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

The New Jersey Department of Health collects data on ambulatory surgery and other outpatient services such as observation services and emergency department (ED) visits. New Jersey uses the following hierarchy and definitions to identify each outpatient record with a patient type:

• Ambulatory surgery is defined by a Uniform Billing Form 04 (UB-04) bill type of 13x for outpatient services, length of stay equal to 0, discharge status of home or home health services, and revenue center codes in the range of 360-369 for operating room (value 1).
• ED visits are defined by a bill type of 13x for outpatient services and a revenue code in the range of 450-459 (value 2).
• Other outpatient services are defined by a bill type of 13x for outpatient services and are not qualified as either an ambulatory surgery or emergency department visit (value 3). Other outpatient services may include observation care.

Because of the hierarchical assignment for the patient type, an outpatient encounter that involves ambulatory surgery and ED services is only flagged as ambulatory surgery. However, ambulatory surgery records with evidence of ED services can be identified by HCUP data element HCUP_ED.

Outpatient Data File Provided to HCUP by the Partner

New Jersey provides HCUP with a combined data set that includes both inpatient and outpatient data. Starting in 2017, the outpatient data are based on admission date, while inpatient records continue to be based on discharge date. Prior to 2017, all records in the source file were based on discharge date. The types of outpatient records provided to HCUP vary by year.

• Starting in data year 2008, New Jersey has provided their complete outpatient data set to HCUP, with the type of outpatient service identified by patient type. The patient type is stored in the HCUP data element OPservice OPservice.
• Prior to data year 2008, New Jersey provided only ambulatory and emergency department records from their broader outpatient data set to HCUP.

Selection of Records for Inclusion in the SASD

Beginning in data year 2008, New Jersey provides HCUP with a patient type indicator in the outpatient file. All records identified by New Jersey as ambulatory surgery are included in the SASD (STATE_AS=1 based on patient type 1).

From data year 2005 through 2007, STATE_AS was set to 1 based on the first two digits of "13" for bill type.

Prior to data year 2005, the following criterion was provided by the New Jersey Partner and used to set STATE_AS to 1: same-day stay (HCUP data element ADATE=DDATE), nonzero charges for the operating room (CHG24 > 0) or for same-day surgery (CHG32 > 0), and discharged to home (DISP = 1).

In addition, any other nonemergent outpatient records also are included in the SASD (STATE_ED not equal to 0).

Additionally, any record in the SASD that also have evidence of ED 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

The New Jersey Department of Health (DOH) licenses facilities with more than one operating room. DOH-licensed centers in the State are required to report their outpatient data. The State Board of Medical Examiners (BME) regulates facilities with only one operating room as part of the physician's or physician group's private medical practice.

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 Processing

Beginning with 2016 data, records with a discharge disposition of "still a patient" are retained in the HCUP SASD. Prior to 2016 data, these records were excluded.

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.