CHARS

1. CHARS COMPREHENSIVE HOSPITAL ABSTRACT REPORTING SYSTEM Database of Hospital Inpatient Discharges Subset of Billing Information from UB 1987- 3rd Quarter of 2007 11 Million Records Purpose: To provide public health personnel, consumers, purchasers, payers, providers and researchers useful information by which to make informed decisions on healthcare.

2. CHARS DATABASE Collects Public Information such as Age Sex Zip Code Billed Charges Diagnoses Procedures CHARS data system used by DOH and those involved with making public policy to: Identify and analyze health trends relating to patients hospitalizations Establish Statewide DRG weights Create hospital specific case mix indices Identify and quantify issues related to heath care access, quality and cost containment www.doh.wa.gov/EHSPHL/hospdata/CHARS

3. How Do We Collect CHARS? Hospitals report through their inpatient billing systems or through the web application 94 Washington hospitals report to CHARS Data usually sent monthly Data edited and error reports sent to hospitals Errors corrected through the online web application CHARS data are released quarterly to all interested users The annual report is issued six months after the close of the calendar year

4. CHARS Changing CHARS to Accommodate Change WAC 246-455 Effective 5/20/07 Expanded fields Diagnoses Procedures Patient�s last Name and First Name New elements to CHARS Race Ethnicity POA Patient middle initial Patient SS # (last 4) Admit hour and Discharge hour New data elements will help create a longitudinal database New data elements will help with data linkage CHARS database more robust for research purposes

5. How Did DOH Make Changes to CHARS? Involved hospitals and data users Data Recommendations Committee Hospital Coordination Visits Involved high profile entities WA Hospital Association ACLU Involved DOH executives

6. What Isn�t in CHARS ? Data from VA, Military Hospitals Data on WA residents treated in Oregon or Idaho Outpatient visits, except Observation (2007) ER visits, unless admitted The Center for Health Statistics does have access to supplemental databases for research: Madigan, Bremerton, Oak Harbor, and Oregon through HCUP (Healthcare Cost and Utilization Project�Federal & State)

7. CHARS DATABASE Public Database Deidentified Standard Reports on CHARS Website Confidential Database WAC 246-455-080 WAC 246-455-090 Researchers/users in DOH (Internal Data Sharing Agreement) L&I, Medicaid, Health Care Authority With Data Sharing Agreement Researchers with IRB approval Data Sharing Contract with University of Washington Non confidential data used for epidemiology class IRB approval for research studies.

8. How Is CHARS Data Used? Non-Infectious Conditions � Epidemiology Maternal and Child Health Cancer Registry Injury Prevention Chronic Disease Prevention Rural Health Certificate of Need University of Washington & other researchers Federal Agency for Healthcare Research and Quality (AHRQ) WSHA Hospitals in Washington State

9. The Health of Washington State2007www.doh.wa.gov/hws/ A statewide assessment of health status, health risks, and health care services Health surveillance report includes health disparities by race and ethnic origin Overarching goals with Health People 2010� national health objectives to increase the quality and years of healthy life and to eliminate health disparities. Each chapter in The Health of Washington State, 2007 looks at how one or more indicators vary in terms of where people live and their individual social and economic characteristics. Shows trends over time, including the most recent data, to assess whether Washington is improving, and identifying emerging problems

10. The Health of Washington State2007www.doh.wa.gov/hws Several references to CHARS as a data source Motor Vehicle Crashes 6.2.1�hospitalization data Hospitalization 2.3.1�CHARS �Leading Causes of Hospitalization 2002-2004 LOS, Discharge status, Charges, Payer, Potentially Avoidable Hospitalizations�AHRQ Prevention Quality Indicators�Washington reported on 8 �COPD, perforated appendix, hypertension, congestive heart failure, dehydration, bacterial pneumonia, urinary tract infection, angina without procedure. Washington�s rate of preventable hospitalizations fared well in 2004 in all except perforated appendix Falls 6.4.1� 2005 there were 12,200 hospitalizations due to falls among people age 65 and older. Falls are the leading cause of injury-related hospitalizations in Washington. Many falls are preventable and a multifactorial risk assessment and management program is the most effective intervention to reduce falls in this group. Healthy People 2010 goal closely related to falls among older adults is reducing the incidence of hip fracture.

11. CHARS Hospital Health Information Department staff play a key role in providing quality data to CHARS The data is really used! Important research is being conducted in Washington state and nationwide Public health decisions and policy are made from CHARS data Thank you for your commitment to quality data!