School of Health Sciences Week 7! Health Care Statistics Fundamentals of Health Information HI 140 Instructor: Alisa Hayes, MSA, RHIA, CCRC School of Health Sciences Week 7! Health Care Statistics 1

Class Reminders Contact Information AIM:AlisaCHayes Email: ahayes@kaplan.edu Office Hours By Appointment Chat conversations during class Please keep conversations focused on class. Type “pause” to comment and “?” to ask a question School of Health Science 2

Chapter 4 Census Inpatient census Number of inpatients present in a health care facility at any one time Census taking time Consistent time of day when all inpatient units count and report the number of patients on the unit (usually midnight) Admission, discharge, transfer are referred to as ADT IPSD – Inpatient Service Days DIPC – Average Daily Inpatient Census Inpatient census taking time is usually midnight (12:00 a.m.) Data used for planning, budgeting, staff Previously done manually Now census is computerized Number of inpatients present on a patient care unit at census taking time each day Plus any patients admitted after the previous census-taking time and discharged before the next census-taking time Unit of measure denoting services received by one inpatient during one 24-hour period Also referred to as: Patient day Inpatient day Census day Bed occupancy day Sum of all the inpatient service days for the period Period can be days, weeks, months, or years Included in the total inpatient service day calculations: Deaths are considered discharges Exception if the term live discharges is used Deaths must be added to the live discharges to get the number of inpatient discharges Not included in the total inpatient service day calculations: Fetal death Not alive at the time of delivery Dead on arrival (DOA) No signs of live at time brought to the hospital Outpatient death Outpatients are not included in inpatient statistics Counted and maintained separately School of Health Science 3

Chapter 4 Census Average daily inpatient census (or average daily census) Average number of inpatients present each day for a given period of time -Average represents days when both large and a low number of patients are serviced -Adults, children, and newborn are reported separately Average daily inpatient census formula includes: -Total inpatient service days for the period -Divided by total number of days in the period -Days in the period (month, semiannual, annual, leap year) -Calculate adults and children separate from newborn School of Health Science 4

Chapter 4 Census To calculate take census from day prior Add in Admissions Subtract Discharges Add in any transfers in Subtract any transfers out A&D on same day? Not included in census calculation, as this is the census number at census taking time School of Health Science 5

Chapter 4 Census Number of inpatients present on a patient care unit at census taking time each day, plus any patients admitted after the previous census-taking time and discharged before the next census-taking time IP Deaths are included in discharges – Fetal deaths, DOA’s and OP deaths are not Census from day prior + admissions – discharges + transfers in – transfers out + patients admitted and discharged on same day = DIPC Sum of all the inpatient service days for the period Period can be days, weeks, months, or years Calculation for a single day is the same as DIPC calculation – typically not looking at a single day though, so you need to look at entire period for which you’re calculating School of Health Science 6

Chapter 4 Census Jan 31: Census 456 Feb 1: Admissions 58 Discharges 45 DOA 3 Calculate: A) Census for February 1 B) IPSD total for February 1 C) DIPC for February 1 School of Health Science 7

Chapter 4 Census #10-(A) Answer – 469 Census on Jan 31 – 456 + 58 Admissions - 45 Discharges = 469 Census School of Health Science 8

Chapter 4 Census #10 (B) Answer – 475 Census on Jan 31 – 456 + 58 Admissions - 45 Discharges + 6 A&D’s = 475 School of Health Science 9

Chapter 4 Census #10 (B) Answer – 475 DIPC (Daily Inpatient Census) and IPSD (Inpatient Service Day) calculations are the same! School of Health Science 10

Chapter 5 Percent of Occupancy Bed Count – Number of Available Beds (both occupied and vacant) Bassinet Count – Number of Newborn Bassinets available (both occupied and vacant) A&C – Adults and Children NB – Newborn Occupancy Ratio – Number of beds occupied/Number of beds available Bassinet occupancy includes: Only newborns born in the hospital during that hospital admission Admitted to the units designated for newborns such as neonatal unit, or intensive care neonatal unit Does not include babies born en route or admitted after being born elsewhere Occupancy does not include beds in the: Emergency department treatment rooms Operating suite Observation 23-hour hold Outpatient procedure department Inpatient bed count day and inpatient bassinet count day Unit of measure denoting the presence of one inpatient bed/bassinet Set up and staffed for use during a 24-hour period Bed and bassinet may be occupied or vacant Inpatient bed count days (total) Sum of inpatient bed count days during the period Period can be days, months, semiannual, or annual Disaster beds Temporary beds not included in the bed count Occupancy ratio Percentage of available beds or bassinets being occupied on a specific day or a designated period of time Day/Month/Year Proportion of inpatient beds occupied Ratio of service days to inpatient bed count days for the period School of Health Science 11

Chapter 5 Percent of Occupancy Total IP Occupancy Percentage Total IPSD for a period Total IP bed count x number of days in period X 100 = Inpatient bed occupancy for period 50 bed hospital with 1410 IP service days for June – what was occupancy percentage? 1410/(50X30) X 100 = 94% Same applies to NB bassinets or specific unit occupancies – just need to adjust the numerator & denominator to reflect appropriate figures For long-term planning Need data for more than one day Applies to both inpatient and bassinet Formula: Total IP service days in a period  100/total bed count days in the period Bed count  number of days in the period When a permanent bed count changes for a period the number in the denominator also changes Total IP service days in a period  100/(Bed count  days) + (bed count  days) School of Health Science 12

