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Hospital Efficiency Index
The Hospital Efficiency Index is a tool that objectively measures a hospital’s inpatient days of care to that of the most efficiently delivered care across the country. The Index may be used to assess the utilization management performance within a grouping of patients (i.e., it could be across an entire hospital, or groupings of patients within a hospital). The utilization performance measures are based on statistical analyses that recognize and adjust for each patient grouping’s unique case mix and severity. The Index measures the difference between the actual length of stay and a nationally determined standard for the most efficiently delivered care for each hospitalization type (i.e., by procedure and severity). Results are shown separately as potentially avoidable hospital days arising from either inappropriate lengths of stay or inappropriate admissions. Inappropriate admissions are based on specialty (primarily defined as Major Diagnostic Category (MDC) medicine vs. surgery). The methodology reflects the mix and severity of cases within the specialty and measures a hospital’s tendency toward inappropriate admissions as compared to benchmark hospitals. This tool is applicable for all Medicare admissions in all states and for Commercial and Medicaid admissions in approximately 20 states. |