Common use of Hospital Inpatient Stay Data Editing and Imputation Clause in Contracts

Hospital Inpatient Stay Data Editing and Imputation. Facility expenditures for hospital inpatient stays were developed in a sequence of logical edits and imputations. “Household” edits were applied to sources and amounts of payment for all events reported by HC respondents. “MPC” edits were applied to provider-reported sources and amounts of payment for records matched to household-reported events. Both sets of edits were used to correct obvious errors (as described above) in the reporting of expenditures. After the data from each source were edited, a decision was made as to whether household- or MPC- reported information would be used in the final editing and imputations for missing expenditures. The general rule was that MPC data would be used for events where a household-reported event corresponded to a MPC-reported event (i.e., a matched event), since providers usually have more complete and accurate data on sources and amounts of payment than households. Separate imputations were performed for flat fee and simple events. Most hospital inpatient stays were imputed as simple events because facility charges for an inpatient hospital stay are rarely grouped with other events. (See Section 2.5.4 for more details on flat fee groups.) Logical edits also were used to sort each event into a specific category for the imputations. Events with complete expenditures were flagged as potential donors for the predictive mean matching imputations, while events with missing expenditure data were assigned to various recipient categories. Each event with missing expenditure data was assigned to a recipient category based on the extent of its missing charge and expenditure data. For example, an event with a known total charge but no expenditure information was assigned to one category, while an event with a known total charge and partial expenditure information was assigned to a different category. Similarly, events without a known total charge and no or partial expenditure information were assigned to various recipient categories. The logical edits produced eight recipient categories in which all events had a common extent of missing data. Separate predictive mean matching imputations were performed on events in each recipient category. For hospital inpatient events, the donor pool was restricted to events with complete expenditures from the MPC. The donor pool included “free events” because, in some instances, providers are not paid for their services. These events represent charity care, bad debt, provider failure to bill, and third party payer restrictions on reimbursement in certain circumstances. If free events were excluded from the donor pool, total expenditures would be over-counted because the distribution of free events among complete events (donors) would not be represented among incomplete events (recipients). Expenditures for services provided by separately billing doctors in hospital settings were also edited and imputed. These expenditures are shown separately from hospital facility charges for hospital inpatient, outpatient, and emergency room care.

Hospital Inpatient Stay Data Editing and Imputation. Facility expenditures for hospital inpatient stays were developed in a sequence of logical edits and imputations. “Household” edits were applied to sources and amounts of payment for all events reported by HC respondents. “MPC” edits were applied to provider-reported sources and amounts of payment for records matched to household-reported events. Both sets of edits were used to correct obvious errors (as described above) in the reporting of expenditures. After the data from each source were edited, a decision was made as to whether household- or MPC- reported information would be used in the final editing and hot-deck imputations for missing expenditures. The general rule was that MPC data would be used for events where a household-household- reported event corresponded to a MPC-reported event (i.e., a matched event), since providers usually have more complete and accurate data on sources and amounts of payment than households. Separate imputations were performed for flat fee and simple events. Most hospital inpatient stays were imputed as simple events because facility charges for an inpatient hospital stay are rarely grouped with other events. (See Section 2.5.4 for more details on flat fee groups.) Logical edits also were used to sort each event into a specific category for the imputations. Events with complete expenditures were flagged as potential donors for the predictive mean matching hot-deck imputations, while events with missing expenditure data were assigned to various recipient categories. Each event with missing expenditure data was assigned to a recipient category based on the extent of its missing charge and expenditure data. For example, an event with a known total charge but no expenditure information was assigned to one category, while an event with a known total charge and partial expenditure information was assigned to a different category. Similarly, events without a known total charge and no or partial expenditure information were assigned to various recipient categories. The logical edits produced eight recipient categories in which all events had a common extent of missing data. Separate predictive mean matching hot-deck imputations were performed on events in each recipient category. For hospital inpatient and emergency room events, the donor pool was restricted to events with complete expenditures from the MPC. Due to the low ratio of donors to recipients for hospital outpatient and office-based events, there were no donor pool restrictions. The donor pool included “free events” because, in some instances, providers are not paid for their services. These events represent charity care, bad debt, provider failure to bill, and third party payer restrictions on reimbursement in certain circumstances. If free events were excluded from the donor pool, total expenditures would be over-counted because the distribution of free events among complete events (donors) would not be represented among incomplete events (recipients). Expenditures for services provided by separately billing doctors in hospital settings were also edited and imputed. These expenditures are shown separately from hospital facility charges for hospital inpatient, outpatient, and emergency room care.

Hospital Inpatient Stay Data Editing and Imputation. Facility expenditures for hospital inpatient stays were developed in a sequence of logical edits and imputations. “Household” edits were applied to sources and amounts of payment for all events reported by HC respondents. “MPC” edits were applied to provider-reported sources and amounts of payment for records matched to household-household- reported events. Both sets of edits were used to correct obvious errors (as described above) in the reporting of expenditures. After the data from each source were edited, a decision was made as to whether household- or MPC- MPC-reported information would be used in the final editing and hot-deck imputations for missing expenditures. The general rule was that MPC data would be used for events where a household-reported event corresponded to a MPC-reported event (i.e., a matched event), since providers usually have more complete and accurate data on sources and amounts of payment than households. Separate imputations were performed for flat fee and simple events. Most hospital inpatient stays were imputed as simple events because facility charges for an inpatient hospital stay are rarely grouped with other events. (See Section 2.5.4 2.6.4 for more details on flat fee groups.) Logical edits also were used to sort each event into a specific category for the imputations. Events with complete expenditures were flagged as potential donors for the predictive mean matching hot-deck imputations, while events with missing expenditure data were assigned to various recipient categories. Each event with missing expenditure data was assigned to a recipient category based on the extent of its missing charge and expenditure data. For example, an event with a known total charge but no expenditure information was assigned to one category, while an event with a known total charge and partial expenditure information was assigned to a different category. Similarly, events without a known total charge and no or partial expenditure information were assigned to various recipient categories. The logical edits produced eight recipient categories in which all events had a common extent of missing data. Separate predictive mean matching hot-deck imputations were performed on events in each recipient category. For hospital inpatient and emergency room events, the donor pool was restricted to events with complete expenditures from the MPC. Due to the low ratio of donors to recipients for hospital outpatient and office based events, there were no donor pool restrictions. The donor pool included “free events” because, in some instances, providers are not paid for their services. These events represent charity care, bad debt, provider failure to bill, and third party payer restrictions on reimbursement in certain circumstances. If free events were excluded from the donor pool, total expenditures would be over-counted because the distribution of free events among complete events (donors) would not be represented among incomplete events (recipients). Expenditures for services provided by separately billing doctors in hospital settings were also edited and imputed. These expenditures are shown separately from hospital facility charges for hospital inpatient, outpatient, and emergency room care.