Hospitalization is a critical metric that shows up in numerous places in Marketscape. In the most general terms, hospitalization means a patient went to a hospital during or after receiving post-acute care. The exact meaning of a specific hospitalization metric, and how it is calculated, could be different depending on where the metric resides in Marketscape.
There are three hospitalization metrics on the Analyze page that are sometimes confusing because it seems they should be the same. In short, the difference is the reference period from which we calculate the hospitalization metric. It is best to get the full picture, so read on.
Also, we will look only at hospitalization metrics for home health agencies. Although some of the concepts included here are transferable to other hospitalization metrics, it would be wise to confirm the meaning and calculation of other metrics in the article for those metrics.
We start on the Explore Page.
On the Explore page, when you look at Home Health Agencies, you will be able to see the % Hospitalized: + 30 Days. This is a general performance metric that measure the percentage of all admissions to the listed home health agency that were admitted to a hospital during their home health stay or within 30 days of discharge.
The calculation would look like this:
A few notes:
- Notice that the calculation says "admissions" in the numerator and denominator. If a specific patient is admitted to home care and then admitted to a hospital multiple times during the reporting period, that pair of events will be counted each time.
- The reporting period for this metric is for two years; aligning with the end of the most recent dataset included in the product.
- The index event, the home health admission, must fall in that two year period.
As we move on, notice that the % Hospitalized: + 30 days for Visiting Nurse Service of New York Home Care is 23.41%.
Our next step is to click on the agency's name and go to the Analyze Page.
At the top of every Analyze page is the Insights section for the selected provider. The first insight for our selected agency is "Hospitalization Rate." And guess what? This is our metric from the Explore page - 23.41%. (During our move from Explore to Analyze, our metric got married and changed its name.)
So far so good, but let's look at a couple other tables. Click on the Quality tab.
There are two tables that are brimming with hospitalization metrics:
- Hospitalization Rates within 30 days from Start of Care by Acuity
- Hospitalization Rates within 90 days from Start of Care by Acuity
These tables show how specific diagnostic categories at different acuity levels impact hospitalization for the selected facility. The simple summary is; pick a diagnosis, slide to the right and pick an acuity level, that is the percentage of patients in that category who are hospitalized within 30 or 90 days of admission to home care.
Click on the images below to enlarge them.
For those of you who don't have your Ph.D. in Trella Health metrics, let dig in a bit on the details.
- 30 days vs. 90 days - For every admission, we track whether that patient was admitted to a hospital within 30 or 90 days of admission.
- Unlike our previous hospitalization metric, these metrics are not calculated over the full length of the stay and 30 days after discharge. These metrics are more directly comparable because of the fixed period between admission to home care and admission to a hospital.
- Acuity - In this table, we show hospitalization rates for the diagnostic categories broken out by acuity. There are four sections, All Acuities, that is a combination of the other three, low, medium, and high.
- For more information on Trella Health Patient Acuity measurements, click here.
- Trella Health Diagnostic Categories - There are 20 different diagnostic categories that you can use to align your assessment of the selected facility with these areas of specialization.
- For more information on Trella Health Diagnostic Groupings, click here.
These two tables have their own article that discuss usage.
What about the Arrows?
This is the part that causes some confusion. If you look at the metric at the bottom all acuities, you would think that the total of all diagnoses for all acuities would be the same metric we started with - 23.41%.
Let looks at what is the same, and what is different.
ALL hospitalization metrics reflect patients who were admitted to home health and then admitted to a hospital during a specific period of time.
The big difference is the time period during which the hospitalization must take place.
|Metric||Reference Period - When could hospitalization take place|
|% Hospitalized: 30 days||At any time from admission through the entire stay, plus 30 days after discharge|
|Hospitalization within 30 days||At any time within 30 days of home health admission|
|Hospitalization within 90 days||At any time within 90 days of home health admission|