- 15 Jul 2023
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URSA-PHF | Hospital Utilization Metrics
- Updated on 15 Jul 2023
- 2 Minutes to read
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Overview
This report contains pre-built boards that introduce users to the different types of hospital encounters, industry standard measures, and key concepts related to each.
Measures included in this report cover both inpatient and outpatient hospital encounters that are frequently used in population health management such as; population rates, encounter plan spending, length of stay, emergency department, and observation stay conversion rates. One notable exclusion are hospital inpatient readmission metrics which, given the breadth of content on that subject, are located in a separate URSA-PHF report.
Use this report to
- Develop an understanding of how hospital encounters are defined and useful ways to disaggregate results across inpatient and outpatient encounters to enhance your analyses.
- Access industry standard population health measures related to hospital encounters such as admissions per thousand member-years, emergency department to inpatient conversion rates, inpatient LOS, and more.
- Leverage pre-built boards that present helpful disaggregated results across measures that can be customized or used as a template for your own hospital utilization boards.
Potential takeaways
- What are my top reasons for inpatient admissions?
- Who are my high utilizers?
- Tell me more about the type and reason for their admissions
- Tell me more about the patient. For example, are there certain patients that the PCP isn't seeing but are driving hospital utilization?
- What types of conditions are being treated in emergency department encounters that don't result in an inpatient hospital stay?
- What is my total spending on that?
- Is there a lot of ED OP utilization that could be avoided if better outpatient services were made available, such as home health?
- Same for observation stays without admissions?
- Are there patients with a new uptick in hospital utilization?
- For those that are admitted, is there an opportunity for a portion of those to have been discharged sooner safely?
- What is driving up LOS? Lack of weekend discharges? Infections/complications?
- What percent of discharges of a certain type (e.g., surgerical admissions on the musculoskelatal system) are discharged home or home with home health versus to a facility such as a SNF?
Measures included in this report
- URSA-PHF-R03: Registry of all URSA-CORE Encounters
- URSA-PHF-R04: Registry of Hospital Inpatient Encounters
- URSA-PHF-R05: Registry of Hospital Observation Stay Encounters
- URSA-PHF-R06: Registry of Emergency Department Encounters
- URSA-PHF-002: Hospital Inpatient Admission PMPM Plan Spending
- URSA-PHF-003: ED Visits without Admission PMPM Plan Spending
- URSA-PHF-005: Hospital Observation Encounter PMPM Plan Spending
- URSA-PHF-009b: Hospital Encounter PMPM Plan Spending
- URSA-PHF-020: Inpatient LOS in Midnights per 1000 Member-Years
- URSA-PHF-020b: Inpatient LOS in Midnights per 1000 Member-Years
- URSA-PHF-021: Admits per 1000 Member-Years
- URSA-PHF-022: ED Visits per 1000 Member-Years
- URSA-PHF-024: Observation Encounters per 1000 Patient-Years
- URSA-PHF-026: Hospital Encounters per 1000 Member-Years
- URSA-PHF-032: Observation to Hospital IP Conversion Rate
- URSA-PHF-033: Emergency Dept. to Hospital IP Conversion Rate