Medicaid Chronic Condition Inpatient Admission ER Visit Zip Code

$179 / year

Medicaid is a state and federal program that provides health coverage for people having a very low income. The dataset contains information on selected chronic health conditions in the Medicaid population at the zip code level.


The chronic health conditions were identified through 3M Clinical Risk Group software and Medicaid enrollment/eligibility, encounter, claim and pharmacy data over a 12 month period. The chronic conditions are categorized into ‘Major diagnostic category’ and ‘Episode disease category’. The chronic health categories represented in the data file are Diabetes Mellitus, Diseases and Disorders of the Cardiovascular System, Diseases and Disorders of the Respiratory System, HIV Infection, Mental Diseases and Disorders, Newborn and Neonates and Substance Abuse. All conditions that have 20 or less unique beneficiaries are suppressed from this data file. Beneficiaries enrolled in both Medicare and Medicaid are known as “dual eligibles.” Medicare beneficiaries were classified as dual eligibles if in any month in the given calendar year they were receiving full or partial Medicaid benefits.
– ##### Major Diagnostic Category Description
– Diabetes Mellitus
– Diseases And Disorders Of The Cardiovascular System
– Diseases And Disorders Of The Respiratory System
– HIV Infection
– Mental Diseases And Disorders
– Newborns And Other Neonates
– Substance Abuse

– ##### Episode Disease Category Description
– Diabetes
– Diabetes – Juvenile Onset
– Diabetes with Circulatory Complication
– Diabetic Coma
– Diabetic Ketoacidosis
– Diabetic Nephropathy
– Diabetic Neuropathy
– Diabetic Retinopathy
– Other Diabetic Complications
– Angina and Ischemic Heart Disease
– Atrial Fibrillation
– Cardiac Device Status
– Cardiac Dysrhythmia and Conduction Disorders
– Cardiomyopathy
– Chronic Cardiovascular Diagnoses – Minor
– Complex Cyanotic and Major Cardiac Septal Anomalies
– Congestive Heart Failure
– Coronary Atherosclerosis
– Coronary Graft Atherosclerosis
– Defibrillator Status
– History of Coronary Artery Bypass Graft
– History of Myocardial Infarction
– History of Percutaneous Transluminal Coronary Angioplasty
– Hypertension
– Malfunction Coronary Bypass Graft
– Malignant and Other Significant Hypertension
– Mechanical Complication of Cardiac Devices, Implants and Grafts
– Other Cardiovascular Diagnoses – Major
– Other Major Congenital Heart Diagnoses Except Valvular
– Pulmonary Hypertension
– Unstable Angina
– Valvular Disorders
– Ventricular and Atrial Septal Defects
– Asthma
– Chronic Bronchitis
– Chronic Obstructive Pulmonary Disease and Bronchiectasis
– Major Respiratory Anomalies
– Other Chronic Pulmonary Diagnoses
– Other Major Chronic Pulmonary Diagnoses
– Status Asthmaticus
– Tracheostomy Status
– HIV Disease
– Attention Deficit / Hyperactivity Disorder
– Bi-Polar Disorder
– Bi-Polar Disorder – Severe
– Chronic Mental Health Diagnoses – Minor
– Chronic Mental Health Diagnoses – Moderate
– Chronic Stress and Anxiety Diagnoses
– Conduct Disorder – Severe
– Conduct, Impulse Control, and Other Disruptive Behavior
– Disorders
– Depression
– Depressive and Other Psychoses
– Depressive Psychosis – Severe
– Eating Disorder
– Major Personality Disorders
– Post Traumatic Stress Disorder
– Schizophrenia
– Schizophrenia – Catatonia
– Schizophrenia – Exacerbation
– Extreme Prematurity – Birthweight NOS
– Prematurity – Birthweight < 1000 Grams
– Prematurity – Birthweight < 750 Grams
– Prematurity – Birthweight 750 – 999 Grams
– Alcoholic Polyneuropathy
– Chronic Alcohol Abuse
– Cocaine Abuse
– Cocaine Abuse – Continuous
– Delirium Tremens
– Drug Abuse – Cannabis/NOS/NEC
– Drug Abuse Related Diagnoses
– Opioid Abuse
– Opioid Abuse – Continuous
– Other Significant Drug Abuse
– Other Significant Drug Abuse – Continuous

Date Created


Last Modified




Update Frequency


Temporal Coverage


Spatial Coverage

State of New York


John Snow Labs;;

Source License URL

Source License Requirements


Source Citation



Chronic Health, Medicaid Health Coverage, 3M Clinical Risk Group, Medicaid Enrollments, Medicaid Eligibility, Chronic Health Categories

Other Titles

Chronic Conditions Prevention Quality Indicators, Medicaid Chronic Conditions Inpatient Admissions and Emergency Room Visits, OR Procedures Medicaid Chronic Conditions Inpatient Admissions and Emergency Room Visits by Zip Code, Hospital Management Inpatient Admissions Readmissions and Emergency Room Visits by Zip Code, Medicaid Chronic Conditions Inpatient Admissions and Emergency Room Visits by Zip Code

YearYear of datadate-
Zip_CodeThe New York State county Zip Codeintegerlevel : Nominal
CountyThe county where the majority of the zip code resides, if the zip code crosses more than one countystring-
Is_Dual_EligibleThe classification of either dually eligible for Medicaid and Medicare (“Dual”) or not dually eligible (“Non-Dual”)boolean-
Major_Diagnostic_CategoryThe 3M Clinical Risk Group chronic health Major Diagnostic Category (MDC) Descriptionstring-
Episode_Disease_CategoryThe 3M Clinical Risk Group chronic health Episode Disease. Category (EDC) Descriptionstring-
Beneficiaries_with_ConditionThe number of Medicaid beneficiaries that meet the MDC and EDC classification criteria. All condition categories 20 or fewer recipients have been suppressed from reportingnumberlevel : Ratio
Beneficiaries_with_AdmissionsThe unique number of Medicaid beneficiaries that meet the Zip Code, County, Dual Status, MDC and EDC classification that had one or more inpatient admissions (for any reason, including newborn and maternity)numberlevel : Ratio
Total_Inpatient_AdmissionsThe total number of inpatient admissions for beneficiaries meeting the Zip Code, County, Dual Status, MDC and EDC classificationnumberlevel : Ratio
Beneficiaries_with_ER_VisitsThe unique number of Medicaid beneficiaries that meet the Zip Code, County, Dual Status, MDC and EDC classification that had one or more Emergency Room (ER) visits (for any reason)numberlevel : Ratio
Total_ER_VisitsThe total number of ER visits for beneficiaries meeting the Zip Code, County, Dual Status, MDC and EDC classificationnumberlevel : Ratio
201211209KingstrueHIV InfectionHIV Disease245548
201211230KingstrueHIV InfectionHIV Disease265636
201211234KingstrueHIV InfectionHIV Disease235538
201214001ErietrueDiabetes MellitusDiabetes298959
201214031ErietrueDiabetes MellitusDiabetes285545
201214051ErietrueDiabetes MellitusDiabetes246647
201310474BronxtrueHIV InfectionHIV Disease214522
201311229KingstrueHIV InfectionHIV Disease214423
201414004ErietrueDiabetes MellitusDiabetes216922
201311235KingstrueHIV InfectionHIV Disease254544