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University of Notre Dame *
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Course
20
Subject
Health Science
Date
Dec 6, 2023
Type
Pages
25
Uploaded by PresidentNarwhalMaster251
Introduction
to
Health
Statistics
Learning
Objectives
At
the
conclusion
of
this
chapter,
you
should
be
able
to
do
the
following:
Recommend
healthcare
statistics
e
Assess
sources
of
data
o
Compare
and
contrast
between
data
and
information,
validity
and
reliability,
descriptive
and
inferential
statistics,
and
primary
and
secondary
data
sources
!
Determine
the
users
of
healthcare
statistics
Key
Terms
Agency
for
Healthcare
Research
and
Descriptive
statistics
Nursing
facility
_
Quality
(AHRQ)
Encounter
Outpatient
Ambulatory
care
facility
Home
health
(HH)
Primary
data
source
Census
Hospice
Secondary
data
source
Centers
for
Disease
Control
and
Inferential
statistics
Visit
Prevention
(CDCQ)
Inpatient
Vital
statistics
Cenler§
for
Medicare
and
Medicaid
Inpatient
census
World
Health
Organization
(WHO)
Services
(CMS)
Managed
care
organization
(MCO)
:11:
term
statistics
has
two
meanings.
First,
it
is
a
number
computed
from
a
larger
group
of
numbers,
which
collectively
Stitute
a
sample
of
data—for
instance,
the
average
number
of
days
that
patients
stay
in
the
hospital
overnight.
Second,
statistics
i
.
f
.
.
o
o
an;:;tzliCS
lsd
rr:ore
broadly
defined
as
a
branch
of
mathematics
concerned
with
collecting,
organizing,
summarizing,
and
-
ng
data,
Statistics
L
‘.\‘A‘P_‘
Originall
.y
Y,
the
term
statistics
referred
to
the
collection
of
data
about
and
for
the
“state.”
The
word
comes
from
the
Italian
Word
stato,
meaning
«
)
ng
“state.”
One
need
only
think
of
i
istics-
i
izati
8s
the
Bureau
of
Labor
Sl
y
our
own
government
and
its
statistics-collecting
organizations,
such
and
Medicaid
Services
(CM
stics,
the
Centers
for
Disease
Control
and
Prevention
(CDC),
and
the
Centers
for
Medicare
S),
for
example.
m
Chapter
1
Introduction
to
Health
Statistics
Health
statistics
provide
information
about
the
health
of
people
and
their
use
of
healthcare
services.
Examples
of
healthcare
statistics
include
average
longevity;
birth
rates;
death
rates;
number
of
people
with
a
disease
in
a
county,
state,
the
US
as
a
whole,
or
the
world;
and
the
frequency
of
usage
of
a
particular
type
of
service
within
a
healthcare
organization.
Reasons
for
Studying
Statistics
Statistics
is
about
using
data
for
decision-making,
which
is
required
in
every
area
of
our
lives.
To
make
decisions,
we
must
have
information.
In
healthcare
settings,
information
is
often
incomplete.
As
a
result,
we
must
learn
to
estimate
the
characteristics
of
a
complete
population
using
statistics
based
on
a
subset
or
sample
of
the
population.
Most
organizations
keep
statistics
to
make
decisions
about
their
business.
For
example,
an
organization
may
use
statistics
to
determine
its
markets;
that
is,
to
identify
who
is
buying
its
products
or
using
its
services
to
decide
how
it
can
increase
the
availability
and
variety
of
products
and
services.
Healthcare
organizations
use
statistics
to
determine
the
use
and
cost
of
services
as
well
as
outcomes
of
patients.
Many
examples
of
healthcare
data
and
statistics
will
be
presented
in
this
text.
Healthcare
Operations
Needs
In
the
healthcare
industry,
there
are
compelling
reasons
to
collect
and
analyze
data
and
compute
statistics.
For
example,
statistics
kept
on
activities
in
the
healthcare
facility
indicate
why
patients
come
to
the
facility
and
the
costs
of
taking
care
of
them.
Patient
care
statistics
and
comparison
of
the
values
for
different
providers
may
be
used
to
measure
the
quality
of
care
provided.
Many
accrediting
agencies
require
a
data
analysis
system
as
part
of
accreditation, and
many
third-party
payers
require
facilities
to
collect
performance
data.
Organizational
leadership
also
may
use
statistics
for
prioritizing
needed
services
and
to
identify
areas
where
efficiency
and
effectiveness
might
be
increased.
For
example,
laboratory
data
may
show
that
most
outpatients
come
in
for
blood
work
early
in
the
day,
so
the
lab
may
add
more
staff
in
the
morning
hours.
Additionally,
healthcare
facilities
are
interested
in
the
types
of
patients
they
have
with
respect
to
their
diagnoses
in
order
to
maintain
the
optimum
physician
specialty
and
other
professional
staff
mix
they
need
to
treat
their
patients.
Public
Health
Needs
Government
agencies
also
need
to
maintain
statistics
on
and
about
the
population
in
order
to
provide
services.
For
example,
the
CDC,
a
division
of
the
Department
of
Health
and
Human
Services
(HHS),
is
recognized
as
the
lead
agency
responsible
for
protecting
the
health
of
the
US
population
by
providing
credible
information
to
help
individuals
make
the
right
healthcare
decisions
and
promoting
quality
of
life
through
the
prevention
and
control
of
disease,
injury,
and
disability
(CDC
2019).
The
organization
compiles
and
uses
health
statistics,
such
as
birth
and
death
statistics,
to
understand
the
conditions
of
life
and
health
in
our
country.
CMS
is
the
division
of
HHS
that
is
responsible
for
administering
the
Medicare
program
and
the
federal
portion
of
the
Medicaid
program.
CMS
also
publishes
information
on
death
rates
among
Medicare
patients,
and
patients
in
diagnosis
and
procedure
categories.
Researchers
use
this
information
for
studies,
which
may
lead
to
improvement
in
patient
care
and
services.
The
Agency
for
Healthcare
Research
and
Quality
(AHRQ),
a
part
of
HHS,
tries
to
make
healthcare
safer;
of
higher
quality;
and
more
accessible,
equitable,
and
affordable.
For
example,
AHRQ
publishes
research-based
fact
sheets
for
patients
and
consumers
on
a
variety
of
issues,
such
as
patient
safety
and
reducing
errors
when
a
patient
is
in
the
hospital.
AHRQ
also
works
within
HHS
and
with
other
partners
to
make
sure
that
the
data
and
statistics
are
understood
and
used.
AHRQ
conducts
research
on
the
elderly,
children,
and various
healthcare
conditions
to
provide
information
to
consumers
and
other
HHS
agencies
so
they
may
meet
their
objectives.
For
example,
their
work
around
how
to
reduce
readmissions
is
intended
to
help
hospitals
by
providing
tools
to
identify
causes
of
readmissions
and
aid
in
the
development
of
prevention
strategies
(AHRQ
2017).
g
The
World
Health
Organization
(WHO),
an
international
organization
founded
by
the
United
Nations
(UN),
18
the
directing
and
coordinating
authority
on
international
health within
the
UN’s
system.
WHO
provides
leadership
on
critical
health
matters,
works
to
support
countries
to
ensure
all
of
their
citizens
have
accessible
and
safe
healthcar®
and
helps
prevent
the
spread
of
communicable
diseases,
especially
vaccine-preventable
diseases.
They
support
gOOd
health
through
the
continuum
of
life
and
are
working
toward
reducing
quality
of
life
disparities
among
countries:
WHO
supports
healthcare
research
in
maternal,
child,
and
adolescent
health;
malaria;
tuberculosis;
HIV;
Ebola;
an
Sources
of
Healthcare
Statistics
m
other
global
healthcare
issues
(WHO
2019).
For
example,
in
1988,
WHO
helped launch
the
Global
Polio
Eradication
Initiative
to
help
protect
all
children
from
polio.
As
a
result
of
this
immunization
initiative,
the
number
of
polio
cases
has
dropped
by
99
percent.
Today,
80
percent
of
the
world’s
population
lives
in
polio-free
regions
(WHO
2019).
importance
of
Data
To
obtain
the
knowledge
they
need
to
make
decisions,
organizations
first
must
determine
Wha:t
data
to
gollect.
Data
are
raw
facts
and
figures
that
can
pertain
to
a
process
or
activity
that
an
organization
is
interested
in
measuring.
Inforn_uanon
is
derived
from
data
for
the
purpose
of
making
decisions.
The
data
used
to
calculate
these
statistics
must
bc?
.Vahd
and
reliable.
Validity
answers
the
question
of
whether
one
measured
what
one
intended
to
measure,
and
rehab_111ty
means
that
there
is
some
consistency
or
ability
to
replicate
results.
For
example,
if
a
supervisor
is
checking
the
coding
work
of
a
new
employee,
the
codes
assigned
should
be
the
same
for
the
supervisor
as
they
were
for
the
employee
for
the
results
to
be
considered
reliable.
Descriptive
Statistics
Versus
Inferential
Statistics
e
————
The
primary
focus
of
descriptive
statistics
is
to
organize
and
describe
the
features
of
data
in
a
study.
Descriptive
statistics
describe
what
the
data
show
about
the
characteristics
of
a
group
or
population;
in
other
words,
they
may
be
used
to
describe
a
particular
population.
For
example,
it
might
be
necessary
to
know
the
average
age
of
patients
or
which
service
is
used
most
in
a
given
facility.
A
database
including
the
age
of
each
patient
may
be
useq
to
calculate
the
descriptive
statistic
average
age.
Inferential
statistics,
on
the
other
hand,
help
organizations
make
inferences
or
decisions
about
a
larger
group
of
data
by
drawing
conclusions
from
a
small
group
of
the
population.
The
smaller
group
selected
from
the
population
is
called
a
sample.
The
results
obtained
from
the
sample,
if
gathered
carefully,
are
assumed
to
be
representative
of
the
entire
population.
Both
types
of
statistics
are
used
in
healthcare.
Sources
of
Healthcare
Statistics
e
——————————
Healthcare
data
are
derived
from
both
primary
and
secondary
data
sources.
It
is
important
to
understand
the
source
of
the
data
prior
to
using
it
to
compute
statistics
for
use
in
decision-making.
Primary
Data
Sources
In
healthcare,
primary
data
source
refers
to
the
record
that
was
developed
by
healthcare
professionals
in
the
process
of
providing
care
or
services
to
a
patient.
Health
records
are
one
of
the
most
important
primary
sources
of
health
statistics
because
they
contain
a
systematic
record
of
a
patient’s
medical
history
and
care.
The
patient’s
health
record
contains
administrative
data,
such
as
admission
and
discharge
dates,
patient
data,
and
billing
data,
as
well
as
clinical
data.
Notes
from
physicians,
such
as
orders,
progress
notes,
operative
reports,
history
and
physical
examination,
and
a
discharge
summary,
may
be
included.
Nurses’
documentation
includes
their
notes
and
assessments
on
admission
and
throughout
the
hospital
stay
and
medication
records.
Reports
from
clinical
departments
1
the
facility,
such
as
laboratory,
blood
bank,
radiology,
pharmacy,
rehabilitation
services,
and
dietary
services,
may
also
be
inf:luded
in
the
health
record.
depal;{t?fiz::flmc;ep;nments
also
keep
statistics
on
the
activities
they
per'form
for
patients.
For
example,
thfe:
lllaboratfiry
B
o
h')’
eep
data
on
the_number
of
lab
tests
performed.
The
r?xd.lology
department
may
keep
track
of
the
number
decide
wheth
1p
X-rays.
Th.e-
physical
t.herapy
department
may
use
statlstlc.al
datg,
such
as
thfe
number
of
patient
visits,
to
sed
in
tunn
;r
l:;1
hire
additional
physical
therapists
or
add
ph-y§1cal
therapist
assistants
to
their
staff.
These
reports
may
be
produce
y
the
managers
of
the
departments
for
productivity
measurement
apd
combined
with
other
departments
to
areport
of
activity
for
the
entire
facility.
The
administration
of
a
hospital
might
ask
staff
to
keep
data
on
the
number
of
pati
)
.
o
‘5
1ents
transferred
to
another
hospital
for
procedures
the
facility
does
not
offer
in
order
to
determine
the
need
for
that
1Ce
at
the
facility.
Another
exam
Of
the
Nationa]
Ceple
of
a
primary
source
of
data
is
vital
statistics.
The
National
Vital
Statistics
System
(NVSS)
is
part
nter
for
Health
Statistics
(NCHS)
of
the
CDC.
These
data
are
provided
to
the
NCHS
throughout
the
m
Chapter
1
Introduction
to
Health
Statistics
50
states;
Washington,
DC;
New
York
City;
and
the
five
territories
of
the
US
—Puerto
Rico,
the
US
Virgin
Islands,
Guam,
American
Samoa,
and
the
Commonwealth
of
the
Northern
Mariana
Islands.
Vital
statistics
refers
to
a
special
group
of
statistics
that
record
important
events
in
our
lives,
such
as
birth,
marriage,
death,
divorce,
and
fetal
death
(CDC
2019).
Healthcare
facilities
are
interested
in
births
and
deaths,
fetal
deaths,
and
induced
terminations
of
pregnancy
to
drive
quality
improvement
initiatives.
Facilities
generally
are
responsible
for
completing
certificates
for
births,
fetal
deaths,
abortions,
and
occasionally,
death
certificates.
All
states
have
laws
that
require
this
data.
The
certificates
are
reported
to
the
individual
state
registrars
and
maintained
permanently.
State
vital
statistics
registrars
compile
the
data
and
report
them
to
the
NCHS.
The
NCHS
has
developed
standard
certificates
and
procedures
that
states
and
territories
must
use
to
facilitate
the
reliable
collection
of
data.
The
standard
certificates
represent
the
minimum
basic
data
set
necessary
for
the
collection
and
publication
of
comparable
national,
state,
and
local
vital
statistics
data.
The
standard
forms
are
revised
about
every
10
to
15
years,
and
the
latest
adoption
to
the
2003
revisions
of
the
US
Standards
Certificate
of
Live
Birth
were
completed
in
2015.
The
NCHS
is
currently
working
on
the
development
of
an
e-Vital
Standards
Initiative
(NCHS
2015)
that
will
provide
support
for
the
development
of
vital
statistics
standards
to
enable
an
exchange
of
data
regarding
births
and
deaths
from
a
healthcare
facility’s
electronic
health
record
system
directly
to
the
state
registrar
and
then
to
the
NCHS.
Data from
the
states
and
territories
provide
important
information
for
use
in
medical
research
and
are
extremely
valuable
in
estimating
population
growth
areas
of
the
country
and
essential
in
planning
and
evaluating
maternal
and
child
health
programs.
The
NCHS
prepares
and
publishes
national
statistics
based
on
vital
statistics
data
because
the
figures
are
important
in
the
fields
of
social
welfare
and
public
health.
Because
of
their
many
uses,
the
data
on
these
certificates
must
be
complete,
reliable,
and
accurate.
Censuses
Another
primary
source
of
health
data
is
the
census.
A
census
is
defined
as
a
survey
of
a
population.
The
US
government
conducts
a
population
census;
that
is,
a
count
of
the
people
residing
in
the
US
and
their
location.
The
US
Constitution
requires
that
a
population
census
be
taken decennially
(every
10
years),
mainly
to
determine
the
number
of
congressional
representatives
in
the
states.
Over
the
years,
Congress
has
authorized
gathering
more
information
about
each
person.
The
census
now
is
used
in
many
ways.
For
instance,
the
amount
of
government
money
given
to
school
districts
is
based
partly
on
the
number
of
children
in
a
district.
Congress
also
has
requested
that
other
types
of
censuses
be
taken
periodically.
These
include
a
census
of
the
types
of
businesses
and
industries
in
the
US;
for
example,
farms
and
fisheries
and
construction,
foreign
trade,
manufacturing,
and
energy
companies.
Aggregated
census
data,
or
data
that
have
been
clustered
together,
are
available
to
the
public.
Healthcare
researchers
use
the
US
census
when
they
want
to
determine
statistics
about
the
population
at
large.
For
example,
if
resecarchers
want
to
show
the
rate
of
maternal
deaths
in
a
population,
they
must
know
information
about
the
size
of
the
population,
which
the
US
census
provides.
Healthcare
facilities
also
have
a
census,
which
is
the
count
of
patients
present
at
a
specific
time
and
place.
A
hospital
inpatient
is
a
patient
who
is
provided
with
room,
board,
and
continuous
general
nursing
services
in
an
area
of
an
acute-
care
facility
where
patients
generally
stay
at
least
overnight.
In
hospitals,
this
census
is
referred
to
as
the
inpatient
census.
The
hospital
census
is
a
source
of
primary
data.
Ambulatory
care
facilities
also
may
keep
a
census.
An
ambulatory
care
facility
is
a
healthcare
facility
that
provides
preventive
or
corrective
healthcare
services
on
a
nonresident
basis
in
a
provider’s
office,
clinic
setting,
or
outpatient
setting.
Patients
treated
in
a
hospital
setting
such
as
the
emergency
department
or
clinic
are
classified
as
outpatient.
The
census
for
this
setting
usually
represents
the
number
of
visits
or
encounters
during
a
specified
period,
usually
one
day.
A
visit
is
a
single
encounter
with
a
healthcare
professional
that
includes
all
the
services
supplied
during
the
encounter.
