ICD D9 CM codes there are also specific requirements for
MS-DRGs and MDC if there are no APR-DRG categories in your input data
you should run the APR-DRG grouper program first; this will create DRGs for you
it is required the users either use their own grouper software
or download and run APR-DRG grouper on their patient discharge data before running the IQI module
finally don't forget to code all types of missing values as a single value
a period for numeric variables and a blank space for character variables
now are ready to get started. we will use the IQI module for our demonstration, remember we've
extracted 12 SAS programs, 2 ASCII text files and 24 CSV files.
we can use these files to compute 28 provider-level indicators and 4 area-level indicators
plus two composite indicators
you can find technical specifications for these indicators on our web site by selecting IQI why resources under the module menu
then scroll down to the link for technical specification which takes you to the individual QI technical specification
let's bring in the input data by copying and pasting in the folder where you downloaded this SAS QI software
hospital discharge input data should be formatted as SAS dataset as I mentioned earlier
please go through the documentation for more instructions on formatting
for example IQI_sample is the input data in SAS format that contains hospital
discharge data and pop 95T15 is the area level population data text file
the population file can be downloaded from the AHRQ website
lets take a look that the hospital discharge input dataset in SAS format this is how the data will look.
create two new folders SAS data and formats inside IQI directory
the first SAS program you need to run is IQI_control.SAS
double click to open it
after you open the program you'll find brief instructions about the module
further down you reach the most important section
a checklist that will guide you through the entire process
please read these instructions carefully
to simplify let's modify only the required part of the program
replace "pathname" with the full string of the directory path were you downloaded the SAS software
we have 18 places where you need to replace the pathname
in addition you will need to change the input
DIS folders specifies the folder that contains the discharge dataset
copy and paste the path of your SAS discharge input dataset
discharge specifies the name of the discharge data file replace it with your SAS discharge input dataset name
pop file specifies the file path of your population file
copy and paste the full folder path
you can ignore any further changes even though they're described as user must modify
in addition you will need to change the population year based on your data
you are basically setting up the location of the input and output files for all other SAS programs
you can ignore any further changes even though they're described as user must modify. Let's talk
about the optional edits that are described as user may modify
for example here this code means the IQP2 is the output dataset generated when we run program P2 that is IQ sas P2.sas this
IQP2 dataset becomes the input for program P3 that is IQ sas P3.sas
IQ P3 is the output data set produced when we've run program P3
users have the option of changing these dataset names
after you've made all the necessary modifications to the control program, save and
click run. make sure to check that the log file does not contain any errors.
errors appear in gray colour, otherwise the logs are in blue. Now you must run the second SAS program IQI_FORMATS.sas
double click to open it
for the rest of the sas programs after the control program, you must edit the programs to specify where the control program is located
this is the only editing these programs need
replaced pathname with the directory path of your downloaded SAS software location, the same as we did in the control program
save it and click run
these first two programs set up the SAS environment for the remaining programs by
creating necessary SAS libraries that are used by other SAS programs
next we're going to run IQI_measures.sas. This program assigns
inpatient quality indicators to each in patient record
you'll need to tell SAS where the control program is located as we just did in the format program
replace pathname with your directory path, this is the only editing needed in this program
save it and click run
the program displays output
now you can take a look at your output data set produced by the program
the program produces output data set in the folders "SASData"
in the output data set IQ1
that calculated numerator and denominator for all IQI indicators will be stored
output data set IQ1 becomes the input for the next program
now you're ready to compute either provider-level or area-level inpatient quality indicators
to obtain the 28 provider-level indicators
you should run program IQI_provider_1.sas which will give you the observed rates
give the full path of the control program location
this is the only editing needed
save the program and click run
program displays screen output
you can see the output dataset IQP2 created in your directory
let's open it and take a look at the data
in this case we view 16 hospitals in our dataset
for example the output is showing indicator IQI 01 numerator values
all other provider-level reporting data for all indicators will be contained in its own column in the output file
similarly if you want to calculate the observed rate for the area level indicators
you should run IQI_area_1 that sat instead of IQI_provider_1.sas right after the format program as shown previously
these steps are the same except you will see the output datasets IQa2
now that we have seen how to run the programs let's see how to extract the data in SAS dataset to a spreadsheet
for example let's choose IQP3
note that the column heading can be displayed as column labels
or column names by going to the view menu and select column labels or column
names. To export the data, go to the file menu and choose export data
make sure you select the check box that displays "write variable labels as column names"
click next, select Microsoft excel workbook.xls from the list and click next, give the path
on your computer where you want to export the data
type a name for your file and click save
click next and make sure to click finish
you can see the data extracted into a spreadsheet
let's summarize the output sets that are of interest
provider-level quality measures can be found in output dataset "IQP2"
"IQP2" gives observed rates similarly
area level quality measures can be found in output datasets IQ 82. You can download SAS QI full software package which includes all four modules from AHRQ website
or you can download each module separately.
The AHRQ website provides many additional resources to help users analyze their own data
You can also download the SAS QI Version 6.0 manual, which covers all the topics we talked about today in greater detail
if you encounter any technical difficulties
you can visit our FAQ and support page
or send an email to QIsupport@ahrq.hhs.gov
The AHRQ Quality Indicators support team can also be reached by phone in the USA at
(301) 427-1949
messages are responded two within three business days