HOUSTON COMMUNITY COLLEGE SYSTEM COLEMAN COLLEGE HEALTH INFORMATION TECHNOLOGY PROGRAM HEALTH CARE STATISTICS HITT 1355 Spring, 2012 (crn83124) INSTRUCTOR Dr. Carla Tyson-Howard,RHIA office hours: Mon & Thr 2pm 4pm phone: (713)718-7347 COURSE DESCRIPTION General principles of health care statistics with emphasis in hospital statistics. Skill development in computation and calculation of health data with overview of guidelines for Texas Department of Health Vital Statistics and studies. PREREQUISITES None CREDIT 3 semester hours TEXTBOOK/REFERENCES Calculating & Reporting Healthcare Statistics L. Horton Health Information Management Technology - M. Johns Health Information: Management of a Strategic Resource M. Abdelhak et. al. Comprehensive Review Guide for Health Information: RHIA & RHIT Exam Prep Handouts distributed by instructor Respondus Lockdown Browser Eagle On-line at http://hccs.eagle On-line.com Your Eagle On-line login user ID will be your HCC User ID (sometimes referred to as the W number). All HCC students have a unique User ID. If you do not know your User ID you can look it up by visiting the HCC home page: o From www.hccs.edu, click on Login Help under the Student System Sign In field o Then click on Retrieve User ID and follow the instructions. Or use the direct link: https://hccsaweb.hccs.edu:8080/servlets/iclientservlet/saua t/?cmd=start The default student password is distance. Students will then be prompted to change their password after their first login. Please visit DE Technical Support FAQs if you need additional assistance with your log in. 1
COURSE GOALS (reference AHIMA entry level competencies) II.4 Calculate and interpret descriptive healthcare statistics. II.5 Present data in verbal and written forms. COURSE OBJECTIVES 1. Compute health care statistics and determine the most appropriate use of these health care statistics in health information management. 2. Organize data generated from health care statistics into appropriate categories. 3. Display data generated from health care statistics using the most appropriate format. 4. Determine which test of significance should be used to test specific hypotheses and which are most appropriate for certain types of data. 5. Explain the steps necessary for designing a research study or grant proposal. 6. Given a specific hypothesis, design a research study to test the hypothesis. 7. Determine the most effective methods to use to test validity and reliability. 8. Demonstrate knowledge of computer applications for calculating statistics. SCANS Competencies F3 Arithmetic, C5 Acquires and evaluates information, F8 Decision Making, C9 Participates as a member of a team, F1 Reading, F2 Writing, F9 Problem Solving, F5 Listening, F12 Reasoning, C18 Selects Technology, C19 Applies Technology to Task COURSE REQUIREMENTS 1. Course is taught via Eagle On-line. 2. Students are to be prepared for class by answering objectives to lessons and completing daily quizzes. 3. Students are required to read all textbook assignments and work all problems in workbooks and syllabus. EQUAL EDUCATIONAL & EMPLOYMENT OPPORTUNITY HCCS seeks to provide equal education opportunities without regard to race, color, religion, national origin, sex, age or handicap. 2
ADA STATEMENT Any student with a documented disability (e.g. physical, learning, psychiatric, vision, hearing, etc.) who needs to arrange reasonable accommodations must contact the Disability Services Office at the respective college at the beginning of each semester. Faculty are authorized to provide only the accommodations requested by the Disability Support Services Office. For questions, contact Donna Price at 713-718-5165 or the Disability Counselor at each college. Also visit the ADA web site at: http://www.hccs.edu/students/disability/index.htm. The Disability Counselor for this college Dr. Raj Gupta. The names and phone numbers are listed in the spring schedule. ATTENDANCE POLICY Students taking Internet courses complete weekly assignments at their own computers and communicate with their instructor by electronic mail and other provided webbased technologies. Students complete assignments, take tests, and complete all other coursework just as they would in an on-campus class. Instructor will have weekly on-line chats with students. Course work will be submitted via the internet. Students must be in attendance on campus for appointed times and major exams. GRADING POLICY Weekly Tests 40% Assignments (cd, videos, research paper, etc) 5% Final examination 45% 3 points added to overall grade for attending HAHIMA meeting Students absent from the class during the time of a major examination for test will have NO MAKE-UP EXAMINATIONS, except upon the discretion of the instructor. Students late for the exam will be allowed to take the exam with the remaining scheduled time. The percentage of each activity will weight in the final grade regardless if the student participated in the activity or test. Academic Dishonesty will not be tolerated. Exams and assignments are individual assignments. Plagiarized and copied papers will be handled in accordance with established HCCS college policy. Do not copy work of others. 3