An
encounter
is
defined
as
the
direct
personal
contact
between
2
patient
and
a
physician
or
other
person
authorized
by
state
licensure
and,
if
applicable,
by
medical
staff
bylaws
to
order
or
furnish
healthcare
services
for
the
diagnosis
or
treatment
of
the
patient.
Secondary
Data
Sources
Secondary
data
sources
are
data
derived
from
primary
sources
and
may
be
reported
by
someone
other
than
the
primary
user.
For
example,
the
disease
and
operation
index
is
a
secondary
source
of
data.
The
disease
index
is
a
listing
©
patients
discharged
with
a
specific
diagnosis
code,
and
an
operation
index
is
similar
to
the
disease
index,
but
the
patients
are
listed
by
the
operation
or
procedure
code.
All
data
in
the
index
comes
f_ro.m
a
prim;}ry
data
source,
the
health
Registries
are
also
considered
secondary
data
sources.
A
registry
is
a
listing
of
patients
who
share‘a
common
characteristic.
For
example,
data
from
patients’
health
records
may
be
used
to
f:re'ate
a
cancer
or
trauma
Feglstry.’l_‘l'us
is
a
listing
of
patients
in
the
facility
who
have
been
diagnosed
with
cancer
and
will
include
their
treatment
information
as
well
as
follow-up
information.
record.
Users
of
Health
Statistics
n
e
Exercise
1.1
Identify
the
following
as
either
a
primary
or
a
secondary
data
source:
Type
of
Healthcare
Data
il
2.
3.
4.
5.
6.
7.
Type
of
Data
Source
Productivity
reports
pulled
from
patient
visit
report
Tumor
registry
State
vital
statistics
Hospital
census
Hospital
disease
index
Patient
health
record
Health
insurance
data
pulled
from
national
census
Users
of
Health
Statistics
All
healthcare
entities
and
third-party
payers
collect
and
use
statistics.
Following
are
examples
of
individuals
and
organizations
that
collect
statistics
and
how
they
use
statistics:
o
Hospital
leadership:
Inpatient
facilities
use
health
statistics
to
help
address
staffing
issues
and
to
determine
the
types
of
services
to
provide.
For
example,
if
the
number
of
patients
in
the
intensive
care
unit
is
increasing,
.the
hospital
administration
may
want
to
consider
adding
beds
and
staff
to
meet
the
growing
need.
Conver§ely,
if
a
request
is
made
to
the
hospital
administration
for
new
facilities
and
equipment
that
cannot
be
substamlatt':c.l
_by
the
statistics,
it
is
unlikely
the
request
will
be
granted.
Quality
management
departments
in
healtlgcare
facnhtu?s
collect
data
to
determine
how
the
facility
is
performing
regarding
patient
care
and
how
it
can
improve
_thenr
patient
care
services.
Leaders
also
use
statistics
to
determine
if
they
have
the
correct
mix
of
medical
specialties
to
treat
the
citizens
in
their
communities.
Healthcare
department
managers:
Individual
department
managers
in
healthcare
organizations
use
statistics
to
implement
their
department
goals.
For
example,
a
manager
needs
to
know
if
he
or
she
is
staying
within
budget.
If
not,
the
manager
will
need
to
investigate.
Cancer
registries:
A
cancer
registry
may
be
maintained
by
a
separate
department
or
may
be
a
functiop
of
the
health
information
department.
States
may
also
have
a
state
cancer
registry
that
is
responsible
for
collectmg.data
about
cancer.
A
cancer
registry
collects
data
about
the
diagnosis,
treatment,
and
follow-up
of
cancer
pgtlepts.
These
statistics
are
important
in
tracking
cancer
survival
rates.
Facilities
may
choose
to
undergo
accred.ltatlon
through
the
American
College
of
Surgeons
Commission
on
Cancer
(ACS
2019).
This
is
an
evaluation
by
an
independent
team
to
determine
whether
the
facility’s
cancer
registry
meets
their
standards,
which
guide
treatment
and
ensure
patient-centered
care.
Statistics
must
show
the
facility
is
providing
high-quality
care
and
f°"°w"~}P
to
its
cancer
patients.
Physicians
and
researchers
conduct
research
studies
to
learn
about
the
biology
of
eancer,
investigate
new
treatments
and
tests,
and
learn
how
to
prevent
cancers
from
occurring.
':I‘“_'Sing
i:acililies:
Long-term
care
(LTC)
or
nursing
facilities
may
use
statistics
to
determine
the
types
of
payers
CIr
patients
have.
These
statistics
also
are
helpful
in
demonstrating
to
the
public
the
types
of
patients
being
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m
Chapter
1
Introduction
to
Health
Statistics
cared
for
and
the
quality
of
care
given.
For
example,
an
LTC
facility
will
collect
data
on
the
number
of
patients
who
are
incontinent.
This
will
tell
the
facility
if
protocols
need
to
be
established
for
patients
in
order
to
help
them
void.
The
American
Health
Care
Association,
a
nonprofit
association
of
LTC
associations,
publishes
statistics
on
the
trends
in
nursing
home
care.
e
Home
health
(HH):
HH
agencies
provide
care
to
elderly,
disabled,
and
convalescent
patients
in
their
homes.
This
is
also
called
home
care.
These
agencies
keep
statistics
to
determine
the
types
of
services
used
by
their
patients
and
their
outcomes.
For
example,
a
HH
agency
would
need
to
know
the
number
of
nursing
visits,
HH
aide
visits,
physical
therapy
treatments,
and
patients
using
various
types
of
equipment,
such
as
oxygen
machines
or
other
respiratory
aids.
Additionally,
agencies
will
report
patient
outcomes,
such
as
the
number
of
patients
who
have
improved,
the
number
of
patients
who
were
compliant
with
taking
their
medications,
or
the
number
of
patients
who
had
to
be
readmitted
to
a
hospital.
e
Hospice:
Hospice
programs
provide
interdisciplinary
programs
of
palliative
care
and
supportive
services
that
address
the
physical,
spiritual,
social,
and
economic
needs
of
terminally
ill
patients
and
their
families.
These
services
may
be
given
in
either
the
home
or
an
inpatient
setting.
A
hospice
needs
to
know
types
of
illnesses
in
order
to
match
the
appropriate
caregiver
with
each
patient.
e
Mental
health
facilities:
These
may
be
inpatient
or
outpatient
facilities.
These
facilities
use
health
statistics
to
determine
whether
they
are
providing
the
proper
services
for
patients
in
the
community.
Because
the
economic
burden
of
psychiatric
illness
is
great,
the
CDC
collects
data
about
mental
illness
and
its
impact
on
the
country.
e
Drug
and
alcohol
facilities:
These
programs
may
be
inpatient,
ambulatory,
or
a
combination
of
the
two.
Statistics
are
important
in
this
area
to
show
the
success
rates
of
these
facilities’
clients.
The
National
Institute
on
Drug
Abuse
and
the
National
Institute
on
Alcohol
Abuse
and
Alcoholism
are
centers
in
the
National
Institutes
of
Health
that
each
collect
statistics
to
conduct
research.
e
Qutpatient
facilities:
These
include
physician
clinics,
surgery
centers,
emergency
centers,
and
the
like.
Outpatient
facilities
often
use
statistics
to
determine
whether
they
are
providing
the
proper
level
of
care
to
the
community.
e
Managed
care
organizations
(MCOs):
An
MCO
is
a
type
of
healthcare
organization
that
delivers
medical
care
and
manages
all
aspects
of
care
or
payment
for
care
by
controlling
access
to
providers
of
care
and
negotiating
discounted
payment
rates
to
providers
of
care.
MCOs
use
statistics
to
determine
whether
they
are
providing
an
appropriate
level
of
care
and
preventive
services
to
their
members.
Additionally,
MCOs
contract
with
healthcare
facilities
to
provide
specific
services
to
their
members
at
a
prenegotiated
rate.
The
MCO
pays
the
agreed-upon
amount
each
time
a
member
uses
the
service.
e
Healthcare
researchers:
Researchers
depend
on
healthcare
statistics
to
conduct
research
and
help
develop
solutions
to
healthcare
problems.
Some
examples
include
research
in
managed
care,
health
law
and
regulations,
mergers
and
acquisitions
of
healthcare
facilities,
physician
practice
issues,
different
types
of
illness
and
risk
factors,
telehealth
issues,
pharmaceutical
research,
drug
and
alcohol
research,
and
so
on.
Healthcare
statistics
can
also
help
researchers
understand
our
quality
of
life.
e
Accreditation
agencies:
These
organizations
use
healthcare
statistics
to
determine
the
most
common
diagnoses
and
procedures
and
whether
the
resources
are
available
to
treat
patients
with
those
diagnoses.
¢
Federal
government:
The
US
government
collects
data
for
public
health
issues.
For
example,
the
CDC
reports
data
on
births,
deaths,
birth
defects,
cancer,
and
HIV/AIDS,
just
to
name
a
few
of
the
categories
of
data.
CMS
uses
data
collected
by
quality
improvement
organizations
for
its
quality
improvement
projects.
Legislators
and
other
policymakers
use
healthcare
statistics
when
working
on
new
laws,
conducting
program
oversight,
and
considering
the
amount
of
the
budget
that
should
be
allotted
to
federal
health
agencies.
Because
health
information
management
(HIM)
professionals
have
a
broad
knowledge
of
healthcare
facilities
as
well
as
immediate
access
to
a
wide
range
of
clinical
data,
they
are
in
the
best
position
to
collect,
prepare
analyze,
and interpret
healthcare
data.
HIM
professionals
must
learn
acceptable
terminology,
definitions,
an
computational
methodology
if
they
are
to
provide
the
basic
and
most
frequently
used
health
statistics.
One
important
point
to
remember
is
that
health
statistics
are
dependent
upon
accurate
reporting
by
those
individuals
responsible
for
the
task.
Chapter
1
Review
n
Chaptel'
1
MatChing
QUiZ
e
—
Match
the
definitions
with
the
terms.
pefinitions:
b.
A
type
of
healthcare
organization
that
delivers
medical
care
and
manages
all
aspects
of
care
or
payment
for
care
by
controlling
access
to
providers
of
care
and
negotiating
discounted
payment
rates
to
providers
of
care
A
comprehensive
term
for
facilities
that
provide
nursing
care
and
related
services
for
residents
requiring
medical,
nursing,
or
rehabilitative
care
The
direct
personal
contact
between
a
patient
and
a
physician
or
other
person
authorized
by
state
licensure
law
and,
if
applicable,
by
medical
staff
bylaws
to
order
or
furnish
healthcare
services
for
the
diagnosis
or
treatment
of
the
patient
.
A
group
of
federal
agencies
that
oversecs
health
promotion
and
disease
control
and
prevention
activities
in
the
US
An
interdisciplinary
program
of
palliative
care
and
supportive
services
that
addresses
the
physical,
spiritual,
social,
and
economic
needs
of
terminally
ill
patients
and
their
families
Data
related
to
births,
deaths,
marriages,
and
fetal
deaths
An
umbrella
term
that
refers
to
the
medical
and
nonmedical
services
provided
to
patients
and
their
families
in
their
places
of
residence
.
Record
developed
by
healthcare
professionals
in
the
process
of
providing
patient
care
The
UN’s
specialized
agency
created
to
ensure
the
attainment
or
the
highest
possible
levels
of
health
by
all
peoples
Data
derived
from
the
primary
patient
record,
such
as
an
index
or
registry
Terms:
Secondary
data
source
Encounter
__
Nursing
facility
WHO
Home
health
Hospice
Vital
statistics
MCO
1
R
R
S
©v
®
N
o
Health
record
Chapter
1
Review
e
e
—
L)
Select
the
best
answer
to
the
following
questions:
1.
The
CDC
is
the
lead
agency
that
.
a.
Accredits
and
licenses
acute
hospital
facilities
in
the
US
b.
Is
responsible
for
providing
vital
statistics
to
various
agencies,
such
as
the
NCHS
C.
Develops
and
updates
ICD-10
for
the
world
d.
Isresponsible
for
protecting
the
health
of
the
people
of
the
US
The
type
of
statistics
that
make
conclusions
about
a
population
by
drawing
conclusions
from
a
sample
1s
called
a.
Descriptive
statistics
-
Inferential
statistics
Generalized
statistics
-
Mathematical
statistics
an
o
m
Chapter
1
Introduction
to
Health
Statistics
10.
-
Which
of
the
following
is
a
primary
source
of
data?
Inpatient
census
Vital
statistics
collected
by
the
NCHS
Health
record
a,
b,and
c
P
AN
b
and
c
only
-
The
division
of
HHS
that
is
responsible
for
administering
the
Medicare
program
is
the
a.
CDC
b.
CMS
¢.
AHRQ
d.
WHO
.
A
secondary
data
source
includes
a.
Vital
statistics
b.
The
health
record
€.
The
physician’s
index
d.
A
videotape
of
a
counseling
session
-
Which
user
of
statistics
has
the
primary
job
of
supporting
terminally
ill
patients
and
their
families?
a.
Home
health
agencies
b.
Nursing
facilities
€.
Hospice
d.
MCOs
.
The
NCHS
keeps
statistics
on
a.
The
licensing
information
on
all
healthcare
providers
in
the
50
states
b.
Cancer
and
other
deadly
diseases
in
the
50
states
and
the
US-owned
territories
€.
Vital
statistics,
such
as
births,
deaths,
and
fetal
deaths,
in
North
America
d.
Vital
statistics,
such
as
births,
deaths,
and
fetal
deaths,
in
the
50
states
and
US
territories
Which
of
the
following
is
not
a
primary
source
of
data?
a.
Health
record
b.
Vital
statistics
€.
Hospital
census
d.
Disease
and
operation
index
To
be
useful,
the
data
used
to
calculate
statistics
must
be
a.
Fair
and
exact
b.
Valid
and
reliable
€.
Honest
and
justified
d.
Simple
and
clear
To
be
reliable,
statistical
data
must
a.
Be
reproducible
b.
Be
applicable
to
what
is
being
measured
¢.
Be
collected
from
one
source
only
d.
Have
multiple
meanings
11.
12.
13.
14.
15.
Chapter
1
Review
n
Which
of
the
following
is
a
secondary
use
of
a
patient
health
record?
a.
Determining
the
results
of
a
diagnostic
test
b.
Identifying
patients
that
have
a
cancer
diagnosis
¢.
Recording
the
health
and
physician
information
during
an
office
visit
d.
Submitting
diagnoses
and
procedures
for
claim
submission
Facilities
may
choose
to
pursue
accreditation
for
their
cancer
registry
with
the
a.
American
College
of
Physicians
b.
American
Cancer
Society
c¢.
American
College
of
Surgeons
d.
National
Institutes
of
Health
The
type
of
patient
who
receives
care
in
a
hospital-based
clinic
or
department
is
called
a(n)
a.
Inpatient
b.
Outpatient
c.
Hospice
patient
d.
MCO
patient
The
number
of
inpatients
present
in
a
healthcare
facility
at
any
given
time
is
called
a(n)
a.
Survey
b.
Census
¢.
Sample
d.
Enumeration
'
An
international
organization
founded
by
the
UN
that
is
the
directing
and
coordinating
authority
on
international
heath
is
called
the
a.
CDC
b.
AHRQ
c¢.
NCHS
d.
WHO
ematics
Review
Learning
Objectives
At
the
conclusion
of
this
chapter,
you
should
be
able
to
do
the
following:
e
Calculate
using
decimals,
ratios,
proportions,
rates,
and
percentages
Differentiate
between
a
numerator
and
denominator
Perform
rounding
of
numbers
/
o
Determine
the
proper
methods
to
convert
among
fractions,
decimals
and
percentages
e
Compute
the
average
or
mean
Key
Terms
Average
Numerator
Ratio
Decimal
Percentage
Rounding
Denominator
Proportion
Whole
number
Fraction
Quotient
Mean
Rate
g‘:lfnbers
may
b_e
expressed
in
a
variety
of
ways
for
use
in
calculating
statistics.
As
discussed
in
the
previous
chapter,
rcv?
anf(rl
statistics
are
needed
to
help
healthcare
organizations
make
decisions.
The
following
sections
explain
and
willew
actions,
quf)tlents,
decimals,
proportions,
how
to
round
numbers,
percentages,
ratios,
rates,
and
averages.
We
Kie
these
statistics
in
subsequent
chapters.
s
bOlSel
.hezfithcare
data
are
collected
and
tabulated
using
software.
There
are
a
number
of
spreadsheet
products
fOrmzminm
t
;
tina.rket
thgt
may
be
used
for
this
purpose:
Microsoft
Excel,
Google
Sheets,
and
Apple
Numbers.
The
using
M;
cgr
::1
:
;s1c
functlona.hty
are
very
similar
among
these
data
tools.
The
examples
in
this
text
will
be
presented
Standard
by
21
;n
Xcg:l.
Exct:)el
is
the
most
utilized
spreadsheet
program
in
the
market
and
is
considered
an
industry
i
y.
dome
basic
con
i
i
i
i
i
subsequent
i~
cepts
of
spreadsheets
will
be
introduced
in
this
chapter
and
expanded
upon
in
Fractions
e
A
fraction
i
1
1S
one
or
m,
.
the
secong
shows
oneore
parts
of
a
whole.
