Transcript Utilization Rates

IDS Training Session – Utilization Rates
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Utilization Rates- Intro
• These reports can help in the process of
planning for new service lines or
equipment; should not be the only source,
however, for making decisions
• Can also be used to plan for physician
recruitment; again should not be the only
source of data for making decisions
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Goals
• Understanding Future Utilization
• Using Physician Office Visit reports
• Using ER Visit reports
• Understanding the Physician Supply /
Need reports
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Caveats
• Most of these reports use national or state
averages – may not apply with your local
area totally
• Other research would be needed to make
decisions regarding the subject matter of
these reports – don’t consider them the
one source for planning
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Caveats
• Data is age / sex adjusted only – other
factors to consider:
– Examples:
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Race
Insurance Coverage
Socio-economic factors
Managed care penetration
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Caveats
• Does not account for technology or
procedure changes
– Example: new equipment changes the way a
patient receives treatment
– Example: new procedure changes how a
patient uses your hospital
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Understanding Data Sources
• The source for most data is National
Ambulatory Medical Care Survey
(NAMCS) which is published by the
National Center for Health Statistics
• http://www.cdc.gov/nchs/products/ad.htm
• Updated annually
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Understanding Data Sources
• Population data is purchased from
Claritas, Inc.
– Updated yearly from the base census year
with projections based on magazine
subscriptions, surveys, etc.
– Provides projections for future years
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Future Utilization Report
• This report projects future utilization by
MHA Service Code
– MHA Service Codes are service lines defined by MHA based on MSDRG
– It is possible to change it to report on another field
• Calculates current use rates by age and
sex
• Applies use rates to the population
projections (from Claritas) to determine
future utilization
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Future Utilization Report
• As mentioned before, the report adjusts for
population changes by age and sex only
but does not account for changes in
medical technology or other factors
influencing hospital usage
• It may tend to overestimate future
utilization
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Future Utilization – Tab 1
• One time period report – does not have to
be limited to one quarter, or year, however
• Choose patient type – inpatient or
outpatient
• If saving as a custom report, input name
and description of report
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Future Utilization – Tab 2
• Choose field to report on
– This can be a case (drg, procedure,
diagnosis) or geographic (zip code, county)
field
– It is also possible to report on UDFs here
• Custom service line
• Custom service areas
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Future Utilization – Tab 3
• Choose case filter
– MS-DRG, PX, DX, or UDF based on a case
field
• Choose geographic filter
– County, Zip code, or UDF based on a
geographic field
• Choose sex and age category filter
– Male or Female
– Age Categories are defined in IDS
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Future Utilization – Tab 4
• Standard IDS output screen – it shows all
of the validation information on the right
side
• Choose Export type then Run an
Individual Report
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Future Utilization - Sample
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*Demo Data
Mapped Data
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*Demo Data
Physician Office Visits by Age / Sex
• The National Center for Health Statistics
(NCHS) publishes national use rates by
age and sex for physician office visits
• The use rates are based on the National
Ambulatory Medical Care Survey
(NAMCS)
• The NAMCS study includes visits to nonfederally employed physicians, excluding
specialties of anesthesiology, radiology
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and pathology
Physician Office Visits by Age / Sex
• The rates are merged with the population
data from Claritas, Inc. to create estimates
for the current year and projections for
future years
• The data are adjusted for age and sex
only! Many other factors may influence
use rates including race, insurance
coverage, socio-economic factors,
managed care penetration, etc.
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PO Visits by Age / Sex Tabs
• On Tab 1, select the year (one year only)
• On Tab 2, select the geographic field to
report on – zip code, county code, or
district council (regions of Michigan)
– UDF option not available
• Select how the data will be sorted
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PO Visits By Age / Sex Tabs
• On Tab 3, select the geographic filter and
the Sex / Age Categories similar to
previous report
– Two tabs within the tab, Geographic and Sex /
Age Categories
– UDFs can be used in filter statement for
geographic filter
• On Tab 4, select output settings, save as a
custom report if necessary
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PO Visits by Age / Sex Example
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*Demo Data
Physician Office Visits by Specialty
• The National Center for Health Statistics
publishes distribution rates for physician
office visits by specialty
• The rates are derived from the National
Ambulatory Medical Care Survey
(NAMCS)
• Report by Specialty
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Physician Office Visits by Specialty
• The number of visits by specialty is calculated by
first estimating the number of visits for a
geography by age and sex and then applying
the appropriate percentage for each specialty
• This report should be used with caution.
• Distributions in any given geography may be
influenced by many factors including availability
of specialists, socio-economic factors, insurance
coverage, etc.
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PO Visits by Specialty Tabs
• On Tab 1, select the year (one year only)
• On Tab 2, select the geographic field to
report on – zip code, county code, or
district council (regions of Michigan)
– UDF option not available
• Select how the data will be sorted
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PO Visits by Specialty Tabs
• On Tab 3, select the geographic filter and
the Specialties
– Two tabs within the tab, Geographic and
Specialties
– UDFs can be used in filter statement for
geographic filter
• On Tab 4, select output settings, save as a
custom report if necessary
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Sample Report
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*Demo Data
ER Visits Report
• The National Center for Health Statistics
(NCHS) publishes use rates by age and
sex for emergency department visits to
non-Federal, short stay and general
hospitals
• The use rates are merged with the
population data from Claritas to create
estimates for the current year and a fiveyear projection
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ER Visits Tabs
• On Tab 1, select the year (one year only)
• On Tab 2, select the geographic field to
report on – zip code, county code, or
district council (regions of Michigan)
– UDF option not available
• Select how the data will be sorted
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ER Visits Tabs
• On Tab 3, select the geographic filter and
the sex and age categories necessary
– Two tabs within the tab, Geographic and sex
and age categories
– UDFs can be used in filter statement for
geographic filter
• On Tab 4, select output settings, save as a
custom report if necessary
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ER Visits Sample
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*Demo Data
Physician Supply / Need by Geography
• Report shows Physician Requirement for
the given area
– Physician Requirement is then used to
calculate the Physician Need
• Physician Requirement is based on use
rates in the comparison geography
– State of Michigan is the default comparison
geography
– Ability to compare your region to other regions
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Supply / Need Tabs
• On Tab 1, select the year (one year only)
• On Tab 2, select the geographic field to
report on – zip code, county code, or
district council (regions of Michigan)
– UDFs are permitted
• Select how the data will be sorted
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Supply / Need Tabs
• On Tab 3, select the geographic filter and
the case filter if necessary
– Only case filters related to specialty, age, or
physician type available
– UDFs can be used in filter statement for
geographic filter
• Then select comparison geographic area –
this will be the area compared to your
geographic filter statement
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Supply / Need Tabs
• On Tab 4, select the output options
• Choose to save as a custom report if
necessary
• “By Specialty” report is similar except it
reports on specialty types, not
geographic fields
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Sample Report – By Geography
• Report compares Ingham county to the state
of Michigan
*Demo Data
Comparative Region is the state
of Michigan
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Sample Report – By Specialty
County compared to Michigan
*Demo Data
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Questions?
Michael Ovsenik
Client Representative
Chris Leong
Client Representative
IDS Client Support
[email protected]
517-886-8448 or 877-999-4653
Http://www.theidsonline.com