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Inpatient Quality Indicators Software Version SAS v2020
Release date: JULY 2020
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This version of AHRQ’s All-Payers version is named SAS QI v2020. 
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- Added support for fiscal year 2020 code updates dictated by the Centers for Disease Control and Prevention (CDC) National
  Center for Health Statistics (NCHS) and Centers for Medicare & Medicaid Services (CMS) through March 31, 2020. 
  The SAS QI v2020 ICD-10-CM/PCS software does not reflect coding updates effective April 1, 2020. 
  These coding changes impact all software modules.
- Modified setnames, labels, and outputs in multiple modules. See log of changes for indicator-by-indicator changes.
- Updated risk-adjustment, signal variance, reference population rates, and composite weights 
  using the 2017 HCUP state inpatient databases.
- Users interested in calculating expected, risk-adjusted, smoothed, or composite values must have major diagnostic categories (MDCs)
  assigned for each discharge on their input file. MDCs are used in risk adjustment, and although the QI software includes a macro to 
  calculate MDC, it does not account for assignments for pre-MDC DRGs or multiple trauma cases (MDC 24). Different versions of the MS-DRG
  grouper produce slightly different results with respect to certain high resource intensity MS-DRGs. Specifically, MS-DRGs 001-017 
  and 981-989 are classified as “preMDC” MS-DRGs, which means that they are associated with such high length of stay and/or cost that
  they supersede the usual assignment of MS-DRGs within body system or MDC categories. For records assigned to these MS-DRGs, some
  versions of the grouper software retain the MDC that would be assigned based on the principal diagnosis and procedure codes, whereas
  other versions of the grouper software overwrite the MDC assignment with a blank, missing, or nonnumeric value such as “PRE.” 
  For those users who need to construct MDC, please view the documentation and software available here:
    https://downloads.cms.gov/files/ms-drg-v37-0-r0-mce.zip
- In AHRQ software v2020, the user now has two options to calibrate smoothed rates and composite values using observed to expected ratio: 
  Option 1: Set Calibration_OE_to_ref_pop to 1 in SAS QI control programs to calibrate using the 2017 HCUP reference population 
  observed-to-expected (O-E) ratio. This is recommended and is therefore the default choice.
  Option 2: Set Calibration_OE_to_ref_pop to 0 in SAS QI control programs to calibrate to the O-E ratio of the user’s input data. 
  This option is provided to large health care systems or states who want to calibrate the predicted QI rates within the system. 
  The caveat is that the interpretation of the rates may be different since the software would still use 2017 
  HCUP reference population rate as multiplier for risk adjustment rates.
  For more details about the O-E ratio adjustment, please refer to the Empirical Methods document.
  https://www.qualityindicators.ahrq.gov/Downloads/Resources/Publications/2020/Empirical_Methods_2020.pdf
- In the IQI module of version 2020 of the SAS QI Software, the APR-DRGs in the risk-adjustment models are based on the patient’s 
  admission diagnoses using POA information.
  
Measure specific changes are outlined in the AHRQ SAS download page;

IQI - https://www.qualityindicators.ahrq.gov/Downloads/Modules/IQI/v2020/ChangeLog_IQI_v2020.pdf

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Version SAS v2019, ICD-10-CM/PCS
Release date: JULY 2019
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This version of AHRQ’s All-Payers version is named SAS QI v2019 ICD-10-CM/PCS. 
 
Because of the transition to ICD-10-CM/PCS, 2018 SAS QI v2019 is the first software to support risk-adjustment using ICD-10-CMS/PCS.
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- Added support for fiscal year 2019 code updates dictated by the Centers for Disease Control and Prevention (CDC) National
  Center for Health Statistics (NCHS) and Centers for Medicare & Medicaid Services (CMS).
- Introduces execution of all the supporting SAS programs from within the IQI_HOSP_CONTROL.sas program.
- SAS program and control file variables were renamed to align the naming with what the module is measuring - changing
  provider to hospital.
- Modified setnames, labels, and outputs in multiple modules. See log of changes for indicator-by-indicator changes.
- Added risk-adjustment, signal variance, reference population rates, and composite weights for the IQI module using
  the 2016 HCUP state inpatient databases. Risk adjustment output is limited to AGE_SEX models.
  
