Uniform data system uds report 2005 comparisons and trends
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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

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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


Patient totals and demographics

Patient Totals and Demographics


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


Uniform data system uds report 2005 comparisons and trends

2005

Black 32%

White34%

Hispanic 33%


Patients by diagnosis

Patients by Diagnosis


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%


Prenatal care

Prenatal Care


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


Productivity charges collections and adjustments

Productivity, Charges, Collections, and Adjustments


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


2005 medical administrative costs

2005 Medical /Administrative Costs


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)


Proportion of payors

Proportion of Payors


Proportion of payors 2001 2005

Proportion of Payors 2001-2005


2005 collections by payor

2005 Collections by Payor


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 PayAmount 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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