Mississippi is one of only two states that do not currently have a statewide health data system that captures at least hospital discharge data. Almost all states collect and analyze hospital data because they recognize the value of this information to the states’ health care system. Forty-two percent of health care spending in Mississippi is to hospitals (the highest rate of all states), and 54 percent of payments to hospitals come from Medicare and Medicaid.
The lack of such a data system in Mississippi severely impedes the state’s ability to identify the causes of injury and illness in our state, to plan or evaluate interventions, or to respond promptly to changes in patterns of illness or injury. We know from mortality data that Mississippi suffers from a greater burden of disease and injury than the rest of the nation. Mississippi, more than any other state, needs to be working to identify underlying causes and contributing factors so that appropriate action can be taken to improve the health status of our citizens.
Applications
Hospital discharge data are used by states in a wide variety of applications:
- Public safety and injury surveillance and prevention;
- Public health, disease surveillance, and disease registries;
- Public health planning and community assessments;
- Public reporting for informed purchasing and comparative reports;
- Quality assessment and performance improvement;
- Health services and health policy research applications; and
- Informing policy deliberations and legislation.
The data generated by these systems are used by a wide range of organizations:
- Government agencies;
- Provider associations;
- Individual health care providers;
- Consumers and health promotion organizations;
- Researchers and educators;
- Policymakers; and
- Third-party payers.
Structure
The majority of statewide health data systems are located in state agencies. Some are operated by private organizations, such as the state’s hospital association. While some state health data systems serve almost exclusively as a data warehouse, collecting data for outside parties to use, other states also conduct a wide range of analyses and produce reports.
Examples of Uses
- North Carolina tracks suicides & suicide attempts.
- Colorado has studied injuries related to lightning strikes.
- Massachusetts monitors injuries resulting from falls, drowning, & motor vehicle accidents.
- Many states use hospital data in their Crash Outcomes Data Evaluation System to monitor injuries from motor vehicle crashes.
- Vermont has used hospital data to estimate the incidence of rare disorders such as Guillain-Barre syndrome.
- New York monitors CVD hospitalization rates and costs.
- Georgia has conducted epidemiological studies on arthritis.
- The March of Dimes estimates the cost of premature births.
- Iowa links hospital and tumor registry data to examine cancer patients’ co-morbidities.
- Several states use hospital data to monitor maternal & child health status indicators for Title V, Maternal and Child Health Block Grant, reporting.
- Many states use hospital data to assess progress toward Healthy People 2010 goals.
- States examine geographic variation in hospitalizations for certain conditions or populations and conduct patient origin analyses.
- Pennsylvania provides hospital-specific data on 28 conditions including volume, charges, risk-adjusted length of stay, risk-adjusted mortality rates, and risk-adjusted readmission rates.
- California has studied quality indicators for community-acquired pneumonia.
- Many states have recently analyzed the trends in infections with methicillin-resistant Staphylococcus aureus (MRSA) to measure the growth in rates and determine what types of patients are most affected.
Potential Impact
Several states study hospitalizations that might have been averted if appropriate & timely ambulatory care had been received. For instance, Florida reports diabetes outcomes including hospitalizations for diabetes with complications and amputation rates.
The Commonwealth Fund’s State Scorecard on Health System Performance1 ranked Mississippi 49th among all the states and the District of Columbia in avoidable hospitalizations and cost. The report noted that if Mississippi performed at the same level as the best state, there would be 23,758 fewer unnecessary hospitalizations, and $105,652,000 would be saved from the reduction in avoidable hospitalizations.
Sources
1 Aiming Higher: Results from a State Scorecard on Health System Performance. The Commonwealth Fund Commission on a High Performance Health System. June 2007.
