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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.
| 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)
|
| 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.
|
| 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)
|
| 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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