Frequently Asked Questions
General Information
1. Do you list all conditions and procedures?
2. Where do the data for your reports come from?
3. How many years of data do you present?
4. What is included in my reports?
6. Can I get another copy of my report?
Physician Information
2. Where does UCHC get the physician information?
3. Where do disciplinary data come from?
4. Why can't I find my physician?
5. What kinds of reports are available?
Hospital Information
1. Does UCompareHealthCare rate hospitals?
4. What procedures or conditions do you have data on?
5. What other kinds of information do you provide on hospitals?
6. How often are the data updated?
7. How do you risk adjust your data?
8. I work at a hospital, and our results do not match UCHC's. Why is there a difference?
Decision Assistant Information
1. Why should I use the Decision Assistant?
2. What will the Decision Assistant tell me?
3. How do I use the Decision Assistant?
4. What are "quality measures"?
5. Why don't I see my condition or procedure here?
6. What procedures are included in IQIs and PSIs?
Nursing Homes Information
1. Where do the data for the nursing home reports come from?
2. Do you rate or rank nursing homes?
3. What nursing homes are in the UCHC database?
4. What information is available on the reports?
5. Where do the deficiency data come from?
General Information
1. Do you list all conditions and procedures?
No. There are many thousands of procedures or conditions, and we cannot offer information on all of them. However, we have selected certain conditions and procedures that are more common or are associated with higher volumes. This way we can offer the maximum amount of information for most people.
2. Where do the data for your reports come from?
UCHC includes data from literally hundreds of sources. We strive to obtain data from highly reliable sources that include federal and state governments, private organizations, and multiple third-party sources. Our proprietary technology and architecture result in very reliable data transformation for inclusion in our data warehouse. Our data collection and transformation processes are based on the logical, documented integration of data with multiple quality checks. This process is designed to remove mistakes and correct for missing data, provide documented measures of confidence in data, reconcile data from multiple sources, and structure data to be usable by end-user applications. Each area of our site has a full explanation of the methodology used to generate that specific report.
3. How many years of data do you present?
UCHC currently has processed three years of Medicare Provider Analysis Review (MEDPar) data (2003, 2004 and 2005). All other data are updated as indicated and are not cumulative in nature. MEDPar data is made available in August for the preceding calendar year. Thus data for 2005 is considered current.
4. What is included in my reports?
UCHC Comparison Reports are available for physicians, hospitals, or nursing homes, depending on which area you select. Physician reports cover training, education, specialty, certification, location of practice, and other matters of interest. Hospital reports provide Inpatient Quality Indicators (IQIs) and Patient Safety Indicators (PSIs) as well as other information on specific conditions, procedures, and services offered by the hospital. Use the Decision Assistant to find the quality measures relevant to the part of the body you are concerned about. Nursing home reports include information on services offered, number of beds, number of nurses, quality measures, inspection results, etc. See the "Sample Report" in each area to get a better feel for the information included.
Risk adjustment is necessary to make meaningful comparisons between providers. Risk adjustment is a statistical process used to identify and adjust for variations in patient outcomes that stem from differences in patient characteristics (or risk factors) among healthcare organizations. It is a process of accounting for differences in patient populations based on potential risk factors such as age, severity of illness, risk of mortality, and other attributes.
The process of risk adjustment takes into consideration that diseases and medical conditions are rarely randomly spread across people and populations. To increase the validity of the measures, risk adjustments evaluates many factors.
To adjust risk, we use the 3M APR-DRG Grouper software product from 3M Health Information Systems, a product also used by more than 1,600 hospitals and 20 states. This system allows us to fairly compare hospitals across a wide range of healthcare measures.
6. Can I get another copy of my report?
Yes. Once you conclude building your report you will receive an email with a link to the report. If you need another copy of this report, you will be able to retrieve it for seven (7) days following your request or up to seven (7) views, whichever occurs first.
Physician Information
No, UCHC does not rate physicians. Instead, we provide relevant information that allows you to assess various qualifications and specialties. This is displayed in a comparative format in your Comparison Report. Where relevant, we also include information on location, gender, medical school, post-graduate training and disciplinary actions.
2. Where does UCHC get the physician information?
UCHC compiles the physician information from over 150 independent sources. These sources include federal and state governments as well as multiple third-party sources. However, it is important to remember that much of this information is "self reported" by the physician. Further investigation can always prove helpful.
3. Where does disciplinary data come from?
UCHC obtains data from the Office of Inspector General (OIG) which lists individuals who have been excluded from participating in federally funded healthcare programs. This is known as an exclusion or sanction.
There are several reasons for exclusion, including :
- conviction relating to fraud
- misdemeanor conviction relating to controlled substances
- license revocation by the State Medical Board
- surrender of a medical license while formal disciplinary actions are proceeding
- any exclusion from any federal or state health programs
- claims for excessive charges, fraud, or kickbacks
- failure to report required information to various state and or government agencies
- failure to grant immediate access for various inspections
- failure to take corrective action on issues found during inspections
- default of health education loans or scholarship obligations
We also collect State Medical Board disciplinary data, if available. Disciplinary actions from State Medical Boards reflect the last 5 years of data. We do not report on malpractice claims.
