The Hospital Financial and Utilization Profile Standard
Report (ST-1) is an annual report from the inpatient hospital
discharge data released by the Utah Health Data Committee, The
ST-1 report serves as the basis for smaller consumer-oriented
reports. The hospital discharge data will be used to support
evaluation and monitoring of annual hospital utilization trends.
The ST-1 contains aggregated all-payer data and compares hospital
financial and utilization data in a standardized format.
The Health Data Committee
Chapter 33a, Title 26, Utah Code Annotated established the
eleven-member Utah Health Data Committee (committee). In
accordance with the act, the committee's purpose is "to direct a
statewide effort to collect, analyze, and distribute health care
data to facilitate the promotion and accessibility of quality and
cost-effective health care and also to facilitate interaction
among those with concern for health care issues".
The Health Data Plan
The committee worked with numerous organizations and
individuals to develop the Utah Health Data Plan, which defines
the implementation of a statewide health data reporting system.
The committee realizes the need for data is great, but recognizes
resources are limited so its activities must be prioritized.
The committee's first priority is inpatient hospital
discharge data. According to statistics released by the Division
of Health Care Financing, Utah Department of Health, hospital
care accounted for 47 percent of total Utah health care
expenditures in 1990. Additionally, hospital billing data was
identified as a readily available data source which was comparable
across hospitals at a state, regional, and national level. Other
committee priorities include financial performance data from the
Medicare Cost Reports, ambulatory data from medical claims, and
research and integration of prevention and work site wellness
issues.
The Hospital Discharge Data Base
Administrative Rule R428 became effective in December 1991,
and mandates that all Utah licensed hospitals, both general acute
care and specialty, will report information on inpatient
discharges, beginning with January 1, 1992. Fifty-five Utah
hospitals in 1993 submitted data in 1992, including nine
psychiatric facilities, seven specialty hospitals, and the
Veterans Administration Medical Center. Shriners Hospital, a
charity hospital, is exempt from reporting requirements.
All hospitals report "discharge data" for each inpatient
served. "Discharge data" means the consolidation of complete
billing, medical, and personal information describing a patient,
the services received, and charges billed for each inpatient
hospital stay.
Discharge data records are being submitted to the office
quarterly. The data elements are based on discharges occurring
in a calendar quarter. If a patient has a bill generated during a
quarter, but has not yet been discharged by the end of the quarter,
data for that stay is not included in the quarter's data.
Uses of Hospital Data
The Health Data Committee has included data on hospital
charges in this report. These charges are comparable across Utah
and throughout the United States.
Billed charges are to be used as only one indicator of
hospital performance. All patients, or insurance plans, do not pay
the same amount for similar treatments, supplies, services, and
procedures, even though they may be billed the same amount.
Hospitals offer a variety of contracts, many with discount
arrangements based on volume. Because of this, the committee was
unable to publish hospital data based on actual payment.
This report shows total charges, which includes both
facility charge and professional charges. We were unable to break
total charges down into these two components due to inconsistency
in the hospitals' reporting of revenue center charges. On the
average, professional charges accounted for a very small
proportion (.006) of total charges in 1993.
This report can be used to compare broad measures of
utilization for all hospitals, but more detailed data is needed to
look at specific performance comparisons between hospitals. It
addresses inpatient utilization issues, but does not directly
measure the quality of medical care or outpatient care.
Although these data cannot answer clinical questions, they
may serve as an important first step toward consumers taking a
more active role in health care decision-making. The price of
hospital services, while important, is not the only consideration
in making inpatient hospital decisions. Other factors that may
influence hospital services include the type of condition treated,
the facility where the admitting doctor has privileges, and
insurance company contractual arrangements. The subscriber should
be familiar with his or her contract long before hospital care is
needed.
MN