Determine profit for each patient

Assignment Help Advanced Statistics

Reference no: EM133090041

Question 1: The CFO at General Hospital noticed that the losses for Medicare CHF patients were becoming larger each year. In order to understand why this is occurring, he assigned a data analyst to review the issue. The analyst requested a file including the following billing information for each case in grouping to one of the CHF MS-DRGs (291, 292, 293):

Data Dictionary

Data Element	Definition
Patient	Patient ID
LOS	Length of Stay
Age	Patient Age Category
Sex	Patient Gender
AmtReim	Amount Paid by Medicare
TotAccomChg	Total Accommodation Charges
TotDeptChg	Total Ancillary/Departmental Charges
NumDxCodes	Number of Diagnosis Codes on Claim
admsrc	Admission Source
dischdest	Discharge Destination
drgcode	MS-DRG Code

For this exercise, you must:
(1) Use the data dictionary to identify the fields that you need to use in order to determine profit (loss) for each patient.
(2) Sort the database by DRG
(3) Determine the loss per patient/case:
(a) Use the spreadsheet and calculate costs using the Cost:Charge model:
Assume that the cost to charge ratio (CCR) for General Hospital is:
0.3 for ancillary departments
0.5 for accommodation departments.
Hint: you need to apply the CCR to determine what the costs are.
(b) Subtract the cost from the amount reimbursed to determine the profit/loss
(4) Creat a new spreadsheet that presents the CFO with the overall loss per DRG.
Submit your work in an Excel spreadsheet.

Attachment:- CHF Data.rar

Reference no: EM133090041

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