Figure
2.1
shows
two
circles;
the
first
circle
is
split
into
two
equal
parts,
and
the
secong
circle
(in
dfr?(rt
of
the
c‘ircle
larger
than
the
other
part.
The
fraction
of
the
first
circle
is
¥;
the
fraction
of
€r
color)
is
%.
The
top
number
is
called
the
numerator
and
the
bottom
number
is
called
the
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n
Chapter
2
Mathematics
Review
Figure
2.1.
Fractions
of
a
circle
e
)
i
4
denominator.
The
denominator
tells
us
how
many
equal
parts
a
whole
is
broken
into.
For
example,
if
we
have
a
fraction
of
%,
the
denominator
is
2.
That
indicates
there
are
two
equal
parts
that
make
up
the
whole.
The
numerator
tells
us
how
many
parts
of
the
whole
we
have
selected.
In
the
fraction
%,
1
of
the
two
equal
parts
were
selected.
In
figure
2.1,
the
first
circle
shows
one
part
shaded
black
of
the
two
equal
parts.
We
can
say
that
%
or
one
out
of
the
two
parts
is
shaded
black.
The
second
circle
in
figure
2.1
depicts
three
out
of
four
equal
parts
is
selected
and
shaded
in
black.
This
represents
%
of
the
circle.
Source:
OAHIMA
Example
2.1:
Of
the
40
patients
with
diabetes
seen
last
month
in
a
physician’s
clinic,
20
were
Caucasian,
10
were
African
American,
and
10
were
Asian
American.
The
following
fractions
show
the
number
of
patients
of
each
race
compared
with
the
total
number
of
patients
who
visited
the
clinic:
Caucasian,
2;
African
American,
;
and
Asian
American,
4.
Fractions
should
be
converted
to
their
simplest
form.
The
simplest
form
of
a
fraction
is
when
the
numerator
and
denominator
do
not
have
any
common
factors.
Each
fraction
can
be
converted
by
dividing
both
top
(numerator)
and
bottom
(denominator)
by
a
common
factor.
In
this
example,
10
is
a
factor
of
both
the
numerator
and
the
denominator:
Caucasians,
%;
African
American,
1;
and
Asian
American,
;.
The
first
fraction
can
be
further
simplified
with
the
common
factor
of
2;
thus,
2
can
be
expressed
as
1.
Factors
are
numbers
that
you
multiply
together
to
get
another
number.
For
example,
2
and
3
are
factors
of
6
(2
times
3
equals
6).
If
two
numbers
can
be
formed
by
using
some
of
the
same
factors,
those
are
called
common
factors.
For
“w
example,
2x3=6
and
2x5=10,
therefore
2
is
a
common
factor
of
both
6
and
10.
Exercise
2.1
Find
the
simplest
form
of
each
of
the
following
fractions:
.
20
40
2.
4
6
3,
12
54
3.
8
12
5.
16
28
vecimols
-
[EER
Quotient
M—
A
quotient
is
the
number
obtained
by
dividing
the
numerator
of
a
fraction
by
the
denominator.
This
number.n.lay
be
expressed
in
decimals.
As
a
simple
example,
consider
the
fraction
%2
(one
half).
Using
your
calculator,
divide
1
by
2.
The
result
is
0.5.
This
is
a
decimal
representation
of
the
quotient
found
by
dividing
the
numerator
1
by
the
denominator
2.
gxample
2.2:
The
14
members
of
your
health
information
class
decide
to
participate
in
your
college’s
information
day.
The
booth
is
going
to
be
open
for
21
hours
over
a
three-day
period.
To
find
out
how
many
_hours
each
student
would
need
to
attend
to
the
booth,
you
would
divide
the
numerator
(21
hours)
by
the
denominator
(14
students).
This
could
be
expressed
as
a
fraction,
21/14,
or
3/2
when
simplified
by
removing
the
common
factor
of
7
from
the
numerator
and
denominator.
This
is
difficult
to
interpret
in
terms
of
hours
per
student.
If
we
restate
the
fraction
3/2
as
the
quotient
1.5,
we
can
easily
see
that
the
number
of
hours
per
student
is
1.5.
It
is
important
to
keep
track
of
the
units
of
measurement
for
data.
The
numerator
and
denominatqr
in
fraclior'ts
may
have
different
units.
In
example
2.2,
the
numerator
is
measured
in
“hours”
and
the
denominator
is
measyred
in
W
wsdents.”
The
resulting
quotient
is
measured
in
“hours
per
student”
or
“units
of
numerator
per
units
of
denominator”
in
general.
A
decimal
is
a
quotient
derived
from
a
fraction
where
the
denominator
is
a
multiple
of
10.
These
fractions
are
sometimes
called
decimal
fractions,
but
that
term
is
rarely
used
in
practice.
The
portion
of
the
decimal
to
the
left
of
the
decimal
point
(.)
is
called
a
whole
number.
The
most
common
use
of
decimals
in
the
real
world
is
the
accounting
of
dollars
and
cents.
If
a
syringe
costs
$2.49,
we
interpret
that
as
2
dollars
and
49
cents.
If
we
just
consider
the
numeric
portion
of
the
cost,
it
is
really
a
whole
number
with
a
decimal.
The
whole
number
is
the
2,
the
number
to
the
left
of
the
decimal
point.
The
decimal
is
the
fractional
portion
to
the
right
of
the
decimal
point,
0.49.
We
convert
0.49
to
49
cents
quickly,
but
we
can
also
think
of
49
cents
as
49/100
of
a
whole
dollar.
The
decimal
fraction
is
then
49/100
that
can
be
expressed
as
the
decimal
0.49.
'
Decimal
fractions
are
typically
expressed
as
decimals
(no
one
says
“49/100
cents”).
The
notation
indicates
a
value
that
is
less
than
one.
In
14.37,
for
example,
the
digits
to
the
right
of
the
decimal
point
(3
and
7)
are
called
decimal
digits.
The
digit
“3”
in
this
example
is
in
the
tenths
position
and
“7”
is
in
the
hundredths
position.
The
decimal
point
is
used
t0
separate
the
fraction
(.37)
of
a
whole
number
from
the
whole
number
itself
(14).
The
decimal
point
is
not
ordinarily
used
in
whole
numbers
(for
example,
14.0)
unless
the
healthcare
facility
has
a
reason
for
doing
so.
Figure
2.2
displays
the
interpretation
of
digits
to
the
left
(whole
numbers)
and
right
(fractional
portions)
of
the
decimal
point
for
a
sample
number
measured
to
the
ten
thousandth
place.
Figure
2.2.
|llustration
of
whole
number
and
decimal
positions
Thousands
Tenths
Thousandths
(1,000)
\
Tens
(10)
\
(1/10)
\
(1/1,000)
Hundreds
Hundredths
Ten
Thousandths
(100)
Ones
(1)
(1/100)
(1/10,000)
Source'.
DAH
IMA
m
Chapter
2
Mathematics
Review
Decimal
numbers
without
a
value
to
the
left
of
the
decimal
point
are
typically
written
with
a
leading
zero
to
call
attention
to
the
decimal
point.
For
example,
.5
is
typically
written
as
0.5.
avicK
e
Example
2.3:
Identify
the
following
decimal
positions
in
the
number
3.492.
3
—
ones
position
4
—
tenths
position
9
—
hundredths
position
2
—
thousandths
position
e
Rounding
Numbers
Rounding
is
a
process
of
approximating
a
number
to
a
level
of
precision
that
is
meaningful
for
the
application.
Numbers
may
be
rounded
to
the
nearest
10,
100,
and
so
on.
In
healthcare
facilities,
rounding
is
commonly
used
when
expressing
data
because
staff
must
manage
statistics
measured
as
both
parts
of
a
whole
number,
as
in
length
of
stay,
and
in
whole
numbers,
as
in
the
number
of
patients
or
census.
|
Rounding
can
occur
in
either
whole
or
decimal
numbers.
The
level
of
rounding
is
expressed
using
the
names
of
the
whole
number
and
decimal
positions
found
in
figure
2.2.
When
rounding
to
the
nearest
digit,
examine
the
digit
to
the
I‘
right
of
the
level
of
rounding.
If
that
digit
is
0,
1,
2, 3,
or
4,
then
round
down.
If
that
digit
is
5,
6,7
8,
or
9,
then
round
up,
One
important
rule
to
remember
in
rounding
is
that
only
the
digit
to
the
right
of
the
position
of
the
level
of
rounding;
should
be
considered.
These
concepts
are
best
explained
through
a
series
of
annotated
examples.
The
determination
of
rounding
up
or
down
when
the
digit
to
be
rounded
is
5
is
not
a
uniform
rule.
For
this
text,
we!
will
round
up.
You
may
encounter
other
texts
or
even
situations
in
practice
where
the
rule
may
differ.
For
example,
W
in
this
text
25
is
rounded
to
the
nearest
10
which
is
30,
but
you
may
find
other
references
that
state
25
should
be}
rounded
to
20
(the
nearest
even
number).
Example
2.4:
Rounding
to
the
nearest
whole
number
or
one:
.
1.9
rounds
to
2
since
9
is
in
the
tenths
place.
.
1.905
rounds
to
2
since
9
is
in
the
tenths
place
and
since
we
only
consider
the
9
when
rounding.
0.5
rounds
to
1
since
5
is
in
the
tenths
place.
.
0.1
rounds
to
0
since
1
is
in
the
tenths
place.
.
9.496
rounds
to
9
since
4
is
in
the
tenths
place.
o
oo
o
Example
2.5:
Rounding
to
the
nearest
ten:
.
31
rounds
to
30
since
the
digit
in
the
ones
place
is
1.
.
31.9 also
rounds
to
30
since
we
only
consider
the
1
in
determining
the
rounding.
35
rounds
to
40
since
the
digit
in
the
ones
place
is
5.
.
439
rounds
to
440
since
the
digit
in
the
ones
place
is
9.
.
2,257.92
rounds
to
2,260
since
the
digit
in
the
ones
place
is
7.
o
a0
o
Example
2.6:
Rounding
to
the
nearest
hundred:
.
4,325
rounds
to
4,300
since
the
digit
in
the
tens
place
is
2.
.
4,325.99
rounds
to
4,300
since
we
only
consider
the
2
in
the tens
place.
.
5,990
rounds
to
6,000
since
the
digit
in
the
tens
place
is
9.
.
79,320.95
rounds
to
79,300
since
the
digit
in
the
tens
place
is
2.
.
99
rounds
to
100
since
the
digit
in
the
tens
place
is
9.
(LI
=T
e
B
w
i
Example
2.7:
Rounding
to
the
nearest
thousand:
.
45,025
rounds
to
45,000
since
the
digit
in
the
hundreds
place
is
0.
.
96,591
rounds
to
97,000
since
the
digit
in
the
hundreds
place
is
5.
42.984.9
rounds
to
43,000
since
the
digit
in
the
hundreds
place
is
9.
.
43,400
rounds
to
43,000
since
the
digit
in
the
hundreds
place
is
4.
.
1,632.01
rounds
to
2,000
since
the
digit
in
the
hundreds
place
is
6.
(G
=N
e
R
i
gxample
2.8:
Rounding
to
the
nearest
tenth:
o0
oP
%"
(ones
or
whole
number
in
this
case).
gxample
2.9:
Rounding
to
the
nearest
hundredth:
a.
b.
c.
d.
€.
Example
2.8d
is
interesting.
Because
the
8
is
in
the
hundredths
place,
9
should
be
rounded
up
to
10.
This
is
achieved
|
by
rounding
the
0.98
up
to
1.0.
When
the
digit
to
be
rounded
up
is
a
9,
then
the
digit
to
the
left
must
be
incremented
|
\
I
Rounding
Numbers
“
1.39
rounds
to
1.4
since
the
digit
in
the
hundredths
place
is
9.
2.91
rounds
to
2.9
since
the
digit
in
the
hundredths
place
is
1.
9.3694
rounds
to
9.4
since
the
digit
in
the
hundredths
place
is
6.
0.98
rounds
to
1.0
since
the
digit
in
the
hundredths
place
is
8.
|
0.06
rounds
to
0.1
since
the
digit
in
the
hundredths
place
is
6.
6.395
rounds
to
6.40
since
the
digit
in
the
thousandths
place
is
5.
3.209
rounds
to
3.21
since
the
digit
in
the
thousandths
place
is
9.
65.591
rounds
to
65.59
since
the
digit
in
the
thousandths
place
is
1.
0.009
rounds
to
0.01
since
the
digit
in
the
thousandths
place
is
9.
0.999
rounds
to
1.00
since
the
digit
in
the
thousandths
place
is
9.
Exercise
2.2
Find
the
quotient
in
the
following
fractions.
Round
to
two
decimal
places.
1.
2
5
2,
3
4
3.
7
8
g,
107
98
5.
54
65
Exercise
2.3
Round
the
following
numbers
to
the
nearest
10.
e
R
Round
the
following
numbers
to
the
nearest
hundred.
6.
7
S
8.
9.
10.
4
338
217
6,989
8,532
156
321
3,807
4,357
8,175
m
Chapter
2
Mathematics
Review
Percentage
m
Round
to
the
nearest
whole
number.
11.
381
12.
55.69
13.
147
14.
62523
15.
100.5
Round
to
the
nearest
tenth
or
one
decimal
place.
16.
19.76
17.
34.623
18.
172.87
19.
99.98
20.
125.969
Round
to
two
decimal
places.
21.
8.36801
22.
14.5264
23.
0.87642
24,
27.99999
25.
15.90176
When
asked
to
provide
an
answer
to
one
decimal
(or
more)
and
the
resulting
answer
is
a
whole
number,
add
(’s
after
the
decimal
point.
For
example,
rounding
10
to
one
decimal
is
10.0
and
rounding
10
to
two
decimals
is
10.00.
Quick
TP
Percentage
L
—————————————————
The
ratio
of
a
part
to
the
whole
is
often
expressed
as
a
percentage. A
percentage
is
a
value
computed
on
the
basis
of
the
whole
divided
into
100
parts.
It
may
help
to
remember
that
percent
means
“per
100”
when
interpreting
percentagesi
Percentages
should
be
labeled
with
either
the
percent
sign
(%)
or
the
word
“percent”
after
the
number
value
is
stated.
FoE
example,
0.34
would
be
written
as
%
and
is
equal
to
34
percent.
Percentages
are
a
useful
way
to
make
fair
comparison
because
the
calculation
of
a
percent
essentially
standardizes
each
value
to
be
scaled
to
“per
100”.
Example
2.10:
If
20
patients
died
in
Hospital A
last
month,
and
50
patients
died
in
Hospital
B
during
the
same
period,
one
might
conclude
that
it
would
be
better
to
use
the
services
at
Hospital
A
because
Hospital
A
had
fewer
deaths.
However,
that
conclusion
would
be
wrong
if
Hospital
A
had
100
discharges
during
the
month
and
Hospital
B
had
500
discharges
for
the
same
period.
Hospital
A:
20/100
=
20%
deaths
Hospital
B:
50/500
=
10%
deaths
In this
case,
the
percent
of
deaths
allows
us
to
compare
Hospital
A
and
Hospital
B
on
the
same
scale
of
deaths
“per
100
Not
all
percentages
are
whole
numbers.
For
example:
—;—
=0.125=12.5%
percentages
can
be
rounded
to
various
levels
just
as
decimals
are.
For
example,
if
we
wanted
to
round
12.5
percent
to
the
nearest
whole
percent,
the
rounded
value
would
be
13
percent
(round
digits
5
and
up
to
the
next
number).
common
Transformations
of
Fractions,
Decimals
and
Percentages
Numbers
may
be
expressed
in
a
different
format
based
on
the
context
in
which
they
are
used.
The
same
value
may
be
expressed
as
a
fraction
(1/2),
decimal
(0.5),
or
percentage
(50
percent).
The
following
section
contains
guidance
on
how
to
convert
between
these
formats.
Converting
a
Fraction
to
a
Percentage
To
convert
a
fraction
to
a
percentage,
divide
the
numerator
by
the
denominator
and
multiply
by
100.
Example
2.11:
Convert
1
to
a
percentage.
Step
1:
Divide
1
by
2.
1+2=0.5
Step
2:
Multiply
by
100.
0.5x100=5%
Converting
a
Decimal
to
a
Percentage
To
convert
a
decimal
to
a
percentage,
simply
multiply
the
decimal
by
100.
The
calculation
changes
the
position
of
the
decimal
point
two
digits
to
the
right.
:
I
Example
2.12:
Convert
the
decimal
0.29
to
a
percentage.
0.29x100
=
29%
Converting
a
Percentage
to
a
Fraction
To
convert
a
percentage
to
a
fraction,
eliminate
the
percent
sign
and
multiply
the
number
by
5+
A
simpler
method
is
10
place
the
number
in
the
numerator
and
100
in
the
denominator.
Example
.2..13:
Convert
5
percent
into
a
fraction.
Step
1:
Eliminate
the
percent
sign
and
multiply
the
value
by
1/100.
Step
2:
Express
the
fracti
.
on
in
simplest
form.
Since
5
is
a
factor
of
both
the
numerator
and
denominator,
the
Simplest
form
is:
5+5
_i
100+5
20
Example
2.14.
Convert
23
T8
:
Step
1:
Elimin
at
percent
into
a
fraction.
¢
the
percent
sign
and
multiply
the
value
by
1/100.
