Hospital Data: Collection Methods And Their Impact

Hospital statistics are an important tool for improving the quality, safety, and sustainability of healthcare systems. They are collected from various sources, including public and private data, such as Medicare claims, hospital cost reports, and commercial licensors. Hospitals also conduct their own surveys and track internal data on quality measures, patient satisfaction, revenue, and safety issues. This internal data includes statistics on patient falls, mortality rates, and hospital-acquired infections, which are also monitored by external organizations like the Centers for Disease Control and Prevention (CDC). The American Hospital Association (AHA) is another key contributor, providing annual surveys and data on hospitals in the United States, including the number of hospitals, hospital beds, and government hospitals. With the growing availability of electronic data systems, hospitals are increasingly able to utilize data to identify areas of improvement and make informed decisions to enhance patient care and overall hospital management.

Patient census statistics

The patient census has a direct impact on a hospital's financial resources, nursing staff satisfaction, patient care outcomes, and patient satisfaction. Striking a balance between staffing levels and patient census is essential for hospital administrators. Understaffing can lead to adverse health outcomes and dissatisfied staff, while overstaffing results in inefficient resource utilization and staff dissatisfaction.

Healthcare facilities face the challenge of determining appropriate staffing levels without knowing the precise number of patients they will treat daily. This unpredictability arises from various factors influencing the patient census, such as the threshold for hospitalization and the complexity of patient cases. Consequently, hospitals analyze patient census data to identify trends and make informed decisions. Some facilities calculate patient census daily or even hourly, while others use historical data to predict future census levels.

The "appropriate" patient census remains a subject of debate among healthcare professionals. While some advocate for higher numbers, others suggest that a lower census improves care delivery. A survey of hospitalists revealed that they saw approximately 15 patients per shift or day, excluding nights, weekends, and holidays. However, most hospitalists feel overburdened by the patient census, leading to suggestions of utilizing NPs or PAs for specific tasks.

A low patient census can lead to overstaffing, resulting in canceled shifts and financial implications for clinicians. Conversely, a high patient census can overwhelm staff, potentially compromising patient care and increasing inpatient mortality risk. Therefore, patient census statistics are vital for hospitals to manage their resources effectively and provide quality patient care.

Quality measures

Hospital statistics are collected from a variety of sources, including individual hospitals, hospital associations, state and regional data organizations, health planning organizations, and federal agencies. These data are used to create quality measures that assess and compare the quality of healthcare organizations. Quality measures are classified as either structural, process, or outcome measures.

Structural measures give consumers an understanding of a hospital's capacity, systems, and processes to provide high-quality care. Examples include the number of beds and types of services available, accreditation status, and the use of electronic medical records or prescription ordering systems.

Process measures inform consumers about the medical care they can expect to receive and contribute to improving health outcomes. They reflect generally accepted clinical practices and recommendations. Examples include the percentage of people receiving preventive services such as immunizations or mammograms, and the use of electronic systems for entering medication orders.

Outcome measures reflect the impact of healthcare services or interventions on patient health status. They represent a "gold standard" in measuring quality, but it's important to consider that outcomes are influenced by numerous factors beyond providers' control. Examples include patient mortality rates by type of condition or procedure and the rate of surgical complications or hospital-acquired infections.

Hospital quality databases such as the Healthcare Cost and Utilization Project (HCUP) and Medicare Provider Analysis and Review (MEDPAR) are valuable sources for assessing hospital quality. HCUP, sponsored by the Agency for Healthcare Research and Quality (AHRQ), offers the largest collection of longitudinal hospital care data in the United States, including all-payer, encounter-level information dating back to 1988. MEDPAR, on the other hand, contains data on claims for services provided to beneficiaries admitted to Medicare-certified inpatient hospitals and skilled nursing facilities.

Point-of-service cash collections

Point-of-service (POS) cash collections refer to the process of collecting patient payments at the time of service. This includes any co-pays, deductibles, or other out-of-pocket expenses that the patient is responsible for paying. Healthcare organisations collect these payments upfront to improve their cash flow, reduce bad debt, and increase patient satisfaction.

The industry-standard benchmark for POS collections is 35%, and organisations can implement effective patient payment policies and procedures to achieve this benchmark. This includes providing clear and transparent cost estimates, offering payment plans, and accepting multiple payment methods. Staff should also be trained to communicate effectively with patients about their financial responsibilities and to collect payments respectfully.

