Organization and Financing of Indigent Hospital Care in South Florida

By Catherine A. Jackson; Amanda Beatty | Go to book overview

APPENDIX D
RECONCILIATION OF HOSPITAL DISCHARGE AND HOSPITAL FINANCIAL DATA

To examine the financial effects of providing care to the uninsured, we used the hospital finance data that are routinely reported to the Florida Health Care Administration. To develop a more stable understanding of the hospital financial situation, we looked at trends from 1998 through 2001. The financial data are reported annually but reflect hospital-specific fiscal years. Here we used the reporting year. To compare the hospital discharge data with the hospital financial data, we looked at the number of discharges by the insurance categories of interest: commercial, Medicaid, and uninsured.

Across the counties, the hospital financial data appear to underreport the number of discharges. Moreover, the under-reporting is not proportional across insurance type.

A number of reasons can be posited why the data are discrepant between the two sources. First, as mentioned above there are reporting period differences - the hospital financial data are reported by hospital-specific fiscal year and the discharge data are reported by calendar year. Second, the insurance category listed in the discharge data is generally the anticipated insurance type. Hospitals may determine that the category should be changed when reimbursement is sought. Unfortunately, this change is rarely reported in the discharge data. Third, there are differences in how some of the categories are reported. Interestingly, Broward County does not use the “other government” category for those patients whose care is subsidized by the county, while Miami-Dade and Palm Beach do (11,875 and 2,237 discharges, respectively). Such variation makes it difficult to compare the numbers of patients treated with local public funding.

Because of the reporting differences, we analyzed the hospital financial data without further reconciliation with the hospital discharge data. In addition, we included the “other government” discharges in the uninsured category.

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