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

The Utah Department of Health, Office of Health Care Statistics, collects information on ambulatory surgery and other ambulatory services using the Current Procedural Terminology (CPT®) and International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes specified in the table.

Outpatient Data File Provided to HCUP by the Partner

Utah provides HCUP with their complete ambulatory surgery and other outpatient services file. If a patient is initially seen in the emergency department and then has an ambulatory surgery, that record is included in the ambulatory surgery file.

For the 2018 data year, a major health system submitted records for a broad group of ambulatory surgical procedures to the Utah Department of Health. The additional records substantially increased the size of the ambulatory surgery file that was submitted to HCUP. Utah is in the process of forming a more precise definition of an ambulatory surgery record to be used by all of their health systems.

Beginning with 2015 data, the Utah Partner organization has requested that data elements AGE, FEMALE and ZIP are set to missing (blank) in the Central Distributor SASD when the record contains an indication of substance abuse or HIV infection.

Selection of Records for Inclusion in the SASD

All records identified by Utah as ambulatory surgery (AS) (i.e., included in the separate AS data file provided to HCUP) are included in the SASD (HCUP data element STATE_AS=1 based on specified range of CPT and/or ICD-9-CM procedures).

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

Utah requires licensed hospital-owned and nonhospital-owned facilities to report data on ambulatory surgeries and diagnostic procedures for each patient discharged from their facility. Voluntary reporting began in 1996 for hospital-owned facilities, and nonhospital-owned facilities followed. Mandated reporting by both types of facilities began in 1998.

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.