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Mayview Regional Service Area Community Inpatient, EAC, and RTF Utilization July 2006 – March 2009 1

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Mayview Regional Service Area. Community Inpatient, EAC, and RTF Utilization July 2006 – March 2009. Findings Tracking since July 2006. For the region, inpatient admissions have slowly decreased over the period. - PowerPoint PPT Presentation

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Page 1: Mayview Regional Service Area

1

Mayview Regional Service Area

Community Inpatient, EAC, and RTFUtilization

July 2006 – March 2009

Timothy M. Casey
Add EAC WL trackingBed Capacity
Page 2: Mayview Regional Service Area

2

FindingsTracking since July 2006

• For the region, inpatient admissions have slowly decreased over the period.

• For the region, Average Length of Stay has remained relatively flat. However, there have been recent increases.

• EAC admissions are trending slightly upward.• EAC ALOS is trending upward.• RTF ALOS is trending upward.

Page 3: Mayview Regional Service Area

3

Inpatient Admissions

• For the region, admission are trending slightly downward. The higher correlation coefficient indicates more stability in the system.

Jan-06

Feb-06

Mar-06

Apr-06

May-06

Jun-06Jul-0

6

Aug-06Sep

-06Oct-

06

Nov-06Dec-

06Jan

-07Feb

-07

Mar-07

Apr-07

May-07

Jun-07Jul-0

7

Aug-07Sep

-07Oct-

07

Nov-07Dec-

07Jan

-08Feb

-08

Mar-08

Apr-08

May-08

Jun-08Jul-0

8

Aug-08Sep

-08Oct-

08

Nov-08Dec-

08Jan

-09Feb

-09

Mar-09

0

100

200

300

400

500

600

700

800

725

598

700 692651 654

699723

648678

634590

652

576

696668

621 612655

626657 662

568594

687

554

646 651623

559611 610

567592

523 516

620

511

581

R² = 0.451907670674792

MRSAP RegionCommunity Acute Psychiatric

Inpatient Admissions

Admissions Linear (Admissions)* Adult, Healthchoices Only* Adult, Healthchoices Only

Page 4: Mayview Regional Service Area

4

Inpatient Admissions

• Admissions continue to trend downward.

Jan-06

Feb-06

Mar-06

Apr-06

May-06

Jun-06Jul-0

6

Aug-06Sep

-06Oct-

06

Nov-06Dec-

06Jan

-07Feb

-07

Mar-07

Apr-07

May-07

Jun-07Jul-0

7

Aug-07Sep

-07Oct-

07

Nov-07Dec-

07Jan

-08Feb

-08

Mar-08

Apr-08

May-08

Jun-08Jul-0

8

Aug-08Sep

-08Oct-

08

Nov-08Dec-

08Jan

-09Feb

-09

Mar-09

0

100

200

300

400

500

600

557

480

551 550510

489

543571

530 541501

460

516

449

548529

479 492524

477506 523

446473

515

424

509 498 498

443465 482

447465

414 419

474

406

454

R² = 0.480927693118028

Allegheny CountyCommunity Acute Psychiatric

Inpatient Admissions

Admissions Linear (Admissions)* Adult, Healthchoices Only

Page 5: Mayview Regional Service Area

5

Inpatient Admissions

• Admissions continue to vary widely.

Jan-06Feb

-06

Mar-06

Apr-06

May-06

Jun-06Jul-0

6

Aug-06Sep

-06Oct-

06

Nov-06Dec-

06Jan

-07Feb

-07

Mar-07

Apr-07

May-07

Jun-07Jul-0

7

Aug-07Sep

-07Oct-

07

Nov-07Dec-

07Jan

-08Feb

-08

Mar-08

Apr-08

May-08

Jun-08Jul-0

8

Aug-08Sep

-08Oct-

08

Nov-08Dec-

08Jan

-09Feb

-09

Mar-09

0

10

20

30

40

50

60

70

65

34

58

51

4244

47

55

3941

48 47

52

29

41

52 51

38

51

4442

48

36

43

59

34

41

60

46

30

5349

44

3639

21

49

3236

R² = 0.181987770245833

Beaver CountyCommunity IP-MH Admissions

Admissions Polynomial (Admissions)* Adult, Healthchoices Only

Page 6: Mayview Regional Service Area

6

Inpatient Admissions

• Admissions have increased over the last three months. However, this trend has occurred in previous time periods.