GRADING SCALE 90-100 A 80-89 B 75-79 C 74 and below F (No Ds will be given) HCC COURSE WITHDRAWAL POLICY The State of Texas has begun to impose penalties on students who drop courses excessively. For example, if you repeat the same course more than twice, you have to pay extra tuition. Beginning in Fall 2007, the Texas Legislature passed a law limiting students to no more than SIX total course withdrawals throughout their educational career in obtaining a certificate and/or degree. To help students avoid having to drop/withdraw from any class, HCC has instituted an Early Alert process by which your professor will alert you and counselors that you might fail a class because of excessive absences and/or poor academic performance. You should visit with your professor or a counselor to learn about what, if any, HCC interventions might be available to assist you online tutoring, child care, financial aid, job placement, etc. to stay in class and improve your academic performance. If you plan on withdrawing from your class, you MUST contact a counselor or your professor prior to withdrawing (dropping) the class and this must be done PRIOR to the withdrawal deadline to receive a W on your transcript. **Final withdrawal deadlines vary each semester and/or depending on class length, please visit the online registration calendars, HCC schedule of classes and catalog, any HCC Registration Office, or any HCC counselor to determine class withdrawal deadlines. Remember to allow a 24-hour response time when communicating via email and/or telephone with a professor and/or counselor. Do not submit a request to discuss withdrawal options less than a day before the deadline. If you do not withdraw before the deadline, you will receive the grade that you are making in the class as your final grade. NOTICE Students who repeat a course for a third or more times may soon face significant tuition/fee increases at HCC and other Texas public colleges and universities. Please ask 4
your instructor/counselor about opportunities for tutoring / other assistance prior to considering course withdrawal or if you are not receiving passing grades. EXPANDED ONLINE TUTORING Onsite tutor is available upon application at the Academic Success Center of Coleman Campus. Online tutoring is offered to students in MATH, BIOL, CHEM, PHYS, ENGL, PSYC, and for papers in all subjects. Students may self-register with any e-mail address, choosing their own user names and passwords. As always, students may submit work 24 / 7/ 365 and will get responses within 24 hours -- and usually much faster than that. For more information or for an electronic version of the registration and information flyer, contact deborah.hardwick@hccs.edu. EARLY ALERT SYLLABUS STATEMENT The Houston Community College Early Alert program has been established to assist in the overall effort to retain students who are at risk of failing, withdrawing, or dropping a course. This process requires instructional faculty and student support staff to identify students who are performing poorly as early as possible and provide relevant support services to help students overcome their deficiencies. A student is identified when an instructor notices academic or personal difficulties that affect student s academic performance. The possible problem (s) could be tardiness, missed/failed test scores, excessive absences, or a number of other circumstances. Once a referral is made counselors will then contact students to discuss the issues and possible solutions to their academic difficulties. 5
