ANNUAL REPORT

THE SPARCS DATA SYSTEM

Background

The Statewide Planning and Research Cooperative System (SPARCS) was implemented by the New York State Department of Health in 1979, with the cooperation and initial financial support of the U.S. Department of Health and Human Services. SPARCS receives, processes, stores, and analyzes the following: inpatient hospitalization data from all Article 28 facilities in New York State and ambulatory surgery data from hospital-based ambulatory surgery services and all other facilities providing ambulatory surgery services.

SPARCS continues to be a comprehensive, integrated information system available to assist hospitals and organizations in the health care industry with health care resource planning, financial analysis, decision making, and surveillance of New York State hospital and ambulatory surgery services and costs. SPARCS has proven to be an effective management tool, not only for the Department of Health but also for the health care industry. Widespread support and advice from many organizations and individuals in the public and private sectors have made possible the development and refinement of SPARCS. The Department of Health continues to invite active participation in improving the quality and usefulness of SPARCS.

The Annual Report Series presents hospital inpatient stay data based on discharges for each year through a set of standard statistical tables which serve the needs of a wide spectrum of health information users.

Data Sources

From 1980 through 1993 SPARCS made use of two data sources:  the Discharge Data Abstract (DDA) and the Uniform Billing Form (UBF). In 1994 SPARCS began collecting essentially the same information from a single source based on the Universal Data Set (UDS) specifications. These specifications blend the UB-92 nationwide inpatient and outpatient billing requirements with the unique billing and discharge data reporting requirements of New York State. The single UDS data stream requires that medical abstract information and billing data are merged before they are sent to SPARCS.

This new electronic format streamlines multiple data submission formats into a single format, removing redundant reporting requirements for hospitals and other health care facilities, while continuing to support the myriad of requests from health care researchers for both billing and medical records data.

Each health care provider submits its SPARCS data in the uniform, computer-readable format described in the UDS. The data are sent to the Department of Health either directly by the hospital or through one of a number of private information processing services. Every record received is edited to identify errors, and hospitals are notified of records needing correction. Each data element must have a valid value before the record is accepted by the system. When a record needs correction, the hospital or processing service is notified. Duplicate submissions are carefully screened.

Data Protection

Regulations governing the confidentiality of SPARCS data were adopted by the New York State Hospital Review and Planning Council with the advice of all sectors of the health care industry. The regulatory, tracking, and monitoring functions of SPARCS are administered by the New York State Department of Health. The responsibility for protecting the confidentiality and privacy of data related to patient care resides with the Commissioner of Health.

To protect patient privacy, patient names are omitted from the SPARCS data set. The focus of the system is the incidence of diseases or conditions requiring hospitalization rather than individual patients. For this reason, users of SPARCS data cannot ascertain the number of individuals treated for a specific disease, only the number of hospitalizations that have occurred.

USING THE SPARCS ANNUAL REPORT

Descriptions of the data displayed in the tables are included below to assist in using the report:

Expected Primary Source of Reimbursement

The expected primary source of reimbursement used in the Annual Report is obtained from the Universal Data Set. This data element is documented at the time of discharge, not the time of payment, and represents the best information available to the hospital when a patient leaves the facility. However, given the complexity of reimbursement processes, especially when a patient appears to be eligible under more than one third-party payment plan, the expected primary payer is not always the ultimate primary payer. There may also be a bias toward under reporting of discharges for third-party payers when there are delays in establishing eligibility.

Special care should be taken in interpreting tabulations of patient days by expected primary source of reimbursement. For each discharge a single payer is reported as the expected primary source of reimbursement. Since many cases have multiple payers, the expected primary payer may not pay the entire bill. This information is displayed on Tables 3, 4, and 9.

Service Categories

The service categories used in the Annual Report are based on categories developed by the New York State Department of Health and are defined in terms of diagnosis and procedure codes from the International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM). This information is displayed on Tables 2, 3, 5, 8, and 12.

NURSERY - Patients whose age is equal to zero and have an ICD-9-CM code of V30.0, V30.1, V31.0, V31.1, V32.0, V32.1, V33.0, V33.1, V34.0, V34.1, V35.0, V35.1, V36.0, V36.1, V37.0, or V37.1 are considered nursery patients. These codes refer only to live-born infants. Definitions of nursery service category and newborn age category are the same.

OBSTETRICAL - Obstetrical patients are females of any age with an ICD-9-CM code within the range of 630 through 634.9 and 640 through 676.9.

PSYCHIATRIC - Psychiatric patients are any age with an ICD-9-CM code within the range of 290 through 319.

PEDIATRIC - Pediatric patients are age 14 years and younger whose primary diagnosis is neither included in the nursery, obstetrical, or psychiatric categories nor classified by ICD-9-CM codes 614 through 629.9 (gynecological) or 635 through 639.9 (abortion).

MEDICAL - Medical patients are age 15 years or older with no reported procedure code or with reported procedure codes greater than 86.99. This category also includes gynecological patients (ICD-9-CM codes 614 through 629.9) of all ages with no reported procedure code or with reported procedure codes greater than 86.99. Excluded are newborn, obstetrical, psychiatric, and pediatric patients as defined above.

SURGICAL - Surgical patients are age 15 years or older with at least one procedure code in the range 01 through 86.99. This category also includes gynecological patients (ICD-9-CM codes 614 through 629.9) of all ages with at least one such procedure code and all patients whose principal diagnoses are codes 635 through 639.9 (abortion). Excluded are newborn, obstetrical, psychiatric, pediatric, and medical patients as defined above.

Length of Stay Calculation

SPARCS calculates a length of stay for each discharge record by subtracting the date of admission from the date of discharge. If a patient is admitted and discharged the same day, the length of stay is one day. This information is displayed on Tables 2 - 9, and 11.

County of Residence

Information on patient's county of residence is displayed on Tables 7, 8, and 12. Detailed information on this data is available by contacting the SPARCS Administrative Unit at (518) 473-8144 or by e-mail at sparcs.submissions@health.ny.gov.

Source of Payment

Pending from SPARCS ADMIN - Description is needed for Source of Payment

Emergency Department Topics

Pending from Biometrics - Descriptions are needed for ED Annual Report topics

Data Elements Collected by Table Number

Data Element by Category Table Number
1 2 3 4 5 6 7 8 9 10 11 12 13A 13B 13C 13D 14A 14B 15A 15B 16A 16B 17A 17B 18A 18B 19
Number of Discharges * X X X X X X X X X * X * X X * * * * * * * * * * * *
Number of Patient Days * *
Average Length of Stay * X X X X X X X X * * * * * * * *
Health Service Area (HSA) * *
Age Group X X X X X * * * *
Patient's Sex X X X X X * *
Expected Primary Source of Reimbursement X X X * *
Service Category X X X X * *
Disposition of Patient X X * *
County of Residence X * * *
County of Hospitalization X X X *
Hospital X X X * *
Discharge Rate *
Federal DRG * * * * * *
Average Total Charge of Stay * X X * * *
Principal Diagnostic Categories X
Surgical Procedure Categories X *
Federal MDC * * * * *
Total Length of Stay * *

* Discontinued in 2003 and forward.