Jan-06

Feb-06

Mar-06

Apr-06

May-06

Jun-06Jul-0

6

Aug-06Sep

-06Oct-

06

Nov-06Dec-

06Jan

-07Feb

-07

Mar-07

Apr-07

May-07

Jun-07Jul-0

7

Aug-07Sep

-07Oct-

07

Nov-07Dec-

07Jan

-08Feb

-08

Mar-08

Apr-08

May-08

Jun-08Jul-0

8

Aug-08Sep

-08Oct-

08

Nov-08Dec-

08Jan

-09Feb

-09

Mar-09

0

5

10

15

20

25

12

14

3

10

17 17

12

16

11

13

9

1615 15

1617

13 13

7

22

16

18

9

12

17

12

9

19

7

13

2019

13 13

11 11

16

20

23

R² = 0.0705307746352972

Greene CountyCommunity IP-MH Admissions

Admissions Linear (Admissions)* Adult, Healthchoices Only

Page 7: Mayview Regional Service Area

7

Inpatient Admissions

• Admissions are trending downward.

Jan-06

Feb-06

Mar-06

Apr-06

May-06

Jun-06Jul-0

6

Aug-06Sep

-06Oct-

06

Nov-06Dec-

06Jan

-07Feb

-07

Mar-07

Apr-07

May-07

Jun-07Jul-0

7

Aug-07Sep

-07Oct-

07

Nov-07Dec-

07Jan

-08Feb

-08

Mar-08

Apr-08

May-08

Jun-08Jul-0

8

Aug-08Sep

-08Oct-

08

Nov-08Dec-

08Jan

-09Feb

-09

Mar-09

0

5

10

15

20

25

30

35

40

45

50

25 26

32 33 34

3942

33

18

2628 27

31

24

38 39

31 30

22

31

47

26

40

25

35 36

31

24 2321 21

15

22

28

21

26

30

14

24

R² = 0.151809481324626

Lawrence CountyCommunity IP-MH Admissions

Admissions Linear (Admissions)* Adult, Healthchoices Only

Page 8: Mayview Regional Service Area

8

Inpatient Admissions

• Admissions are trending slightly downward.

Jan-06

Feb-06

Mar-06

Apr-06

May-06

Jun-06Jul-0

6

Aug-06Sep

-06Oct-

06

Nov-06Dec-

06Jan

-07Feb

-07

Mar-07

Apr-07

May-07

Jun-07Jul-0

7

Aug-07Sep

-07Oct-

07

Nov-07Dec-

07Jan

-08Feb

-08

Mar-08

Apr-08

May-08

Jun-08Jul-0

8

Aug-08Sep

-08Oct-

08

Nov-08Dec-

08Jan

-09Feb

-09

Mar-09

0

10

20

30

40

50

60

70

66

44

56

48 48

65

55

4850

57

48

4038

59

53

31

47

39

51 52

46 47

3741

61

48

56

50 4952 52

4541

50

38 39

51

39

44

R² = 0.11153042908906

Washington CountyCommunity IP-MH Admissions

Admissions Linear (Admissions)* Adult, Healthchoices Only

Page 9: Mayview Regional Service Area

9

Inpatient Admission Rate

• Allegheny shows the highest admission rate, with an average of 7.39 admissions per 1000 enrollees vs. 4.19 in the other counties.