L
B
100
~
100
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m
Chapter
2
Mathematics
Review
Step
2:
Express
the
fraction
in
simplest
form.
There
are
no
common
factors
for
23
and
100.
Therefore,
23/100
is
the
simplest
form
for
this
fraction.
Converting
a
Percentage
to
a
Decimal
To
convert
a
percentage
to
a
decimal,
eliminate
the
percent
sign
and
divide
the
remaining
number
by
100.
This
is
the
equivalent
of
moving
the
decimal
point
two
places
to
the
left.
Hint:
If
the
percentage
is
less
than
10,
place
a
0
in
front
of
the
value
and
place
the
decimal
point
in
front
of
the
0.
Example
2.15:
Convert
76
percent
to
a
decimal.
|
Step
1:
Eliminate
the
percent
sign:
76.
,
Step
2:
Divide
the
number
by
100.
|
76+100=0.76
’
Example
2.16:
Convert
4
percent
to
a
decimal.
Step
1:
Eliminate
the
percent
sign:
4.
Step
2:
Divide
the
number
by
100.
4+100=0.04
Example
2.17:
Convert
109
percent
to
a
decimal.
Step
1:
Eliminate
the
percent
sign:
109.
Step
2:
Divide
the
number
by
100.
109
+100=1.09
@
The
decimal
point
in
whole
numbers
is
often
not
displayed,
but
it
is
still
present.
For
example,
76,
76.,
and
76.0
arg
all
equivalent
numbers.
When
the
decimal
point
is
not
displayed,
it
is
sometimes
confusing
to
visualize
moving
it
1d
QUICK
whole
number
with
the
decimal
point
present
for
these
conversions.
Using
Excel
to
Convert
Fractions
to
Decimals
and
Percentages
Using
spreadsheet
software
such
as
Excel
is
very
convenient
when
converting
fractions
to
quotients
and
decimals
OF
percentages.
First,
let’s
look
at
the
anatomy
of
a
spreadsheet
to
understand
how
we
may
use
that tool
to
help with
thi§
type
of
calculation.
You
can
think
of
a
spreadsheet
as
a
table
with
rows
and
columns.
In
figure
2.3,
the
rows
of
the
spreadsheet
are
labeled
by
the
numbers
1
through
5.
The
columns
are
labeled
witlh
letters
A
through
C.
Excel
spreadsheets
can
be
very
large.
The
most
recent
version
of
Excel
can
hold
up
to
1,048,578
rows
by
16,384
columns.
The
cells
are
referenced
by
their
row
and
column.
The
upper
left
cell
is
referred
to
as
cell
AR
The
cell
below
Al
is
A2
and
the
cell
to
the
right
of
A1
is
B1.
Figure
2.4
shows
the
cells
with
their
labels.
The
cells
in
a
spreadsheet
may
hold
either
values
or
calculation
instructions.
For
example,
if
we
wanted
to
calculal§
the
value
in
example
2.2
using
Excel,
we
could
put
the
numerator
(21
hours)
in
cell
A2,
the
denominator
(14
studentsy
into
cell
B2,
and
then
the
formula
to
calculate
the
value
of
dividing
the
numerator
by
the
denominator
in
cell
C2.
Figui§
2.5
shows
the
values
that
should
be
keyed
into
each
cell.
Figure
2.3.
Spreadsheet
example
W'
the
left
or
right
for
the
percent-to-decimal
and
decimal-to-percent
conversions.
It
may
be
helpful
to
actually
write
the
figure
2.4.
Display
of
cell
references
in
spreadsheet
4
A
B
c
1
A1
|B1
C1
2
A2
B2
c2
3
A3
[Bs
c3
4
A4
B4
c4
5
A5
B5
c5
6
A6
IB6
c6
"
Figure
2.5.
Excel
calculation
example
|
5
4
A
B
c
D
1
|Hours
Students
'Hours
per
Student
'
2
21
14/=A2/B2
<<
Keyed
Values
3
21|
14;1.5
<<
Results
Notice
that
the
cells
Al,
B1,
and
C1
are
used
as
title
or
label
cells.
They
are
not
part
of
the
calculation
but
are
important
to
include
so
that
the
units
and
interpretation
of
the
various
values
can
be
conveyed
to
the
reader.
The
value
in
C2
is
a
calculation
or
formula.
All
calculation
cells
in
a
spreadsheet
must
begin
with
an
equal
sign
or
“=.”
This
is
a
signal
to
Excel
that
a
calculation
should
be
performed
as
opposed
to
simply
displaying
the
values
keyed
into
the
cell.
In
addition
to
performing
calculations,
Excel
has
a
number
of
formatting
options
that
can
make
rounding
and
converting
to
percentages
very
easy.
staff
members
with
RHIT
credentials,
5
staff
members
with
RHIA
credentials,
and
the
remaining
staff
with
no
l
Example
2.18:
Suppose
General
Hospital’s
health
information
management
(HIM)
staff
of
48
includes
20
credentials.
What
percentage
of
the
HIM
staff
has
an
RHIT
credential?
Round
to
the
nearest
tenth
of
a
percent.
Let’s
walk
through
the
steps
in
calculating
a
percent
by
hand:
1.
Determine
the
numerator
and
denominator:
a.
Numerator
—
number
of
RHITs
b.
Denominator
-
total
staff
1
.
Divide
numerator
by
denominator.
[
Multiply
by
100
to
convert
to
a
percentage.
-
Round
to
the
nearest
whole
percent.
The
steps
i
ite
simi
4
!
€ps
In
Excel
are
quite
similar,
but
the
conversion
to
a
percentage
and
rounding
may
be
completed
via
formatting.
EPS
(displayed
in
figure
2.6):
5
;
Put
the
labels
of
each
column
in
cells
A1,
B1,
and
C1.
=
Enter
the
numerator
(20)
into
cell
A2.
3.
E
i
F
nter
the
denominator
(48)
into
cell
B2.
«
Enter
the
formula
“=A2/B2”
into
cell
C2.
n
Chapter2
Mathematics
Review
b
Percentage
b
|
Figure
2.6.
Example
2.18
steps
1-4
7
4.
—
12
Formula
version:
3
5.
—
4|
A
B
c
|
15
1
|RHITs
Staff
|RHIT
Percent
l
)
]
o
t
|_A2iB2
|
Convert
the
following
decimals
to
percentages
(round
to
one
decimal
place):
)
|
6.
0.28
Calculated
version:
7.
0.07
4
»
|
B
|
¢
|
1
|RHITs
|[Staff
RHIT
Percent
8.
01254
2
20
48|
0.416666667
9.
0.4299
3
‘
!
10.
0.9981
Figure
2.7.
Format
menu
Convert
the
following
percentages
to
fractions:
:
11.
42%
c2
|
o
Il
=A2/R2
N
|
Calibri
|11
"%
Arg
%9
E
t
;
12.
58%
A
A
B8
‘
—
s
3
0
|
.
=
e
A
el
0
g
13.
78%
1
JRHIT
staff
RHIT
Perce
[
=
e
L
I
|
.
2
20
48]0.416666667
lec
Raculte
14.
75%
=
T
Y
o
"
s
15.
20%
Figure
2.8.
Results
for
example
2.4
Convert
the
following
percentages
to
decimals:
16.
12%
4l
A
i
c
17.
27%
1
RHIT
iStaff
RHIT
Percent
2
20
48
41.7%
18.
0.5%
19.
7.5%
5.
Format
the
value
in
C2
as
a
percent.
20.
3.49
a.
Highlight
the
value
in
cell
C2
by
clicking
on
the
cell.
.
-
b.
Right
click
on
the
cell
to
display
the
format
menu
in
figure
2.7.
S
exasg::!};igrr’e;ctgl;)rltir
in
};(;ur
loc.al
physician’s
'clinic
saw
150
adults
in
one
week
for
their
annual
physical
¢.
Select
the
“%>
icon
from
the
format
menu.
T
«
&
ose
150
patients,
67
{ecenved
the
flu
vaccine.
Express
the
rate
of
the
flu
vaccine
.
lon
in
percent.
Round
to
one
decimal
place.
Perform
this
calculation
using
a
calculator
and
repeat
d.
Excel
will
round
the
nearest
whole
percent
by
default.
the
calculation
using
Excel.
(Hint:
Follow
the
steps
in
example
2.18.)
e.
Right
click
on
the
percentage
value
to
display
the
format
menu
once
again.
22.
The
physic;
.
o
:
'
_
_
L
.
physician
practice
you
work
for
needs
a
new
paper
shredder.
The
t
-
,
gallons.
You
did
some
investioati
i
:
:
_
)
)
o
.
)
|
.
gation
and
secured
five
offers
from
different
companies.
The
shredd
1l
The
resulting
value
is
41.7
percent
as
displayed
in
figure
2.8.
Repeat
the
calculation
using
your
calculator
to
chet
equal
quality.
Set
A
;
)
.
P
S
MICHSHIEGIdETstateia
of
.
g
P
play
&
p
gy
Y.
Set
up
an
Excel
spreadsheet
using
the
information
here.
Which
company
is
giving
you
the
best
deal?
Hint:
Cal
1
:
.
discounted
pr(i:cl:leat;[e
thg
dlscgunted
price
and
then
add
in
the
shipping
and
handling
where
appropriate.
Calculate
the
¥y
subtracting
the
discount
dollar
amount
from
the
list
price.
Exercise
2.4
Complete
the
following
conversions.
C‘"“pany
%
$
o
-[)'i'scoumq
_.D.'Slc)(:illztul
ShHll;[::(lllEl:ig"d.
Convert
the
following
fractions
to
percentages
(round
to
one
decimal
place):
gz:g::y
B
$625:()0
ig;/:
g;eoioo-()@
.
2
C()mpani
f)
$551.00
15%,
$33OO
8
Company
£
$584.00
25%
i
2_
_3_
$57900
200/0
5
5
Local
$00.00
3.
2
4
m
Chapter
2
Mathematics
Review
23.
Using
the
information
found
in
the
scenario
below,
complete
the
following
tables
using
Excel.
Forty
patients
were
seen
in
the
Hematology/Oncology
Clinic
last
Tuesday.
Twenty
patients
had
sickle-cell
anemia,
|
12
patients
had
hemophilia,
6
patients
had
Ewing’s
sarcoma,
and
2
patients
had
Wilms’
tumor.
Express
in
counts,
decimals
(round
to
two
places),
and
percentages
(round
to
whole
percent)
the
number
of
patients
with
each
condition
compared
with
the
number
of
patients
who
visited
the
clinic
last
Tuesday.
—_M—M
|
Sickle
cell
'
Hemophilia
Ewing’s
Wilms’
1
Total
Ratios
Sre—
;
A
ratio
is
a
number
found
by
dividing
one
quantity
by
another;
also,
a
general
term
that
can
include
a
number
of
specific
measures
such
as
proportion,
percentage,
and
rate.
Ratios
typically
express
the
relationship
of
ongd
quantity
to
another.
To
calculate
ratios,
one
quantity
is
compared
to
another.
The
number
can
be
greater
than
or
less
than
1.
Ratios
may
be
expressed
in
a
fractional
form,
but
they
have
a
different
interpretation
than
fractiong
,'
Fractions
are
essentially
numbers:
¥
is
a
fraction
and
its
representation
might
be
%2,
0.5,
or
even
50
percent,
ag
we
demonstrated
earlier
in
the
chapter.
It
is
an
expression
of
a
part
of
a
whole.
Ratios
are
a
comparison
of
twg
subsets.
l
Example
2.19:
If
seven
men
and
five
women
were
in
a
group,
the
ratio
of
men
to
women
would
be
£
.
This
ratio
also
may
be
written
as
7:5
and
verbalized
as
7
to
5.
ratio
of
men
to
women
is
a
different
value
than
the
percentage
of
men.
The
fractiol
Notice
in
example
2.19
that
the
the
group
or
7/12.
We
may
express
this
as
@
of
men
in
this
case
would
be
the
number
of
men
divided
by
the
total
in
decimal,
0.58,
or
a
percentage,
58
percent.
Ratios
should
be
expressed
in
their
simplest
form
just
like
fractions,
and
they
may
be
applied
to
a
particulal
situation
by
multiplying
the
numerator
and
denominator
by
the
same
factor.
Suppose
we
wanted
to
recruit
a
foclis
group
of
36
members
and
wanted
to
maintain
the
ratio
of
men
to
women
of
7:5
found
in
example
2.19.
Table
2.1
shoW
how
the
ratio
of
men
to
women
can
be
maintained
for
focus
groups
of
various
sizes.
Table
2.1.
Focus
groups
of
various
sizes
Focus
Group
Size
|
Number
of
Men
|
Number
of
Women
|
12
7
S
24
(multiply
by
2)
14
10
36
(multiply
by
3)
21
15
48
(multiply
by
4)
28
20
Example
2.20:
If
an
HIM
department
of
16
staff
includes
6
RHIAs
and
10
RHITs,
what
is
the
ratio
of
RHIAs
10
RHITs?
The
ratio
of
RHIAs
to
RHITs
is
6
to
10
or
6:10
or
6/10.
All
of
these
are
equivalent
expressions
of
the
same
ratids
Notice
that
2
is
a
factor
of
both
6
and
10.
This
ratio
should
be
expressed
in
its
simplest
form:
E:Eizgoflfi
or
“3to05”
10
102
5
Ratios
23
e
gxercise
2.5
1.
Express
the
following
ratios
in
their
simplest
form.
8:96
3:15
8:16
12:72
e.
57
2.
A
group
of
15
men
and
20
women
have
diabetes.
Express
the
ratio
i
i
n
of
i
diabetes.
Calculate
it
to
its
simplest
form.
P
B
e
oo
er
o
3.
Your
college
bookstore
reported
that
of
the
1,000
books
sold
durin
.
e
g
enrollment,
320
were
HIM
books.
E
the
ratio
of
HIM
books
to
the
total
number
of
books
sold.
Calculate
it
to
its
simplest
form.
L
4.
There
are
12
1r}structors
i_n
your
HIM
program.
Five
of
these
are
male
instructors,
and
the
rest
are
female
Express
the
ratio
of
male
instructors
to
female
instructors.
Calculate
it
to
its
simplest
form
.
5.
((j)f
the
1]:%
instruc;lors
in'
‘[hef
[t))revious
example,
three
have
a
master’s
degree
and
the
rest
have
a
bachelor’s
egree.
Express
the
ratio
of
bachelor’s
degree
prepared
instructors
to
master’
i
xpress
th
ster’s
de
Calculate
it
to
its
simplest
form.
B
6.
Community
Hospital
reported
16
births
this
past
month.
Four
wer
i
i
.
.
¢
male.
What
i
female
births?
Calculate
it
to
its
simplest
form.
i
Proportions
chl):g:gl:nofi
1sda
type
of
ratio
in
WhiCl:l
x
is
a
portion
of
the
whole
(x
+
y).
In
a
proportion,
the
numerator
is
always
in
the
denominator.
A
proportion
may
be
expressed
as
a
percentage,
a
decimal,
or
a
fraction.
Ex
:
ample
2.21:
If
2
women
out
of
a
group
of
10
over
the
age
of
50
have
had
breast
cancer,
what
is
the
proportion
of
women
who
have
h
i
e
o
ad
breast
cancer
in
the
over-50
age
group?
Express
the
proportion
as
a
gzep
1:
Find
the
size
of
the
whole
group:
10.
St:p
g:
Iélnd
the
number
of
women
who
had
breast
cancer:
2.
P
3:
Calculate
the
proportion
as
portion/whole.
Portion
of
women
over
50
that
had
breast
cancer
_
2
Number
in
group
of
women
over
50
10
Step
4:
Convert
to
a
decimal.
2
—=2+10=02
10
8
a;Ir‘:able
2.2
shows
a
sam
e
aclte-care
facilit
o
€Istand
which
d
y
re
admiteq
on
days,
P;fi
gomsglttl‘f‘:’tl:edhslallstlcal
report
provided
by
the
information
systems
(IS)
department
ays
admissions
ek
SE
OW.
t.he
dgpartment
uses
proportions
expressed
as
percentages
to
Mondays
or
Saturises
Xamining
this
table,
we
can
see
that
less
than
10
percent
of
the
patients
ays.
This
type
of
report
can
guide
staffing
levels
during
high-
and
low-volume
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m
Chapter
2
Mathematics
Review
Table
2.2.
Administrator's
semiannual
reference
report
A
dministrator’s
Semiannual
Reference
Repor
dmissions
by
Day
of
Weel
711/20XX-12/31/20X
Number
of
Patients
Sunday
1,283
18.7
Monday
577
8.4
:
Tuesday
1,126
16.4
|
Wednesday
1,301
189
|
Thursday
1,240
18.0
Friday
702
10.2
|
Saturday
645
9.4
Totals
6,874
100.0
Exercise
2.6
1.
A
school
district
wants
to
know
the
proportion
of
students
who
have
deferrals
for
mandated
vaccines.
District
School
#1
has
237
students.
Of
the
237
students,
225
students
are
up
to
date
on
their
vaccines.
There
are
12
students
with
deferrals.
What
is
the
proportion
of
students
with
deferrals
who
have
not
been
vaccinated?
Round
to
two
decimal
places.
2.
At
Community
Clinic,
50
patients
were
seen
in
one
day.
Of
those,
6
have
type
2
diabetes
mellitus.
