1. Has Payment, for AMI, to above National Average Hospitals, Increased?
Farrokh Alemi, Ph.D.

2. Download, Unzip, Rename Data
To H-YYYY-MM

3. Merge into Access in Order of Date1 2 4 3

4. Upload from File Names Indicated from Database for the Year

5. Ignore Tables with Same Time Periods
Only 3 unique time periods in 9 tables:
in HQI_HOSP_AMI_Payment
in HQI_HOSP_Payment
in HQI_HOSP_PaymentAndValueOfCare4

6. Join Tables on Provider & Measure ID

7. Select above Average Hospitals

8. Drop Hospitals Not Reporting
Remove Hospitals Not Reporting
Remove Hospitals Not Reporting
Remove Hospitals Not Reporting

9. Restrict to AMI 30 Day Measure
Select Measure Payment_30_AMI

10. Average Payment across Hospitals
Average = Total Payment / Number of Cases
Total Payment is Sum of Hospital Averages times Number of Cases
Paid :
CCur(Sum(CCur(CStr([HQI_HOSP_AMI_Payment]![payment])) * Int(CStr([HQI_HOSP_AMI_Payment]![denominator]))) / Sum(Int(CStr([HQI_HOSP_AMI_Payment]![denominator]))))
Divide by Sum of Cases across Hospitals
Ccur converts to currency from text
CStr converts to string from memo
Int converts to integer

11. Calculation for

12. Calculation for
SELECT Count(([HQI_HOSP_Payment]![Provider ID])) AS [Hospitals ]
, StDev(CCur(CStr([HQI_HOSP_Payment]![Payment]))) AS [StDev ]
, CCur(Sum(CCur(CStr([HQI_HOSP_Payment]![Payment]))* Int(CStr([HQI_HOSP_Payment]![denominator]))) / Sum(Int(CStr([HQI_HOSP_Payment]![denominator])))) AS [Paid ]
FROM HQI_HOSP_AMI_Payment INNER JOIN HQI_HOSP_Payment
ON (HQI_HOSP_AMI_Payment.[Measure ID] = HQI_HOSP_Payment.[Measure ID]) AND (HQI_HOSP_AMI_Payment.[Provider ID] = HQI_HOSP_Payment.[Provider ID])
WHERE (((HQI_HOSP_AMI_Payment.[Compared to National]) Like "*Greater*") AND ((HQI_HOSP_AMI_Payment.Denominator)<>"Not Available") AND ((HQI_HOSP_AMI_Payment.[Measure ID])="PAYM_30_AMI"));

13. Three Query Results Time Period Number of Hospitals Average Payment
Standard Deviation
382
$23,827.56
$24,168.80
381
$24,511.89

14. Calculate Control Limits
Time period
Number of Hospitals
382
381
Observed Average
$23,827.56
$24,168.80
$24,511.89
Standard Deviation
$1,052.52
$1,228.38
$1,353.20
Grand Average
$24,169.42
Upper Limit
$26,232.36
$26,577.05
$26,821.70
Lower Limit
$22,106.48
$21,761.79
$21,517.14
Standard Deviation calculated in SQL
Upper Limit =Grand Average * Standard Deviation
Lower Limit =Grand Average – 1.96 * Standard Deviation

15. Plot Control Chart

16. Payment to 381 hospitals that received above average hospital payments in period did not change in subsequent time periods
No change in AMI payments for hospitals that had initially received above national average payments