- Remove measures from version 2019:
	IQI 01 Esophageal Resection Volume
	IQI 02 Pancreatic Resection Volume
	IQI 04 Abdominal Aortic Aneurysm (AAA) Repair Volume
	IQI 05 Coronary Artery Bypass Graft (CABG)
	IQI 06 Percutaneous Coronary Intervention (PCI) Volume
	IQI 07 Carotid Endarterectomy Volume
	IQI 13 Craniotomy Mortality Rate
	IQI 14 Hip Replacement Mortality Rate

- Users interested in calculating expected, risk-adjusted, smoothed, or composite values must have major diagnostic categories (MDCs)
  assigned for each discharge on their input file. MDCs are used in risk adjustment, and although the QI software includes a macro to 
  calculate MDC, it does not account for assignments for pre-MDC DRGs or multiple trauma cases (MDC 24). Different versions of the MS-DRG
  grouper produce slightly different results with respect to certain high resource intensity MS-DRGs. Specifically, MS-DRGs 001-017 
  and 981-989 are classified as “preMDC” MS-DRGs, which means that they are associated with such high length of stay and/or cost that
  they supersede the usual assignment of MS-DRGs within body system or MDC categories. For records assigned to these MS-DRGs, some
  versions of the grouper software retain the MDC that would be assigned based on the principal diagnosis and procedure codes, whereas
  other versions of the grouper software overwrite the MDC assignment with a blank, missing, or nonnumeric value such as “PRE.” 
  For those users who need to construct MDC, please view the documentation and software available here:
    https://downloads.cms.gov/files/MS-DRG-V36-0-R0-MSGMCE-V36-0-R0-MCE-V36-0-R0.zip
- In the IQI module of version 2019 of the SAS QI Software, the APR-DRGs in the risk-adjustment models are based on the patient’s discharge
  diagnosis and does not consider POA information. 
- The naming convention for programs for measures focusing on care inside hospitals are referred to as hospital instead of provider. 

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Measure specific changes are outlined in the AHRQ SAS download page;

IQI - https://www.qualityindicators.ahrq.gov/Downloads/Modules/IQI/v2019/ChangeLog_IQI_v2019.pdf

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Version SAS v2018, ICD-10-CM/PCS (Non-Risk Adjusted)
Release date: JUNE 2018
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This version of AHRQ’s All-Payers version is named SAS QI v2018 ICD-10-CM/PCS (Non Risk Adjusted). AHRQ has revised the 
versioning approach with their software tools to better reflect the fiscal year the software tools are released, 
instead of an incremental version number. Hence, the next All-Payers release will not be called v8.0, but instead, will be 
called v2018.
 
Because of the transition to ICD-10-CM/PCS, risk adjustment is not supported in the 2018 SAS 
(or in v6.0 and v7.0 beta SAS software) for ICD-10-CM/PCS. 
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- Added support for fiscal year 2018 code updates dictated by the Centers for Disease Control and Prevention (CDC) National
  Center for Health Statistics (NCHS) and Centers for Medicare & Medicaid Services(CMS).
- Consolidated formats for DIAPHRP and LUNGBIP into THORAIP due to redundancy.
- Suppressed output of NQI 02, Neonatal Mortality rate, pending technical specification review.
- Updated AHRQ Population file to use US Census 'County Population by Characteristics: 2010-2017 Vintage' tables.
  The new population file uses Census estimates for singe year age population to create AHRQ 18+ age bands, This file includes estimates for the 1995 to 2017 period.
  Population data from years 1995-1999 uses a different method for the age group (18 – 24) compared to the population data starting with 2000.