To improve their POS collections performance, healthcare organisations can use revenue cycle software, which streamlines the payment process and provides patients with a clear understanding of their financial responsibility upfront. This software can automate the payment process, verify insurance eligibility, and provide a breakdown of a patient's financial responsibility, improving efficiency and reducing errors.

According to the Healthcare Financial Management Association's 2014 applications, point-of-service collections were as high as 39% for individual providers and 27% for large hospital systems. This reflected an increase from the previous year, indicating that hospitals are placing more emphasis on collecting payments at the point of service.

To optimise their POS collections, organisations can also implement pre-payment policies, such as reaching out to patients via phone before their appointment to provide a cost estimate and request payment. Automated messaging systems can also remind patients about their upcoming service and their agreed-upon payments. These practices improve patient collections efforts and contribute to long-term financial wellness.

Hospital-acquired infections

In the United States, hospital statistics are collected by the American Hospital Association (AHA) and the American Hospital Directory (AHD), among other organisations. The AHA provides annual surveys of hospitals in the US, including data on the number of government hospitals, the number of hospitals in each state, and the number of hospital beds. The AHD, on the other hand, provides data and analytics on over 7,000 hospitals nationwide, derived from both public and private sources such as Medicare claims data, hospital cost reports, and commercial licensors.

The CDC's HAI surveillance systems, including the NHSN and the Emerging Infections Program Healthcare-Associated Infections – Community Interface (EIP HAIC), provide valuable insights into the prevalence of HAIs. According to the CDC, on any given day, about one in 31 hospital patients has at least one healthcare-associated infection. The 2023 National and State HAI Progress Report highlighted specific types of infections, such as central line-associated bloodstream infections (CLABSIs), catheter-associated urinary tract infections (CAUTIs), ventilator-associated events (VAEs), surgical site infections (SSIs), and methicillin-resistant Staphylococcus aureus (MRSA) bloodstream infections.

In addition to the CDC's efforts, other federal agencies contribute to HAI data collection and prevention. These include the Centers for Medicare and Medicaid Services (CMS) and the Agency for Healthcare Research and Quality (AHRQ). Furthermore, the Antibiotic Resistance & Patient Safety Portal (AR&PSP) offers enhanced data visualisation tools for understanding HAI data, allowing for more informed decision-making and targeted prevention initiatives.

The progress in reducing HAIs is evident, with the CDC reporting significant decreases in specific types of infections between 2022 and 2023. For instance, there was a 16% decrease in MRSA infections, a 13% decrease in CLABSI, and an 11% decrease in CAUTI in acute care hospitals. However, there was an 8% increase in surgical site infections (SSIs) following abdominal hysterectomy, underscoring the ongoing challenges in infection control.

Hospital employment

One source of hospital employment data is the American Hospital Association (AHA), which conducts an annual survey of hospitals in the United States. The AHA survey includes information on the number of government hospitals, the number of hospitals in each state, and the number of hospital beds. This data is made available through the AHA's Annual Survey Database and its publications, such as the Fast Facts on U.S. Hospitals.

Another source of hospital employment statistics is the National Center for Health Statistics (NCHS), which is part of the Centers for Disease Control and Prevention (CDC). The NCHS collects data through population surveys, healthcare provider surveys, and data collection systems. The NCHS conducts the National Ambulatory Medical Care Survey (NAMCS), which collects information on medical services provided in outpatient settings. Additionally, the NCHS utilizes the National Vital Statistics System, which compiles data from birth and death certificates.

The American Hospital Directory (AHD) is another provider of hospital employment data, drawing from both public and private sources. The AHD offers information on more than 7,000 hospitals, including Medicare claims data, hospital cost reports, and commercial licensors.

Furthermore, specialized research studies may be conducted to examine specific aspects of hospital employment. These studies employ statistical analyses to compare different data collection methods and assess the effectiveness and efficiency of health services.

Additionally, the Bureau of Labor Statistics provides valuable insights into hospital employment. They offer data on employee earnings, weekly hours, and the incidence and provisions of employee benefits. The Bureau also presents information on workplace fatalities, injury rates, and pricing indices within the hospital industry.

By utilizing these diverse methods and sources, a comprehensive understanding of hospital employment can be attained, facilitating informed decision-making and strategic planning in the healthcare sector.

Frequently asked questions