The Hospital Day of the Week Report™

Source of Data: Medicare Provider Analysis and Review File (MedPAR File)
This report includes records for 100 percent of Medicare PPS beneficiaries discharged from short term acute care hospital inpatient services for the most currently available federal fiscal year. The records are extracted from the actual bills submitted for payment to Medicare by the provider. All Diagnostic Related Groups (DRGs) listed are those assigned by the Centers for Medicare and Medicaid Services (CMS) to the patient when he/she was discharged by the facility. To make the data as accurate, relevant and comparable across institutions as possible, a small proportion of records with various specific anomalies -- as identified by Data Advantage’s proprietary data screening and statistical cleansing algorithms -- have been excluded.

Report Description
The Day of the Week (DOW) module is a multi-page report that provides an in-depth analysis of the impact that the length of stay has on a hospital’s profitability and efficiency for each DRG (Diagnostic Related Group). While this report does not attempt to summarize all the variables that are associated with the actual charges or costs for any specific patient or DRG, it does show profit/loss trends as related to length of stay. Length of stay can be affected by how efficiently patients are treated. In addition, the DOW report displays the length of stay variability within the hospital based on “day of admit” and the impact that the various discharge options may have on the length of stay.

Report Definitions

• Profit by LOS Worksheet

This graph provides information regarding the average (mean) overall profit/loss for Medicare discharges based on length of stay. The average profit/loss is graphically presented for all cases that had a one-day length of stay, two-day length of stay, and so on. This data can be used to determine profitability trends and help the hospital determine at what point the patients within a specific DRG may not be profitable. The data presented in this table could be used as a starting point for initiating inquiries focused on improving overall hospital efficiency and profitability. In each table, the very last data point will always display the overall profit/loss for the specific DRG. At the bottom of the graph is a data table that displays the percentage of total cases with profit/loss by day.


• LOS by Admit Day Worksheet

The information provided in this graph illustrates the average (mean) length of stay experienced by a patient within a chosen DRG depending on the day of the week that they were admitted to the hospital. The purpose of this chart is to graphically display variations in the length of stay relative to the day of the week that a patient was admitted, and to point out any possible patterns or opportunities that may exist (e.g. patients admitted on Friday having a longer LOS that may be related to lack of staffing or availability of testing over the weekend). Included in this table as a reference point, is the CMS Geometric Mean Length of Stay (GMLOS) for the specific DRG displayed. The GMLOS is the national mean length of stay for each DRG as determined and published by CMS (Centers for Medicare and Medicaid Services). The data table below the chart provides the average length of stay for each day of the week, the GMLOS, the profit/loss per case for each day of admission, and the percentage of patients who were admitted on each specific day.


• Length of Stay by Admission Day by Admission Source

This graph compares the average length of stay for patients being admitted from the hospital’s emergency department (ED) versus those who have been admitted from every other available source (e.g. direct admits, transfers, etc.), again broken down by each day of the week. The purpose of this report is to point out the variability between the ED and all other admission sources and to suggest possible opportunities for increased efficiency (e.g. if patients have a shorter length of stay coming from the ED than other admission sources than it could be possible that the ED diagnostic and/or initiation of treatment process is more efficient). The GMLOS for the DRG is provided as a reference point. The data table below the chart displays the ALOS for those patients who were admitted from the ED for each day of the week, the ALOS for those patients who were admitted from every other source besides the emergency room, and the GMLOS. Also provided are the average, per case, profit/loss figures for patients who were admitted from the ED, the profit/loss for patients who were admitted from every other source, the percentage of all the ED patients who were admitted on each specific day, and finally the percentage of all non-ED patients who were admitted on each specific day.


• Discharge Destination by Day of the Week

Displayed in this graph is the discharge destination of all patients within the chosen DRG, broken down by each day of the week. Each bar graph is color coded to reflect a specific discharge destination to provide a quick visual representation of the discharge destination variability based on the day of the week. The purpose of this graph is to suggest discharge patterns and how the availability or possible lack of availability of a specific discharge destination may impact the overall LOS. Below the chart is a table that lists out all the specific destinations for which data is available and the percent of the patients associated with each destination for each specific day.


• BenchMarks Worksheet

The purpose of this worksheet is to summarize available benchmark information applicable to the hospital that is being profiled by the DOW report. Along with providing a summary of the target hospital’s data, the benchmark worksheet provides comparative values from the Metropolitan Statistical Area (MSA) and the State within which the target hospital resides. Also provided as benchmarks are summaries from hospitals that are of comparable bed size, urban or rural location, teaching versus non-teaching, and profit versus non-profit as is applicable to the target hospital. National figures are provided for every hospital.