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All Inpatient Admissions

Significant Findings

Actual and expected values for average length of stay:

Average length of stay in this study area rose 45.7 percent, from 4.3 days to 6.2 days. Around $934,000 could have been saved if average length of stay had been equal to the expected value of 4.8 days. If current conditions continue into the next period, this trend will result in $2.3 million of additional expenses.

Explanations: The increase in average length of stay in this study area is related to the fact that average length of stay in High-cost Admissions rose 93.6 percent, from 16.8 days to 32.5 days. The observed deviation from the expected value is related to the fact that average length of stay in Mental Health Admissions was 544.8% above the expected value (72.0 days versus 11.2 days).

Recommendation: Review the utilization concurrent review program for length of stay. Because there are care management programs that are condition specific, e.g. mental health, catastrophic, you should check to see if KeFiR key findings surface by benefit area or by MDC. This will help to target an intervention.

Projected savings: $699,000 (based on an expected payoff of 30%).

Percent of Total Inpatient Payments by High-cost admission?

Total Payments Summary

Actual and expected values for total inpatient payments:

Total inpatient payments in this study area rose 8.8 percent, from $3.8 million to $4.1 million. Around $1.7 million could have been saved if total inpatient payments had been equal to the expected value of $2.5 million. If current conditions continue into the next period, this trend will result in $1.7 million of additional expenses.

The increase in total inpatient payments in this study area is related to the fact that number of covered lives in this study area rose 11.7 percent, from 4696 to 5245. The observed deviation from the expected value is related to the fact that payments per day was 85.1% above the expected value ($3,797.91 versus $2,052.33).

Measures Table

      Measure        1992        1993  Change   1993 Norm   Diff.
 ------------ ----------- ----------- ------- ----------- -------
Total payment  $3,802,222  $4,135,736    8.8%  $2,478,167   66.9%
   Pay/capita        $809        $788   -2.6%        $472   66.9%
Covered lives        4696        5245   11.7%
     Episodes         349         352    0.9%
  Average LOS    4.3 days    6.2 days   45.7%    4.8 days   29.2%
      Pay/day      $2,558      $1,893  -26.0%      $1,394   35.8%
    Adms/1000        74.3        67.1   -9.7%        70.5   -4.9%
Readmit-30 rt         8.0         8.5    6.2%
   Mjr adv rt        13.5        13.6    1.3%

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