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.