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Prevention Quality Indicators (PQI) Software Version SAS v2024
RELEASE DATE: July 2024
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This version of AHRQ's all-payer software is named SAS QI v2024
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- Reflects coding changes based on fiscal year 2024 coding updates to the International Classification 
  of Diseases, Tenth Revision, Clinical Modification/Procedure Coding System (ICD-10-CM/PCS). These coding 
  changes impact all software modules.
- Includes modified code sets, labels, and output in multiple modules. See log of changes for 
  indicator-by-indicator changes.
- Updates risk-adjustment, signal variance, and reference population rates using data from the 2021
  Healthcare Cost and Utilization Project (HCUP) State Inpatient Databases (SID).
- Updates QI population file estimates covering the years 2000 through 2023 using US Census Bureau data. 
  Please see the population file methodology at: 
  http://www.qualityindicators.ahrq.gov/Downloads/Software/SAS/V2024/AHRQ_QI_v2024_ICD10_Population_File.pdf 
- Revised Major Diagnostic Category (MDC) Requirements
     • SAS QI v2024 now includes additional checks on user input for MDC_PROVIDED to avoid software errors. 
       In the case where MDC_PROVIDED is not 0 or 1, or if MDC_PROVIDED = 1 but the MDC values are out of range of 
       0-25, the software will not execute to avoid errors or unexpected results. 
- Continues to provide the option to produce stratified rates. Expected rates, risk-adjusted rates, smoothed rates, 
  and composites are suppressed in certain situations. Because age and gender are used in risk adjustment models, 
  it is inappropriate to produce risk-adjusted rates for any stratum that includes these variables.

Measure specific changes are outlined in the AHRQ SAS download page;
PQI - https://www.qualityindicators.ahrq.gov/Downloads/Modules/PQI/V2024/ChangeLog_PQI_v2024.pdf

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Prevention Quality Indicators (PQI) Software Version SAS v2023
Release date: AUGUST 2023
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This version of AHRQ's all-payers version is named SAS QI v2023
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- Reflects coding changes based on fiscal year 2023 coding updates to the International Classification 
  of Diseases, Tenth Revision, Clinical Modification/Procedure Coding System (ICD-10-CM/PCS). 
  These coding changes impact all software modules.
- Includes modified code sets, labels, and output in multiple modules. See log of changes for 
  indicator-by-indicator changes.
- Includes risk-adjustment, signal variance, and reference population rates using data from the 2019 and 2020
  Healthcare Cost and Utilization Project (HCUP) State Inpatient Databases (SID). The use of multiple years of 
  data serves several purposes, such as allowing users to select the appropriate year for the denominator as well as 
  for the risk-adjustment model, providing risk-adjusted scores appropriate to either a pandemic period (2020) 
  or a non-pandemic period (2019), according to user preference.
- Revised Major Diagnostic Category (MDC) Requirements
     • v2023 creates new assignments for MDC 14 (obstetrics) based on the diagnosis codes from a MDC 14 code list 
	   in order to allow users to generate risk-adjusted, smoothed, or composite rates for indicators where MDC 14 
	   is used in the measure specifications. Starting with v2023, the area-level indicators no longer require MDCs. 
	   Consequently, the MDC_PROVIDED option has been removed as it does not have any impact on the software. 
	   The software will not suppress risk-adjusted rates and smoothed rates.
- Continues to provide the option to produce stratified rates. Expected rates, risk-adjusted rates, smoothed rates, 
  and composites are suppressed in certain situations. Because age and gender are used in risk adjustment models, 
  it is inappropriate to produce risk-adjusted rates for any stratum that includes these variables.
- Updated QI population file estimates covering the years 2000 through 2022 using US Census Bureau data. 
  Please see the population file methodology at: 
  http://www.qualityindicators.ahrq.gov/Downloads/Software/SAS/V2023/AHRQ_QI_v2023_ICD10_Population_File.pdf 

Measure specific changes are outlined in the AHRQ SAS download page;
PQI - https://www.qualityindicators.ahrq.gov/Downloads/Modules/PQI/V2023/ChangeLog_PQI_v2023.pdf

