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About the Report

 

Why is this report important to me?

If you or someone you know has hip or knee problems, you may find this report helpful when considering where to receive treatment. Hospitals can vary, sometimes quite a bit, in terms of what they charge and their quality and safety for patients.

Why are you producing this report?

The 2005 Utah Legislature passed a bill called Senate Bill 132 (SB132) requiring the Utah Health Data Committee to publish annual reports that compare hospitals based on charges, quality and patient safety for consumers. After the bill passed, the Committee appointed 20 members to serve on the SB 132 Task Force to guide development of the consumer reports. The Task Force includes voices from consumers, hospitals, health professionals and public health agencies. The primary role of the Task Force is to be a technical advisory group that provides consultation to the Utah Health Data Committee and its staff members in the Office of Health Care Statistics on measures, methods and priorities for developing Health Care Consumer Reports and a related web reporting system. This report is one of a series of health care consumer reports that the Office of Health Care Statistics is developing in response to Senate Bill 132.

What is the purpose of the Utah Health Data Committee?

The Utah Health Data Committee was established by the Utah Legislature in 1990 to collect, analyze and distribute state health care data.

Who else helped to shape this report?

A focus group was held in Salt Lake County. Utah citizens provided useful feedback to make this report consumer-friendly. One orthopedic surgeon as well as other doctors and health educators reviewed the report’s medical information. Five bio-statisticians assisted in selecting the appropriate statistical method for comparing hospital performance.

About the Data

 

Where does the data come from?

Most of the data in this report come from hospital claim records. Utah hospitals are required by law to submit a standard set of information about each patient who spends at least one night in the hospital to the Office of Health Care Statistics, Utah Department of Health, for the Utah Hospital Discharge Database. The Agency for Health Care Research and Quality (AHRQ), a federal agency in charge of quality of care, provided national information.

Has the data been verified by others?

Yes, Utah hospitals have reviewed the report for accuracy.

Why use these indicators/measures?

AHRQ developed the Inpatient Quality Indicators (IQIs) for in-hospital deaths used in this report. The IQIs allow comparison among Utah hospitals and other U.S. hospitals that treated similar patients. The report shows IQIs for a serious condition (hip fracture) and for a major surgery (hip joint replacement). Currently there is no IQI for knee joint replacement. Measures for average charges are All Patient Refined Diagnosis Related Groups (APR-DRGs) for similar, though not identical, hip and knee procedures and conditions.

What are the limitations of quality comparisons in the report?

Many factors affect a hospital’s performance on quality and safety measures. Such factors include the hospital’s size, the number of orthopedic procedures performed, available orthopedic specialists, teaching status and especially how ill the hospital’s patients are. Hospitals that treat high-risk (very ill) patients may have higher percentages of deaths than hospitals that transfer these patients. Hospitals that treat patients near the end of their life may have higher percentages of deaths. Hospitals may report patient diagnosis codes differently. This could impact the accuracy of quality measurement among hospitals. The quality indicators adjust for how ill each hospital’s patients are, but the adjustment may not be adequate. The Utah Hospital Discharge Database includes up to nine diagnoses and up to six procedures for each patient. Some patients have additional diagnoses and procedures that are not included in this database. As a result, the measures of patient illness may not be accurate. See Glossary and Technical Document for more about hip replacement and hip fracture indicators.

What are the limitations of the charge comparisons in the report?

The charges shown in this report differ from “costs,” “reimbursement,” “price” and “payment.” Different payers have different arrangements with each hospital for payment. Many factors will affect the cost for your hospital stay, including whether you have health insurance, the type of insurance and the billing procedures at the hospital. This report excludes outlier (unusually high) charge cases and length of stay cases from the calculation of average charges (see Glossary). The indicators used in this report do not distinguish between patients with a single knee replacement and patients with bilateral knee replacements (both knees replaced during the same hospital stay).

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Last updated: November 13, 2008 1:37 PM