Modul Pelatihan Praktisi Rekam Medis unit 4 c “The key of Question Answer”

Appendix 2 – Answer Key to Appendix 1

Education Module 4 – Healthcare Statistics

 based on IFHRO modul

EXERCISE 1 – Patient Care Unit CENSUS

1.    Using the information from the left of the page, complete the daily census for patient unit A.

UNIT A                                                                        DAILY CENSUS FOR DATE 6.3.06

 

John Smith adm. from                                    a.         No. on unit last report              40

O.P.D. (Dr. Richard)

Adam James adm. Dr. Maurice                                 No. admitted                             5

Stanley Paul adm. G.P.                                              No. transfers in                         1

Anthony Greech trans.                                   b.         Total                                          6

from other hospital

Patrick Sterling trans.                                                 No. discharges                          5

from Med. (Ward B)

Gordon Thompson died 10.30 a.m.                            No. Deaths                                2

Wayne Johnson emerg. adm.                                    No. transfers out                       1

Brett Arnold disch. O.P.D.                              c.         Total                              8

Michael Stephens disch. G.P.           

Adam Carpenter trans.                                               Today’s census

to Psych. (Ward D)                                                     a + b ‑ c           =  40 + 6 – 8 = 38

John Trip trans. to

other hospital

Wayne Johnson died 4.30 p.m.

John Smith disch. O.P.D.

Thomas Adams disch. O.P.D.

2.    Number of patient days for patient unit A on 6-3-06:   40

38 + 2 patients admitted and discharged on 6-3-06  =  40

 

                                    EXERCISE 2 ‑ HOSPITAL CENSUS REPORT

Date:        6-3-06    

Complete the data for Unit A from Exercise 1.

Complete the Hospital Census report.

What checks for accuracy can you use?

 Unit  Prev.

Day

Census

 Admi-

ssions

 Transfers

In

 Discharges  Transfers

Out

 Today’s

Census

 Alive  Deaths
 A   40  5  1 from B  5  2  1 to D  38
 B   35   4  2 from C      1 to A  41
 C   23   8     4     2 to B  25
 D   28   3  1 from A   2   1    28
 E   30   6     3      33
 TOTAL  156  26  4  14  3  4     165

 

Accuracy checks:

1.    Total transfers in equal total transfers out

2.    Today’s hospital census is result of adding total admissions and transfers in to previous day census, and subtracting from this the total discharges and transfers out.

156 + 26 + 4 – 14 – 3 – 4 = 165

 

                                             EXERCISE 3 ‑ HOSPITAL CENSUS

Complete today’s hospital census report

HOSPITAL CENSUS REPORT 

 

August 27, 2006.

 Unit  Prev.

Day

Census

 Admi-

ssions

 Transfers

In

  Discharges  Transfers

Out

 Today’s

Census

 Discharges  Deaths
 A   40   3     2    2 to B   39
 B   26     2 from A   4  1  1 to D   22
 C   31   8  2 from D   5  1     35
 D   45     1 from B  10    2 to C   34
 E   12   6           18
 TOTAL  154  17  5  21  2  5  148

 

 

                                                                EXERCISE 4

1.    Compute the length of stay of 10 patients who were discharged from hospital on October 6, 2006.  Their dates of admission were as follows:

(a)        September 12                     24                 (f)        September 11 ­   25

(b)        September 28                  ­­­     8                 (g)        October 5                        1

(c)        September 30                       6                  (h)       September 16    20

(d)        September 26                     10                  (i)        October 6                          1

(e)        October 4                  2                              (j)        August 13                        54 

(k) What was the average LOS?     15.1  151 divided by 10

2.    In a 200 bed hospital, the patient days for 2006 were 62,050.   The 6,495 patients who were discharged or died had a total of 61,930 days care.  Using the above figures, compute the following averages and rates, showing formulae used.

(a)        62050 divided by 365 = 170 patients

(b)        (62050 x 100) divided by (200 x 365) = 85.0%

(c)        61930 divided by 6495  =  9.54 or 9.5 days

 

EXERCISE 5

1.    A Coronary Care Unit in a large teaching hospital had a total bed count of 20 beds in 2006.  During the year the patient days for the unit were calculated at 5,260 days.  The 1,255 inpatients who were discharged from the unit during 2006 spent a total of 5,066 days there.

