Overview

Hospitalization is a critical metric that shows up in numerous places in Marketscape Insights. In the most general terms, a hospitalization event is when a patient is admitted to a hospital during a post-acute stay or within 30 days after discharge from post-acute care. The exact meaning of a specific hospitalization metric, and how it is calculated, could be different depending on where the metric resides in Marketscape Insights.

The different hospitalization metrics have different names. If the names match between two different locations in Marketscape Insights, the metric is the same.

As always, similar metrics in different tables might be different numbers or percentages because they tell different stories based on the context. Our analytics are designed to help you make decisions based on the content of each different story. Or, if you like, each table provides a specific perspective on a provider. When you look at the same provider from the different perspective of another table, what you see regarding a specific metric might be different. For this reason, metrics that are similar might not match between different tables. This is especially important to remember in the case of hospitalization metrics that we have sliced a number of different ways.

There are three different Hospitalization rates in Marketscape Insights:

• Hospitalization Rate: Stay + 30 days - a patient is hospitalized during a hospice stay or within 30 days of discharge from hospice care. For the details, click here.
• Facility Specific Hospitalization Rate - a patient, discharged from the selected facility, is hospitalized during a hospice stay or within 30 days of discharge from hospice care. For the details, click here.
• Trended Hospitalization Rate - a patient is hospitalized during a hospice stay or within 30 days of discharge from hospice care. This metric is calculated on a one year reporting period ending in the quarter listed in each column. For the details, click here.

In this article we refer to PAC or post-acute care. PAC could refer to SNF, home health, or hospice care. How the metrics for each are calculated is similar, so the more generic term is used to facilitate ease of understanding across the different lines of business.

Usage

Excellent post-acute care should impact overall patient care by keeping patients out of the hospital. The spread of hospitalization metrics available in Marketscape Insights will allow you to evaluate your own agency's performance against state and county benchmarks. In addition, you can see how you stack up against your competitors in many tables.

To find your competitors, you will need to perform a competitive analysis. For more information on how to perform a competitive analysis, click here.

Calculation Basics

In all of the hospitalization metrics, the calculations are similar. At the most basic, it is the number of patients hospitalized during a post-acute stay or within 30 days after discharge divided by the total number of patients admitted to the post-acute agency, times 100%.

The equation looks like this:

Differences in how we calculate each count, numerator and/or denominator is what differentiates the spread of hospitalization metrics. Those differences are described for each metric below for each metric.

State and County Benchmarks

In many locations there are state and county benchmarks for comparison. These are calculated for all similar post-acute agencies in either the state or county, using the same equation as for the specific agency on the page, or in the table.

Hospitalization Rate: Stay + 30 Days

Where to find it

Explore page for Facilities > Main table - SNF and HHA only

This column is shared: what appears in this column depends on the claim type. Note the differences below:

• If the claim type for the facility is inpatient, the metric in the column will be a readmission rate for the listed facility.
• If the claim type for the facility is outpatient, this column will always be empty. There is no such thing as hospitalization or readmission for outpatient.
• If the claim type is HHA or SNF, the metric in the column will be the hospitalization rate for the listed facility.

Facility Analyze Page > Destinations > Hospice Destinations Table

Physicians Analyze Page > Destinations > Hospice Destinations Table

This metric is calculated for the selected physician's patients who were admitted to the hospice listed in the row.

Engage > Presentation for a Physician > Hospice Agency Utilization Metrics > Diagnostic Category

Create a Presentation - The table in the image is included by default

Understanding the Metric

This is our broadest view of hospitalization in Marketscape Insights. For an event to be a hospitalization, the patient would need to be admitted to inpatient care during a post-acute stay or in the 30 days following post-acute discharge. For home health, this includes transfers.

Any Length of Stay - We calculate this metric on a stay of any length in part to distinguish this metric from readmission rates that have a fixed 30 day period. Other issues to consider:

• In many cases, an admission to inpatient care from post-acute care triggers/requires a discharge from the post-acute stay. The exception is a home health transfer where the episode/stay continues. When a discharge does occur, we count the event as a hospitalization, and the 30 days post discharge don't apply.
• In the case of a patient who is discharged from post-acute care, we then consider that stay/event a hospitalization if the patient is admitted to inpatient care within 30 days of post-acute discharge.

Facility Specific Hospitalization Rate

Where to find it

Facility Analyze Page > Destinations > Hospice Destinations Table

Understanding the Metric

This metric is found on the Analyze page in the destinations table for the selected facility (hospital or SNF). The calculation is the same as for Hospitalization Rate: Stay + 30 Days with one difference; for the post-acute agency in each row, we calculate the hospitalization rate for only patients discharged from the selected facility.

Why is the Facility Specific metric always larger than Percent Hospitalized: + 30 Days?

There are a few differences between the Hospitalization Rate: +30 days and the Facility Specific Hospitalization Rate that set them apart. Because these two metrics sit side by side in the Destinations table (above), it is helpful to describe these differences. The following table shows the major differences between the two metrics:

Patient Acuity	Patients used to calculate this metric could be admitted to hospice from inpatient care, or by physician referral. The patient population is more "general" and is therefore a good baseline for understanding hospitalization in general.	The patients used to calculate the facility specific metric were ALL admitted from inpatient or SNF care to hospice. This population of patients will have a higher acuity, that is, they are more sick. This means that they are more likely to be returned to short term inpatient care when compared to the overall pool of patients admitted to hospice care.
Frequent Flyers A patient admitted and discharged multiple times from the hospital (INP)	As with the patient acuity, since this metric includes a broader, more general population, the impact of patients with multiple inpatient admissions and discharges is smaller	Since this metric is calculated against a smaller population, the impact of patients who are admitted and discharged multiple times has a higher overall impact on the calculation, pushing it higher.
Frequent Flyers #2		In addition, what sometimes happens with this type of patient is that they have multiple discharges from inpatient care within the 30 day reference period prior to post-acute admission. As a result, a single hospitalization event has more than one prior "from this specific facility" discharge events, each of which is counted. In this case, the discharging facility is hit for two hospitalization counts for the single patient.

Trended Hospitalization Rate

Where to find it

Hospice Analyze Page > Quality > Hospitalization Rate (12 Month Rolling) table

Understanding the Metric

This metric is calculated the same way as Hospitalization Rate: Stay + 30 Days.

There are two differences:

• The reporting period for the trended metrics is one year instead of two.
• The reporting period for each quarter ends in the quarter listed. See image for how the reporting period is adjusted.

In this image, we only show reporting periods for the two most recent quarters. The previous quarters would extend further to the left, that is, into earlier quarters.