Health Information Management Technology: An Applied Approach Third Edition

1. Health Information Management Technology: An Applied ApproachThird Edition Chapter 10: Healthcare Statistics

2. Descriptive Statistics • Most common type of statistics encountered by health information technician • Describe population

3. Types of Data • Measurement • Scales of measurement • Nominal-level data • Ordinal-level data • Interval-level data • Ratio-level data

4. Scales of Measurement • Nominal-level data • Groups or categories • Measures data by name • Groups are mutually exclusive • Example: race • Ordinal-level data • Some order • Order is meaningful – not number • Example: staging pressure ulcer

5. Scales of Measurement • Interval-level data • Ordered and continuous data • Zero point is arbitrarily established • Intervals between successive values are equal • Example: temperature

6. Scales of Measures • Ratio-level data • Highest level of measurement • Defined unit of measure • Real zero value • Intervals between successive values are equal • Example: length of stay

7. Discrete and Continuous Data • Discrete variables: • Nominal or ordinal data • Fall into categories • Example: Gender • Continuous variables • Interval or ratio data • Includes fractions • Can perform mathematically calculations

8. Ratios, Proportions, and Rates • Indicate number of times something happens • Examples: morbidity, mortality, and natality

9. Ratio • Quantities being compared may be completely independent or show part of whole • Independent • 255 patients discharged alive, 15 died • Part of whole • 15 patients died out of 270 discharges

10. Proportions • Type of ratio • Quantity is part of whole • Numerator is always included in denominator • 2 patients have cancer / 2 patients with cancer + 8 without cancer = 0.2

11. Rates • Used to measure event over time. • May be used in performance improvement studies • Number of cases occurring during a given time period / total cases or population at risk during the same time period

12. Ratio, Proportion, and Rates • Rounding • Policy should state 1 or 2 decimal points • Round up at 5 or higher

13. Measures of Central Tendency and Variability • Mean • Median • Mode • Variability • Range • Variance • Standard deviation

14. Frequency Distribution • Values a variable can take and number of observations for each value

15. Mean • Arithmetic average of frequency distribution • Disadvantages • Fractional values • Sensitive to extreme measures

16. Median • Midpoint of a frequency distribution • Advantages • Relatively easy to calculate • Based on whole distribution—not portion • Outliers do not influence it

17. Mode • Most frequent observation • Advantages • Easy to obtain and interpret • Not sensitive to extremes • Easy to communication and explain • Disadvantages • Not descriptive when mode does not occur often and there is a large number of observations • May be more than one mode • Does not provide information on entire distribution

18. Range • Difference between smallest and largest value

19. Graphic Display of Data • Presents large quantities of information • Purpose is to communicate information about data • Graph should • Display data • Allow user to think about meaning of data • Avoid distortion of data • Encourage user to make comparisons • Reveal data at several levels—broad overview to fine detail

20. Tables • Orderly arrangement of values that groups data into rows and columns

21. Characteristics of Tables • Self-explanatory • All sources should be specified • Headings for columns and rows should be specific and understandable • Row and column totals should have been checked for accuracy • Enter zero or dash rather than leave cell blank • Categories should be mutually exclusive and exhaustive

22. Data Alignment • Text in table should be aligned at left • Heading may be centered • Numeric values should be right aligned • Decimals should be aligned

23. Charts and Graphics • Emphasize points and analyze and clarify relationships among variables • Principles • Distortion • Proportion and scale • Abbreviations • Color • Print

24. Bar Charts • Displays data from one or more variables • Bars may be horizontal or vertical

25. Pie Chart • Slices of pie show proportional contribution of each part

26. Line Graph • Display time trends • X-axis shows unit of time • Y-axis shows variable being plotted • Line connecting series of points • Several sets of data can be presented on one graph • Different lines • Y-axis can be numbers or percent

27. All Graphs Should: • Be easy to read • Use proper scale • Complete and accurate title • Informative legend

28. Histogram • Displays frequency distribution

29. Histogram vs. Bar Graph • Bar graph • Data falls into groups or categories • Categories are noncontinuous (discrete) • Can be in fractions • Histogram • Continuous variables • May be number or percent

