You are a health care administrator of your local medical facility, and you have been asked to give a presentation showing the im

HTH 1306, Introduction to Health Care Statistics 1

Course Learning Outcomes for Unit III

Upon completion of this unit, students should be able to:

1. Describe how statistics are used in health care.

1.1 Explain the use of the census, inpatient census, and daily inpatient census.

3. Customize statistics to meet needs of health care organizations.

3.1 Describe how the census is used in the hospital and what the census tells the hospital.

Course/Unit

Learning Outcomes

Learning Activity

1.1

Unit Lesson

Chapter 4

Unit III PowerPoint Presentation

3.1

Unit Lesson

Chapter 4

Unit III PowerPoint Presentation

Required Unit Resources

Chapter 4: Hospital Census

Unit Lesson

Typically, when the average person hears the word

census, he or she most likely associates the word with

the decennial census. The purpose of the census is to

measure the population of the United States during a

set time. Historically, the original purpose of collecting

census data was focused on calculating the number of

people living in the United States based on certain

criteria such as gender, age, and race (Koch, 2015).

Today, the census has a political relevance, and some

may even believe that it supports our democracy.

Representation in government is based on population,

so an accurate count of citizens serves essential to

ensure the correct amount of representation in

government for a specific geographic location or state.

In addition, proper calculation of census data can assist

in trend analysis of the population.

For example, if the population of the United States grew

by 15% in one decade but 10% of the growth was in the

Western United States, an analysis of growth patterns

could be conducted to see why the growth was so substantial within a certain area. Many possible reasons

could attribute to such growth. High birth rates, immigration, and increased life spans because of innovations

in medical care could have all affected the growth, but witho ut a proper and consistent census, the growth

analysis would be unclear.

UNIT III STUDY GUIDE

Census

2010 C ensus form, with hand and pen

(Sm ontgom 65, 2010)

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Other important information is also obtained through conducting the census. For example, numerous

questions are asked to the general population such as income level, educational status, employment status,

and those insured versus those who are not. Consequently, many feel that a census is unnecessary in

today’s changing environment and are lobbying for the process to stop. While the information is extremely

important to the government for trend analysis, it is also important to others. For example, just imagine the

potential clientele that a marketing company could realize if the organization were to gain access to the

census listing. Even worse, with hacking and identity theft on the rise, the potential for individual damage

because of potential compromise is overwhelming. Even with the increased risks of identity theft due to the

prevalence of technology in our current lives, participation in the decennial census is not optional. Fai lure to

participate can result in large fines levied by the government ( Koch, 2015). While following the same basic

premise, census within the health care organization (HCO) is performed in a slightly different manner and for

slightly different reasons.

The Census and Health Care

The census within the HCO falls into one of three bas ic

categories to include general census, inpatient census,

and daily inpatient census (Koch, 2015). General

census, referred to as simply census, is the number of

patients admitted into the HCO and measured at a given

time. In most cases, HCOs set the census-taking-time

(CTT) for midnight because it is usually the least busy

time of day. Inpatient census often refers to the number

of inpatients within the hospital with a certain day that

were admitted by the CTT. In both cases, the amount of

patients within the HCO at CTT are only included in the

count.

Patients may be admitted and discharged on the same

day or before the CTT. An accurate count of these

patients must be tracked in some manner. This is where

the daily inpatient census comes into play. The daily

inpatient census is the number of patients present at CTT, plus those patients admitted and discharged

before CTT. The daily inpatient census displays the total number of patients treated over a 24-hour timeframe

(Koch, 2015).

For example, if a patient was admitted to the hospital after census was taken on June 2 (12:01 am) and was

discharged before census was taken on June 3 (4 p.m.), the patient would not be included in the census

because the patient would not be present at CTT. However, inpatient s ervices were provided to the patient,

and while the patient was admitted and discharged, he or she would be included into the daily inpatient

census (DIPC).

The DIPC in very important from the financial perspective because it directly corresponds to the inpatient

service day (ISPD). The ISPD is a unit of measurement outlining all of the services provided to one individual

inpatient over a 24-hour period. The number of ISPD and DIPC of inpatients during a 24-hour period are in

direct correlation. The ISPD can be calculated at any frequency. While they are calculated daily, they can also

be calculated on a weekly or monthly basis. ISPDs are designed to calculate the volume of services provided

by the HCO, so the more ISPDs, the more stabilization the health care organization realizes from a financial

perspective (Koch, 2015). For financial prosperity, the proper calculation of census using inpatient service

days is of utmost importance.