(a)   5260 divided by 365 =  14.41 or 14 patients

(b)   5066 divided by 1255 = 4.03 or 4.0 days

(c)   (5260 x 100) divided by (20 x 365) = 72.054 or 72.1%

2.    The following data have been collected from a 700 bed general hospital during 2006:

Patients admitted                                                          14,117

Total discharges/deaths                                                14,086

Total discharge days                                                   137,202

Total inpatient patient days                                         226,842

Total registered outpatient attendances                      192,846

From the information above, calculate the following, showing formulae:‑

(a)        137202 divided by 14086 = 9.74 or 9.7 days

(b)        226842 divided by 365 =  621.48 or 622 patients

(c)        (226842 x 100) divided by (700 x 365) =  88.78 or 88.8%

3.    In a local hospital, the average length of stay in January 2006 was 10.4 days.  The number of patient days care rendered to discharged patients in the same period was 5,460.  How many discharges were there in January?

                             5460 divided by 10.4  = 525 discharges/deaths

4.    A 460 bed general hospital assigned 215 beds for general medical service, 125 beds for general surgery including Orthopedics, the remainder, 120, were divided among the other services.  For the past 12 months (2004) the number of patient days within the three major categories were:

Pt. days                            Beds                       Bed days

A.  General medicine       59,059                         215      x 365                 78690           

B.  General surgery          43,070                         125      x 365                 45750

C.  Other services                        35,040                         120      x 365                 43920

Using the above information calculate the following for each of the three categories:

 

General Medicine                           General Surgery                  Other Services

(i)     5905900/78690= 75.1%         4307000/45750 = 94.1%       3504000/43920 = 79.8%

(ii)   59059/365 = 161.36 or 161    43070/365 = 117.67 or 118   35040/365 = 95.73 or 96

 

 

 

 

 

EXERCISE 6

A 477 bed general hospital had 15,746 patients discharged/died in 2006.  Total deaths for the year were 487.  There were 81 cases reported to the Coroner, and 351 autopsies were performed.

Total patient days were 136,995 and the total length of stay of discharged/died patients was 136,540. 

Give the formulae, and using the above information, compute the following:

1.    (487 x 100) divided by 15746 = 3.09 or 3.1%

2.    15746 divided by 477 = 33.01 or 33.0

3.    (351 x 100) divided by (487 – 81) = 86.453 or 86.5%

(The 81 Coroner’s cases were NOT autopsied at the hospital)

4.    136450 divided by 15746 = 8.67 or 8.7 days

 

EXERCISE 7

1.    The following data have been collected from a local hospital.  The average length of stay in June was 5.2 days.  The total length of stay of discharged/died patients in the same period was 2,730.  There were 18 deaths, including 2 unautopsied Coroner’s cases and 12 autopsies were performed.

a.          Number of patients discharged/died = 525

(18 x 100) divided by 525 = 3.43 or 3.4%

b.          (12 x 100) divided by (18 – 2) = 75.0% (.0 for uniformity with other indicators)

2.    The following data have been collected from a 700 bed general hospital during 2006.

Patients admitted                                                             19,957

Total discharges/deaths                                                   19,933

Patients remaining in hospital midnight

Dec.31, 2005                                                           632

Patients remaining in hospital midnight

Dec.31, 2004                                                           656

Total length of stay of discharged/died patients           218,515

Total patient days                                                         236,842

Total deaths                                                                         615

Total autopsies performed                                                   485

Coroner’s cases (unautopsied)                                              43

Number of anaesthetics administered                             6,925

Number of operations performed                                    7,700

Total registered outpatients                                           192,846

From the information above, calculate the following:

a.         236842 divided by 365 =  648.88 or 649 patients

b.         (615 x 100) divided by 19933 = 3.08 or 3.1%

c.         (700 x 365) – 236842 divided by 19933 = 0.93 or 0.9 days

d.         (485 x 100) divided by 615 =  78.86 or 78.9%

e.         (485 x 100) divided by (615 – 43) = 84.79 or 84.8%

f.          (236842 x 100) divided by (700 x 365) = 92.69 or 92.7%

g.         218515 divided by 19933 = 10.96 or 11.0 days  (.0 added for uniformity)

 

EXERCISE 8

The following information was collected from a 500 bed hospital and includes the census figures for the 30th September, 2006 and the monthly figures for the month of September, 2004.

(a)  September 30

Patients in hospital at midnight                             418

Patients discharged 30th September                     17

Patients admitted 30th September                        24

(6 patients were admitted and discharged

the same day.)