What
i
the
proportion
of
people
in
the
group
who
have
diabetes?
Express
as
a
decimal
and
round
to
two
decimil
places.
3.
At
Community
Clinic,
Dr.
Clark
treats
only
diabetic
patients.
He
has
650
active
patients.
Of
those,
458
ha/@i
attended
his
specialized
training
session
for
newly
diagnosed
diabetes.
What
proportion
of
Dr.
Clark’s
patieni8
have
undergone
his
training?
Express
as
a
decimal
and
round
to
two
decimal
places.
4.
At
Community
Clinic,
Dr.
Simpson,
an
interventional
cardiologist,
saw
270
patients
last
quarter.
Of
those,
I
performed
stent
procedures
on
182
patients.
What
is
the
proportion
of
Dr.
Simpson’s
patients
who
have
stent
procedures?
Express
as
a
decimal
and
round
to
two
decimal
places.
5.
Dr.
Rutan,
an
internist
at
Community
Clinic,
asked
that
14
of
the
35
patients
he
saw
last
week
get
their
x-ré
and
lab
work
completed
the
day
before
their
appointments.
What
is
the
proportion
of
Dr.
Rutan’s
palien
who
had
preliminary
work
completed
prior
to
their
appointments?
Express
as
a
decimal
and
round
to
18
decimal
places.
Rates
A
rate
is
a
fraction
that
is
formulated
to
express
the
relationship
between
the
numerator
and
denominator.
A
medsis
of
time
is
often
an
intrinsic
part
of
the
denominator.
For
example,
number
of
patients
treated
per
day
or
charts
el
per
shift
are
rates
that
are
used
in
healthcare.
Healthcare
facilities
calculate
many
types
of
rates
to
determine
hoW
3
are
performing
compared
to
benchmark
or
best
practice
value.
i
The
term
rate
is
often
used
loosely
to
refer
to
rate,
proportion,
percentage,
and
ratio.
Indeed,
many
books
,'
organizations
use
these
terms
interchangeably.
For
this
reason,
it
is
important
to
be
aware
of
how
any
measure
repd!
r
is
defined
and
calculated.
For
rates,
proportions,
and
ratios, the
numerator
and
denominator
must
be
clearly
defl
and
documented
to
communicate
the
interpretation
of
the
value
to
the
reader.
The
basic
rule
of
thumb
for
calculatin,
i
indi
i
[
g
rates
is
to
indicate
the
number
of
times
something
actually
h
i
.
-
a
relation
to
the
number
of
times
it
could
have
happened
(actual/potential
or
part/base).
The
nun%ber
of
tiymesptieen:\(fle;r:
occurred
is
the
part
that
we
would
like
to
measure;
the
number
of
ti
.
;
imes
the
event
could
have
i
we
use
for
comparison.
The
formula
for
determining
rates
is
as
follows:
N
Part
P
Rate
=
,
or
R=—
B
Base
Example
2.22:
If
10
of
the
35
patients
visitin
ician’s
offi
i
:
g
a
physician’s
office
receive
i
i
i
for
that
set
of
patients?
Round
to
two
decimal
places.
2
fluvaccine,
whatls
the
vaccine
rate
Step
1:
Determine
the
event
to
be
measured:
flu
vaccines.
Step
2:
Determine
the
number
that
actually
happened
(part):
10.
Step
3:
Determine
the
number
that
could
have
happened
(base):
Step
4:
Calculate
the
rate:
PP
(base):
35
]
10
Vaccine
Rate
=
E
=10+35=0.285
round
to
0.29
211[
.calclulazjt(;ns
should
be
checked
to
make
sure
they
are
reasonable
in
the
context
of
the
calculation.
Misplaced
&Y
decima
points
agi
a
common
source
of
mathematical
errors.
For
example,
a
hospital
death
rate
of
25
percent
should
w
seem
unreasonable
because
it
indicates
that
one
of
every
four
patients
treated
at
this
hospital
died.
Thus,
the
decimal
S
)
placement
in
this
calculation
should
be
checked.
The
correct
d
}
j
B
oot
wioch
mouad
bewoors
rectitin
rect
death
rate
for
this
hospital
may
be
2.5
percent
or
0.25
Averages
e
——
A
;
.
L
n
average
or
mean
is
the
value
obtained
by
dividing
the
sum
of
a
set
of
numbers
by
a
count
of
the
number
of
values
in
]
l
f
"
f
.
.
e
.
i
101€
A€
[Eul
mn
:hzll:
tE]
10')
The
symbol
X
(pronounced
“ex
bar”)
is
used
to
represent
the
mean
in
this
formula.
K=
Sum
of
all
values
Count
of
value
Exampl
tLet’
i
Ple
2.23:
Let’s
say
that
you
completed
six
medical
terminology
tests.
Your
scores
are
82,
78,
94,
56
91,
and
85.
Accordi
i
i
l
o
ording
to
the
calculation
displayed
below,
your
average
score
on
the
medical
terminology
82+78+94+56+91+85
486
6
=68
X=
81
There
ar
e
several
different
¢
]
]
Other
types
Ofavera'fire
"
ypes
of
averages
used
in
healthcare.
The
arithmetic
mean
or
average
is
presented
here.
-
ges
may
be
encountered
in
healthcare
and
will
be
presented
in
later
chapters.
E
ACel
may
be
yseq
to
calculat
S
e
averages
also.
To
solve
example
2.23
using
Excel,
follow
these
steps:
o
ues
into
column
A
as
displayed
in
cells
A2
through
A7
in
figure
2.9.
:
€y
the
formula
dis
Wlth
an
“=*
he
8
cells
A
ffiffigtl;ese
tep
1:
Enter
the
test
val
Sign
o
thgia%fed
in
cell
B8
in
figure
2.9
into
cell
A8.
Notice
that
this
is
a
formula
and
therefore
xcel
knows
to
evaluate
the
formula.
The
Excel
function
is
called
“average”
and
the
S
are
the
ce]
]
BB
A7
ells
that
we
want
to
average.
The
range
of
cells
is
written
as
A2:A7.
Excel
interprets
this
m
Chapter
2
Mathematics
Review
Chapter
2
Review
27
Figure
2.9.
Calculating
an
average
using
Excel
d.
A
measure
used
to
com
c
:
cd
10
are
an
t
.
.
(numerator)
with
the
nurfiber
of
tienZZ;larcl)
Z:/re;}[me,
fiicomparlson
olgthcanumbergot-imesyanyeyent-did.happen
A
B
e.
The
relation
of
c'>rn'em
art
to
th
:
could
have
happened
(denominator)
;
]
|
.
B
e
p
‘
0.
!
e
whole
with
respect
to
magnitude,
quantity,
or
degree
;
|
f§.
The
value
obtained
by
dividing
the
sum
of
a
set
of
numbers
by
the
number
of
values
i
2
32\
g
The
part
of
a
fraction
below
the
line
signifying
division
that
functi
i
Ya
uesin
the
set.
3
gj
ll
nto
how
many
parts
the
unit
is
divided
ctions
as
the
divisor
of
the
numerator
and
indicates
-
56l
‘
h.
The
nufnber
re'sulting
from
the
division
of
one
number
by
another
6
o1
i.
A
quotient
derived
from
a
fraction
where
the
denominator
is
a
multiple
of
10
7
85|
.
j.
The
process
of
approximating
a
number
8
81
|
<<=average(A2:A7)
Terms
|
Exercise
2.7
R
umemitor
6.
____
Whole
number
2.
Rate
.
0
.
5
1
.
1.
Community
Hospital
reported
the
following
birth
weights,
in
pounds,
for
babies
born
January
30,
20XX:
3
Fraction
____Proportion
6.9,3.7,7.7,6.6,7.3,
5.5,9.9,7.0,5.5,
and
7.7.
What
was
the
average
birth
weight
for
the
day?
Round
to
two
©
S
8.
_
Decimal
decimal
places.
4.
Average
9
Ui
-
ing
2.
A
patient’s
temperature
for
five
days
after
surgery
taken
at
7:00
a.m.
each
morning
was
recorded
as
101.7§
5.
_
Denominator
10
Quoti
100.4,
98.9,
100.2,
and
98.6.
What
was
the
patient’s
average
temperature
after
surgery?
Round
to
two
decimal
i
uotient
places.
Chapter
2
Review
-
3.
A
patient’s
blood
sugar
was
recorded
for
seven
days
at
8:00
a.m.
and
recorded
as
the
following:
164,
15§
172,
145,
138,
136,
and
142.
What
was
the
patient’s
average
blood
sugar
at
8:00
a.m.?
Round
to
a
whol§
Complete
the
following
exercises.
number.
4.
A
patient’s
systolic
blood
pressure
was
recorded
from
February
1
through
February
7
at
6:30
a.m.
ea
5
1.
C
:
:
moFr)ning
N
th}é
Following:
P
y
&
y
onvert
the
fraction
1
to
a
quotient
and
then
a
percentage.
’
2.
Round
the
followin
:
February
1
130
.
g
percentages
to
two
decimal
places.
February2
135
b
13‘
b
February3
132
-
13.655%
February4
126
€.
0.569%
February
5
120
d.
98.990%
February
6
122
e.
98.9999,
February
7
124
:
,
o
)
’fl?
«3.
Round
the
following
percentages
to
deci
Create
an
Excel
spreadsheet
to
calculate
the
patient’s
average
systolic
blood
pressure
at
6:30
a.m.
Round
@
a.
0.6989%
g
one
decimal
place.
whole
number.
N
b.
53.123%
5.
There
are
five
health
record
analysts
in
the
HIM
department
where
you
are
working.
Their
hourly
wages
at
¢.
0.075%
$13.87
$14.02,
$15.56,
$15.75,
and
$16.32.
What
is
the
average
salary
for
the
health
record
analysts?
Perform
U
d.
343
Z
calculation
both
by
hand
and
using
Excel.
Round
to
two
decimal
places.
gie<:337%
€.
3.876%
4-
C()m
1
.
a
Cz:
P
following
conversions:
.
.
'
vert
Lt
.
Chapter
2
Matching
Quiz
B
-
(;6:
a
percentage
with
two
decimal
places.
—_—
i
R
3;”/
to
a
percentage
with
two
decimal
places.
Match
the
definitions
with
the
terms.
d.
°
10
a
fraction.
Calculate
it
to
its
simplest
form.
Convert
34%
to
a
decimal
Definitions:
a.
One
or
more
parts
of
a
whole
b.
A
type
of
ratio
in
which
x
is
a
portion
of
the
whole
(x
+
).
¢.
Aninteger
with
no
fractional
or
decimal
parts
m
Chapter
2
Mathematics
Review
5.
Convert
the
following
fractions
to
their
simplest
form:
12.
H
a
3
|
9
!
13
b.
4
14.
8
¢
1
5
d
3
'
5
e.
124
248
6.
Recreate
the
following
table
in
Excel.
Use
an
Excel
formula
to
calculate
each
percentage
to
verify
that
th
calculations
are
correct.
If
any
are
incorrect,
note
which
ones
and
provide
the
correct
answers.
i
-
Community
Hospital
-ator’s
Semiannual
Reference
-‘e]_)
Discharges
by
Day
of
Week
g
BRSO
QIR
il
y
Day
[T
"
Porcent
of
Paticnts.
Sunday
1,187
19.1%
Monday
755
11.3%
.
Tuesday
1,085
16.3%
|
Wednesday
1,031
15.5%
Thursday
1,024
17.0%
Friday
808
12.1%
Saturday
773
11.6%
Totals
6,663
100.0%
7.
A
physician
on
your
staff
performed
44
cardiac
catheterizations
last
month.
Thirty-four
of
those
treated
Wel
male.
What
is
the
ratio
of
male
patients
to
female
patients
who
had
cardiac
catheterizations?
What
is
i
proportion
of
males?
Round
to
one
decimal
point.
8.
It
was
reported
in
your
department
meeting
that
over
the
past
year
your
hospital
decreased
the
number
s
employees
by
4
percent.
Last
year
there
were
389
people
employed;
how
many
fewer
employees
are
there
"
year?
Round
to
a
whole
number.
$1,100.
The
local
supply
company
gives
the
facility
a
13
percent
reduction
on
all
items
they
purchase.
"8
price
will
your
manager
pay?
P
Your
beginning
salary
as
an
analyst
in
the
HIM
department
is
$14.50
per
hour.
You
are
due
to
!'e‘fe'v
3.4
percent
cost-of-living
raise
in
your
next
paycheck.
Your
performance
evaluation
is
coming
up
I
.
month,
and
you
believe
you
should
get
an
additional
5
percent
increase
based
on
your
excellent
perfOl'ma
F
What
should
your
hourly
wage
be
after
your
next
paycheck,
and
what
do
you
anticipate
it
will
be
after
performance
evaluation?
:
I8
Last
year,
you
purchased
equipment
in
the
HIM
department
for
$14,250.
You
have
been
told
that
equipment
you
bought
has
depreciated
in
value
by
20
percent.
What
is
the
value
of
the
equipment
noW
10.
11.
Chapter
2
Review
n
You
just
scored
40
points
out
of
a
possible
50
on
your
health
informati
i
ornte
did
yow
caaa]
y!
rmation
test.
What
percentage
of
available
.
Last
year,
the
number
of
hospitals
in
your
state
decreased
from
320
to
240.
What
is
the
percentage
of
decrease?
Use
Excel
and
the
data
in
the
following
table
to
determine
the
average
bi
i
rth
mother.
Round
to
one
decimal
place.
B
L
s
A
March
1
through
March
!
5.6
1
185
z
6.7
2
193
3
59
3
155
4
6.0
4
342
5
39
5
25.6
6
9.2
6
29.7
7
10.3
7
248
8
113
8
26.6
9
6.9
9
17.3
10
7.1
10
26.5
i
5.9
1
24.7
12
5.7
12
232
13
52
13
21.4
14
6.9
14
229
15
102
15
3L
Totals
o
For
t
g
'
he
following
questions,
refer
to
the
following
Quarterly
Coding
Professional
Accuracy
Report.
15,
Are
the
i
-
calculations
of
the
o
;
percentage
of
records
accurately
coded
9.
Your
manager
needs
to
purchase
a
computer
for
the
new
receptionist
in
your
department.
The
usual
pricey
16.
g
y
S
——
Coding
professi
.
Tecalcslgte
1iieSrSI;)nal
D
determined
her
accuracy
rate
for
the
quarter
to
be
95.9
percent.
She
would
like
you
to
Ccuracy
rate
because
she
thinks
it
is
incorrect
in
the
report.
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m
Chapter
2
Mathematics
Review
[e]
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Qo
°
5
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E
L
-
:
=
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EE
8
Patient
Census
N
o0
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ug
:
S
EWME
EWc
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—
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—
—
—
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&
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8
Learning
Objectives
&
S
&
o
.
.
)
I
M
2
At
the
conclusion
of
this
chapter,
you
should
be
able
to
do
the
following:
P
—
o
3
e
g‘
s
Perform
the
calculations
of
the
following
healthcare
utilization
statistics:
inpatient
admission,
inpatient
census,
complete
o
o
@
S
n
<
Py
master
census,
daily
inpatient
census,
inpatient
service
day,
total
inpatient
service
days,
and
admission
and
discharge
on
S
the
same
day
(A&D)
£
Q
9
2
®
R
R
e
Differentiate
between
an
interhospital
(interfacility)
transfer
and
an
intrahospital
transfer
o
>
>
S
=%
o
o
P
y
P
é
<
a
=
o
S
ol
e
Calculate
daily
census
and
inpatient
service
days
using
the
admission
and
discharge
data
provided
:
=
)
a
.
:
.
.
.
=
e
Calculate
census
and
inpatient
service
days
with
data
given
for
newborns
and
transfers
=
|
Calculat
d
inpatient
days
with
data
g
f
b
d
transf
:
<
BNz
[c
|8
|
e
=)
¥
A
Y
B
Key
Terms
-
=
o~
0
o~
o
Admission
date
Discharge
Interhospital
transfer
3
&
3
b
<
<
Average
daily
inpatient
census
Discharge
date
Intrahospital
transfer
gcnsus
day
Inpatient
admission
Newborn
.
I
B
.
o
Omplete
master
census
Inpatient
census
Patient
care
unit
(PCU)
R
R
N
N
N
s
Daily
inpatient
censu
i
i
ient
d
S
—
S
=}
S
e}
S
Inpatient
service
day
Patient
day
s
(g
s
S
(S
Hospi
.
e
.
.
tha?zl:,alsbkeep
track
of
patient
census
statistics
to*determine
when
they
have
the
largest
number
of
patients
and
when
g
=
=
2
Ԥ
3;
there
'IT
-
dr0P§.
They
can
then
tell
when
the
busiest
times
of
the
year
are
to
determine
increasing
staffing,
whether
A
s
<
"
PN
in
pati‘cy(:tfml){
Patient
care
units
being
overburdened
by
a
large
number
of
patients,
and
which
units
have
a
decrease
Pétients
;o
:
esources
al}ocated
to
those
units
may
change
throughout
the
year
to
accommodate
the
units
with
more
-
=
L
-
2
off.
H<)s:pit'1lICI§S
fegardlpg
low
census
staffing
may
be
enforced
when
needed,
and
staff
may
be
asked
to
take
time
2
§
=
Q
%
&
intereste
i‘n
ufl
(llmmslrapon
also
reviews
the
census
by
individual
physician
and
patient
care
units
because
they
are
fderstanding
trends
in
the
patient
admission
process
and
the
factors
that
may
be
driving
those
trends.