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Version 7.0.1 Beta, ICD-10-CM/PCS
Release date: December 2017
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AHRQ has named this a “beta version” as a signal to users that there may be significant differences
between results obtained when using data and QI software based on ICD-9-CM coding vs. the results 
obtained when using data and QI software based on ICD-10-CM/PCS.
Users should interpret rates using the 7.0 beta version with caution. 
A brief introduction to the differences between ICD-9-CM and ICD-10-CM/PCS 
is available at: https://www.hcup-us.ahrq.gov/datainnovations/BriefIntrotoICD-10Codes041117.pdf
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The v7.0.1 Beta includes updates to the PDI, PQI, and PQI09 modules.
- Added support for the updated area population file for the years 2016 and 2017.
  The population data is used in calculating the denominator of area level indicators.
  The 1995 to 2017 population file is available for download on the AHRQ SAS Software website.
  http://www.qualityindicators.ahrq.gov/Software/SAS.aspx
- Except for the addition of 2016 and 2017 population data, this version is exactly same as SAS QI 7.0 Beta.

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Version 7.0 Beta, ICD-10-CM/PCS
Release date: September 2017
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-  Adds PQI_AREA_CONDITION.sas to calculate diabetes rates for prevention quality indicators across stratifiers.  (PQI)
- Remove unused PDI variables DUALCAT, FIPST, CNTPRDAY, CONGCAT, TRNSFER, TRNSOUT, MAXPR, NOPOUB04, NOPRDAY, ARRY6, ARRY3, PAY2
- Remove unused IQI variables MORT30, DNR, FIPSTCO, FIPST, PSTCO, LOS, POPCAT, DUALCAT, PAY2, TRNSFER, MAXDX, MAXPR, NOPOUB04, NOPRDAY,
     TRNSOUT, CNTPRDAY, ARRY1, ARRY3, ARRY6
- Remove unused PSI variables ASOURCE, FIPSTCO, FIPST, and PSTCO, POPCAT, DUALCAT, MAXDX, MAXPR, NOPOUB04, NOPRDAY, TRNSOUT, TRANSFER
     PAY2, CNTPRDAY, ARRY1, ARRY3, ARRY4, ARRY6
- Remove unused PQI variables DUALCAT, PAY2, POVCAT1-POVCAT10, FEMALE, PVIDX, AGECAT1-AGECAT14, FAGECAT1-FAGECAT14, ARRY1, ARRY2, ARRY3
- Added support for ICD Version 34 and MS-DRG Version 34 codes through 09/30/2017
- Remove measures from version 7.0.
    IQI 23 Laparoscopic Cholecystectomy Rate
    IQI 24 Incidental Appendectomy in the Elderly Rate
    IQI 25 Bilateral Cardiac Catheterization Rate
    IQI 26 Coronary Artery Bypass Graft (CABG) Rate
    IQI 27 Percutaneous Coronary Intervention (PCI) Rate
    IQI 28 Hysterectomy Rate
    IQI 29 Laminectomy or Spinal Fusion Rate
    PSI 21 Retained Surgical Item or Unretrieved Device Fragment Rate 
    PSI 22 Iatrogenic Pneumothorax Rate 
    PSI 23 Central Venous Catheter-Related Blood Stream Infection Rate 
    PSI 24 Postoperative Wound Dehiscence Rate
    PSI 25 Unrecognized Abdominopelvic Accidental Puncture or Laceration Rate 
    PSI 26 Transfusion Reaction Rate 
    PSI 27 Postoperative Hemorrhage or Hematoma Rate

- Added exclusion for cases in hospice care at admission where POINTOFORIGINUB04 equal to 'F'.  (applicable to: IQI 15-20; PSI 04).
- Add support for present on admission exemption diagnosis codes based on date of discharge.

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Measure specific changes are outlined in the AHRQ SAS download page;

PQI - https://www.qualityindicators.ahrq.gov/Downloads/Modules/PQI/v2018/ChangeLog_PQI_v2018.pdf

IQI - https://www.qualityindicators.ahrq.gov/Downloads/Modules/IQI/v2018/ChangeLog_IQI_v2018.pdf

PSI - https://www.qualityindicators.ahrq.gov/Downloads/Modules/PSI/V2018/ChangeLog_PSI_v2018.pdf 

PDI - https://www.qualityindicators.ahrq.gov/Downloads/Modules/PDI/V2018/ChangeLog_PDI_v2018.pdf 
