Statistics
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| Daily Inpatient Census | Total number of patients treated during a 24 hour period.
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| Inpatient Service Day | Services received by one inpatient in 24 hour period.
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| Total Inpatient Service Days | Sum of all inpatient service days for each of the days in the period.
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| FORMULA: Average Daily Census | Total inpatient service days (excluding newborns)/ Total number of days in the period.
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| Length of Stay | Number of calendar days from admission to discharge.
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| Total length of stay | Sum of the days stay of any group of inpatients discharged during specific period of time.
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| FORMULA: Average LOS | Total length of stay (discharge days) / Total number of discharges.
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| Inpatient bed count | Number of available hospital beds, both occupied and vacant, on any given day.
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| Inpatient Bed count day | Counts the presence of one ipatient bed (occupied or vacant)that is set up and staffed for use in one 24 hour period.
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| Total inpatient bed count day. | Sum of inpatient bed count days for each of the days in a period.
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| FORMULA: Percentage of occupancy | Total number of inpatient service days for a period (x 100) / total inpatient bed count days (x) number of days in the period.
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| FORMULA: Direct bed turnover rate | total number of discharges for a period / average bed count for the same period.
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| FORMULA: indirect formula bed turnover rate | Percentage of occupancy (x) days in the period (x 100) / average length of stay. Note: Used when the bed count changes during the period in question.
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| FORMULA: Anesthesia death rate | Total number of deaths caused by an anesthetic agent (x 100) / total number of anesthetics administered.
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| FORMULA: Fetal Death Rate (Still birth) | Total number of intermediate and lat fetal deaths (x 100) / total number of births (and) intermediate and late fetal deaths.
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| FORMULA: Gross hospital death rate | Total number of inpatient deaths (including newborns) (x 100) / total number of discharges (including deaths & newborns)
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| FORMULA: Net Hospital Death Rate | Number of inpatient deaths (including NB) minus deaths < 48 hours of admission (x 100) / total discharges (including deaths & newborns) minus deaths < 48 hours
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| FORMULA: Maternal Death Rate | Total number of maternal deaths for a period (x 100) total number of obstetrical discharges.
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| FORMULA: Neonatal Death Rate (infant mortality rate) | Total number of newborn deaths for a period (x 100) / total number of newborn discharges.
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| FORMULA: Post - operative death rate | number of deaths within 10 days of surgery (x 100) / total number of patients operated on.
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| FORMULA: Newborn Autopsy | Number of autopsies on NB deaths (x 100) / Total number of NB deaths.
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| FORMULA: Fetal autopsy rate | Number of autopsies on intermediate & late fetal deaths (x 100) / total number of intermediate and late fetal deaths.
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| FORMULA: Gross Autopsy Rate | Total inpatient autopsies for a period (x 100) / total inpatient deaths for the period.
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| FORMULA: Net autopsy rate | Total inpatient autopsies for a period (x 100) / total inpatient deaths (minus) unautopsied coroner's or medical examiner's cases for the period.
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| FORMULA: Hospital Autopsy rate (adjusted) | Total hospital autopsies (x 100) /Number of deaths of hospital patients whose bodies are available for hospital autopsy.
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| FORMULA: Total Hospital (morbidity) infection rate | Total number of hospital infection (x 100)/ total number of discharges.
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| FORMULA: Nosocomial infection rate | Number of hospital acquired infections ( x 100) / total number of discharges (including deaths)
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| FORMULA: Community acquired infection rate | Number of community-acquired infections (x 100) / total number of discharges.
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| FORMULA: Post-operative infection rate | Number of post-operative infections for a period (within 10 days postop) (x 100) / total number of operations performed.
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| FORMULA: Cesarean section rate | Total number of Cesarean sections performed in a period (x 100) / total number of deliveries in a period.
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| FORMULA: Consultation rate | total number of consultations for a period (x 100) / total number of discharges for the period.
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| FORMULA: Delinquent medical record rate | total number of delinquent records (x 100) / average number of discharges during a completion period.
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| FORMULA: Incomplete medical record rate | Total number of incomplete records (x 100) / total number of discharges during the completion period.
