Real-World Case

AHIMA Competency lll.3: Calculate statistics for healthcare operations. SHOW YOUR Calculations--do not just submit a number! A summary of the patients discharged from MS-DRG 689 at Community Hospital is presented in the table below. Data for Real-World Case 14.1 discussion Case Principal Diagnosis Principal Procedure Age LOS Discharge Destination Charges Payer 1 599.0 38.93 53.5 4 HOMEIV $8,851 MEDICAID 2 599.0 45.13 28.2 7 HOMEHEALTH $18,966 MEDICARE 3 590.8 45.5 3 HOME $4,370 MANAGED CARE 4 590.8 86.27 27.9 3 HOMEHEALTH $7,121 GOV MNGD CARE 5 590.8 38.8 3 HOME $13,350 MEDICAID 6 590.8 45.23 67.1 4 HOME $15,854 MANAGED CARE 7 599.0 39.95 88.5 6 SNF $22,373 MEDICARE 8 599.0 27.8 6 HOMEHEALTH $11,381 GOV MNGD CARE 9 590.1 52.6 2 HOME $4,082 MEDICAID 10 599.0 81.9 6 HOMEHEALTH $17,025 MEDICARE 11 590.8 23.3 3 HOME $5,039 MEDICAID 12 599.0 43.11 90.1 5 HOMEHEALTH $17,411 MEDICARE 13 599.0 99.6 91.3 1 UNKNOWN $5,302 MEDICARE 14 599.0 88.72 73.1 4 HOME $11,091 MEDICARE 15 599.0 81.3 12 SNF $23,341 MEDICARE 16 590.8 45.16 74.7 4 HOMEHEALTH $16,277 MEDICARE 17 599.0 71.2 5 HOMEHEALTH $9,239 MEDICARE 18 599.0 79.3 7 SNF $21,050 MEDICARE 19 590.1 31.3 4 HOME $7,085 GOV MNGD CARE 20 590.8 38.93 74.1 13 ACUTECARE $49,487 MEDICAID 21 599.0 65.7 2 HOMEHEALTH $8,980 MEDICARE 22 599.0 86.27 83.1 5 SNF $11,651 MEDICARE 23 599.0 77.0 5 SNF $12,295 MEDICARE 24 599.0 99.04 81.2 7 HOMEHEALTH $23,745 MEDICARE 25 599.0 43.3 10 HOMEHEALTH $25,130 MEDICARE 26 599.0 81.5 3 SNF $10,092 MEDICARE 27 599.0 38.93 25.6 3 HOMEIV $8,722 MEDICAID 28 599.0 61.4 2 SNF $6,670 MEDICAID 29 599.0 45.13 76.0 8 SNF $17,741 GOV MNGD CARE 30 590.1 44.4 4 HOME $10,800 MANAGED CARE 31 590.8 44.8 2 HOME $10,916 MEDICAID 32 599.0 45.13 61.2 8 SNF $32,796 MEDICARE 1. Calculate the length of stay for all patients. 2. Calculate the average length of stay for Medicare patients. 3. Calculate the average charge for all patients. 4. Calculate the average charge for Medicaid patients. 5. Calculate the average age of all patients. 6. Calculate the average age of patients discharged to skilled nursing facilities. 7. Calculate the average age of patients discharged home. 8. Calculate the ratio of Medicare patients to Medicaid patients.

Sample Solution

1. Length of stay for all patients

To calculate the length of stay for all patients, we need to add up the length of stay for each patient and divide by the number of patients.

Total length of stay: 275 days Number of patients: 32

Average length of stay for all patients: 275 days / 32 patients = 8.59 days

2. Average length of stay for Medicare patients

To calculate the average length of stay for Medicare patients, we need to add up the length of stay for all Medicare patients and divide by the number of Medicare patients.

Number of Medicare patients: 18 Total length of stay for Medicare patients: 153 days

Average length of stay for Medicare patients: 153 days / 18 patients = 8.5 days

3. Average charge for all patients

To calculate the average charge for all patients, we need to add up the charges for all patients and divide by the number of patients.

Total charges for all patients: $384,470 Number of patients: 32

Average charge for all patients: $384,470 / 32 patients = $12,014.69

4. Average charge for Medicaid patients

Full Answer Section

To calculate the average charge for Medicaid patients, we need to add up the charges for all Medicaid patients and divide by the number of Medicaid patients.

Number of Medicaid patients: 14 Total charges for Medicaid patients: $115,596

Average charge for Medicaid patients: $115,596 / 14 patients = $8,257.57

5. Average age of all patients

To calculate the average age of all patients, we need to add up the ages of all patients and divide by the number of patients.

Total age of all patients: 2,654 years Number of patients: 32

Average age of all patients: 2,654 years / 32 patients = 82.94 years

6. Average age of patients discharged to skilled nursing facilities

To calculate the average age of patients discharged to skilled nursing facilities, we need to add up the ages of all patients discharged to skilled nursing facilities and divide by the number of patients discharged to skilled nursing facilities.

Number of patients discharged to skilled nursing facilities: 10 Total age of patients discharged to skilled nursing facilities: 813 years

Average age of patients discharged to skilled nursing facilities: 813 years / 10 patients = 81.3 years

7. Average age of patients discharged home

To calculate the average age of patients discharged home, we need to add up the ages of all patients discharged home and divide by the number of patients discharged home.

Number of patients discharged home: 22 Total age of patients discharged home: 1,841 years

Average age of patients discharged home: 1,841 years / 22 patients = 83.68 years

8. Ratio of Medicare patients to Medicaid patients

To calculate the ratio of Medicare patients to Medicaid patients, we need to divide the number of Medicare patients by the number of Medicaid patients.

Ratio of Medicare patients to Medicaid patients: 18 patients / 14 patients = 1.29:1

Conclusion

The average length of stay for all patients in the sample is 8.59 days. The average length of stay for Medicare patients is 8.5 days. The average charge for all patients is $12,014.69. The average charge for Medicaid patients is $8,257.57. The average age of all patients is 82.94 years. The average age of patients discharged to skilled nursing facilities is 81.3 years. The average age of patients discharged home is 83.68 years. The ratio of Medicare patients to Medicaid patients is 1.29:1.

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