Jan-06Feb

-06

Mar-06

Apr-06

May-06

Jun-06Jul-0

6

Aug-06Sep

-06Oct-

06

Nov-06Dec-

06Jan

-07Feb

-07

Mar-07

Apr-07

May-07

Jun-07Jul-0

7

Aug-07Sep

-07Oct-

07

Nov-07Dec-

07Jan

-08Feb

-08

Mar-08

Apr-08

May-08

Jun-08Jul-0

8

Aug-08Sep

-08Oct-

08

Nov-08Dec-

08Jan

-09Feb

-09

Mar-09

0.00

1.00

2.00

3.00

4.00

5.00

6.00

7.00

8.00

9.00

10.00

MRSAP RegionCommunity IP-MH Admission Rate Per 1,000 Enrollees

Allegheny vs. Other Counties

AGH Linear (AGH) Other CTYs Linear (Other CTYs)

Page 10: Mayview Regional Service Area

10

Inpatient Length of Stay

• For the region, ALOS is trending slightly upward. MLOS usually exists between five and six days.

Jan-06Feb

-06

Mar-06

Apr-06

May-06

Jun-06Jul-0

6

Aug-06Sep

-06Oct-

06

Nov-06Dec-

06Jan

-07Feb

-07

Mar-07

Apr-07

May-07

Jun-07Jul-0

7

Aug-07Sep

-07Oct-

07

Nov-07Dec-

07Jan

-08Feb

-08

Mar-08

Apr-08

May-08

Jun-08Jul-0

8

Aug-08Sep

-08Oct-

08

Nov-08Dec-

08Jan

-09Feb

-09

Mar-09

0.00

1.00

2.00

3.00

4.00

5.00

6.00

7.00

8.00

9.00

10.00

6.476.60

8.79

6.697.27

5.89

7.066.71

7.837.467.27

6.48

7.517.297.70

7.117.737.57

7.197.027.35

6.93

8.23

7.547.08

6.796.817.007.51

6.396.647.27

7.938.35

7.137.167.71

7.277.59R² = 0.0354175527273044

R² = 0.0998081192319145

MRSAP RegionCommunity Acute Psychiatric

Average/Median Length of Stay

ALOS Linear (ALOS) MLOS Linear (MLOS)* Adult, Healthchoices Only* Adult, Healthchoices Only

Page 11: Mayview Regional Service Area

11

Inpatient Length of Stay

• ALOS is trending slightly upward• MLOS fluctuates between six and seven days.

Jan-06Feb

-06

Mar-06

Apr-06

May-06

Jun-06Jul-0

6

Aug-06Sep

-06Oct-

06

Nov-06Dec-

06Jan

-07Feb

-07

Mar-07

Apr-07

May-07

Jun-07Jul-0

7

Aug-07Sep

-07Oct-

07

Nov-07Dec-

07Jan

-08Feb

-08

Mar-08

Apr-08

May-08

Jun-08Jul-0

8

Aug-08Sep

-08Oct-

08

Nov-08Dec-

08Jan

-09Feb

-09

Mar-09

0.00

2.00

4.00

6.00

8.00

10.00

12.00

14.00

16.00

9.75 9.37

11.1310.8110.7311.29

12.39

10.6111.0611.39

10.0510.3210.5110.3810.5810.3210.67

12.4512.0411.10

9.4510.47

8.929.36

10.559.70

10.1311.0811.30

9.46

10.8110.41

11.60

13.69

11.81

10.31

13.30

11.9811.16R² = 0.0616756317123923

Allegheny CountyCommunity Acute Psychiatric

Inpatient Avg/Median Length of Stay

ALOS Linear (ALOS) Median LOS* Adult, Healthchoices Only

Page 12: Mayview Regional Service Area

12

Inpatient Length of Stay

• ALOS per month has increased approximately one day over the entire period.