ASSIGNMENTS All assignments due the end of the lesson week on Saturday at 11pm. Refer to Eagle On-line for due dates. Use the Microsoft Office suite for preparing all documents. 1. Video Reviews On various weeks, student will be assigned a web video broadcast to watch. Submit the following: a. Title of video b. Statistical topic discussed c. Implications for Health Information 2. Design Monthly and Annual Hospital Statistical Report a. Review the monthly and annual statistical reports in Lesson 1. b. Using Excel and instructions from lesson 1, design a monthly statistical report. c. Using Excel and instructions from lesson 7, build onto database from lesson 1. 3. National Center for Health Statistics a. Browse the NCHS website at Teen Birth Rate Rises for First Time in 15 Years and listen to the I-tunes podcast at http://www.cdc.gov/nchs/pressroom/statcasts/statc ast_02_120507.mp3 b. Write a report and discuss the results of the NCHS findings unmarried childbearing. How was this data obtained? What are the implications for health information practitioners? 4. Vital Statistics a. Go to the TDSHS and download the Powerpoint presentation on basic birth registration through Texas Electronic Registration (or use the TDSHS- Birth Powerpoint file located in lesson 2). b. Go to the TDSHS and download the Basic TER Death Registration for Local Registrars (ppt 5.9M) (or use the TDSHS-Death Powerpoint file located in lesson 2.) c. Answer the following questions: Who may request a copy of a birth and death certificate? If the mother is not married, can the father s name be placed on the birth certificate? 6
What does father need to sign in order to be placed on birth certificate of unwed mother? What does the Health & Safety Code Title 3 Vital Statistics Chapter 192 Birth Records state? Compare the items entered on a death certificate to those entered on a birth certificate. What statistics may be obtained from the birth certificate versus the death certificate data? 5. CD Assignments a. Calculate and submit exercises 2.1 through 12.2 from CD in textbook, Calculating & Reporting Healthcare Statistics. 6. Lessons 6 a. Calculate and answer hypothesis questions of lesson 6. b. Enroll in Introduction to Statistics, Empirical Research Methods, and StatTutor Exercises at http://oli.web.cmu.edu/openlearning/ Complete tutorials for each lesson 7. Lesson 7 a. Complete and submit statistical report. 8. Research a. Utilizing the APA writing style http://www.dianahacker.com/resdoc/p04_c09_o.html write a research report of the cause and effect of tobacco smoking. You must include the following (see Guide to Writing My Research Paper): Statement of the problem Research (alternative) hypothesis Null hypothesis Statistical data Graph Table 7
HEALTH CARE STATISTICS CALENDER & OBJECTIVES *Students on campus room 538 Instructor will be online with GoToMeeting Tuesdays from 5-6pm. Chat discussion topics will be sent via Eagle On-line email. Tests are to be done on an individual bases and academic dishonesty will result in dismissal from program. Tests close Sunday at 11pm. Students cannot see results of tests. Instructor will share the top 10% of missed questions with students. See Eagle On-line for Tests/Quiz dates. Week 1 Jan 17 th Course Introduction Week 2 Jan 24 th LESSON 1 Statistics Defined, HIM Role, Reports Johns 429, 453-454, 481-485 (New Johns Abdelhak 372; 404 Horton chp 1 glossary of terms Define the following terms: statistics medical service hospital hospital inpatient hospital outpatient disposition principal diagnosis data complication discharge days transfer newborn home health ambulatory care outpatient consultation surgical procedure delivery morbidity hospice emergency patient encounter nosocomial infection comorbidity occasion of service patient mortality hospital newborn inpatient inpatient hospitalization inpatient admission inpatient discharge daily inpatient census inpatient service day hypothesis null hypothesis Describe the health information practitioner s role in health care statistics. Where do statistics in healthcare statistics originate? What are some external sources of healthcare data? Who are the users of healthcare? 8
