Initial Patient Population Size Non-Medicare Only

Specifications Manual for Joint Commission National Quality Measures (v2015A)

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Release Notes:
Data Element
Version 2015A

Data Element Name:

Initial Patient Population Size Non-Medicare Only

Collected For:

AMI, HBIPS, HF, PC, PN, Transmission, Patient Population Data File , Used in transmission of the Hospital Initial Patient Population Data file.

Note:
Refer to the HBIPS Hospital Initial Patient Population Data XML File Layout in the Transmission section of this manual.

Definition:

Indicates the number of episode of care (EOC) records identified for a hospital with Medicare NOT listed as a payment source prior to the application of data integrity filters, measure exclusions, and/or sampling methodology for the specified time period.

The data element is based on the hospital's initial identification of non-Medicare EOC records for a measure set, stratum, or sub-population. This initial data pull utilizes administrative data such as ICD-9-CM diagnosis and procedure codes, admission date, and birthdate.

For the discharge measures (eg. HBIPS-1, 4, PC-01), refer to the Initial Patient Population discussion in the Measure Information section of this manual for more information.

For the HBIPS event measures (HBIPS-2 and 3), the Initial Patient Population Size Non-Medicare Only is equal to those EOC records in the census data identified as not having Medicare listed as a payment source. The HBIPS census data are calculated by (Psychiatric Inpatient Day-Non-Medicare Only - Total Leave Days-Non-Medicare Only). Initial Patient Population Size Non-Medicare Only is not derived from those cases that pass through the Initial Patient Population algorithm.

Note:
If the hospitals data has been sampled, this field contains the population from which the sample was originally drawn, NOT the sample size.

Suggested Data Collection Question:

Not Applicable

Format:

Length:	6
Type:	Numeric
Occurs:	Non-stratified Measure Sets: One Initial Patient Population Size Non-Medicare Only per hospitals measure set (e.g., AMI, HF, PN, and STK). Stratified Measure Sets: One Initial Patient Population Size Non-Medicare Only per measure set stratum or sub-population the hospital is participating in: * The PC measure set has three occurrences, one for the mother sub-population and two for the newborn sub-populations. * The HBIPS measure set has four occurrences, one for each age stratum. Note: Refer to the appropriate version of the Specifications Manual for National Quality Inpatient Measures for the number of occurrences for the CAC, VTE, and SCIP measure sets.

Allowable Values:

0 through 999,999

Notes for Abstraction:

Initial Patient Population Size-Non-Medicare Only must contain the actual number of patients in the population even if the hospital has five or fewer discharges (both Medicare and non-Medicare combined) in a quarter and has decided to not submit patient level data.

Suggested Data Sources:

Not Applicable

Additional Notes:

Guidelines for Abstraction:

Inclusion	Exclusion
None	None

Initial Patient Population Size Non-Medicare Only

Specifications Manual for Joint Commission National Quality Measures (v2015A)
Discharges 01-01-15 (1Q15) through 09-30-15 (3Q15)