Jan-06Feb

-06

Mar-06

Apr-06

May-06

Jun-06Jul-0

6

Aug-06Sep

-06Oct-

06

Nov-06Dec-

06Jan

-07Feb

-07

Mar-07

Apr-07

May-07

Jun-07Jul-0

7

Aug-07Sep

-07Oct-

07

Nov-07Dec-

07Jan

-08Feb

-08

Mar-08

Apr-08

May-08

Jun-08Jul-0

8

Aug-08Sep

-08Oct-

08

Nov-08Dec-

08Jan

-09Feb

-09

Mar-09

0.00

1.00

2.00

3.00

4.00

5.00

6.00

7.00

8.00

9.00

4.794.804.60

5.71

7.22

4.635.17

6.046.176.245.96

6.266.226.576.40

5.22

6.63

5.275.415.17

6.436.33

7.10

8.33

5.225.446.06

6.80

5.966.56

5.005.54

6.84

5.055.23

7.30

5.87

7.03

7.80

R² = 0.119166493522913

Beaver CountyCommunity IP-MH Avg/Median Length of Stay

ALOS Linear (ALOS) MLOS* Adult, Healthchoices Only

Page 13: Mayview Regional Service Area

13

Inpatient Length of Stay

• ALOS continues to fluctuate.

Jan-06Feb

-06

Mar-06

Apr-06

May-06

Jun-06Jul-0

6

Aug-06Sep

-06Oct-

06

Nov-06Dec-

06Jan

-07Feb

-07

Mar-07

Apr-07

May-07

Jun-07Jul-0

7

Aug-07Sep

-07Oct-

07

Nov-07Dec-

07Jan

-08Feb

-08

Mar-08

Apr-08

May-08

Jun-08Jul-0

8

Aug-08Sep

-08Oct-

08

Nov-08Dec-

08Jan

-09Feb

-09

Mar-09

0.00

2.00

4.00

6.00

8.00

10.00

12.00

14.00

16.00

5.30

7.17

15.00

3.55

6.60

3.00

8.00

4.71

7.306.866.56

5.83

7.608.43

5.335.14

9.53

5.936.576.17

9.06

6.84

12.27

6.095.36

8.077.40

5.85

8.50

5.45

6.836.83

9.5710.20

8.507.827.69

6.75

5.52

R² = 0.0178064506160085

Greene CountyCommunity IP-MH Avg/Median Length of Stay

ALOS Linear (ALOS) MLOS

Page 14: Mayview Regional Service Area

14

Inpatient Length of Stay

• ALOS is trending downward over the entire period.

Jan-06Feb

-06

Mar-06

Apr-06

May-06

Jun-06Jul-0

6

Aug-06Sep

-06Oct-

06

Nov-06Dec-

06Jan

-07Feb

-07

Mar-07

Apr-07

May-07

Jun-07Jul-0

7

Aug-07Sep

-07Oct-

07

Nov-07Dec-

07Jan

-08Feb

-08

Mar-08

Apr-08

May-08

Jun-08Jul-0

8

Aug-08Sep

-08Oct-

08

Nov-08Dec-

08Jan

-09Feb

-09

Mar-09

0.00

1.00

2.00

3.00

4.00

5.00

6.00

7.00

8.00

9.00

10.00

6.27

5.43

6.316.416.11

4.68

3.78

6.32

8.20

5.14

6.45

3.85

6.61

5.48

7.536.91

6.40

8.59

6.316.38

5.175.20

6.51

9.17

6.33

5.094.895.00

5.74

4.234.05

4.73

4.044.63

3.894.12

6.10

4.00

6.74R² = 0.0950821135512946

Lawrence CountyCommunity IP-MH Avg/Median Length of Stay

ALOS Linear (ALOS) MLOS

Page 15: Mayview Regional Service Area

15

Inpatient Length of Stay

• ALOS is trending very slightly upward.