Assignments Due: 1. Algebra Help-Equations 2. What is Statistics? (video) 3. Math Review 2.1 & 2.2 (book CD) 4. Design monthly and annual health care statistic reports. Using Excel, create a database of patients. The hospital has 10 beds and 30 patients (name your hospital after yourself). Include the number of admission, discharges and deaths. State each patients date of admission and date of discharge. Calculate each patients length of stays and the total length of stay. Week 3 Jan 31 st LESSON 2 Measures of Central Tendency, Data, Quality Control, Vital Statistics, Data Presentation Johns 434-452; 470-495 Abdelhak 372; 384-392 Horton chp. 1-2,10; glossary Define measures of central tendency. Describe methods of data presentation. Describe the quality control methods for data collection. Define vital records and statistics and terms related to reproductive health statistics. Assignments due: 1. Algebra Help- Word Problems 2. Comparing Means (video) 3. Presenting Data 11.1 & 11.2 (book CD) 4. National Center for Health Statistics a. Browse the NCHS website at Teen Birth Rate Rises for First Time in 15 Years and listen to the I-tunes podcast at http://www.cdc.gov/nchs/pressroom/statcasts/statc ast_02_120507.mp3 b. Write a report and discuss the results of the NCHS findings unmarried childbearing. How was this data obtained? What are the implications for health information practitioners? 9
5. Vital Statistics a. Go to the TDSHS and download the Powerpoint presentation on basic birth registration through Texas Electronic Registration (or use the TDSHS- Birth Powerpoint file located in lesson 2). b. Go to the TDSHS and download the Basic TER Death Registration for Local Registrars (ppt 5.9M) (or use the TDSHS-Death Powerpoint file located in lesson 2.) c. View the U.S. Standard Birth, Death and Fetal Death Certificates (linked in lesson 2). d. Answer the following questions: Who may request a copy of a birth and death certificate? If the mother is not married, can the father s name be placed on the birth certificate? What does father need to sign in order to be placed on birth certificate of unwed mother? What does the Health & Safety Code Title 3 Vital Statistics Chapter 192 Birth Records state? Compare the items entered on a death certificate to those entered on a fetal death certificate. What statistics may be obtained from the birth certificate versus the death certificate data? Week 4 Feb 7 th LESSON 3 Inpatient Census, Computing Percentages Johns 452-456 Abdelhak 382 Horton chp. 3; glossary of terms Define the following: daily census inpatient service day total inpatient days total service inpatient days inpatient census average daily census Calculate the average daily census. Assignments due: 1. Patient Census 3.1 & 3.2 (book CD) 2. Significance Tests (video) 10
Week 5 Feb 14 th LESSON 4 Length of Stay, Occupancy Rate Johns 457-461 Abdelhak 382-383 Horton chp. 4-5; glossary of terms Define the following: length of stay total length of stay inpatient bed count inpatient bed count day bed turnover rate Define and calculate average length of stay. Define and calculate percent of occupancy. Assignments due: 1. Occupancy Rate 4.1 & 4.2 (book CD) 2. Length of Stay 5.1 & 5.2 (book CD) *Week 6 Tuesday, February 21 st 5:30pm room 538 Mid-Term Test Week 7 Feb 28 th LESSON 5 Mortality Rate, Autopsy Rate, Other Rates Johns 462-470 Abdelhak 373-381 Horton chp.7-9 Define the following: hospital autopsy neonatal death neonatal period maternal death pregnancy termination fetal death stillborn infant infant death abortion hospital inpatient autopsy Define and calculate the following: death rate postoperative death rate Cesarean section rate other rates maternal death rate fetal death rate anesthesia death rate hospital adjusted autopsy rate net autopsy rate gross autopsy rate Calculate statistics computed within the health information department such as: Productivity Staffing levels 11
Budgeting Unit cost Assignments due: 1. Confidence Intervals (video) 2. Death Rate 6.1 & 6.2 (book CD) 3. Autopsy Rate 7.1 & 7.2 (book CD) 4. Morbidity 8.1 & 8.2 (book CD) 5. HIM Statistics 9.1 & 9.2 (book CD) Week 8 Mar 6 th LESSON 6 Test of Significance / Normal Curve Abdelhak 384-385; 388-400; chap 12 1. Define and describe the following: standard deviation chi-square correlation z-score t-test ANOVA test of significance variance range level of significance Assignments Due: 1. Case Study (video) 2. Enroll in Introduction to Statistics, Empirical Research Methods, and StatTutor Exercises at http://oli.web.cmu.edu/openlearning/ a. Complete tutorials for each lesson b. Copy and upload scores of StatTutor to Eagle Online 3. Use the following lengths of stays data sets and Excel software to a. Calculate the standard deviation of each Hospital lengths of stays. I. Explain the significance of the calculated standard deviation for each Hospital. Is the standard deviation large or small? How are the values in the set dispersed around the mean? b. Calculate the t-test between Hospitals1 and 2. I. State whether you accept or reject the following null hypothesis: There is no statistical significant difference between the lengths of stays of Hospital 1 and Hospital 2. c. Calculate the t-test between Hospitals 2 and 3. 12