Chapter 5 Percent of Occupancy Page 96, #5 Golden Valley Hospital A&C NB Ortho Bed/Bass Ct 80 10 12 March: Adm 105 57 47 Discharged 99 57 47 Deaths 5 1 2 IPSD 1,998 268 278 Bed (A&C) Occupancy Rate for March Bassinet (NB) Occupancy Rate for March Orthopedic Unit Occupancy Rate for March School of Health Science 13

Chapter 5 Percent of Occupancy Total IPSD for a period Total IP bed count x number of days in period X 100 = Inpatient bed occupancy for period 1998 80 X 31 X 100 = 80.56% School of Health Science 14

Chapter 5 Percent of Occupancy #5, B Total NB IP Service Days for the month Total NB Bassinet Ct X # of days in month X 100 268 10 X 31 86.45% School of Health Science 15

Chapter 5 Percent of Occupancy Total Ortho IP Service Days for the month Total Ortho Bed Ct X # of days in month X 100 278 12 X 31 74.73% School of Health Science 16

Chapter 6 Length of Stay/Discharge Days Discharge – termination of hospitalization – includes AMA & death Length of Stay (LOS) – number of calendar days from admission to discharge for a patient Discharge Days – same as LOS Length of stay and discharge days Manage utilization of services Discharge days Analyze and compare groups of patients by disease, treatment, age, procedures, provider Discharge Termination of hospitalization is written Death is a discharge Against medical advice (AMA) Patient leaves the hospital without a written order or approval to leave Calculated for each patient upon discharge Total number of days the patient was hospitalized and received services Calculate by subtracting the date of admission from the date of discharge Compiled at the time of discharge or death LOS Number of calendar days from admission to discharge for each individual inpatient Synonymous terms include: Days of service Duration of hospitalization Discharge days (DD) School of Health Science 17

Chapter 6 Length of Stay/Discharge Days A&D on same day? 1 day LOS Admitted 1 day, d/c the next? 1 day LOS Anything longer – count the day of admission and all subsequent days except the day of discharge Remember your # of days in month – 30 days hath September, April, June & November, all the rest have 31 (except February…) Count each day of an inpatient stay except the day of discharge Long length of stays can include many months Remember number of days in a month to calculate long LOS School of Health Science 18

Chapter 6 Length of Stay/Discharge Days Admitted on December 1st Discharged on December 13th What is LOS?? 12 days Count December 1 – 12, do not count 12/13 School of Health Science 19

Chapter 6 Length of Stay/Discharge Days Sum of the days of stay of all inpatients, or a group of patients Discharged during a specified period of time such as a date, week, month, or year Synonymous term Discharge days Average Length of Stay (ALOS) Average length of hospitalization of a group of inpatients discharged during a period of time such as a date, week, month, or year Most common use of discharge days is in determining the average length of stay Compute adults and children separate from newborn Formula for adults and children: Total LOS (discharge days)/total discharges Formula for newborn: Total NB length of stay (discharge days)/total newborn discharges School of Health Science 20

Chapter 6 Length of Stay/Discharge Days Total Length of Stay (A&C) Total Discharges Hospital had total of 700 discharges in March, with 3,500 discharge days, what is Average LOS? 3500/700 = 5 – Average LOS was 5 days Compute adults and children separate from newborn Formula for adults and children: Total LOS (discharge days)/total discharges Formula for newborn: Total NB length of stay (discharge days)/total newborn discharges School of Health Science 21

Chapter 6 Length of Stay/Discharge Days Example: Page 113-114 #9 Healthful Hospital (April) A&C NB Bed/Bassinet Ct 180 15 Adm 905 88 Disch 895 86 IPSD 4820 339 Discharge Days 4785 330 ALOS for A&C ALOS for NB *(R5) % of occupancy for A&C *(R5) % of occupancy for NB School of Health Science 22

Chapter 6 Length of Stay/Discharge Days #9, A Total Length of Stay (A&C) Total Discharges 4785 895 =5.35 Days – ALOS for A&C #9, B Total Newborn LOS (discharge days) Total Newborn Discharges 330 86 =3.84 days – ALOS for NB School of Health Science 23

Chapter 6 Length of Stay/Discharge Days #9, A Total IPSD for a period Total IP bed count x number of days in period X 100 = Inpatient bed occupancy for period 4820 180 X 30 X 100 =89.26% #9, B Total NB IP Service Days for the month Total NB Bassinet Ct X # of days in month 339 15 X 30 =75.33% School of Health Science 24

Current Week 6/29/11-7/5/11 Read Chapters 4, 5 & 6 in statistics textbook Participate in Discussion Participate in Seminar Complete practice tests Take Unit 7 Quiz complete the self-tests and the chapter tests for each chapter. These are not graded; however, you will have a much better understanding of the material and the formulas if you complete them. The answers are found in the back of your book. Try not to look at the answers until you have attempted the problems on your own You should practice the computation of the formulas before taking the Unit Quiz. twenty multiple-choice, true-false and/or short answer questions. You will have one hour for the quiz, and can take this quiz ONCE. School of Health Science 25

Next Week 7/6/11-7/12/11 Read Chapters 8 & 10 in statistics textbook Participate in Discussion Participate in Seminar Complete practice tests Take Unit 8 Quiz School of Health Science 26

Any questions?? School of Health Science 27