Jan-06Feb

-06

Mar-06

Apr-06

May-06

Jun-06Jul-0

6

Aug-06Sep

-06Oct-

06

Nov-06Dec-

06Jan

-07Feb

-07

Mar-07

Apr-07

May-07

Jun-07Jul-0

7

Aug-07Sep

-07Oct-

07

Nov-07Dec-

07Jan

-08Feb

-08

Mar-08

Apr-08

May-08

Jun-08Jul-0

8

Aug-08Sep

-08Oct-

08

Nov-08Dec-

08Jan

-09Feb

-09

Mar-09

0.00

1.00

2.00

3.00

4.00

5.00

6.00

7.00

8.00

9.00

10.00

6.256.25

6.926.98

5.695.875.965.856.44

7.687.34

6.136.58

5.57

8.66

7.98

5.435.605.62

6.296.66

5.836.32

4.75

7.92

5.665.57

6.296.076.256.53

8.84

7.608.19

6.216.24

5.57

6.606.75R² = 0.00812649276293964

Washington CountyCommunity IP-MH Avg/Median Length of Stay

ALOS Linear (ALOS) MLOS

Page 16: Mayview Regional Service Area

16

Inpatient Readmissions

• Readmission rates for all categories are trending downward.

Jan-06Feb

-06

Mar-06

Apr-06

May-06

Jun-06Jul-0

6

Aug-06Sep

-06Oct-

06

Nov-06Dec-

06Jan

-07Feb

-07

Mar-07

Apr-07

May-07

Jun-07Jul-0

7

Aug-07Sep

-07Oct-

07

Nov-07Dec-

07Jan

-08Feb

-08

Mar-08

Apr-08

May-08

Jun-08Jul-0

8

Aug-08Sep

-08Oct-

08

Nov-08Dec-

08Jan

-09Feb

-09

Mar-09

0.00

0.50

1.00

1.50

2.00

2.50

3.00

3.50

4.00

4.50

5.00

Mayview RegionCommunity Inpatient Readmissions Rates

Readmit 1 To 7 Rate Linear (Readmit 1 To 7 Rate) Readmit 8 To 30 RateLinear (Readmit 8 To 30 Rate) Readmit 31 To 90 Rate Linear (Readmit 31 To 90 Rate)

* Adult, HC Only Rates per 1000 eligibles

Page 17: Mayview Regional Service Area

17

Inpatient Readmissions

• Both readmission categories are trending downward.

Jan-06

Feb-06

Mar-06

Apr-06

May-06

Jun-06Jul-0

6

Aug-06Sep

-06Oct-

06

Nov-06Dec-

06Jan

-07Feb

-07

Mar-07

Apr-07

May-07

Jun-07Jul-0

7

Aug-07Sep

-07Oct-

07

Nov-07Dec-

07Jan

-08Feb

-08

Mar-08

Apr-08

May-08

Jun-08Jul-0

8

Aug-08Sep

-08Oct-

08

Nov-08Dec-

08Jan

-09Feb

-09

Mar-09

0

10

20

30

40

50

60

70

80

90

R² = 0.114564952921893

R² = 0.279255021212779

Allegheny CountyCommunity Inpatient Readmissions

Readmits 1 To 7 Linear (Readmits 1 To 7) Readmits 8 To 30 Linear (Readmits 8 To 30)

Page 18: Mayview Regional Service Area

18

Inpatient Readmissions

• Both categories are trending slightly downward.

Jan-06Feb

-06

Mar-06

Apr-06

May-06

Jun-06Jul-0

6

Aug-06Sep

-06Oct-

06

Nov-06Dec-

06Jan

-07Feb

-07

Mar-07

Apr-07

May-07

Jun-07Jul-0

7

Aug-07Sep

-07Oct-

07

Nov-07Dec-

07Jan

-08Feb

-08

Mar-08

Apr-08

May-08

Jun-08Jul-0

8

Aug-08Sep

-08Oct-

08

Nov-08Dec-

08Jan

-09Feb

-09

Mar-09

0.00

0.20

0.40

0.60

0.80

1.00

1.20

1.40

0.50

0.680.72

0.52

0.65

0.48

0.650.740.720.69

0.810.74

0.580.64

0.74

0.420.450.54

0.68

0.84

0.51

0.78

0.570.600.62

0.27

0.67

0.80

0.660.57

0.480.480.530.56

0.410.47

0.360.41

0.53

R² = 0.166257154207527

R² = 0.360467835438103

Allegheny CountyCommunity Inpatient Readmissions Rates

Readmit 1 To 7 Rate Linear (Readmit 1 To 7 Rate) Readmit 8 To 30 Rate Linear (Readmit 8 To 30 Rate)

* Adult, Healthchoices Only Rates per 1000 eligibles

Page 19: Mayview Regional Service Area

19

Extended Acute AdmissionsAllegheny County Only

• Admissions by month are very small.