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| FORMULA: Percentage of medicare patients | Total number of Medicare discharges (x 100) / total number of adult and children discharges.
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| FORMULA: Percentage of Medicare discharge days | Total number of Medicare discharge days (x 100) / total number of discharge days for adults and children.
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| FORMULA: Admission rate | Number of re-admissions for a period (x 100) / number of total admissions (including re-admissions).
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| Mean | Add all the available values and divide the sum by the total number of values.
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| Median | The midpoint of a series of numbers.
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| Mode | The number that occurs the most in a series.
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| Client | A person who receives professional services; a patient in a behavioral health setting, adult care.
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| Resident | A patient who resides in a long-term care facility.
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| American College of Surgeons | developed a system of hospital standardization that would improve patient care and recognize hospitals that had the highest ideals.
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| Hill-Burton | Provided funding for the construction of hospitals and other healthcare facilities based on state need.
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| 1965 - Title XVIII | Social Security Act of 1935
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| Americal Medical Association (AMA) | Founded for the pursose of improving the quality of medical education and the ethics of practicing medicine.
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| American Hospital Association (AHA) | Founded for the purpose of promoting public welfare by providing improved health care in hospitals.
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| Flexner Report | Revealed serious problems that existed in medical education. It served as an impetus to establishing the accreditation of medical schools by the AMA.
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| American College of Surgeons (ACS) | Founded for the purposes of establishing standards of care and recognizing hospitals that have high ideals. Adopted the m
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| FORMULA: Total Hospital (morbidity) infection rate | Total number of hospital infection (x 100)/ total number of discharges.
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| FORMULA: Nosocomial infection rate | Number of hospital acquired infections ( x 100) / total number of discharges (including deaths)
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| FORMULA: Community acquired infection rate | Number of community-acquired infections (x 100) / total number of discharges.
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| FORMULA: Post-operative infection rate | Number of post-operative infections for a period (within 10 days postop) (x 100) / total number of operations performed.
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| FORMULA: Cesarean section rate | Total number of Cesarean sections performed in a period (x 100) / total number of deliveries in a period.
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| FORMULA: Consultation rate | total number of consultations for a period (x 100) / total number of discharges for the period.
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| FORMULA: Delinquent medical record rate | total number of delinquent records (x 100) / average number of discharges during a completion period.
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| FORMULA: Incomplete medical record rate | Total number of incomplete records (x 100) / total number of discharges during the completion period.
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| FORMULA: Percentage of medicare patients | Total number of Medicare discharges (x 100) / total number of adult and children discharges.
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| FORMULA: Percentage of Medicare discharge days | Total number of Medicare discharge days (x 100) / total number of discharge days for adults and children.
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| FORMULA: Admission rate | Number of re-admissions for a period (x 100) / number of total admissions (including re-admissions).
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| Mean | Add all the available values and divide the sum by the total number of values.
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| Median | The midpoint of a series of numbers.
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| Mode | The number that occurs the most in a series.
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| Client | A person who receives professional services; a patient in a behavioral health setting, adult care.
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| Resident | A patient who resides in a long-term care facility.
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| American College of Surgeons | developed a system of hospital standardization that would improve patient care and recognize hospitals that had the highest ideals.
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| Hill-Burton | Provided funding for the construction of hospitals and other healthcare facilities based on state need.
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| 1965 - Title XVIII | Social Security Act of 1935
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| Americal Medical Association (AMA) | Founded for the pursose of improving the quality of medical education and the ethics of practicing medicine.
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| American Hospital Association (AHA) | Founded for the purpose of promoting public welfare by providing improved health care in hospitals.
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| Flexner Report | Revealed serious problems that existed in medical education. It served as an impetus to establishing the accreditation of medical schools by the AMA.
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| American College of Surgeons (ACS) | Founded for the purposes of establishing standards of care and recognizing hospitals that have high ideals. Adopted the minimum standards which identified factors that are essential to proper care.
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| Hill - Burton | Provided funding for the Contstruction of healthcare facilities and equipment basedon state need.
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| Joint Commission (TJC) | Adopted the Hospital standardization program from the ACS.
