Information Bulletin, September 1998


Data Submissions
Year 2000
Error Correction
HCRA Task Force Addressing Hospital Performance
Internet News

Data Submissions

The September update shows an excellent response from facilities throughout New York State submitting approximately 97% of their projected 1997 SPARCS inpatient data. SPARCS staff have been contacting those facilities reporting fewer discharges for 1997 in comparison to their 1996 submissions. Facilities are asked to provide SPARCS with an explanation for the shortfall or specify a timetable concerning when their submissions will be brought up to date. We anticipate publishing the 1997 Annual Report Series data tables after the October update. The ARS publication will note those facilities with a shortfall, along with an explanation for that shortfall.

There are a few facilities that have a data shortfall at this time because their original or corrected acute care inpatient data has not be submitted to SPARCS. Should you have any questions concerning the status of your 1997 inpatient data please do not hesitate to contact SPARCS at (518) 473-8144. You can also view the SPARCS audit reports online to see the status of your inpatient or outpatient master file submissions.

Year 2000

SPARCS will be able to accept the millennium ready UDS Version 5 format as of October 1, 1998. Any vendor or provider wanting to test Version 5 submissions may NOW send tapes or diskettes labelled as VERSION 5 TEST to the SPARCS Unit. The current Version 4.1 UDS format will be accepted until December 31, 1999, but we would strongly encourage providers and vendors to migrate to the millennium ready format in accordance with the Medicare directives, which mandates Version 5 use by the end of this calendar year.

Error Correction

In a continuing effort to monitor and improve the quality of data submitted to SPARCS, we recently compared SPARCS 1997 submissions with the Institutional Cost Report (ICR) data reported to the Division of Healthcare Financing. The unresolved SPARCS submission errors accounted for a significant number of the discrepancies between the two data sources. Providers and vendors should be reminded that records flagged in error on the edit reports returned with each submission are not merged into the SPARCS master files. By requesting the SPARCS History Report for any given year, a list of these unresolved error records may be obtained.

HCRA Task Force Addressing Hospital Performance

The NYS Task Force on Health Care Quality Improvement and Information Systems, a broad-based advisory group to the DOH, is developing a report that will present hospital performance data to the public. The group, comprised of representatives from the medical, provider, nursing, data management, employer, consumer, and payer communities, is charged by the Health Care Reform Act of 1996 to develop both the content and the format of the report. The report will include risk-adjusted quality measures for services delivered in the inpatient and ambulatory surgery settings.

The task force has been studying the issue of severity adjustment to ensure that the report accounts for differences in patient characteristics across institutions. A significant portion of that discussion has focused on the "emergent diagnosis indicator" on the SPARCS file. This indicator, which allows clinicians to identify whether a specific condition is present on admission, is being increasingly recognized as a valuable enhancement to the ability to adjust performance measures to reflect differences in patient severity of illness. Several commercial severity adjustment vendors who have discussed their products with the task force have already incorporated or are planning to incorporate the indicator into their systems.

The indicator has enormous potential to improve severity adjustment processes and their resulting measures. The success of these efforts, of course, relies on the accuracy of the coding of the measure. Recent audits of the reporting of the indicator show significant variation across hospitals in New York and suggest a need for closer scrutiny of these data at the hospital level. Hospitals should ensure that clinicians and data personnel are aware of the importance of accurate coding of the emergent indicator. The DOH will encourage a dialogue with data management and clinical staff to ensure that this indicator is accurately reported. By working together, we can only improve the usefulness of any severity-adjusted hospital inpatient measures that are developed or employed in performance improvement initiatives.

Editor's Note: We would like to thank the Division of Planning Policy and Resource Development for the above contribution to the SPARCS Bulletin to share with our readers one important use of SPARCS data.

Internet News

We recently posted the entire SPARCS Operations Guide on our web site, as well as additional documentation changes. We have also completed some cross referencing between pages which will make for easier navigation around our pages.

On our web site you will always find the most recent updates to SPARCS and UDS documentation, current audit counts by facility, all annual report tables, and the most recent versions of the HCNAPPS and EPS Software used for submitting data via electronic mail.

We encourage you to also look at the Department of Health Web site, www.health.state.ny.us, for additional useful information. Remember that we welcome suggestions for future enhancements to both sites!