30. Frequency Polygon • Graph depicting frequency of continuous data • Line format • May have several frequency polygons on one graph

31. Hospital Statistics • Collect information on inpatient and outpatients on daily basis • Monitor volume of students

32. Standard Definitions • Hospital inpatient • Hospital newborn inpatient • Inpatient hospitalization • Inpatient admission • Inpatient discharge • Hospital outpatient

33. Inpatient Census Data • Census reports patient activity for a 24 hour reporting period • Inpatients admitted • Inpatients discharged • Intrahospital transfers • Take count at same time of data • Account for patients admitted and discharged on same day

34. Inpatient Service Day • Unit of measure for services received by one patient during a 24 hour period • Daily inpatient census is equal to number of inpatient service days for a single day • Compiled daily, weekly, monthly, and annually

35. Inpatient Bed Occupancy Rate • Also called percentage of occupancy • Percentage of official beds occupied by hospital inpatients for given period of time • Bed count • Bed count days • May be greater than 100%

36. Length of Stay Data • Calculated for each patient after discharge • Calendar days from day of admission to discharge • Adjust calculations for hospitalizations that cross calendar months • Length of stay for patients admitted and discharged on same day is 1 • Total length of stay

37. Hospital Death (Mortality Rate) • Based on number of patients discharged alive and dead from facility • Gross death rate • Proportion of all hospital discharges that ended in death • Net death rate • Adjust death rate which excludes patients who died within 48 hours of admission

38. Newborn Death Rate • Newborns are included in hospital’s gross and net death rate • Calculated separately • Includes only newborns born alive at the hospital

39. Fetal Death Rate • Death that occurs prior to fetus’s complete expulsion or extraction from mother in a hospital facility • Any length of pregnancy

40. Fetal Death Classifications • Early fetal death: less than 20 weeks or weight of 500 grams or less • Intermediate fetal death: at least 20 but less than 28 weeks or weight of between 501 and 1,000 grams • Late fetal death: 28 weeks or weight of more than 1,000 grams

41. Maternal Death Rate • Death of any woman from any cause related to, or aggravated by, pregnancy or its management, regardless of duration or site of the pregnancy • Does not include accidental or incidental causes • Types • Direct maternal death rate • Indirect material death rate

42. Autopsy Rates • Examination of dead body to determine cause of death • Types of autopsies • Hospital inpatient autopsy • Hospital autopsy

43. Types of Autopsy Rates • Gross autopsy rates • Net autopsy rate • Removes coroner or medical examiner cases • Hospital autopsy rate • Includes • Bodies of inpatients who died in hospital excluding coroner or medical examiner • Bodies of other hospital patients including ambulatory care, home health, and former hospital patients who died elsewhere but whose body is made available for autopsy

44. Available for Autopsy Includes • Autopsy is performed by hospital pathologists or designated physician on body of patient treated at some point in the hospital • Report of autopsy is filed in health record and in hospital laboratory or pathology department • Tissue specimens maintained in hospital lab

45. Fetal Autopsy Rate • Performed to determine cause of fetal loss • Performed on intermediate or late fetal deaths

46. Hospital Infection Rates • Hospital-acquired infection rates • May be calculated for unit or entire hospital • Postoperative infection rate • Clean surgical case • Surgical procedure • Surgical operation

47. Consultation Rate • Consultation is when two or more physicians collaborate on patients diagnosis or treatment

48. National Vital Statistics System • Vital statistics • Collection and analysis of data related to: birth, death, marriage, divorce, fetal death, and induced terminations of pregnancy • Used as part of effort to preserve and improve health of population • National Vital Statistics System • Maintains official vital statistics of the United States • Part of National Center for Health Statistics

49. Vital Statistics • Standard forms • Model procedures • Standard certificates • Minimum basic data set • Revise about every 10 years • Used in • Research • Epidemiology • Public health programs

50. Certificate of Live Birth • Collects information on child and parents • Collects information on pregnancy • Not part of official birth certificate