<Nl
O
ey
o
Inpatient
Census
T
%
g
%
%
g
Hosp't
|
-
1
-]
o
o
o
Ita
Manage
ob
'@
eb@m
8
o
Uelldgemen
;
:
4
;
;
3
;
.%D
2
g
g
£8%
228
£
S
4
of
patiens
in
the
h
_l
uses
census
data
for
various
purposes,
including
planning,
budgeting,
and
staffing.
The
accounting
Se
|w
9E
Bg
85
2
CAre
facilir:
ospital
is
an
import
istic
t
i
)
:
2
o
s
86
&8¢
&9
8
e
8
g
fi
in
cility’s
formal
acc
portant
statistic
tracked
by
hospital
leaders.
An
inpatient
admission
is
when
an
acute
Oa
UVa
Lea
=
N;n
A8€a
Of
the
fi);
‘i‘l,)l;ance
of
a
patient
who
is
to
be
provided
with
room,
board,
and
continuous
nursing
service
S
admigre
g
to
anz
ass?re
Patnents.
generally
stay
at
least
overnight.
The
inpatient
census
indicates
the
number
of
igned
to
an
inpatient
bed
in
the
facility
at
a
particular
point
in
time.
m
Chapter
3
Patient
Census
A
staff
member,
usually
2
member
of
the
nursing
staff,
on
each
patient
care
unit
(PCU)
is
designated
to
count
the
patients
on
that unit
each
day.
A
PCU
is
an
organizational
entity
of
a
healthcare
facility
organized
both
physically
and
functionally
to
provide
care.
For
example,
the
intensive
care
unit
(ICU)
would
be
considered
a
PCU.
In
some
facilities,
PCUs
may
be
designated
by
location,
such
as
2-West
or
3-North,
or
by
specialties
such
as
oncology,
neurology,
or
surgery.
The
inpatient
census-taking
time
is
usually
at
midnight
but
may
occur
at
any
time
as
long
as
the
time
is
consistent
for
the
entire
facility;
that
is,
each
PCU
conducts
the
census
at
the
same
time.
Around
midnight
is
a
good
time
to
take
the
census
because
patients
are
usually
in
their
beds.
It
would
be
difficult
to
account
for
all
patients
at
8:00
a.m.,
for
example,
becausg
they
might
be
in
an
exam
room,
with
radiology,
in
surgery,
with
their
healthcare
provider,
or
just
taking
a
walk
in
the
hospital,
The
necessary
data
are
first
entered
into
the
computer
as
admissions,
discharges,
or
intrahospital
transfers
and
then
verified
at
the
designated
time
by
the
responsible
person
on
each
PCU.
In
this
context,
an
admission
date
is
the
day
a
patient
first
enters
the
hospital
as
an
inpatient.
A
discharge
date
is
the
day
the
patient
leaves
the
hospital.
Discharges
include
patients
who
are
sent
home,
those
who
die
in
the
hospital,
and
interhospital
transfers.
Interhospital
transfers
are
events
when
a
patient
leaves
one
hospital
and
is
immediately
admitted
to
another
hospital
or
healthcare
facility,
Intrahospital
transfers
are
transfers
within
the
hospital
from
one
PCU
to
another
during
an
inpatient
admission.
Figure
3.1
shows
a
form
for
a
manual
daily
census
summary
for
a
nursing
home.
Although
most
census
data
are
now
collected
via
electronic
forms
or
custom
spreadsheets,
the
contents
are
essentially
the
same
as
displayed
in
the
pape
form
in
figure
3.1.
Figure
3.1.
Daily
census
summary
at
Community
Manor
Nursing
Home
Community
Manor
Nursing
Home
Daily
Census
Summary
To
be
completed
daily
at
12:01
a.m.
by
charge
nurse
Hall:
A
B
C
D
Date
Initial
admits—New
residents
Date
Time
a.m.—p.m.
a.m.—p.m.
4.m.~p.m.
a.m.—p.m.
Time
a.m.—p.m.
a.m.—p.m.
a.m.—p.m.
Time
Discharged
to
home
or
transfer
Date
Transfer
to
hospital
Location
Date
a.m.—p.m.
a.m.—p.m.
a.m.—p.m.
a.m.—p.m.
Time
Returned
Time
a.m.—p.m.
a.m.—p.m.
a.m.—p.m.
Qut
on
leave—Pass
Date
Left
a.m.—p.m.
a.m.~p.m.
a.m.—p.m.
Time
of
Death
a.m,—p.m.
a.m.—p.m.
a.m.—p.m.
Time
a.m.—p.m.
a.m.—p.m.
a.m.—p.m.
a.m.—p.m.
Deceased
Date
Return
from
hospital
stay
Date
Charge
nurse:
Source:
©OAHIMA
Inpatient
Census
m
complete
Master
Census
[n
addition
to
reporting
the
head
count
to
the
central
collection
area,
each
PCU
reports,
the
number
of
patients
admitted
discharged,
and
transferred
into
or
out
of
the
PCU
that
day.
This
is
commonly
referred
to
as
the
admission
discharge
and,
(ransfer
(ADT)
system
in
a
facility.
The
transfers
tabulated
in
the
ADT
system
are
intrahospital
transfers.
The
fentral
collection
area
then
uses
the
census
from
all
the
units
to
compile
a
total
census
for
the
facility,
sometimes
r;aferred
to
as
the
complete
master
census.
The
complete
master
census
shows
the
names
of
patients
present
at
a
particular
point
in
time
and
their
location.
In
most
facilities
this
is
a
computerized
process
that
is
linked
with
the
facility’s
master
patient
index,
billing
system,
and
other
electronic
health
record
systems.
g
The
spreadsheet
template
presented
in
figure
3.2
may
be
used
to
calculate
the
inpatient
census.
Figure
3.2-
Inpatient
census
template
&
A
B
1
Data
Element
Value
2
|Starting
inpatient
census
(@12:01
am)
3
|
Admissions
(Not
discharged
same
day)
4
|Discharges
(Not
admitted
same
day)
5
|
Ending
inpatient
census
(Midnight)
=B2+B3-B4
l
Exal_nple
3.1
The'number
o’f
patients
in
General
Hospital
at
midnight
on
May
1
is
230.
Two
patients
are
admitted
and
40
patients
are
discharged
on
May
2.
What
is
the
inpatient
census
for
General
Hospital
on
May
2?7
Manual
calculation:
230
+
2
—
40
=
192
Using
Excel:
44
A
B
1
Data
Element
Value
2
|Starting
inpatient
census
(@12:01
am)
230
3
|Admissions
(Not
discharged
same
day)
2
4
|Discharges
(Not
admitted
same
day)
40
5
|Ending
inpatient
census
(Midnight)
192
6
Exercise
3.1
‘
ADnswer
the
following
questions.
1.
APCUL
:
Could
th;iglfr?;nllt
of
20
Patle_rlts
at
1:90
a.m.
on
September
1,
and
30
patients
at
the
same
time
on
September
2.
a2,
ave
been
different
if
the
PCU
had
taken
a
census
at
12:01
a.m.
on
both
days?
Would
A
you
accept
the
di
i
i
i
:
:
consistent
Withil?itself?
ifferent
PCUs
in
the
hospital
taking
censuses
at
different
times
as
long
as
each
unit
is
A
patient
i
transferre
.
;
.
i
.
additional
e
d
at
5:00
p.m.
to
unit
A
from
unit
B
is
counted
in
unit
A’s
12:01
a.m.
census
as
one
tient
;
<
;
.
»
d;t)resent.
Would
that
patient
still
be
included
in
unit
B’s
12:01
a.m.
census?
e
.
;
:
5.
On)
0
describe
a
patient
who
is
transferred
from
one
PCU
to
another
within
the
same
facility?
U|y
1
your
¢
:
L)
om
:
i
i231
Patients
haye
cor::::nini,
hospital
h§s
124
inpatients
who
are
staying
overnight
in
their
facility.
In
addition,
neluded
in
1o
bt
nto
the
hospital
for
various
tests
and
treatments.
Which
of
these
patients
would
be
census,
the
124
patients,
the 231
patients,
or
the
355
patients?
m
Chapter
3
Patient
Census
Inpatient
Census
m
Figure
3.3.
Spreadsheet
template
for
daily
inpatient
census
calculations
.
e
P
4
Exercise
3.2
)
A
2
1
Data
Element
Value
1.
The
census
at
12:01
a.m.
on
June
1is
110.
Three
patients
were
admitted
on
June
1
at
6:00
a.m.
and
discharged
2
|Starting
inpatient
census
(@12:01
am)
later
that
same
day.
One
patient
admitted
at
6:00
a.m.
died
at
5:30
p.m.
the
same
afternoon.
What
is
the
3
|Admissions
(Not
discharged
same
day)
3
PCU’s
daily
inpatient
census
for
June
1?
4
|Admitted
&
Discharged
Same
Da
’
)
o
,
,
_
o
I
5
|Discharges
(Not
ad?nitted
same
d);y)
2.
Which
statistic
is
more
useful
in
understanding
the
patients
served
at
a
facility,
census
or
daily
inpatient
census?
Why?
6
|Daily
inpatient
Census
=B2+B3+B4-B5
i
3.
Community
Hospital’s
census
at
12:01
a.m.
on
September
19
was
327.
On
that
day,
12
patients
were
admitted
and
10
patients
were
discharged.
Calculate
the
inpatient
census
for
September
19.
\
4.
Community
Hospital’s
Critical
Care
Unit
(CCU)
census
at
12:01
a.m.
on
December
2
was
14.
Four
patients
Figure
3.4.
Example
daily
inpatient
census
calculation
were
admitted
to
the
CCU
on
December
2,
one patient
was
transferred
to
the
medicine
unit,
and
one
patient
died.
Calculate
the
inpatient
census
for
the
CCU
for
December
2.
4
A
B
5.
The
census
in
the
telemetry
unit
at
Community
Hospital
on
May
1
was
26
patients.
Two
patients
were
admitted
1
Data
Element
Value
after
stent
insertions
and
three
patients
were
transferred
into
the
unit
from
the
ICU.
On
the
same
day,
four
2
[Starting
inpatient
census
(@12:01
am)
20
'
patients
were
discharged
and
one
patient
was
transferred
to
the
ICU.
One
patient
was
admitted
at
7:00
p.m.
3
|Admissions
(Not
discharged
same
day)
0
;
and
was
discharged
and
transferred
at
9:00
p.m.
to
another
facility.
What
will
the
daily
inpatient
census
of
the
‘4
|Admitted
&
Discharged
Same
Day
1
’
telemetry
unit
be
for
May
1?
5
|
Discharges
(Not
admitted
same
day)
0
6
iDT“Y
inpatient
Census
21
=
.
|
Inpatient
Service
Days
An
inpatient
service
day
is
a
unit
of
measure
denoting
the
services
received
by
one
inpatient
in
one
24-hour
period
.
.
or
any
portion
of
that
24-hour
period.
The 24-hour
period
is
the
time
between
the
census-taking
hours
on
two
Dally
Inpatlent
Census
successive
days.
The
usual
24-hour
reporting
period
begins
at
12:01
a.m.
and
ends
at
midnight.
One
inpatient
service
The
daily
inpatient
census
is
2
statistic
that
measures
the
number
of
patients
admitted
to
the
hospital
or
unit
at
an§
day
is
counted
for
each
inpatient
admission
when
a
patient
is
admitted
and
discharged
on
the
same
day
because
they
time
during
a
given
day.
Therefore,
it
includes
the
number
of
inpatients
present
at
census-taking
time
each
day,
pli§
received services
during
that
stay.
Failure
to
account
for
this
time
will
result
in
lost
credit
for
the
services
provided
to
any
inpatients
who
were
both
admitted
and
discharged
after
the
census-taking
time
the
previous
day.
Thus,
a
patieii§
that
patient.
.
admitted
to
the
hospital
at
8:00
a.m.
on
June
1
and
discharged
at
10:00
p.m.
that
same
day
would
not
be
present
fo
There
are
a
number
of
important
issues
concerning
inpatient
service
days.
These
include
the
following:
the
midnight
head
count.
Therefore,
he
or
she
would
not
appear
on
the
census
report.
However,
the
patient
must
b
.
.
.
&
accounted
for
separately
in
some
manner.
For
an
example,
in
an
ICU,
a
patient
could
be
admitted
at
8:00
a.m.
an§
®
One
unit
of
one
service
day
is
not
usually
divided
or
reported
as
a
fraction
of
a
day.
consume
a
high
volume
of
services
and
staff
time
before
passing
away.
This
resource
intensity
would
not
be
v181b_
®
The
‘day
of
admission
is
counted
as
an
inpatient
service
day,
but
the
day
of
discharge
is
not.
Therefore,
no
patient
|
on
the
midnight
census
but
is
critically
important
in
determining
staffing.
Figure
3.3
displays
an
example
spreadshed
admitted
to
an
inpatient
unit
can
have
a
zero-service
day
stay.
template
that
is
useful
when
calculating
daily
inpatient
census.
-
.
da
Tllll
lnPatlen't
service
day
may
also
be
referred
to
as
a
patient
day,
inpatient
day,
bed
occupancy
day,
or
census
¥
The
operative
word
here
is
service;
that
is,
the
number
of
patients
who
received
service
on
a
particular
day.
Using
Example
3.2:
Twenty
patients
are
on
a
PCU.
One
patient
was
admitted
at
10:00
a.m.
and.dlscharged
at
7:00_p-m~
::ll‘:aflllll
term
“inpatient
service
day”
reflects
the
hospital
function
of
providing
services
to
patients
each
day
and
more
I
If
there
are
no
other
discharges,
the
daily
inpatient
census
for
this
day
is
21.
The
patient
that
was
admitte
Scrvl;c)é
%efmes
the
quantity
counted.
If
20
patients
are
provided
services
in
one
24-hour
period,
the
number
of
inpatient
and
discharged
on
that
day
is
added
to
the
20
patients
already
on
the
unit.
differemays
for
that
calendar
day
is
20.
Although
inpatient
service
days
and
the
daily
inpatient
census
are
used
for
two
.
~
the
PUrposes.,
the
calculation
is
the
same
for
both
statistics.
The
daily
inpatient
census
is
a
statistic
representing
Manual
Calculation:
20
+
1
=21
.
N
mber
of
patients
(people)
that
were
t
in
the
hospital
at
any
time
during
the
day,
while
the
inpatient
servi
Figure
3.4
shows
how
to
use
the
Microsoft
Excel
template
in
figure
3.3.
SIS
A
statistic
measur
present
in
the
hospital
at
any
time
during
the
day,
while
the
inpatient
service
inpatient
service
4
ed
in
days.
Therefore,
the
template
displayed
in
figure
3.2
may
also
be
used
to
determine
the
Presented
i
figureag,sstxlith
one
minor
change
in
the
title
listed
in
cell
A6.
The
revised
inpatient
service
day
template
is
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m
Chapter
3
Patient
Census
Figure
3.5.
Spreadsheet
template
to
calculate inpatient
service
days
A
B
Data
Element
Value
Starting
inpatient
census
(@12:01
am)
Admissions
(Not
discharged
same
day)
Admitted
&
Discharged
Same
Day
Discharges
(Not
admitted
same
day)
Inpatient
Service
Days
=B2+B3+B4-B5
oo
&
WiN
=
Exercise
3.3
Differentiate
among
census,
inpatient
census,
daily
inpatient
census,
and
inpatient
service
days.
If
a
facility
has
129
inpatient
service
days,
would
129
also
be
the
daily
inpatient
census
or
inpatient
census?
Total
Inpatient
Service
Days
The
term
total
inpatient
service
days
refers
to
the
sum
of
all
inpatient
service
days
for
each
of
the
days
during
a
specified:
period
of
time.
For
example,
if
the
inpatient
service
days
for
June
1,2,
and
3
are
100, 105,
and
101,
the
total
for
the
three
days
is
306.
Typically,
total
inpatient
service
days
are
calculated
monthly,
quarterly,
semiannually,
or
annually.
Example
3.3:
Given
the
following
inpatient
service
days
for
Community
Hospital,
a
75-bed
facility,
what
is
the
total
number
of
inpatient
service
days
provided
during
these
10
days
in
June?
Date
1-Jun
2-Jun
3-Jun
4-Jun
5-Jun
Inpatient
70
71
72
68
69
Service
Days
6-Jun
7-Jun
&-Jun
9-Jun
10-Jun
71
73
74
69
70
l
Total
inpatient
service
days
=
704+71+72+68+69+71+73+74+69+70
=
707
days
Be
sure
to
note
the
units
of
measure
for
each
statistic
calculated.
Total
inpatient
service
days
are
measured
in
dayss
Census
statistics
(daily,
inpatient,
master)
are
measured
in
people
or
patients.
QuickK
TP
Exercise
3.4
Complete
the
following
exercises.
1.
The
time
for
taking
the
inpatient
census
must
always
be
a.
Variable
b.
Consistent
c.
12:00
p.m.
d.
11:39
a.m.
2.
Patient
day
or
inpatient
day
is
more
correctly
termed
a.
Inpatient
service
day
b.
Daily
inpatient
census
c.
Total
inpatient
service
day(s)
d.
