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Uniform Data System (UDS) Report 2005: Comparisons and Trends. September 2006 Cassandra Arceneaux MD, MPH General Preventive Medicine Resident- UTMB. Objectives . Identify demographics and total number of patients seen over past 5 years

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Uniform data system uds report 2005 comparisons and trends

Uniform Data System (UDS) Report 2005: Comparisons and Trends

September 2006

Cassandra Arceneaux MD, MPH

General Preventive Medicine Resident- UTMB


Objectives
Objectives

  • Identify demographics and total number of patients seen over past 5 years

  • Compare medical productivity to other districts and previous years

  • Compare costs by encounter and service

  • Discuss bad debt and adjustments

  • Review statistics by payor categories



2005 statistics
2005 Statistics

  • 2005 total patients

    • 17,519

  • Receiving medical services

    • 16,818

  • Prenatal patients

    • 73


Total patients
Total Patients

Total Pts. = Total users of all services

Medical Services = No. of pts. using medical services


Patients by age and gender
Patients by Age and Gender

2005

* Groups noted as target populations by UDS


2005

Black 32%

White34%

Hispanic 33%



Prenatal patients
Prenatal Patients

* Did not report less than 2 prenatal visits


2005 prenatal patients by race
2005 Prenatal Patients by Race

Total Patients

Prenatal Patients

32%

34%

33%



Delivery postpartum and infant utilization
Delivery, Postpartum, and Infant Utilization

*Less than 2 visits not reported

*No BW <1501g


2005 enrollment of prenatal care users in wic
2005 Enrollment of Prenatal Care Users in WIC

  • Prenatal care users: 78%

  • Infants: 49%

  • Postpartum care users: 49%


Visits by primary diagnosis
Visits by Primary Diagnosis**

*2001-2003 values represent all mental disorders excluding drug and ETOH dependence; later part of 2004 first mental health counselor hired

**some data limitations include accuracy of diagnosis and coding and what diagnosis was listed as primary


Patients with primary diagnosis
Patients with Primary Diagnosis**

*2001-2003 values represent all mental disorders excluding drug and ETOH dependence; later part of 2004 first mental health counselor hired

**some data limitations include accuracy of diagnosis and coding and what diagnosis was listed as primary


Preventive service visits
Preventive Service Visits**

*up to age 11

**some data limitations include accuracy of diagnosis and coding and what diagnosis was listed as primary


Preventive service patients
Preventive Service Patients**

*up to age 11

**some data limitations include accuracy of diagnosis and coding and what diagnosis was listed as primary



Medical team productivity
Medical Team Productivity

Medical Team Productivity =

Total visits for physicians and mid-levels

(Total physician FTEs**)+ (Total Midlevel FTEs/2)

*2003 Excludes Psychiatry

**FTEs = Full Time Equivalent Hours or 2080 hrs


Dental team productivity
Dental Team Productivity

Dental Team Total Visits for dentists and hygienists

Productivity = Total dentist FTEs + hygienists FTEs


Medical cost per visit
Medical Cost Per Visit*

$117

$109

$105

$90

Medical Cost Total Medical Service Costs - Lab/Xray

Per Visit= Total Medical Service Visits - Nursing

* Includes Psychiatry


Medical costs definitions
Medical Costs (Definitions)

  • Costs for Medical Care

    • Medical Staff

    • Lab and X-Ray

    • Medical/Other Direct

  • Costs for Medical Services

    • Dental Health

    • Mental health

    • Substance Abuse

    • Pharmacy/Pharmaceuticals

    • Other Professional Costs

  • Costs for Enabling and other Program Related Services


Administrative costs definition
Administrative Costs (Definition)

Total Facility Costs +Total Administration Costs = Overhead



Medical vs administrative costs
Medical Vs. Administrative Costs

*STD fund and WIC fund moved from clinic into general fund; loss in providers


Laboratory and pharmacy costs
Laboratory and Pharmacy Costs

Lab/X-ray Total Lab/X-ray Costs including Overhead

Costs = Total Medical Visits – Nurse Visits

Pharmacy (Accrued Cost of Pharmacy not including pharmaceuticals) +

Costs = (Accrued cost of pharmaceuticals)





Medicaid patients
Medicaid Patients

Number of 4C’s pts with Medicaid by year


Bad debt as of self pay charges
Bad Debt as % of Self Pay Charges

Bad Self-Pay Bad Debt Write-off

Debt = Self-Pay Charges


Self pay collection rate
Self Pay Collection Rate

Self Pay Amount Collected

Collection Rate = Full Charges


Surplus deficit as total cost
Surplus/Deficit as % Total Cost

Surplus/ (Total Amount Collected + Total Revenue) – Total Accrued Costs incl.Overhead

Deficit = Total Accrued Costs including Overhead

*2005 does not really reflect a deficit but a transfer of excess funds reserved for Texas City renovations


Findings
Findings

  • Total number of patients have decreased

  • Due to limitations in coding we are unable to assess utilization trends by diagnosis

  • An apparent decrease in preventive visits and decline in visits for major diagnoses

  • Medical team productivity increased and is significantly high compared to state and national CHC averages


Findings1
Findings

  • Medical cost per encounter remains less than state and national CHC averages

  • In 2005 the proportion of private insurance and Medicaid patients has increased compared to the uninsured

  • Number of Medicaid patients has decreased since 2003

  • Collection rate continues to be low for self payers compared to standard set by state

  • Bad debt continues to increase


Limitations
Limitations

  • There is a discrepancy between what the UDS reports and what the AS-400 shows

  • UDS methods of calculation and reporting have changed since 2002

  • Current system has inability to accurately assess utilization by health conditions diagnosed and coded


Opportunities
Opportunities

  • Maintain provider productivity

  • Increase utilization rate among all clinic patients

  • Increase number of insured patients

  • Increase collections

  • EMR implementation will help to improve health data quality


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