 Profile Compare
Estimated Patient Volumes
Patient volumes
are estimated using data from a hospital's most recent Medicare
Cost Report, Medicare inpatient claims data (MedPAR), and Medicare
outpatient claims data (OPPS). Estimates are rounded to
the nearest hundred.
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Inpatient
Surgeries
= MedicareSurgeries / (MedicareDischarges /
TotalDischarges) |
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where:
MedicareSurgeries =
number of Medicare inpatient claims for surgical DRGs (MedPAR)
MedicareDischarges =
total number of Medicare discharges per the hospital's
most recent cost report (W/S S-3, part 1, line 12,
column 13)
TotalDischarges =
total number of discharges (all payors) per the
hospital's most recent cost report (W/S S-3, part 1,
line 12, column 15)
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Outpatient
Surgeries
=
MedicareSurgeries / (MedicareDays / TotalDays) |
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where:
MedicareSurgeries =
number of Medicare outpatient claims with revenue code
360 or 361 (OPPS)
MedicareDays =
total Medicare patient days per the hospital's most
recent cost report (W/S S-3, part 1, line 5, column 4)
TotalDays =
total patient days (all payors) per the hospital's most
recent cost report (W/S S-3, part 1, line 5, column 6)
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Births
= NurseryDays / AvgLOS |
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where:
NurseryDays =
number of patient days for nursery per the hospital's
most recent cost report (W/S S-3, part 1, line 11,
column 6)
AvgLOS
=
national average length of stay for normal newborns (DRG 391) and prematurity without major problems (DRG 388) = 2.3*
*per
per AHRQ/HCUP statistics for year 2006.
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Outpatient
Claims
=
MedicareClaims / (MedicareDays / TotalDays) |
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where:
MedicareClaims =
total number of Medicare outpatient claims (OPPS)
MedicareDays =
total Medicare patient days per the hospital's most
recent cost report (W/S S-3, part 1, line 5, column 4)
TotalDays =
total patient days (all payors) per the hospital's most
recent cost report (W/S S-3, part 1, line 5, column 6)
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Emergency
Room Visits (not admitted)
= MedicareERClaims / (MedicareDays / TotalDays) |
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where:
MedicareERClaims =
total number of Medicare outpatient claims with revenue
code 45x (OPPS)
MedicareDays =
total Medicare patient days per the hospital's most
recent cost report (W/S S-3, part 1, line 5, column 4)
TotalDays =
total patient days (all payors) per the hospital's most
recent cost report (W/S S-3, part 1, line 5, column 6)
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Emergency
Room Visits (admitted)
= MedicareIPClaimsWithER / (MedicareDischarges /
TotalDischarges) |
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where:
MedicareIPClaimsWithER =
Number of Medicare inpatient claims with charges for
emergency services (MedPAR)
MedicareDischarges =
total number of Medicare discharges per the hospital's
most recent cost report (W/S S-3, part 1, line 12,
column 13)
TotalDischarges =
total number of discharges (all payors) per the
hospital's most recent cost report (W/S S-3, part 1,
line 12, column 15)
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