(b)  September  2004

Total number of discharges/deaths                     1088

Total deaths                                                               43

Coroner’s Cases (unautopsied)                                  4

Total number of autopsies performed                       28

Total number of anaesthetics administered            467

Total number of outpatient attendances              16203

Total patient days during September                   12332

Total length of stay of discharged/died   

patients                                                     10943

From the above figures, calculate the following:‑

1.    Census for the 30th September                           418 – 17 + 24   =  425

2.    Patient days for 30th September                         425 + 6  =  431           

3.    12332 divided by 30 =  411.06 or 411 patients

4.    (12332 x 100) divided by (500 x 30) = 82.21 or 82.2%

5.    10943 divided by 1088  =  10.06 or 10.1 days

6.    (28 x 100) divided by 43  =  65.12 or 65.1%

7.    1088 divided by 500 =  2.18 or 2.2

8.    (43 x 100) divided by 1088  = 3.95 or 4.0%

9.    (28 x 100) divided by (43 – 4)  =  71.79 or 71.8%

 

EXERCISE 9

1.    In an obstetric hospital there were 310 live births in June 2004; of this number 7 died within the early neonatal period.  The hospital also registered 8 fetal deaths for the same month.  What rates were calculated below?

a.  (8 + 7) x 100 divided by (310 + 8) = 4.72 or 4.7%                 Perinatal death rate

b.  8 x 100 divided by (310 + 8) = 2.52 or 2.5%                          Fetal death

2.    An obstetric hospital published the following figures in 2004.

Obstetrical discharges

  • delivered                                      2288
  • undelivered                                  327
  • aborted                                            39

Total infants discharged/died                         2255

Total births (live)                                                2309

Infant deaths (early neonatal)                            56

Fetal deaths                                                            36

Maternal deaths                                                          3

Using the above information, calculate the following:

a.  3 x 100 divided by (2299 + 327 + 139)  =  0.1%

b.  56 x 100 divided by 2255  =  2.48 or 2.5%

c.  36 x 100 divided by (2309 + 36)  =  1.54 or 1.5%  

d.  (36 + 56) x 100 divided by (2309 + 36) =  3.92 or 3.9%

3.    A 320 bed obstetric hospital had 10,220 obstetric separations in 2006. There were 7,016 live births; 139 fetal deaths; 523 caesarean sections were performed with a total of 6,968 deliveries for the year and 2 maternal deaths.  There were 4 infant deaths classed as early neonatal.  Using the above information, calculate the following:

a.  139 x 100 divided by (7016 + 139)  =  1.94 or 1.9%

b.  523 x 100 divided by 6968  = 7.51 or 7.5%

c.  (139 + 4) x 100 divided by (139 + 7016) = 1.99 or 2.0%

It is not reasonable to have only 4 infant deaths.  The medical record professional should investigate to be sure that infants who die minutes after birth are not being classified as fetal deaths.

 

 

 

EXERCISE 10

You have received the following medical statistics for review prior to their publication in the Annual Report of a General Hospital.  What comments do you have regarding the accuracy of the data?

Available beds (Bed complement)                                                                             430

Total admissions                                                                                                    11,285

Total discharges/deaths                                                                             11,123

Total deaths                                                                                                                521

Patients in hospital at midnight on 31 December 2003                                              344

Patients in hospital at midnight on 31 December 2004                                              371

Autopsies performed (including 2 autopsied Coroner’s Cases)                                 378

Coroner’s cases                                                                                                            44

Total patient days                                                                                                 128,954

Total length of stay of discharged/died patients                                                  126,872

Out‑patient visits                                                                                                  106,750

There is an inconsistency in the inpatient data.  If there were 344 patients in hospital at the beginning of the year and 11,285 admissions and 11,123 discharges/deaths, there would be 506  patients remaining at the end of the year which is impossible given that the hospital has 430 beds.   344 + 11285 – 11123 = 506

Average daily census                         352                  Divided by 365 rather than 366

Percentage of Occupancy                 81.9%

Turnover rate                                      25.9

Hospital death rate                              46.8%              Multiplied by 1000 rather than 100

Gross autopsy rate                             0.73%              Did not multiply by 100

Net autopsy rate                                 0.79%              Did not multiply by 100

 selesai @hak cipta Dr iwan suwandy 2010

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