 Hospital Rate with Low Volume
Different hospitals treat different types of patients based on the needs of their communities. Some hospitals care for a large number (volume) of patients with a given condition or procedure and some hospitals a smaller volume. In addition, most of the measures in CheckPoint require that each patient included in a measure meets defined criteria. These conditions may result in a low volume of patients reported (generally considered less than 25 patients) for a measure.
When this occurs, each patient’s result can have a large impact on the hospital’s rate. To better understand this effect, compare Hospital A and Hospital B. Hospital A has 100 patients that meet the criteria for a measure. If Hospital A providers the required care to all 100 patients, their rate is 100%. If Hospital A, for whatever reason, does not provide the required care to 1 patient, their rate is 99%. On the other hand, Hospital B has 4 patients that meet the criteria for a measure. If Hospital B provides the required care to all 4 patients, their rate is 100%. If Hospital B, for whatever reason, does not provide the required care to 1 patient, their rate is 75%. All of these rates are accurate, but the low number of patients reported by Hospital B makes their reported rate much lower when they do not provide the required care to the same number of patients.
Low reporting volume also affects the ability to use the current rate to predict future performance. Be careful when drawing conclusions about hospitals that have a small reporting volume.
For most measures, low volume is considered 25 cases or less. For mortality and utilization indicators, the threshold is 30 cases. For volume indicators, the threshold is 5 cases. Read more about mortality, utilization and volume indicators here.
No data collected at this time or no cases met criteria
Not all hospitals collect and report data for all of the measures reported in CheckPoint. There are several reasons for this.
A hospital may not provide care to the type of patients that are reported on by one or more of the measures in CheckPoint. If a patient requires care that is not provided by the hospital where they are currently receiving care, that hospital will transfer that patient to another hospital.
Hospitals provide many types of care. Each hospital has a quality improvement plan that determines which types of patients they will monitor and focus their improvement efforts on. If a hospital determines that they will not monitor their care in an area where CheckPoint has measures, this hospital will not have any data to report to CheckPoint for that type of care.
In order for a patient's information to be included in a CheckPoint measure, that patient must meet certain criteria. The criteria are required to increase the chance that the information reported for each hospital is the same. If a patient's information does not meet these criteria, that case is removed from the measure. On occasion, this will eliminate all cases from the report for an individual hospital even though they provide that type of care.
Data collected, but the report shows a "+" sign
Many measures in CheckPoint include patient data that are collected over time. Rates for measures that have less than 25 cases are reported in two ways:
- Click on the hospital name to view all measure rates for that hospital
- Click on the + sign in the report to view a trend report for that hospital and measure
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