Health Care StatisticsHealth Care Statistics-Census--Census-

Sources of DataSources of Data

Medical RecordMedical Record AbstractsAbstracts Ancillary reportsAncillary reports Admission, Transfer, Census and Admission, Transfer, Census and

Discharge listsDischarge lists Incident reportsIncident reports

Requestors of DataRequestors of Data

Administration and Governing BodyAdministration and Governing Body Medical StaffMedical Staff Outside agenciesOutside agencies Other organizationsOther organizations

Vital StatisticsVital Statistics

State laws require that these vital State laws require that these vital events be registered with the stateevents be registered with the state

Birth and death certificatesBirth and death certificates

CensusCensus

““an official, usually periodic an official, usually periodic enumeration of population”enumeration of population”

A count of peopleA count of people

A count of a population or subgroupA count of a population or subgroup

Inpatient CensusInpatient Census

The number of inpatients present at The number of inpatients present at any one timeany one time

Inpatients – formally admitted to the Inpatients – formally admitted to the hospital and occupy a bed at least hospital and occupy a bed at least overnightovernight

Outpatients – receive service on a more Outpatients – receive service on a more limited basis and are not assigned an limited basis and are not assigned an inpatient hospital bedinpatient hospital bed

Census TakingCensus Taking

Time of day: The most important Time of day: The most important factor is consistency. The hospital factor is consistency. The hospital should establish a time and stick to itshould establish a time and stick to it

Midnight is a common census taking Midnight is a common census taking timetime

Census ReportingCensus Reporting

In most hospitals where there is In most hospitals where there is computerization, census is computerization, census is automatically generated based on automatically generated based on admission, discharge, and transfer admission, discharge, and transfer data entered into the computer data entered into the computer throughout the daythroughout the day

Manually: a form is completedManually: a form is completed

Transfer DataTransfer Data

Intrahospital transfers: The TRF-in data Intrahospital transfers: The TRF-in data should always equal the TRF-out data should always equal the TRF-out data

Discharge transfers: listed in the Discharge transfers: listed in the census as a dischargecensus as a discharge

A transfer is counted as a census A transfer is counted as a census patient only on the unit on which the patient only on the unit on which the patient is present at census-taking timepatient is present at census-taking time

ExampleExample

March 1: Sally Smith was admitted to March 1: Sally Smith was admitted to the medical unit. She then needed the medical unit. She then needed emergency surgery and she was taken emergency surgery and she was taken to surgery and transferred to the to surgery and transferred to the surgery unit. Her condition worsened surgery unit. Her condition worsened and she was transferred to ICU. She and she was transferred to ICU. She stabilized and was transferred back to stabilized and was transferred back to the surgical unit. Where will Sally be the surgical unit. Where will Sally be counted at the end of the day at census counted at the end of the day at census taking time?taking time?

AnswerAnswer

Sally will be listed as:Sally will be listed as: A TRF-out of the medical unitA TRF-out of the medical unit TRF-in to the surgical unitTRF-in to the surgical unit TRF-out of the surgical unitTRF-out of the surgical unit TRF-in and TRF-out of the ICUTRF-in and TRF-out of the ICU TRF-in on the surgical unit where she is TRF-in on the surgical unit where she is

counted as an inpatient for March 1counted as an inpatient for March 1

A&DA&D

Admitted and discharged the same Admitted and discharged the same dayday Deaths, DC AMA, transfers, etc.Deaths, DC AMA, transfers, etc.

Inpatients because they occupied a Inpatients because they occupied a inpatient bedinpatient bed

They need to be counted in certain They need to be counted in certain census reportscensus reports

Inpatient CensusInpatient Census

Refers only to the patients present at Refers only to the patients present at census taking timecensus taking time

Daily Inpatient Census Daily Inpatient Census (DIPC)(DIPC)

Refers to the number of inpatients Refers to the number of inpatients present at the census taking time present at the census taking time each day plus any inpatients who each day plus any inpatients who were admitted and discharged the were admitted and discharged the same day (A&D)same day (A&D)

Synonymous with Inpatient Service Synonymous with Inpatient Service Day (IPSD)Day (IPSD)

Calculating IPSD/DIPCCalculating IPSD/DIPC

The census taken at census taking timeThe census taken at census taking time Plus admissionsPlus admissions Minus dischargesMinus discharges 1 inpatient day must be added for any 1 inpatient day must be added for any

A&DsA&Ds The total is most representative of The total is most representative of

service rendered in the 24-hour periodservice rendered in the 24-hour period

DeathsDeaths

Deaths are considered discharges Deaths are considered discharges unless the facility notes otherwiseunless the facility notes otherwise

Facility may specify “live” dischargesFacility may specify “live” discharges

ExclusionsExclusions

Fetal Death: a fetus that was not Fetal Death: a fetus that was not alive at the time of delivery was alive at the time of delivery was never a patient and is not included in never a patient and is not included in inpatient statisticsinpatient statistics

DOA: Dead on arrival patient, never DOA: Dead on arrival patient, never revived, was never an inpatient and revived, was never an inpatient and is not includedis not included

OP Death: only inpatients are OP Death: only inpatients are included in inpatient statisticsincluded in inpatient statistics

Census recording tipsCensus recording tips

Use plus and minus signs in front of Use plus and minus signs in front of data to indicate whether a number data to indicate whether a number should be added or subtractedshould be added or subtracted

Cross out data that are irrelevantCross out data that are irrelevant

ExampleExample

May 31 midnight censusMay 31 midnight census 4343 June 1 admittedJune 1 admitted +8+8

dischargeddischarged -2 -2

TRF-inTRF-in +1+1

TRF-outTRF-out 0 0

A&DA&D 2 2

What is the census for June What is the census for June 1?1?

43+8-2+1=43+8-2+1= 5050

What is the Daily Inpatient What is the Daily Inpatient Census or IPSD for June 1?Census or IPSD for June 1?

Hint: the DIPC/IPSD includes A&D’sHint: the DIPC/IPSD includes A&D’s

What is the Daily Inpatient What is the Daily Inpatient Census or IPSD for June 1?Census or IPSD for June 1?

5252

Beds/BassinetsBeds/Bassinets

Bed: hospital bed, includes all Bed: hospital bed, includes all patients not born in the hospitalpatients not born in the hospital

Bassinet: beds for newborns (NB)Bassinet: beds for newborns (NB)

Newborn (NB)Newborn (NB)

Any live infant born in the hospital is Any live infant born in the hospital is considered a newborn and is included in the considered a newborn and is included in the bassinet countbassinet count

Stillborn infants are not included in the Stillborn infants are not included in the newborn count. They are included in a fetal newborn count. They are included in a fetal death count.death count.

Babies born at home or en route to the hospital Babies born at home or en route to the hospital are not included in the newborn bassinet count. are not included in the newborn bassinet count. These babies are included in the bed count. These babies are included in the bed count.

Average Daily CensusAverage Daily Census

Total inpatient service days for a Total inpatient service days for a periodperiod

Total number of days in the periodTotal number of days in the period

Example:Example: 792792 = 113 = 113

77