Types of Ambulatory Surgery and Other Outpatient Services Collected by the Partner

The Hawaii Health Information Corporation (HHIC) collects data on ambulatory surgery and other outpatient services. HHIC defines ambulatory surgery as same-day hospital surgery events that are performed on an outpatient basis. HHIC does not provide hospitals with a more specific criterion for defining an ambulatory surgery encounter, such as a range of procedure codes or revenue center codes. Beginning in data year 2011, HHIC began collecting encounter-level data for outpatient observation services.

Outpatient Data File Provided to HCUP by the Partner

HHIC provides HCUP with their complete ambulatory surgery and other outpatient services file, which is provided separately from their emergency department (ED) file. Starting in data year 2011, observation service encounters are included with the ambulatory surgery data.

Included in the file is a record type indicator, which distinguishes between an ambulatory surgery record (value 2) and beginning in 2011, an observation services record (value 5).

Selection of Records for Inclusion in the SASD

All records identified by HHIC as ambulatory surgery (AS) (included in the separate AS data file provided to HCUP) are included in the SASD (HCUP data element STATE_AS=1 based on record type "2").

Additionally, any records in the SASD that also have evidence of emergency department services based on the HCUP criteria (HCUP data element HCUP_ED > 0), are also included in the HCUP State Emergency Department Databases (SEDD). These records will have the same value for the HCUP data element KEY.

Types of Facilities Included in the Files Provided to HCUP by the Partner

HHIC collects data on ambulatory surgeries performed in hospital-owned facilities. HHIC does not collect data from ambulatory surgery facilities that are not owned by a hospital.

Identification of Hospital-Owned Ambulatory Surgery and Other Types of Outpatient Facilities in the SASD

The designation of a facility as hospital-owned is specific to its financial relationship with a hospital that provides inpatient care and not related to its physical location. Hospital-owned ambulatory surgery and other outpatient care facilities may be contained within the hospital, physically attached to the hospital, or located in a different geographic area. The designation as hospital-owned means that HCUP can identify that the hospital is billing for this service.

Starting in data year 2018, the HCUP data element HOSPITAL_OWNED can be used to identify hospital-owned facilities with ambulatory surgery and possibly other outpatient care data in the SASD. A facility is considered hospital-owned (HOSPITAL_OWNED = 1) if any one of the following is true:

• The facility is listed in the American Hospital Association (AHA) Annual Survey Database^TM.
• The facility is not listed in the AHA database, but the facility provides inpatient discharge data to HCUP.
• Documentation provided by the data source clearly indicates that the facility is hospital-owned.

If the facility in the SASD does not meet any of the above criteria, it is marked as not being owned by a hospital (HOSPITAL_OWNED = 0). Not all hospitals report to the AHA, so there is a possibility that some facilities marked with HOSPITAL_OWNED=0 are hospital-owned.

From data year 1998-2018, the HCUP data element was called FREESTANDING. A facility is considered hospital-owned (FREESTANDING = 0) if any one of the following is true:

• The facility is listed in the American Hospital Association (AHA) Annual Survey Database^TM.
• The facility is not listed in the AHA database, but the facility provides inpatient discharge data to HCUP.
• Documentation provided by the data source clearly indicates that the facility is hospital-owned.

If the facility in the SASD does not meet any of the above criteria, it is marked as not being owned by a hospital (FREESTANDING = 1). Not all hospitals report to the AHA, so there is a possibility that some facilities marked with FREESTANDING=1 are hospital-owned.

Exclusion of Records During HCUP Data Processing

Records with a discharge disposition of "still a patient" are excluded from the HCUP SASD.

Beginning in 2010, records with a designation of "admitted as an inpatient" are retained in the SASD, even though this rarely occurs. Prior to 2010, records with a designation of "admitted as an inpatient" were excluded from the files.