Census
Calculation
of
Inpatient
Service
Days
m
3.
The
inpatient
census
at
12:01
a.m.
is
24.
Two
patients
were
admitted
at
1:00
p.m.
One
patient
died
at
3:15
p.m.,
and
the
other
patient
was
discharged
at
10:00
p.m.
The
inpatient
service
days
for
that
day
are
3
a.
22
b.
24
c.
25
d.
26
4.
The
difference
between
the
census
and
the
daily
inpatient
census
is
that
any
patients
admitted
and
discharged
the
same
day
are
added
to
a.
The
census
to
calculate
the
daily
inpatient
census
b.
The
12:01
a.m.
(or
other
designated
time)
head
count
to
calculate
the
daily
census
c¢.
Bothaandb
d.
Neither
anorb
5.
Which
of
the
following
should
be
used
when
calculating
the
number
of
inpatients
who
received
service
on
a
particular
day?
a.
Inpatient
census
b.
Daily
inpatient
census
¢.
Total
inpatient
service
days
d.
Census
Calculation
of
Inpatient
Service
Days
e
———————————————
The
calculation
of
inpatient
service
days
is
the
measurement
of
services
received
by
all
inpatients
in
one
24-hour
period
(the
time
between
the
census-taking
hours
on
two
successive
days).
The
usual
reporting
period
begins
at
12:01
a.m.
and
ends
at
12:00
a.m.
(midnight).
Moreover,
one
inpatient
day
must
be
counted
for
each inpatient
admitted
and
discharged
on
the
same
day
between
two
successive
census-taking
hours.
The
definitions
of
census,
inpatient
service
day,
and
total
inpatient
service
days
provide
clues
for
actual
computation.
The
sample
shown
in
table
3.1
includes
all
of
a
hospital’s
inpatient
care
units.
A
summary
of
all
such
units
helps
the
administration
review
the
hospital’s
overall
level
of
activity.
Table
3.1.
Sample
inpatient
service
days
display
Sample
Inpatient
Service
Days
r:;:?'ber
of
patients
in
hospital
at
12:01
a.m.
on
November
1
257
i
;
the
number
of
paticnts
admitted
on
November
1
+
45
Subtoty]
Miflus
\he
numb
.
.
302
Numb
mber
of
patients
discharged
(including
deaths)
on
November
1
—
24
e
-
.
Plus
lh<:
:igéll)tlents
in
hospital
at
11:59
p.m.
on
November
1
(subtotal)
278
.-
er
of
Patlents
both
admitted
and
discharged
on
November
1
et
patient
service
days
for
November
1
T
Someti),
.
nes
yo
-
.
.
Q
inpatien;
Sezviger;ay
be
qsked
by
administration
to
exclude
PCUs
such
as
ICUs
and
obstetrical
units
from
the
Varies
greatly
fro
ayz-
Umts
s_uch
as
these
are
often
studied
separately
because
the
intensity
of
service
on
these
units
m
the
intensity
of
services
provided
on
medical
and
surgical
units.
Tab'e
3.2
shOWS
a
Perf
.
..
.
.
.
3
:
Orman
Zample
of
how
hospital
administration
can
use
inpatient
service
days
data
to
determine
emonstrates
that
the
spreadsheet
template
from
figure
3.5
may
be
used
to
perform
the
same
c‘“fiulalion‘fe‘
Figure
3.6
m
Chapter
3
Patient
Census
Table
3.2.
Year-to-date
inpatient
service
days
Medicine
13,762
15,000
15,608
Surgery
8,953
13,500
11,634
2,681
ICU
3874
3,500
3,623
251
Step-down
679
1,500
-821
1,278
-599
Rehabilitation
1,646
2,500
-854
2,136
490
Obstetrics
1,730
2,200
—470
2,188
—458
Psychiatry
1,002
1,800
798
872
130
Newborn
1,689
1,800
-111
2,099
-410
Neonatal
ICU
2,875
3,900
-1,025
2,643
232
Pediatrics
645
1,000
-355
833
—188
Total
36,855
46,700
-9,845
42,914
—6,059
Figure
3.6.
Sample
inpatient
service
days
calculation
using
spreadsheet
template
in
figure
3.5
4l
A
B
1
Data
Element
Value
2
|
Starting
inpatient
census
(@12:01
am)
257
3
|
Admissions
(Not
discharged
same
day)
45
4
|
Admitted
&
Discharged
Same
Day
4
5
|
Discharges
(Not
admitted
same
day)
24
6
|
Inpatient
Service
Days
282
)
Hospital
statistics
are
often
tabulated
separately
for
adults
and
children
and
newborns.
Newborns
(NB)
are
defil
to
be
an
inpatient
who
was
born
in
a
hospital
at
the
beginning
of
the
current
inpatient
hospitalization.
auick
TIP
This
medical
center’s
analysis
of
its
inpatient
service
days
can
be
examined
to
determine
how
well
the
facility
i
doi
year
to
date
and
to
compare
its
performance
with
the
previous
year.
This
can
lead
to
discussions
by
hospital
leaders
concerning
marketing
of
their
services
or
examination
of
whether
there
are
enough
practitioners
in
those
services.
Before
beginning
the
actual
calculation
of
census
data
and
inpatient
service
days,
it
is
important
to
undef?m
the
calculation
of
transfers.
The
calculation
of
transfers
occurs
on
the
PCU
census.
Transfers
in
and
out
of
the
unité
shown
as
subdivisions
of
patients
admitted
to
and
discharged
from
the
unit.
The
hospital
may
be
referred
to
as
the
“house,”
as
in
“How
many
patients
are
in
the
house?”
This
refers
10
number
of
patients
in
the
hospital.
QUICK
AL
@
The
census
for
the
next
day
must
begin
with
the
11:59
p.m.
census
data
and
not
inpatient
service
days.
Calculate
undet
assumption
that
the
patients
admitted
and
discharged
on
the
same
day
and
the
transfers
are
not
newborns.
QuICK
TP
Summary
of
Census
Data
ufl:
gxample
3.4:
Figure
3.7
displays
census
calculation
data
in
a
format
frequently
used
by
hospitals.
Key
to
abbreviations
used
in
this
example
W_
Adults
and
children
NB
Newborns
(born
during
the
hospital
stay)
Adm
Admissions
(includes
transfers
into
the
hospital)
Bir
Births
Trf
Intra-hospital
Transfers—may
be
into
a
unit
(in)
or
out
of
a
unit
(out).
Dis
Discharges
(including
transfers
out
of
hospital
and
deaths)
A/D
Admitted
and
discharged
on
same
day
Transfers
may
also
be
abbreviated
as
TX
and
discharges
may
also
be
abbreviated
as
DC.
OUT$K
In
this
example,
a
patient
head
count
at
12:01
a.m.
on
June
1
shows
48
adult
and
child
inpatients
and
two
newborns.
This
type
of
display
allows
a
unit
manager
to
view
the
flow
of
patients
into
and
out
of
the
unit.
The
last
three
columns
are
discussed
later
in
this
chapter.
Note
that
the
end
census
of
49
A/C
patients
and
1
NB
may
be
used
as
the
starting
census
for
the
next
day.
Flgure
3.7.
Example
census
tracking
table
Start
Activity
into
unit
Activity
out
of
unit
End
.
12:01
a.m.
11:59
p.n;.
Serv
Census
Adm
Trf
Total
Dis
Dis
Trf
Census
Days
Day
A/C
NB
AJC
Bir
in
AIC
NB
A/IC
NB
out
AIC
NB
A/D
A/IC
NB
1-Jun
48
2
2
1
1
51
3
1
2
1
49
1
1
50
1
The
following
points
are
important
to
keep
in
mind:
.
Th.e
teljms.
transfers
in
and
transfers
out
refer
to
intrahospital
transfers,
that
is,
transfers
between
inpatient
units
w1th1n
the
hospital.
Transfers
in
and
out
of
the
hospital
(called
interhospital
or
interfacility
transfers)
are
included
in
admissions
and
discharges.
I:ansll’ers
in
.and
out
of
any
specific
medical
care
unit
may
or
may
not
be
equal,
but
they
must
be
equal
for
the
5
fc;ra
'l?OSpltgl
summary.
Every
patientstransferred
into
a
unit
on
any
given
day
must
have
been
transferred
out
nother
unit.
Failure
of
these
data
to
balance
may
mean
that
a
unit
neglected
to
report
transfers
correctly.
New
:
.
Sep';?z:)(nl‘s
are
considered
separately
for
all
computations
based
on
census
data.
They
should
be
reported
(4
.
by
.
.
.
.
-
.
Producedy
upless
otherwise
directed
by
administration,
medical
staff,
or
other
persons
using
the
statistical
data
ed.
Births
are
considered
newborn
admissions.
The
cen
COmmOnslus
a;
the
close
of
one
day
(11:59
p.m.)
is
the
inpatient
census
at
the
beginning
of
the
next
day
and
is
y
reierred
to
as
the
number
of
patients
remaining.
Summary
of
Census
Data
The
PIOCEsS
of
verifyi
:
if
Monthly
o
year|
gn
Ny
-
and
bo
a?:
:-rz
l'l(;m
this
sum,
the
ny
€
num
;
Sount
g
1.5
p.:xerlgg
;l)atlents
remaini
LIRATIOS
'_-
v
sum§n
;‘:t;
((l)i;ti
obtained
by
the
process
of
Falculating
census
statistics
on
a
daily
basis
is
called
the
8
during
the
moe;:;us
data,
meaning
a
concise
summary
of
the
data.
The
total
number
of
patients
ik
or
year
is
a'dded
to
the
patients-remaining
census
with
which
the
month
or
year
er
of
discharges
(including
deaths)
during
the
month
or
year
is
subtracted.
The
resulting
o
ioht
of
1
ng
at
the
end
of
the
month
or
year.
This
number
should
equal
the
actual
head
of
that
month
or
year.
Table
3.3
shows
a
sample
monthly
census
summary.
Notice
ddmitteg
“
Chapter
3
Patient
Census
Table
3.3.
Sample
monthly
census
summary
0|.n,|,m‘|ni‘ty
\Hospiltl'
|
Number
of
patients
in
hospital
at
12:01
a.m.
on
October
1
48
2
Add
the
number
of
patients
admitted
in
October
+
100
+
7
Subtotal
148
9
Subtract
the
number
of
patients
discharged
(including
deaths)
in
October
-
110
-5
Number
of
patients
in
hospital
at
11:59
p.m.,
October
31
38
4
that
patients
admitted
and
discharged
on
the
same
day
are
not
included
in
the
monthly
census
calculations
in
table
3.3
The
monthly
census
is
intended
to
measure
the
patients
actually
present
at
the
census-taking
time
and
not
the
patientg:
actually
served during
the
month.
This
demonstrates
the
key
difference
between
census
calculations
and
inpatienf
service
days.
When
you
summarize
monthly
or
annual
census
data,
you
are
verifying
that
the
columns
have
been
added
correctly;
This
procedure
also
verifies
that
no
error
was
made
in
the
original
data
on
one
or
more
lines.
This
verification
i
accomplished
by
taking
the
12:01
a.m.
inpatient
ccnsus
at
the
beginning
of
the
period,
adding
total
admissions
ang
transfers
in,
and
subtracting
total
discharges
and
transfers
out.
The
resultant
data
represent
the
ending
census
on
thg
last
day
of
the
period
(month
or
year).
Exercise
3.5
Complete
the
following
exercises.
1.
Using
the
data
given
in
example
3.4,
create
a
spreadsheet
to
calculate
the
census
for
June
2.
Then,
fill
in
the
blanks
in
the
table
below.
‘
=
ot
@
:
FM)
|
servbn
'
=
Jays
“A/C
|
NB
|
AIC
|
NB
|
out
|
AIC_[
NB_LAD
AIC
|
il
T
A/C
|
NI
1
2
6/2
3
4
1
2
2.
What
data
will
you
use
to
begin
June
3,
and
why?
3.
Fill
in
the
blanks
in
the
table
below.
What
are
the
inpatient
service
days
for
June
2
and
3?
6/1
48
2
2
1
1
51
3
1
2
1
49
1
6/2
49
1
3
1
2
54
2
4
1
2
48
1
1
6/3
1
1
1
3
0
1
0
4.
Would
a
newborn
ever
be
considered
an
A/D?
.
excludt
5.
At
this
point,
you
have
inpatient
service
days
for
three
successive
days.
The
total
of
these
data,
Il
pitd
newborns,
for
June
1,2,
and
3
is
145
(50
+
49
+
46).
What
will
you
need
to
know
and
do
to
get
the
hos
inpatient
service
days
for
the
entire
month
of
June?
Summary
of
Census
Data
n
—
gxercise
3.6
Using
the
information
supplied
for
June
1,
fill
in
the
blanks
in
the
table
below.
—
=
!l_
]
-';*
:
l‘A‘
i
AR
230
12
20
5
5
"
19
6/1
4
3
62
21
4
1
19
4
1
0
6/3
23
6
0
24
5
0
3
6/4
25
5
1
23
4
1
1
6/5
24
4
2
18
%)
2,
2
Exercise
3.7
Two
hundred
and
fifty
adults
and
children
were
in
the
hospital
at
12:01
a.m.
on
August
1.
There
were
23
newborns
at
12:01
a.m.
on
August
1.
During
August,
the
following
data
were
compiled:
Adults
and
children
1,353
Newborns
73
Discharges
(including
deaths):
_
Adults
and
children
1,348
Newborns
65
1.
What
would
the
inpatient
census
for
adults
and
children
be
on
August
31
at
11:59
p.m.?
2.
What
would
the
inpatient
census
be
for
newborns
on
August
317
3.
Can
the
inpatient
service
days
be
calculated
with
the
information
supplied
in
the
previous
question?
Explain
Wwhy
or
why
not.
8.
The
surgery
unit
in
Community
Hospital
has
reported
the
following
data.
Do
these
data
look
correct?
Explain
*tin
|
oL
|
ou
4
2
26
2
your
answer.
»
OnM
:
.
]
Dllrinarlc\:/lll
1,
the
telemetry
unit
at
Community
Hospital
has
reported
the
15
patients
on
the
unit
at
12:01
a.m.
€
March,
the
following
data
were
collected:
Admissions
240
Discharges
(including
deaths)
232
What
would
the
;
th
i
-
€
Inpatient
census
be
on
March
31
at
11:59
p.m.
in
the
telemetry
unit?
Exercise
3.5
This
¢
$
ACICise
consi
Us;i
Consi
SIng
the
dag,
Sts
of
two
wo
4
provided
fo,
e
rksheets
for
calculating
a
month’s
inpatient
census
and
inpatient
service
days.
1,
complete
the
first
worksheet.
If
your
findings
do
not
match
the
data
for
May
31,
h
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n
Chapter
3
Patient
Census
Average
Daily
Inpatient
Census
“
you
have
made
an
error
either
in
your
column
additions
or
on
one
or
more
of
the
horizontal
lines
above
the
worksheet
2
total.
You
must
correct
this
error
to
ensure
the
validity
of
the
monthly
totals.
If
the
column
additions
are
correct,
F
Monthiv
Datao
rAdult
d
Child
Mav
20X
i
th
d
worksheet
for
the
recap.
Use
a
spreadsheet
to
complete
these
worksheets.
ecap
of
Monthly
Data
for
Adults
and
Children:
Yiay
continue
on
to
the
second
worksheet
[o
p
p
P
“
o
e
(PRE
k
Worksheet
1
'
12:01
a.m.
Census
A/C
165
'
Admissions
Adult
and
Children
+
I
]L
Adm
@
Disc
I
!
s
||
Serv
days
Transfers
in
¥
Y
“arc
|
NB
|
in
|
AC
|
NB
|
AC
[
NB
|
ou
|
A
I
NB
LA
LA/C
LN
[
_
=
1
TEERL
IS
Dol
O
g
202
A
oW
LY
TRORN
SR
SSIESEE
R
RS
S
|
Discharges
Adult
and
Children
=
2
185
3
24
4
7
12
3
6
1
‘
Transfers
out
=
3
18
3
3
16
)
)
0
\
11:59
p.m.
Census
A/C
on
May
31
=
'
«ap
of
Monthly
Data
for
Newborns:
4
17
2
5
15
2
4
0
l
Recaj
5
13
0
il
12
1
3
0
)
12:01
a.m.
Census
NB
6
20
0
6
19
o
4
0
|
Newborn
Admissions
+
7
21
0
14
17
0
12
0
“
Total
NB
=
8
27
1
10
23
3
8
3
Discharges
NB
=
9
23
4
6
%)
3
14
o)
11:59
p.m.
Census
NB
on
May
31
=
10
2
)
8
15
1
10
1
Serv
Days
A/C
(total
inpatient
service
days
excluding
newborns)
11
17
3
7
14
4
5
3
Serv
Days
NB
(total
newborn
service
days)
12
19
3
6
17
2
4
0
{Total
inpatient
service
days
13
14
1
4
12
2
2
0
j
]
‘.
14
el
)
&
9
3
7
0
Average
Daily
Inpatient
Census
o
—————————————
6
1
L2
£
1+
B
i
i
The
average
daily
inpatient
census
is
the
average
or
mean
number
of
inpatients
present
in
the
hospital
each
day
for
a
-
16
23
3
6
15
4
2
0
givep
period
of
time.