I. State whether you accept or reject the following null hypothesis: There is no statistical significant difference between the lengths of stays of Hospital 2 and Hospital 3. d. Calculate the ANOVA of the Hospitals lengths of stays. I. State whether you accept or reject the following null hypothesis: There is no statistical significant difference between the lengths of stays of Hospital 1, Hospital 2 and Hospital 3. Hospital 1 Hospital 2 Hospital 3 12 45 106 13 45 109 13 48 109 13 52 109 14 53 109 16 53 109 16 53 109 20 57 112 21 58 115 21 59 120 Week 9 Mar 13 th Spring Break Week 10 Mar 20 th Lesson 6 (continued) 13
Week 11 Mar 27 th LESSON 6 (continued) Assignments Due: 1. Descriptive Statistics 10.1 & 10.2 (book CD 2. Inferential Statistics 12.1 & 12.2 (book CD) Week 12 Apr 3 rd LESSON 7 Computer Generated Reports Excel Assignments Due: 1. Utilizing the computer software Microsoft Excel, expand your hospital statistical report from lesson 1. It must be composed of the following information: hospital name name of report report time frame (ie: Sept, 20xx) number of beds (13) 30 patient names admission and discharge dates (admit and discharge patients in the same month and year) length of stay for each discharge (discharge days) average length of stay for the month standard deviation of the discharge days occupancy rate Make a graph of all the patients lengths of stays. Submit the report via Eagle On-line. If average mid-term score below 74 or below, see instructor. March 29 th last day to drop with grade of W. See syllabus page 3, Grading Policy for weighted averages. Week 13 Apr 10 th LESSON 8 Introduction to Epidemiology Abdelhak chap. 12 Define the following terms: epidemiology rate health rehabilitation epidemic endemic risk factor cohort ecology 14
Week 14 Apr 17 th LESSON 9 Introduction to Research Horton chap. 10-11 Abdelhak chap. 12 Define the following terms: hypothesis null hypothesis research reliability experiment control variables bias validity sample population Discuss various approaches to research. Identify the steps in research. Peruse the HCUP FACTS AND FIGURES Statistics on Hospital-Based Care in the United States, 2007 to see how statistics are used to report hospital statistics. http://www.hcupus.ahrq.gov/reports/factsandfigures/2007/highlightsv2. jsp Assignments Due: 1. Correlation (video) 2. Experimental Design (video) 3. Utilizing the APA writing style http://www.dianahacker.com/resdoc/p04_c09_o.html write a research report of the cause and effect of tobacco smoking. You must following the Guide to Writing Your Research Paper and include the following: Cover sheet Table of Contents Introduction Methodology Findings Conclusion References Statistical data with graph and a table of the data. a. Prepare a PowerPoint (or another media of your choice) for presentation Week 15 Apr 24 th Tobacco Presentations * Week 16 Tuesday, May 1 st, 5:30pm room 538 COMPREHENSIVE FINAL EXAMINATION 15
Formulas for Commonly Computed Healthcare Rates & Percentages Average Daily Census Total service days for the unit for the period Total number of days in the period Average Length of Stay Total length of stay (discharge days) Total discharges (includes deaths) Percentage of Occupancy Total service days for a period X 100 Total bed count days in the period Hospital Death Rate (Gross) Number of deaths of inpatients in period X 100 Number of discharges (including deaths) Gross Autopsy Rate Total inpatient autopsies for a given period X 100 Total inpatient deaths for the period Net Autopsy Rate Total inpatient autopsies for a given period Total inpatient deaths minus unautopsied coroners or medical examiners cases X 100 Hospital Autopsy Rate (Adjusted) Total hospital autopsies X 100 Number of deaths of hospital patients whose bodies are available for hospital autopsy 16
Fetal Death Rate Total number of intermediate and/or late fetal deaths X 100 Total number of live births + intermediate and late fetal deaths for the period Neonatal Mortality Rate (Death Rate) Total number of newborn deaths for a period X 100 Total number of newborn infant discharges (including deaths) for the period Maternal Mortality Rate (Death Rate) Total number of direct maternal deaths for a period X 100 Total number of obstetrical discharges (including deaths) for the period Caesarean Section Rate Total number of caesarian sections performed X 100 Total number of deliveries in the period (including caesarian sections) 17
18