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| OSHA | which mandated that employers provide a safe and healthy work environment
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| TEFRA | Established a mechanism for controlling the cost of the Medicare program.
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| COBRA | Antidumping statute, established criteria for the transfer and discharge of Medicare and Medicaid patients.
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| Patient Self-Determination Act | Increased the public's awareness of state laws governing patient options and rights and advancement directives.
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| HIPAA | improving access, affordability and adequacy of health insurance, established fraud and abuse detection program for health plans.
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| Agency for Healthcare Reasearch and Quality (AHRQ) | Primary focus is to produce and disseminate scientific and policy-relevant information that improves the quality, reduces the cost, and enhances the effectiveness of healthcare.
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| Center for Disease Control and Prevention | concerned with communicable diseases, environmental health, and foreign quarantine.
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| National Institutes of Health | A major research center composed of numerous departments and divisions. It is a major source of funding for health-related research.
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| Health Care Financing Administration (HCFA) | Responsible for the Medicare program and the federal government's role in the Medicare programs.
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| Licensure | gives legal approval for a facility to operate or for a person to practice within his or her profession.
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| Accreditation | The process by which an organization or agency performs an external review and grants recognization to a program of study or institution that meets certain predetermined standards.
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| Joint Commission | Establishes guidelines and standards for the operation and management of health care facilties with emphasis on healthcare functions crucial to patient care.
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| CARF - Commission on Accreditation of Rehabilitation Facilities | Independent accrediting agency for rehabilitation facilities.
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| NCQA - National Committee for Quality Assurance | independent accrediting agency for Managed Care Organizations.
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| HEDIS | Standardized set of performance measures designed to allow purchasers and consumers to compare the performance of managed care plans.
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| AMA | Involved in the accrediation of medical schools, residency programs and certain allied health programs.
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| Ambulator care | is the comprehensive term for al ltypes of health care provided in an outpatient setting, the patient travels to and from the facility on the same day and is not hospitalized.
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| Short-term | less than 30 days.
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| Long-term | 30 or more days.
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| Governing body | the board of trustees, board of governor or board of directors, is a group of individuals who have the ultimate legal authority and responsibility for the operation of the hospital including quality and cost of care.
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| CEO | Hospital administrator or President, selected by the governing board. Liaison between the governing board and the medical staff.
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| COO | Executive vice president who report directly to the CEO.
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| CIO | primary responsibility for information resources management in the organization.
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| CFO | Chief Financial Officer.
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| Medical Staff | Staff of licensed physicians. Governed by its own bylaws which must be approved by the governing board. The primary responsibility of the medical staff is the quality of the professional services provided by the members with clinical privileges.
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| Retrospective payment system | payment method in which the cost to provide the healthcare is figured after the healthcare was provided and based on the provider's statement of cost.
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| Fee-for-service | payment method in which the cost is based on the provider's estimate of the cost for services rendered.
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| TEFRA | set a limit on reimbursement for Medicare and required the development of a prospective payment system for Medicare reimbursement.
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| Prospective payment system | payment method in which the amount of payment is fixed in advance of services rendered; the rate is established annually by HCFA.
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| RBRVS | Reimbursement for physician services.
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| Title XIX | Medicaid
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| Title XVIII | Medicare
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| Medicare, part A | helps to pay for inpatient hospital care, inpatient care in nursing facility, home health care, hospice.
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| Medicare, part B | Voluntary insurance designed to supplement the cost of inpatient and outpatient care that is not covered under part A.
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| Fiscal intermediary | an organization that has contracted to manage the processing of claims and payments to the providers for Medicare Part A.
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| Managed Care | a health care system that is designed to minimize unnecessary utilization of services and contain costs while ensuring that a high quality of care is maintained.
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| Medicare reimbursement | Terms are set by each state.
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| Case management | an aspect of health care that refers to all activities including assessment, treatment planning, referral, and follow-up.
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| Prospective review | review of healthcare services PRIOR TO to the provision of those services.
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| Concurrent review | monitoring a patient's length of stay from the time of admission to discharge.
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| Retrospective review | Review of the utilization of health care services AFTER the services were provided.