The
total
inpatient
service
days
for
any
period
(usually
a
month
or
a
year)
represent
the
inpatient
17
17
1
3
13
3
1
1
service
days
for
all
the
calendar
days
in
that
period.
The
formula
for
calculating
the
average
daily
inpatient
census
is:
18
1
g
2
2]
1
8
2
;
Total
inpatient
service
days
(excluding
newborns)
19
17
0
7
25
3
2
1
Ave
Daily
Inp
Census
=
-
-
Total
number
of
days
in
the
period
20
13
2
3
27
4
4
0
1
12
1
5
21
2
5
3
’
Whenhcalculating
the
average
daily
inpatient
census
for
a
month,
you
need
to
know
how
many
days
there
are
in
each
"
2
10
0
1
17
4
1
2
11O
23
9
2
4
18
1
4
0
EIAmple
3.5:
If
a
h
.
¢
.
.
.
i
.
.
24
23
4
3
12
3
2
2
e,
:
If
a
hospital
had
6,653
inpatient
service
days
for
adults
and
children
and
155
inpatient
service
days
for
25
15
5
4
2
5
3
1
oS
for
the
month
of
May,
what
was
the
average
daily
inpatient
census
in
May?
Round
to
the
nearest
whole
number.
26
13
3
2
9
1
4
0
Ave
Daily
Inp
C
Total
inpatient
service
days
(excluding
newborns)
|
np
Census
=
2
=
L
.
22
1
0
2
P
Total
number
of
days
in
May
|
28
29
2
5
22
4
4
3
29
23
4
1
25
3
2
1
Ave
Daily
Inp
Census
=
(N
214.61
rounded
to
215
patients
30
15
1
4
21
2
3
0
31
hox
ASmentioneq
earlier,
adul
:
31
16
4
2
18
3
2
3
‘Dbpn.al‘s
administratio,
,N
ults
and
children
are
calculated
separately
from
newborns
unless
otherwise
directed
by the
Totals
oz?lalmain
anewborn
m.l
ewborn
census
data
can
distort
statistics
related
to
resource
use.
For
example,
it
costs
less
{
€L
a
specifieq
period.
it
rsery
than
it
doe.s
to
staff
other
PCUs.
If
the
average
daily
inpatient
census
is
consistently
low
1
»
It
may
be
appropriate
to
close
PCUs
to
reduce
expenses.
’
Whether
w—
With
g
round
1o
a
whole
numbper
;
the
indivi
ital’
jsi
i
j
;
o
atq
represening
e
is
the
individual
hospital’s
decision.
There
is
a
difference
between
working
"t'ullrl
Present
numpey
M[,D
2
ecause
you
cannot
have
a
portion
of
a
person
)
and
working
with
percentages
icare
statisyjc,
(Ref:
ny
facilities
use
a
whole
number
when
calculating
the
census
and
fractions
with
other
er
to
chapter
2
to
review
rounding.)
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- Unlimited textbook solutions
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'h
"
Chapter
3
Patient
Census
Example
3.6:
A
150-bed
hospital
reports
3,489
inpatient
service
days
for
December.
Calculate
the
average
daily
inpatient
census
for
December.
Round
to
the
nearest
whole
number.
Total
inpatient
service
days
(excluding
newborns)
Ave
Daily
Inp
Census
=
-
Total
number
of
days
in
December
Ave
Daily
Inp
Census
=
%
=112.54
rounded
to
113
patients
Again,
this
number
is
important
to
administration
because
they
will
want
to
know
how
many
patients
are
being
served
eaclj
month
to
determine
staffing
and
supply
needs
for
practitioners
and
to
monitor
the
overall
financial
performance
of
the
facility,
Average
Daily
Newborn
Census
The
formula
for
calculating
the
average
daily
newborn
census
follows
the
same
pattern
as
the
formula
for
calculatip
the
average
daily
inpatient
census
of
adults
and
children.
Total
newborns
inpatient
service
days
Ave
Daily
NB
C
=
M
ensus
Total
number
of
days
in
the
period
Example
3.7:
A
hospital
with
20
bassinets
had
552
newborn
inpatient
service
days
during
April.
What
was
th
average
newborn
daily
census
in
April?
Round
to
the
nearest
whole
number.
Total
newborns
inpatient
service
days
Ave
Daily
NB
C
=
M
ensus
Total
number
of
days
in
April
Ave
Daily
NB
Census
=
%
=
18.4
rounded
to
18
newborns
Assume
all
exercises
in
this
text
do
not
occur
on
a
leap
year.
A
leap
year
is
a
year
in
which
an
extra
day
is
add
o
to
the
calendar
at
the
end
of
February,
giving
February
29
days.
Therefore,
regular
years
have
365
days;
leap
yel
%
have
366.
Leap
years
only
occur
on
an
even-numbered
year,
so
if
the
example
is
an
odd
year,
one
not
need
consi
'
a
leap
year
as
a
possibility.
Average
Daily
Inpatient
Census
for
a
Patient
Care
Unit
The
hospital’s
administration
often
finds
it
helpful
to
know
the
average
use
of
a
specific
medical
care
unit
(for
exampl
to
know
whether
additional
beds
are
needed
for
the
ICU).
Statistics
are
the
basis
for
decision-making.
The
formulal
calculating
the
average
daily
inpatient
census
for
a
care
unit
is
the
same
used
in
the
overall
average
daily
inpatient
CeNi8
The
difference
here
is
that
the
inpatient
service
days
specific
to
the
PCU
measured
should
be
included
in
the
numerdd
Example
3.8:
A
hospital
with
a
24-bed
CCU
reports
740
inpatient
service
days
for
July.
Calculate
the
average
da
inpatient
census.
Round
to
the
nearest
whole
number.
Total
inpatient
service
days
for
the
CCU
Ave
Daily
Inp
C
CCU=
VoDl
e
Total
number
of
days
in
July
Ave
Daily
Inp
Census
for
CCU
=
%
=23.87
rounded
to
24
patients
1s
IS
O
Do
not
confuse
the
terms
regarding
the
census
and
inpatient
service
days.
Inpatient
census
refers
to
patien
-,pfl"d
i
at
the
census
taking
time.
Some
healthcare
facility
staff
may
just
say
“census”—they
are
referring
to
the
Nl
Wk
census.
The
average
inpatient
census
is
the
mean
number
of
hospital
inpatients
present
in
the
hospital
€3<"
i
.
.
.
.
;
.
:
.
.
cant
a
given
period.
The
inpatient
service
days
include
any
patients
who
were
admitted
and
discharged
on
the
5@
Chapter
3
Matching
Quiz
“
—
.
Exercise
3.9
Complete
the
following
exercises.
1.
Community
Hospital
has
200
beds
and
25
newborn
bassinets.
The
total
inpatient
service
days
for
M
5,297
for
adults
and
children
and
486
for
newborns.
)
ys
tor
May
were
a.
What
is
the
average
daily
inpatient
census
for
adults
and
children?
Round
to
a
whole
number.
b.
Determine
the
average
daily
newborn
census.
Round
to
a
whole
number.
2.
A
150-bed,
15-bassinet
hospital
has
4,350
inpatient
service
days
for
adults
and
children
and
360
newborn
service
days
during
June.
a.
What
is
the
average
daily
inpatient
census,
excluding
newborns?
Round
to
a
whole
number.
b.
Determine
the
average
daily
newborn
census.
Round
to
a
whole
number.
3.
Calculate
the
average
daily
newborn
census
for
a
125-bed,
10-bassinet
hospital
with
3,001
inpatient
service
days
for
adults
and
children
and
298
inpatient
service
days
for
newborns
during
February
(not
a
leap
year).
Round
your
answer
to
a
whole
number.
4.
If
you
neefi
to
calculate
the
average
daily
inpatient
census
of
the
surgical
unit,
where
can
you
obtain
the
surgical
unit’s
inpatient
service
days?
5.
Community
Hospital’s
burn
unit
has
12
beds.
The
inpatient
service
days
for
the
burn
unit
in
December
were
358.
What
is
the
average
daily
inpatient
census
for
the
burn
unit
during
December?
Round
your
answer
to
a
whole
number.
Chapter
3
Formulae
for
Calculation
of
Bed
Occupancy
Statistics
m
Numerator
Denominator
Inpatient
bed
occupancy
rate
Total
number
of
inpatient
service
days
Total
number
of
inpatient
bed
count
for
a
given
period
days
for
the
same
period
Newborn
bassinet
occupancy
e
Total
number
of
newborn
inpatient
.
Total
number
of
bassinet
bed
count
days
service
days
for
a
given
period
for
the
same
period
Bed
k
s
Wover
rate
(direct
Number
of
discharges
(including
For
Average
bed
count
during
the
period
,
mula)
deaths)
for
a
period
et
S
umover
rate
(ind;
i
FOrmula)
ate
(indirect
I())ecrciggancy
rate
X
number
of
days
in
Average
length
of
stay
for
period
Chapter
3
Matching
Quiz
May
:
ch
the
deflnitions
with
the
terms
Definitions:
a.
Th
b
€day
that
4
patien
t
fir
:
:
:
SMean
or
4y,
St
enters
the
hospital
as
an
inpatient.
numb
deois
:
.
.
.
ot
e
er
of
hospital
inpatients
present
in
the
hospital
each
day
for
a
given
period
of
time
ents
§o
o
.
.
after
the
Censu‘s).rteie'm
at.
census-taking
time
each
day
plus
any
inpatients
who
were
both
admitted
and
€
Mumbe,
¢
inpa
aking
time
the
previous
day
tie
:
.
NS
occupying
a
bed
in
a
healthcare
facility
at
any
given
time
age
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Chapter
3
Review
u
n
Chapter
3
Patient
Census
c.
The
same
hospital
provided
12,345
newborn
days
of
service
in
its
35-bassinet
nursery
during
the
year.
What
e.
A
change
in
medical
care
unit
or
medical
staff
unit
during
an
inpatient
stay
was
the
average
daily
newborn
census?
i
i
i
i
to
provide
care
f.
An
organizational
entity
within
a
healthcare
facility
organized
both
phySle‘“)'
a“dzf:';‘ctil(:-“a:)i’og
p
o
g.
A
unit
of
measure
equivalent
to
the
services
received
by
one
inpatient
during
one
24-hour
p
.
i
i
i
i
ified
period
of
time
B.
32
h.
The
sum
of
all
inpatient
service
days
for
each
of
the
days
during
a
specificd
P
<
D.
34
Terms:
i
sfer
‘
d.
The
same
hospital’s
new
surgery
unit
has
50
beds.
During
July,
the
unit
provided
1,705
days
of
service.
R
Inpatient
census
>
IRICE
What
was
the
average
daily
inpatient
census
for
the
surgery
unit
in
July?
daily
inpatient
census
2.
PCU
6
Average
A
5
3.
Total
inpatient
service
days
7.
Admission
day
-
4.
Daily
inpatient
census
8.
Patient
day
C.
54
D.
55
e.
Do
you
think
the
hospital’s
administration
provided
enough
beds
for
the
new
surgery
unit?
Chapter
3
Review
7.
Using
the
statistics
from
the
following
monthly
report
from
the
nursing
administration
of
Community
Hospital,
an
acute-care
facility,
use
Excel
to
calculate
the
current
month’s
(November)
average
daily
inpatient
census
for
1.
Whatis
an
intrahospital
transfer?
each
nursing
unit
and
the
totals.
Note:
This
facility’s
policy
is
to
round
to
a
whole
number.
2.
Differentiate
between
the
terms
inpatient
census
and
daily
inpatient
census.
h
)
|
'I
3.
Isit
possible
that
the
transfers
into
a
PCU
may
not
equal
the
transfers
out
of
the
same
PCU
on
the
same
da
P
T——
4.
When
must
transfers
in
and
transfers
out
be
equal?
s
i
i
427.
On
February
2,
37
patients
Wé
|
|
5.
At
11:59
p.m.
on
February
1,
the
Community
Hospital
census
was
R
ays
npatient
Census
d
the
answers
to
whole
numbe
who
died
later
that
day
in
the
CCU.
Answer
the
following
questions
and
roun
a.
Calculate
the
hospital
inpatient
census
for
February
2.
Medicine/Surgery
40
1,108
admitted,
33
were
discharged,
and
2
were
admitted
and
discharged
that
(ciiay.hir;
télglgxilcgl’etgzsczg:]l;‘
u{
Uit
February
1
was
16.
On
February
2,
six
patients
were
admitted,
four
were
discharged,
.
|
Wfi
B
Pediatrics
40
997
C
D
E
F
G
b.
Calculate
the
hospital
daily
inpatient
census
for
February
2
Obstetrics
25
733
¢.
Calculate
the
CCU
inpatient
census
for
February
2.
Rehabilitation
15
400
d.
Calculate
the
CCU
inpatient
service
days
for
February
2.
2.
0p
il
i
CCU
20
592
.
On
Ju
18
3
6.
In
20XX,
a
hospital
had
175
beds
for
adults
and
children
from
J
anuaryhllgirc‘;‘;rglgei‘;rlle
During
theyfirsl
Surg%c?ll
ICU
(SICU)
15
445
hospital
increased
its
beds
to
250
and
the
number
remained
at
25.0
tflrouglt
N
children.
During
the
pas
Medicine
ICU
(MICU)
20
585
months,
30,875
patient
days
of
service
were
provided
to
the
hospital’s
adl}
:
oy
t.he
answers
to
Wi
Total
Adult
and
Children
175
months:
36:982
days
of
service
were
provided.
Answer
the
following
questions
an
rou
|
B
Nevborn
=
s
588
numbers.
This
is
a
non-leap
year.
J
Special
Car
B
Nursery
10
201
ily
inpatient
for
the
first
six
months?
&
a.
What
was
the
average
daily
inpatient
census
1or
K
Neonatal
[CU
(NICU)
T
e
A.
169
Yotal
Nursery
B.
170
8
Community
Hosp;
:
C.
171
¥
Hospital
reported
the
following
for
the
month
of
July
20XX.
Round
your
answers
to
whole
numbers.
D.
172
b.
What
was
the
average
daily
inpatient
census
for
the
entire
year?
A.
184
B"&iuning
cens
us
on
July
1
B.
185
Admmissions
y
92
53
Disch.
301
C.
186
Eharges
ang
Deaths
286
50
D.
187
o
Patien,
Service
Days
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m
Chapter
3
Patient
Census
-
.
Chapter
3
Review
49
-
a.
Calculate
the
average
daily
inpatient
census
for
adults
and
children.
13.
University
Hospital
is
a
765-bed
facility
with
250,415
inpatient
service
days
for
the
past
year.
What
thei
’
.
What
was
their
b.
Calculate
the
average
daily
inpatient
census
for
newborns.
average
daily
census
for
the
period?
Round
to
a
whole
number.
]
c.
What
will
the
census
for
adults
and
children
be
at
11:59
p.m.
on
July
317
14.
In
February
20XX
(a
leap
year),
Children’s
Hospital reported
they
had
500
inpatient
service
days
in
thei
‘
s
in
their
d.
What
will
the
nursery
census
be
at
11:59
p.m.
on
July
31?
neurosurgery
unit.
What
was
the
average
daily
inpatient
census?
Round
to
a
whole
number
‘
|
9.
Metropolitan
Hospital
has
a
large,
busy
rehabilitation
unit.
The
30-bed
unit
reported
the
following
inpatientg
15.
Of
the
500
inpatient
service
days
in
the
above
example,
386
were
Dr.
Smith’s
patients.
What
percentage
of
service
days
for
the
week
of
April
6.
Use
the
information
that
follows
to
determine
the
average
daily
inpatienf
census
for
the
week
of
April
6
through
April
12.
Round
to
three
digits
after
the
decimal.
inpatient
service
days
did
Dr.
Smith
have
in
the
neurosurgery
unit?
Round
to
one
decimal
place
Metropolitan
Hospital
i
Rehabilitation
Unit
Inpatient
Service
Days
pril
6-April
12,
20XX
-
|
Inpatient
Service
Days
April
6
29
April
7
28
April
8
29
April
9
26
April
10
27
April
11
28
April
12
29
10.
Children’s
Hospital reported
the
following
statistics
for
March
20XX.
Use
an
Excel
spreadsheet
to
calculd
the
average
daily
inpatient
census
for
each
unit
and
the
total.
Round
each
calculation
to
a
whole
number.
Children’s
Hospital
~
Average
Daily
Inpatient
Censu:
-
Pediatrics
Surgical
Hematology
Oncology
20
566
Neurology/Neurosurgical
30
756
Renal/Gastroenterology/Endocrinology
20
555
Respiratory
30
897
Cardiac
Medicine/Surgical
20
589
Infant
Care
Unit
10
281
Pediatric
Intensive
Care
20
540
Total
180
11.
Community
Hospital
has
15
bassinets
with
286
newborn
inpatient
service
days
during
October.
What
i
average
daily
census
for
October?
Round
to
a
whole
number.
12.
The
planning
committee
for
Metropolitan
Hospital
is
studying
the
activity
of
their
burn
unit,
W.h'Chfi
15
beds.
During
the
third
quarter
of
the
year
(July,
August,
and
September),
there
were
1,356
“‘Paoly
service
days.
What
is
the
average
daily
census
for
this
period?
How
could
this
information
be
importa™
planning
committee
at
Metropolitan
Hospital?
Round
to
a
whole
number.
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