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Prevention Quality Indicators Software Version SAS v2022
Release date: JULY 2022
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This version of AHRQ's All-Payers version is named SAS QI v2022
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- Added support for fiscal year 2022 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)
  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 for PSI, IQI, PDI, 
  and PQI modules using the 2019 HCUP state inpatient databases.
- Users must have major diagnostic categories (MDC) assigned for each discharge on their input file. MDCs are used in measure specifications.
  The AHRQ v2022 software no longer imputes MDC as in v2021 since the calculation is error-prone when 
  the correct classification software is not applied to the input data. Different versions of the Medicare 
  Severity-Diagnostic Related Group (MS-DRG) grouper produce slightly different results with respect to certain high 
  resource intensity MS-DRGs. Specifically, MS-DRGs 001-019 and 981-989 are classified as "pre-MDC" 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." 
  Thus, users MUST PROVIDE the MDC generated by the Centers for Medicare & Medicaid Services (CMS) MS-DRG grouper software, 
  without imputing or mapping from MS-DRGs. For accurate results, all eligible records should have an MDC between 01 and 25. 
  For those users who need to construct MDC, please view the documentation and software available here:
  https://www.cms.gov/files/zip/icd-10-ms-drgs-v391-effective-april-1-2022.zip.
- Users should set the MDC_PROVIDED macro variable to "0" in the CONTROL program when MDC is missing or incomplete on the input data. 
  If MDC is available and fully coded, users should set the MDC_PROVIDED macro variables to "1". 
  If users set the MDC_PROVIDED macro variable to "1" in the CONTROL  program, but MDC values are missing on input data, 
  the software will exclude those discharges with missing MDCs and output an error message – "ERROR: MDC_PROVIDED = 1 in 
  CONTROL program but all MDC values are missing on input data".      
- In AHRQ software v2022, users continue to have 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 2019 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. 
      Starting with AHRQ SAS QI v2021, there is a new step in the software to rescale the predicted probabilities if the O/E calibration 
      pushes them above 1.0. The caveat is that the interpretation of the rates may be different since the software would still use 2019 
      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/2022/Empirical_Methods_2022.pdf
- Updated QI population file to use intercensal and postcensal estimates of county-level population by single-year age group, sex, race,
  and Hispanic origin covering the years 2000 through 2021 are from the US Census Bureau. The new population file uses Census estimates for 
  single year age population to create AHRQ age bands. Please see the details around the population file methodology at: 
  http://www.qualityindicators.ahrq.gov/Downloads/Software/SAS/V2022/AHRQ_QI_v2022_ICD10_Population_File.pdf 

Measure specific changes are outlined in the AHRQ SAS download page;
PQI - https://www.qualityindicators.ahrq.gov/Downloads/Modules/PQI/V2022/ChangeLog_PQI_v2022.pdf

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Prevention Quality Indicators Software Version SAS v2021
Release date: JULY 2021
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This version of AHRQ's All-Payers version is named SAS QI v2021.
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- Added support for fiscal year 2021 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)
  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 for PSI, IQI, PDI, 
  and PQI modules using the 2018 HCUP state inpatient databases.
- In AHRQ software v2021, the user 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 2018 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. 
      Starting with AHRQ SAS QI v2021, there is a new step in the software to rescale the predicted probabilities if the O/E calibration 
      pushes them above 1.0. The caveat is that the interpretation of the rates may be different since the software would still use 2018 
      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/2021/Empirical_Methods_2021.pdf
- Udpdated QI population file to use intercensal and postcensal estimates of county-level population by single-year age group, sex, race,
  and Hispanic origin covering the years 2000 are through 2020 from the US Census Bureau. The new population file uses Census estimates for 
  single year age population to create AHRQ age bands. Please see the details around the population file methodology at: 
  http://www.qualityindicators.ahrq.gov/Downloads/Software/SAS/V2021/AHRQ_QI_v2021 _ICD10_Population_File.pdf 

Measure specific changes are outlined in the AHRQ SAS download page;
PQI - https://www.qualityindicators.ahrq.gov/Downloads/Modules/PQI/v2021/ChangeLog_PQI_v2021.pdf

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Prevention 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 for PSI, IQI, PDI, 
  and PQI modules 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
- Updated AHRQ Population file to use intercensal and postcensal estimates of county-level population by single-year age group, sex, race, 
  and Hispanic origin covering the years 2000 through 2019 from the US Census Bureau. The new population file uses Census estimates for
  single year age population to create AHRQ age bands.

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

PQI - https://www.qualityindicators.ahrq.gov/Downloads/Modules/PQI/v2020/ChangeLog_PQI_v2020.pdf

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Prevention Quality Indicator Software 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, 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 PQI_AREA_CONTROL.sas program.
- Modified setnames, labels, and outputs in multiple modules. See log of changes for indicator-by-indicator changes.
- Added risk-adjustment, signal variance, and reference population rates for PQI module using
  the 2016 HCUP state inpatient databases.
  The previous version of this indicator allowed the denominator to be specified with the diabetic population only and calculated with the SAS QI
  software through the condition-specific denominator. However, the disease-specific denominator file (PQI_Area_Condition.sas) has been temporarily
  removed from the software for further review and updates. So, the calculation of condition specific rates for PQI 01, 03, 14 and 16 is not available in v2019
- Remove measures from version 2019:
	PQI 02 Perforated Appendix Admission Rate
	PQI 09 Low Birth Weight Rate - PQI09 was available as a stand alone module and included in the PDI Module.
	PQI 11 Community-Acquired Pneumonia Admission 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
- Updated AHRQ Population file to use intercensal and postcensal estimates of county-level population by single-year age group, sex, race, 
  and Hispanic origin covering the years 2000 through 2018 from the US Census Bureau. The new population file uses Census estimates for
  single year age population to create AHRQ age bands.

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

PQI - https://www.qualityindicators.ahrq.gov/Downloads/Modules/PQI/v2019/ChangeLog_PQI_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 