Aug-06Sep

-06Oct-

06

Nov-06Dec-

06Jan

-07Feb

-07

Mar-07

Apr-07

May-07

Jun-07Jul-0

7

Aug-07Sep

-07Oct-

07

Nov-07Dec-

07Jan

-08Feb

-08

Mar-08

Apr-08

May-08

Jun-08Jul-0

8

Aug-08Sep

-08Oct-

08

Nov-08Dec-

08Jan

-09Feb

-09

Mar-09

0

1

2

3

4

5

6

7

8

9

3

6

2

3

0

2 2

3

1

0

5

4

3

1

3

2

1

8

2

4

5

6

3

2

3 3

7

3

5

6

3

5

R² = 0.14036871962423

Allegheny CountyCommunity Extended Acute Admissions

Series1 Linear (Series1)

Page 20: Mayview Regional Service Area

20

Extended Acute - Length of Stay Allegheny County Only

• The ALOS for those discharged is 127.55 days with a MLOS of 97.00 days. The break in the line is reflective of zero discharges in July 2008. The average days on the waiting list are 73 days and the ALOS including those in-house, is 156 days.

Jan-06Feb

-06

Mar-06

Apr-06

May-06

Jun-06Jul-0

6

Aug-06Sep

-06Oct-

06

Nov-06Dec-

06Jan

-07Feb

-07

Mar-07

Apr-07

May-07

Jun-07Jul-0

7

Aug-07Sep

-07Oct-

07

Nov-07Dec-

07Jan

-08Feb

-08

Mar-08

Apr-08

May-08

Jun-08Jul-0

8

Aug-08Sep

-08Oct-

08

Nov-08Dec-

08Jan

-09Feb

-09

Mar-09

0

50

100

150

200

250

300

2746

7692.25

178

143.5

90

196

103.5

47.5

243

58.5

117.333333333333

70

171.5

88

212.333333333333

61

145

104

58.5

109

218.5

190

140.714285714286

67.75

186.714285714286

120.857142857143

215.4

R² = 0.122594644224227

Allegheny CountyCommunity Extended Acute Avg/Median Length of Stay

ALOS Linear (ALOS) MLOS

Total ALOS: 127.55 days MLOS: 97.00 days

For consumers discharged

Page 21: Mayview Regional Service Area

21

RTF AdmissionsAllegheny County Only

• Admissions by month are trending slightly upward.

Jan-06

Feb-06

Mar-06

Apr-06

May-06

Jun-06

Jul-0

6

Aug-06

Sep-06

Oct-06

Nov-06

Dec-06Jan

-07

Feb-07

Mar-07

Apr-07

May-07

Jun-07

Jul-0

7

Aug-07

Sep-07

Oct-07

Nov-07

Dec-07

Jan-08

Feb-08

Mar-08

Apr-08

May-08

Jun-08

Jul-0

8

Aug-08

Sep-08

Oct-08

Nov-08

Dec-08Jan

-09

Feb-09

Mar-09

0

1

2

3

4

5

6

7

8

9

5

1

8

4

5 5

4

8

5

3

2

7

4

5 5

3

5 5

4

7

4

3

6 6

3

4

3

2

7

4

8

3

7 7

4 4

8

7

6

R² = 0.0376687098329466

Allegheny CountyRTF Admissions

Admissions Linear (Admissions)

Page 22: Mayview Regional Service Area

22

RTF- Length of Stay Allegheny County Only

• The ALOS for those discharged is 63.93 days for the entire period.

0.00

20.00

40.00

60.00

80.00

100.00

120.00

140.00

160.00

180.00

R² = 0.203648500040702

Allegheny CountyRTF

Avg/Median Length of Stay

ALOS Linear (ALOS) MLOS