Frequency of the Census

The census with the HCO is calculated for a certain period time, on a daily basis, or as an average. A period

is a unit of time. It can include two days, a week, a month, or any other period. Period census is calculated by

dividing the total inpatients provided for a certain period divided by the total days with in the period of

measure.

Census in Health care Categories Census in H ealthcare C ategories

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For example, if the number of patients received at a hospital over a week were as follows:

Day Number of Patients

Sunday 130

Monday 120

Tuesday 115

Wednesday 160

Thursday 125

Friday 150

Saturday 115

The period census would be 130.7 or 131. The period census was calculated by adding the patient totals for

each day and then dividing by the total days. The sum of the inpatients for the total days equals 915.

This number is then divided by the number of days, which is seven.

Calculating daily census is reflective of the patient present at the CTT and is usually accomplished with

performing basic mathematics. For example, on June 1, a hospital had 53 patients at CTT, and on June 2, six

patients were discharged and two were admitted, the census would be 49 for the daily total for daily total for

June 2 (53–6+2). Average census is measured in the same manner as period census but normally for longer

periods. It often provides a better overview in comparison to period census because the fluctuations on

specific periods are eliminated over time.

With period census, high points and low points of occupancy can greatly affect the count. F or purpose of

calculation, deaths are considered discharges and are included in the total unless a live discharge is

displayed. For inpatient discharge rates, deaths and live discharges are included, with the exception of fetal

deaths, patients who present dead on arrival, and outpatient deaths (Koch, 2015).

• Fetal deaths are classified as those infants who were not alive at the time of delivery.

• Dead on arrival refers to the group of patients who arrive at the hospital without any signs of life and

all resuscitative measures have failed to revive the patient.

• Outpatient deaths are a classification of patients who have not been assigned an inpatient bed.

130 + 120 + 115 + 160 + 125 + 150 + 115 = 915

915 ÷ 7 = 130.7

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Because this population of patients is deducted

from the overall census numbers, it is very

critical to have knowledge and a firm grasp on

the exclusion of this data set as it pertains to

census calculations. The determination of the

patient status will force the use of different

numbers when calculating service days and

census. Adults and children (A&C) have

different classifications of stay in comparison to

newborns (NB). In addition, the two have

different categories of stay. The classifications

of stay are based on the specific factors

relating to the age of the patient, and in the

cases on newborns, if the newborn was born

within the actual HCO.

For statistical purposes, inpatients are defined

within two categories of stay. The two

categories are beds and bassinets (Koch,

2015)

• Beds are normally for patients who are not born with the health care organization during that specific

term of hospitalization. Adults and children (A&C) are the only group of patients assigned a hospital

bed; simply meaning that they will require an actual hospital bed for a period of stay. A&C reflect any

group of patients other than newborns born within facility.

• Bassinet statistics include newborns, who require a bassinet for an inpatient stay. Newborns are

classified as infants born within the health care organization. There are situations in which newborns

may not be included into the hospital’s bassinet count. For example, if a mother calls emergency

medical services (EMS) for transport and delivers while in transport, th e newborn would be included

into the bed statistics, even though a bassinet is used during the inpatient stay. This is because the

infant was not actually born in the HCO during the beginning of the inpatient stay.

A&C are included within the inpatient census statistics, while newborns have another determining factor due

specialization of care required. All components are very important when determining the census of the

organization. Therefore, knowledge of each component is essential to understanding the impact of census on

the organization by the student.

References

Jeep5d. (2014). Women patients in a hospital [Photograph]. Dreamstime. https://www.dreamstime.com/stock-

photos-women-patients-hospital-image37443423

Koch, G. (2015). Basic allied health statistics and analysis (4th ed.). Cengage Learning.

Smontgom65. (2010). 2010 Census form, with hand and pen [Photograph]. Dreamstime.

https://www.dreamstime.com/stock-image-2010-census-form-hand-pen-image13501991

Female patient in a hospital

(Jeep5d, 2014)

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Learning Activities (Nongraded)

Nongraded Learning Activities are provided to aid students in their course of study. You do not have to submit

them. If you have questions, contact your instructor for further guidance and information.

Welcome to the third unit of the course. Before completing your graded work, consider reflecting on the below

questions.

• Why is a census important in relation to the general population and within health care?

• How does properly acquiring census affect the financial stability of the organization?

• Are there differences in calculating hospital stays for certain patient groups?