4. Why can't I find my physician?
If we are not able to verify all components of a physician profile, we eliminate the record from our database. We feel that this provides the most comprehensive and accurate use of our data. UCHC does not claim to have all physicians in our database. However, the vast majority of all practicing physicians are properly profiled in our database.
5. What kind of reports are available?
UCHC provides physician reports in a format that allows for easy comparison of physicians. Our reports include demographic, professional, educational, and disciplinary information and areas of specialties. All information is delivered in a tabular format, with all definitions clearly described for the user. See the "Sample Physician Comparison Report" for more details.
Hospital Information
1. Does UCompareHealthCare rate hospitals?
UCHC does not rate hospitals. There are many factors that affect quality care, and different conditions require different expertise. We provide you with the relevant quality measures and information that will allow you to pick what is important to you and give you a general perspective of quality, capabilities, and services of each hospital.
"PSI" stands for Patient Safety Indicator. PSIs are measures that take into account adverse events that patients experience as a result of exposure to the healthcare system. Events that are considered in PSIs are those that are probably preventable through changes at the system or provider level, as opposed to complications that are unavoidable risks of the procedure.
It is well established that healthcare organizations can reduce complications and adverse events by improving the environment for safety. Implementing technical changes, such as electronic medical record systems, improving staff awareness of patient safety risks, and having a mechanism to measure these indicators allows for an on-going means of assessment and improvement.
"IQI" stands for Inpatient Quality Indicator. IQIs reflect the quality of care given in hospitals. Inpatient Quality Indicators include four distinct types of measures.
- 1. Volume measures consider the number of a specified inpatient procedure performed at a given hospital and are indirect measures of quality. They are based on the premise that performing more of a specific procedure may produce better outcomes. They are considered a proxy of quality.
- 2. In-hospital mortality for inpatient procedures measures report the number of deaths per 100 patients associated with particular common procedures or discharge codes. The procedures selected are those where mortality has been shown to vary across hospitals. These measures, when associated with high rates of mortality may be an indication of poorer quality.
- 3. Mortality indicators for inpatient conditions. These conditions include those where mortality varies across hospitals. High rates of mortality may be associated with deficiencies in the quality of care.
- 4. Utilization indicators account for procedures that may be overused, underused, or misused.
4. What procedures or conditions do you have data on?
UCHC provides IQIs on 14 specific conditions or procedures. We also provide information on volume, cost, length of stay, and mortality for an additional 22 common procedures or conditions.
5. What other kind of information do you provide on hospitals?
UCHC provides comprehensive information on over 5,500 U.S. hospitals. This information includes demographics, hospital services available, in-patient quality indicators( IQIs), patient safety indicators (PSIs), and procedure and condition information for 22 different areas of interest.
6. How often are the data updated?
Hospital data are updated at least once a year. MEDPar (Medicare Provider Analysis Review) data, which we use to derive many of the quality measures, is only released once a year, and include the previous year's administrative discharge data.
7. How do you risk adjust your data?
UCHC uses 3M APR-DRG Grouper software from 3M Health Information Systems. This product is also the recommended risk adjustment method for many of the IQIs and PSIs we report.
8. I work at a hospital and our results do not match UCHC's. Why is there a difference?
There are many factors that could influence the correlation of one set of results to another. The various rules used for extraction of data create some variation. Transformation of the data and the added effect of data cleaning may produce additional variation. Results should not be dramatically different, however, and the significance of such variation is open to personal interpretation.
Decision Assistant Information
1. Why should I use the Decision Assistant?
By using the Decision Assistant, you are able to preview the type of information that will be included in your UCHC Hospital Comparison Reports prior to requesting it. You will be able to make sure that you receive the maximum amount of information available from our database. This process also allows you to participate in the educational aspect of our product offerings.
2. What will the Decision Assistant tell me?
When you use the Decision Assistant, you can highlight the area of the body most closely related to the condition or procedure of concern to learn more about quality measures related to that part of the body. An example might be hysterectomy. You would highlight the female reproductive system, and all categories of information available for this procedure will be listed in a general tabulated format for your review. You will also be able to gain more in-depth information by clicking on a particular quality measure such as IQI or PSI, and receive a full definition and in many cases an illustration, which will assist you in your research process.
3. How do I use the Decision Assistant?
Click on the part of the Decision Assistant's body (male or female) that relates to your procedure, condition, or area of concern. This will open a more detailed view, listing the type of information available to help you in selecting a hospital for this procedure or condition. You will also be able to use the "Find Specialists" feature of our product for information on physicians who specialize in areas important to you. Your search for physicians and hospitals will be based on this information.
