Who is Kentucky Hospital Association (KHA)?

Founded more than 80 years ago, the Kentucky Hospital Association is a partnership of people and organizations dedicated to improving health care delivery throughout the Commonwealth.  The Association facilities collaborative efforts among Kentucky hospitals, all of which are members of KHA, and is the source for strategic information about the constantly changing health care environment.  The mission of the Kentucky Hospital Association is to provide representation and member services that assist hospitals to fulfill their mission in serving the health care needs of the public.  For more information on KHA, please visit our web site at www.kyha.com.

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About This Report

Through publication of this report, Kentuckyís hospital continue their commitment to helping the public better understand the health care delivery system and cost of health care services.

The Kentucky Hospital Association collects billing data from all Kentucky acute care hospitals for all patients who were admitted for inpatient care.  Hospitals report data on a quarterly basis.  This report covers inpatient discharges at Kentuckyís acute care hospitals for the most recent 12 month period where quarterly data has been finalized. 

The information in this report is hospital-specific and includes for each MSDRG (Medicare Severity Adjusted Diagnosis Related Groups) the number of cases each hospital treated for the MSDRG, the median length of stay and median charges and  the median age of patients.  Information is provided on the top 200 MSDRGs that account for more than 87% of all admissions to  Kentucky acute care hospitals.  KHA continues to expand the list of MSDRGs included in this report to additional conditions if patient volume is large enough to support statistically reliable data.  

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Why Provide Information by MSDRGs?

The data provided to KHA by Kentucky hospitals is grouped into illness categories, called Diagnosis Related Groups, or MSDRGs.    MSDRGs group similar patients requiring similar hospital resources to take care of them, and similar anticipated lengths of stay.  Each patient admitted to the hospital gets assigned one DRG for that visit.  It is based on a number of factors:  the main diagnosis for the admission, along with other conditions noted, procedures performed, and age of patient.  Other conditions that can influence the MSDRG assigned are complications and co-morbidities that cause the hospital stay to be longer in many persons.  Providing information about MSDRGs can give you an idea about the types of cases that particular hospitals are seeing. 

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Hospital Charges

This report includes median hospital charge information for discharges falling within a given severity level for a diagnostic condition (MSDRG).  The policy and setting of charges is determined by individual hospital. While charges are what the hospital reports on the billing form, they may not accurately represent the amount a hospital receives in payment for the services it delivers.  However, hospital charges are used almost universally by those attempting to assess the costs of health care.  Hospital charge data does not include separate physician charges.

The charges listed are averages for items and services provided by hospitals, based on the number of patients and total charges for that illness.  Figures include charges for the hospital room, hospital services ordered by a doctor (such as ex-rays and laboratory tests), and personal care items (such as hospital gowns). 

The median value was used in order to eliminate extremely low or high charges.  Without these extreme values, the average charges and the typical range of charges are more representative of the charges that most patients would experience.  A hospitalís charges for the 10th percentile and 90th percentile reflect a statistical standard range.  About 80% of the time, the hospitalís total listed charge will be between the 10th and 90th percentiles.   This helps to tell you what is likely to happen within a given hospital. Because these figures are averages, they may be different from what you are billed.    The numbers do not measure quality of care.

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Why Charges May Vary

Charges vary because no two patients, conditions, reactions to medications or treatment, or time of recovery are identical.

Individual physician judgment based on patient needs influences treatment decisions. Some MSDRGs have little variation of charges within the minor severity level because physicians agree on standard treatment procedures.  Other MSDRGs can have a significant range of charges because the MSDRG includes a wide variety of illnesses and treatment among these illnesses is not standardized.  Charges may be higher at hospitals located in areas of the state where wage levels and cost of living is higher.  Hospitals affiliated with medical schools and those which incur additional costs associated with training medical and allied health students may also have higher charges.

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Volume of Cases

For each hospital, the total number of cases for each condition (MSDRG) is reported.  This can give a patient an idea of the experience each facility has in treating such patients. 

The number of cases represents separate hospital admissions, not individual patients.  A patient readmitted several times would be included each time in the number of cases. 

Hospitals are not listed on a report if they had fewer than 20 cases treated for that condition (MSDRG) within the 12 month period covered by the data.  Such low volume cannot be considered meaningful. 

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Length of Stay

Length of stay in a hospital can vary because of many factors, such as older patients requiring more services, hospitals treating patients who are more severely ill than the average patient or who have more complications and/or multiple conditions requiring treatment during their hospitalization.  Length of stay can be shorter for hospitals where additional resources such as nursing home or home health services are readily available in the community to provide any necessary follow up care. 

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How to Use This Report

This report can be used as a tool.  It should not be used to generalize about the overall quality of care at a hospital.  Consumers should talk with your physician and ask the following questions:

  • Ask which MSDRG category and severity level might be comparable to your condition
  • Ask how your illness and health status might affect procedures performed, length of stay, and the cost of your care
  • Ask your insurance company what is covered under your plan and what you will be expected to pay out of pocket for the proposed medical care
  • Ask what other additional charges you can expect to receive from physicians who may provide services during your hospitalization, such as pathology, radiology, or other consultations.

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Performance Measures

The measurement of quality is highly complex, and the information used to capture such measures is limited.   Systems to measure and compare hospital performance are in the developmental stages.  Hospital personnel use the information to pinpoint areas for potential improvement within the facility.  Click here for more information about the National Initiatives that Kentucky Hospitals are participating in.