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| EXAMPLE: Gross Death Rate | Anywhere Health Care Facility shows 752 discharges (including deaths) for October 1995. 12 deaths were also shown: 12(x100)/ 752 = 1.60%
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| EXAMPLE: Net Death Rate | Inpatients deaths at Anywhere Hospital for 1995 totaled 50. Less than 48 hours totaled 15. Total discharges (including deaths) 15,546. (50-15)(x100) / 15,546-15) = 0.23
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| FORMULA: Gross death Rate | total # of deaths (x 100) / # of Discharges (incl. deaths)
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| FORMULA: Net death rate | Total Inpatient deaths - (deaths <48 hour) / total discharges (inc. deaths) - (deaths < 48 hours)
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| FORMULA: Anesthesia Death rate | Total # of anesthesia deaths in a period (x 100) / # of anesthestics administered
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| FORMULA: Post operative death rate | Total deaths (w/i 10 days of surgery) (x 100) / Total # of patients receiving surgery.
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| FORMULA: Maternal death rate | Total number of obstetric deaths (x 100) / total # of discharges of obstetric patients (incl deaths)
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| FORMULA: Sandy Beach Hospital reports 1652 discharges for September. The infection control reports 21 nosocomial infections and 27 community acquired infection. What is the community acquired infection rate? | Formula; 27 x 100/ 1652
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| Physicians are expected to see six patients per hour on average. The physicians with the highest productivity are exempt from on-call. Which physician will get the weekend off this week? | Saw 185 patients during 32 hour week: 185/32Saw 161 patients during 30 hour week: 161/30Saw 200 patients during 35 hour week: 200/35Saw 157 patients during 26 hour week: 157/26Answer: 157/26
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| If there are 150,000 medical records and the Health Information Dept. receives 3545 requests for records, what percentage are requested weekly. | Formula: 3545 x 100/ 150,000.
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| What type of data is this: | 01, none, 02, little to none, 03, Moderate, 04, Heavy, 05 Severe. This is ordinal,
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| You have collected the following information. You want to stay within the reimbursement rate by your company. You must not spend more than $10.00. | Bon appetite ($8.00 with 0.75 standard deviation. Example: Standard deviation x 2 = $1.50) $8.00 - 1.50 = $6.50/ $8.00 + 1.50 = $9.50
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| Organizations collect statistics to increase their knowledge of a specified population. The knowledge doesn't come automatically. It is developed in the following sequence: | data -> information -> facts -> knowledge
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| Interrater reliability: | Bayside coders recode records from the previous week in an effort to improve and monitor coding consistency.
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| Which coder has the best overall accuracy? | Coder A: (28), 22 (x100)/(28),20(x100)/(28)Coder B: (18) 16 (x100)/28;16 (x100)/ 28Coder C: (45) 42 (x100)/45; 43 (x100/45 Coder D: (17) 15 (x100/ 17 ; 16 (x100)/ 17;Answer: C
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| Phyllis saw Dr. Holland at an office visit. Jean called Dr. Holland with a question. He returned the call. Howard was seen by Dr. Holland in ER. The prescription was authorized by Dr. Horton for Jackson. Which of these is an encounter? | Phyllis and Howard had patient encounters.
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| Male - 1Female - 2what type of data is this? | Nominal data
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| Measure of central tendency: | Mean, Median, Mode.
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| Mean | Most common measure because it can be used for variances and standard deviations. Add up all the values and divide by the total number of items.
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| Mean | 6+4+2+5+20+25+18+4 = 84 84 / 8 = 10.5 days
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| Median | 1, 8, 6, 4, 2, 5, 9 rearrange in order: 1,2,4,5,6,8,9
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| Median (with even numbers) | 16,4,21,100,7,1 rearrange in order: 1,4,7,16,21,100 (7+16) / 2
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| Mode | The value that occurs most often in the sequence: 1,2,2,7,7,6,5,2,7,3,7
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| UHDDS | Uniform hospital discharge data set
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| MDS | Long term care.
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| WHO | Developed ICD systems.
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| DEEDS | for Emergency Departments (data elements/ uniform collection)
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| UACDS | Uniform Ambulatory Data Set
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Created by:
arlindsey