4. What are "quality measures"?
UCHC uses two types of quality measures: Inpatient Quality Indicators (IQIs) and Patient Safety Indicators (PSIs).
IQI's (Inpatient Quality Indicators) are defined by specific types of procedures and conditions within the hospital and include volumes, post procedural mortality rates, in-hospital mortality rates as well as utilization rates for various procedures and conditions. The (IQI) measures have been reviewed thoroughly by AHRQ and are well documented. Providing this information with other indicators in a comparative format with proper risk adjustment provides a very reasonable look at quality within the hospital for procedures and conditions such as PCTA, CABG, CHF, AAA, Phuemonia and others.
PSI's (Patient Safety Indicators) are measures which have also been reviewed thoroughly by AHRQ and screen for adverse events that patients experience as a result of exposure to the health care system. These events are likely amenable to prevention by changes at the system or provider level. These measures look at conditions such as ulcers, foreign body left during a procedure and postoperative sepsis rates to name a few. These measures do not always relate to your specific condition or procedure, however, when used in a general sense with other measures and information provide a reasonable view of the quality from one institution to another.
5. Why don't I see my condition or procedure here?
There are thousands of procedures performed in U.S. hospitals. Because it is not possible for UCHC to compile data on each type of procedure, certain "quality measures" are used to identify quality issues in related areas. UCompareHealthCare has mapped many possible procedures you might be looking for to our list of quality measures to help you understand the quality of care you might expect.
It is not possible to provide quality measures for every particular condition or procedure—there are thousands of different procedures performed in U.S. hospitals. However, we have created a menu of selected information based on areas of the body. This menu is rooted primarily in the Major Diagnostic Categories (MDCs). All possible principal diagnoses and procedures are divided into 25 categories—MDCs—which are grouped primarily by organ systems. UCompareHealthCare has created this tool to help you select the quality measures most relevant to your procedure, condition or body system of interest. Along with additional categories, giving consideration to the frequency of the condition or procedure and availability of data for proper analysis, the "Decision Assistant" will display a list of the type of information that is available to you.
6. What procedures are included in IQIs and PSIs?
IQIs and PSIs are two types of information you should be familiar with to help you make informed healthcare comparisons. Both these groupings of quality measures were developed by the Agency for Healthcare Research and Quality (AHRQ), which is administered by the United States Department of Health and Human Services. For further explanation, see "Know your IQIs and your PSIs."
In addition, UCHC has included 22 common conditions or procedures which have not been reviewed by AHRQ. We report volumes, length of stay, mortality rates, and costs versus national averages for these specific conditions and procedures. They are also closely mapped to the major diagnostic categories (MDCs).
For example: If you are seeking information on kidney transplants, there are no specific quality measures which we could provide for that procedure. Instead you may look at Patient Safety Indicators or other similar or related procedures and conditions for the hospitals you are comparing. Patient Safety Indicators (PSIs) are measures that take into account adverse events that patients experience as a result of exposure to the healthcare system. Events that are considered in PSIs are those that are probably preventable through changes at the system or provider level, as opposed to complications that are unavoidable risks of the procedure. You may also wish to compare PSIs for two or more institutions.
We always describe exactly what kind of information will be included in your Comparison Report.
Nursing Home Information
1. Where do the data for the nursing home reports come from?
UCHC's information on nursing homes is based on data collected by the federal government, as well the Centers for Medicare & Medicaid Services (CMS) online survey, The American Health Association's Online Survey Certification and Reporting (OSCAR) database, and the Minimum Data Set (MDS), which is part of the federally mandated process for clinical assessment of all residents in Medicare- or Medicaid-certified nursing homes. UCHC updates its database every three months from the CMS sources.
2. Do you rate or rank nursing homes?
No, we do not rank, rate or otherwise grade nursing homes. We provide detailed information on each nursing home that allows you to make relevant decisions based on your individual circumstances.
3. What nursing homes are in the UCHC database?
UCHC nursing home data include information on nursing homes that are Medicare or Medicaid certified. These nursing homes provide skilled nursing care. There are many other types of facilities that provide various levels of health care and assistance with activities of daily living. Many of these facilities are licensed only at the state level. In addition, some nursing homes that provide a full range of care, including skilled nursing services, choose not to participate in Medicare or Medicaid. For information about any facility not found in this database, you should contact your state survey agency.
4. What information is available on the reports?
Your Nursing Home Comparison Report includes information on location and services offered, number of beds and number of nurses, quality measures, inspection results and ownership information. This is presented in a comparative format; you can compare up to four (4) nursing homes at a time.
5. Where do the deficiency data come from?
We report on regulatory requirements that the nursing home failed to meet. We do not include the entire inspection report. The detailed inspection report (form HCFA-2567) contains the specific findings that support the state's determination that the requirement was not met. A complete inspection report and the nursing home's corresponding plan of correction to address the deficiencies found during the inspection are available from the state survey agency or from the nursing home itself.
