Hospital Discharges by Cause (OASIS Detailed Causes, Nested)

Limitaciones

Inpatient stays of Georgia residents in Georgia's non-federal hospitals by principal diagnosis and home county: a person admitted twice counts twice; stays in other states are missing, so border counties look low. Causes nest: never add them. OASIS withholds the all-cause age-adjusted rate for Georgia and 83-142 counties a year: use discharge_rate_per_100k. Race groups start in 2016 and run low (unknown ethnicity is only in race_unknown; NULL above 20%). OASIS withholds rates on 1-4 stays (NULL here). Age-adjusted rates are OASIS's: weighted averages of age-specific rates with the year 2000 U.S. standard million as weights, so places and groups with different age mixes compare fairly; they never add or average across rows. OASIS publishes every count, however small, and withholds rates based on 1-4 events (NULL here); the platform adds no suppression of its own and never recomputes a withheld rate. A group with no residents in a place (num_population 0) has no rate (NULL): OASIS shows a crude rate of 0 there (and withholds the age-adjusted rate itself), but a rate on no population is undefined and would rank as the lowest (our mask; the count stays 0). OASIS codes the withheld all-cause age-adjusted rate -3: in at least one of its age groups the place's stays outnumber its residents (a person can have several stays), probably the under-1 group, where each newborn's birth is a stay (our reading; OASIS shows no age-specific figure). 37% of the other rows with at least one stay have no age-adjusted rate, mostly 1-4 stays in small counties, small groups and rare causes. A discharge is one inpatient stay in a non-federal acute-care hospital in Georgia, counted in the year the patient left (alive or dead), by the patient's county of residence: a person admitted twice counts twice, newborns' birth stays and deliveries are included, and stays of Georgia residents in other states' hospitals or in federal (VA and military) hospitals are not, so counties near another state's hospitals may look low. The counties next to Chattanooga, Tennessee show it most: all-cause crude rates per 100,000 in 2024 of Dade 458.4, Catoosa 1,159.2, Walker 2,062.4, against Georgia's 9,871.1 (our reading: their residents use Tennessee hospitals). OASIS's hospital data records no ethnicity before 2016 (every stay of earlier years is unknown ethnicity), so the race groups, which are built from race x ethnicity (hispanic of any race, the rest non-Hispanic), start in 2016; earlier years have all, male and female rows only. From 2016 some hospitals still record no ethnicity: 3.2% (2024) to 13.3% (2016) of Georgia's stays a year are race_unknown, almost all of unknown ethnicity, and in some counties far more (up to 86% of a county's stays in a year), so the race groups' counts and rates run low, unevenly by county and year; OASIS itself advises caution with Hispanic figures. Where race or ethnicity is unknown for more than 20% of a place-year's stays (race_unknown / all), the race groups' counts and rates for that place and year are NULL (our mask, OASIS's own 20% threshold for missing items): each group's count would miss its share of the unknowns, so its rate runs low and its trend follows the recording, not the group. The all, sex and race_unknown rows are kept, so the unknown share stays visible. It applies to 168 county-years (61 counties, never Georgia). A small race group's rates can also run implausibly high where hospital records and the Census estimates classify race differently: Rabun County's native_american crude rate in 2021 is 97,368.4 per 100,000 (37 stays among 38 residents), kept as published. race_unknown is our calculation, all minus the seven race groups (unknown ethnicity, or non-Hispanic of unknown race): a count with no population or rate. Causes are coded in ICD-9-CM until September 2015 and ICD-10-CM from October 2015, which breaks some causes' series (OASIS's reporting-issues page), 2015 mixing both: Georgia's hypertensive_heart_disease 937 in 2014 and 13,937 in 2017; hypertension 7,459 in 2014 and 2,843 in 2017; other_chronic_lower_respiratory_diseases 579 in 2014 and 4,114 in 2017; perinatal_infections 55 in 2014 and 425 in 2017; accidental_shooting 272 in 2014 and 719 in 2017; hypertensive_heart_and_chronic_kidney_disease 2,329 in 2014 and 19,789 in 2017; respiratory_distress_syndrome 190 in 2014 and 452 in 2017. lack_of_oxygen_to_the_fetus has no rows from 2016 (Georgia: 44 stays in 2014, 36 in 2015): OASIS defines it as P20-P21, codes ICD-10-CM does not have, so no stay can carry it (rows dropped, not served as zeros) and it has no series after 2015. emphysema moves with no documented cause (171 stays in 2017, 1,487 in 2023, 386 in 2025). Within a group the listed causes never overlap but need not add up to it: they do exactly only in endocrine_nutritional_and_metabolic_diseases, mental_and_behavioral_disorders, nervous_system_diseases, genitourinary_diseases; elsewhere the rest of the group is in no listed cause (heart failure in major_cardiovascular_diseases, for example). The 15 groups never overlap either, and 31% to 42% of Georgia's stays a year are in none of them, such as childbirth and newborns' birth stays (our reading: OASIS's list has no group for them). Washington County's stays nearly doubled for two years (3,117 in 2005, 6,050 in 2007, 5,949 in 2008, 3,448 in 2009), the highest all-cause rates of any county and year: kept as published, probably a reporting change (our reading). Pickens County's stays jump for one year (3,588 in 2012, 5,703 in 2013, 3,548 in 2014), and 12 small counties (Baker, Chattahoochee, Clay, McIntosh, Marion, Montgomery, Schley, Stewart, Talbot, Taylor, Twiggs and Webster) have 5,954 stays together in 2000 against 9,656 in 2001: both kept as published, probably reporting problems (our reading). On all rows, OASIS's rates of breast, cervical, uterine, ovarian, prostate and testicular cancer divide by the whole population, both sexes; the male and female rows divide by that sex's population. num_population is OASIS's own population (its population module) for the place, year and group, the denominator of every crude rate (num_discharges / num_population x 100,000 reproduces each published crude rate); the race groups' populations add to all, as do male and female. OASIS documents reporting gaps: external causes and falls undercounted in 2009 (mostly DeKalb, Fulton and Cobb residents aged 0-19); no 2012 data from Hart County Hospital (Hart and nearby counties low); and in 2013 Candler County's hospital did not report (Candler low, Bulloch, Evans, Emanuel and Tattnall slightly), with mental and behavioral disorders under-reported mainly for Clayton and Spalding residents (https://oasis.state.ga.us/dtt/content/KDIMorb.html). 2025, the newest year, was added to OASIS on 2026-09-03; OASIS marks no year provisional. Counties add up to Georgia, except race groups from 2016, whose counts are NULL in the county-years the race mask covers (Georgia's race rows count every county, so a race group's counties add up to less there). Not served: OASIS's deduplicated measures (people rather than stays or visits), its SES-vulnerability rows and payer 'rates' (each divides by the whole place's population; payer counts and shares are their own topic), age and education breakdowns, and the significance-flag and percent measures. tract_geoid is always NULL.