Data is enlightening, but also overwhelming. Data can be incredibly useful, but must also be used with forethought. We live in an age where almost every function relies on the analysis of data, which allows us to find trends and solve problems — but could also leave us in a state of thought paralysis.
Hospital and healthcare executives are very aware of the perks and cautions of comparative data and benchmarking. Looking at clinical, operational and financial data can help providers identify problems as well as stay on pace with competitors or national leaders. Too much data, however, can make even the most IT-savvy hospital executives feel as though they are caught in quicksand.
For the second year, Becker's Hospital Review has collected 200 benchmarks related to some of the most important day-to-day areas hospital executives oversee: quality, patient satisfaction, operations, utilization and finance. As hospitals continue to move toward value-based care and a more seamless care continuum, the following data and metrics will give some insight as to what providers should expect — and how they can improve.
Quality and process of care
Source: Hospital Compare, Department of Health & Human Services, National Averages July 2013.
Hospital-acquired conditions and other national averages (all per 1,000 discharges)
Collapsed lung due to medical treatment: 0.35
A wound that splits open on the abdomen or pelvis after surgery: 0.95
Accidental cuts and tears from medical treatment: 2.05
Serious blood clots after surgery: 4.71
Deaths among patients with serious treatable complications after surgery: 113.43
Objects accidentally left in the body after surgery: 0.028
Severe pressure/bed sores: 0.136
Falls and injuries: 0.527
Infection from a urinary catheter: 0.358
Signs of uncontrolled blood sugar: 0.058
Heart attack patients
Who were given fibrinolytic medication within 30 minutes of arrival: 61 percent
Who were given angioplasty within 90 minutes of arrival: 95 percent
Who were given aspirin at discharge: 99 percent
Who were given a prescription for a statin at discharge: 98 percent
Outpatients with chest pain or possible heart attack who got drugs to break up blood clots within 30 minutes of arrival: 58 percent
Outpatients with chest pain or possible heart attack who got aspirin within 24 hours of arrival: 97 percent
Average number of minutes before outpatients with chest pain or possible heart attack who needed specialized care were transferred to another hospital: 58 minutes
Average number of minutes before outpatients with chest pain or possible heart attack got an ECG: 7 minutes
Median time to fibrinolysis: 28 minutes
Heart failure patients
Who were given discharge instructions: 93 percent
Who were given an evaluation of left ventricular systolic function: 99 percent
Who were given ACE inhibitor or ARB for left ventricular systolic dysfunction: 97 percent
Pneumonia patients
Whose initial emergency room blood culture was performed prior to the administration of the first hospital dose of antibiotics: 97 percent
Who were given the most appropriate initial antibiotic(s): 95 percent
Surgery patients
Who were given an antibiotic at the right time (within one hour before surgery) to help prevent infection: 98 percent
Whose preventive antibiotics were stopped at the right time (within 24 hours after surgery): 97 percent
Who got treatment at the right time (within 24 hours before or after their surgery) to help prevent blood clots after certain types of surgery: 98 percent
Who were taking heart drugs (beta blockers) before coming to the hospital and who were kept on the beta blockers during the period just before and after their surgery: 97 percent
Who were given the right kind of antibiotic to help prevent infection: 99 percent
Heart surgery patients whose blood sugar is kept under good control in the days right after surgery: 96 percent
Whose urinary catheters were removed on the first or second day after surgery: 96 percent
Who were actively warmed in the operating room or whose body temperate was near normal by the end of the surgery: 100 percent
Whose physicians ordered treatments to prevent blood clots after certain types of surgeries: 98 percent
Outpatients having surgery who got an antibiotic at the right time (within one hour before surgery): 97 percent
Outpatients having surgery who got the right kind of antibiotic: 97 percent
Emergency department patients
Average time spent in the ED before patients were admitted to the hospital as an inpatient: 274 minutes
Average time patients spent in the ED after the physician decided to admit them as an inpatient but before leaving the ED for their inpatient room: 96 minutes
Average time patients spent in the ED before being sent home: 138 minutes
Average time patients spent in the ED before they were seen by a healthcare professional: 28 minutes
Average time patients who came to the ED with broken bones had to wait before receiving pain medication: 60 minutes
Percentage of patients who came to the ED with stroke symptoms who received brain scan results within 45 minutes of arrival: 46 percent
Preventive care patients
Assessed and given flu vaccination: 86 percent
Assessed and given pneumonia vaccination: 88 percent
Children's asthma patients
Who received reliever medication while hospitalized for asthma: 100 percent
Who received systemic corticosteroid medication that reduces inflammation and controls symptoms while hospitalized for asthma: 100 percent
And their caregivers who received a home management plan of care while hospitalized for asthma: 86 percent
Patient satisfaction
Source: Hospital Compare, Department of Health & Human Services, National Averages July 2013.
Overall hospital rating
Patients who gave the hospital a rating of nine or 10: 70 percent
Patients who gave the hospital a rating of seven or eight: 22 percent
Patients who gave the hospital a rating of six or lower: 8 percent
Patient recommendation
Patients who said, yes, they would definitely recommend the hospital to friends and family: 71 percent
Patients who said, yes, they would probably recommend the hospital to friends and family: 24 percent
Patients who said, no, they probably or definitely would not recommend the hospital to friends and family: 5 percent
Cleanliness
Patients who said their room and bathroom was "always" clean: 73 percent
Patients who said their room and bathroom was "usually" clean: 18 percent
Patients who said their room and bathroom was "sometimes" or "never" clean: 9 percent
Noise
Patients who said the area around their room was "always" quiet at night: 60 percent
Patients who said the area around their room was "usually" quiet at night: 30 percent
Patients who said the area around their room was "sometimes" or "never" quiet at night: 10 percent
Physician and nurse communication
Patients who said their nurses "always" communicated well: 78 percent
Patients who said their nurses "usually" communicated well: 17 percent
Patients who said their nurses "sometimes" or "never" communicated well: 5 percent
Patients who said their physicians "always" communicated well: 81 percent
Patients who said their physicians "usually" communicated well: 15 percent
Patients who said their physicians "sometimes" or "never" communicated well: 4 percent
Pain control
Patients who said their pain was "always" well controlled: 71 percent
Patients who said their pain was "usually" well controlled: 22 percent
Patients who said their pain was "sometimes" or "never" well controlled: 7 percent
Staff explanations
Patients who said staff "always" explained medicines before administering: 63 percent
Patients who said staff "usually" explained medicines before administering: 18 percent
Patients who said staff "sometimes" or "never" explained medicines before administering: 19 percent
Staff help
Patients who said they "always" received help as soon as they wanted: 67 percent
Patients who said they "usually" received help as soon as they wanted: 24 percent
Patients who said they "sometimes" or "never" received help as soon as they wanted: 9 percent
Recovery information
Patients who said staff provided information about what to do during their recovery at home: 84 percent
Patients who said staff did not provide information about what to do during their recovery at home: 16 percent
Operations and utilization
Source: American Hospital Association, AHA Hospital Statistics Report, 2013 Edition.
Average full-time staff
Hospitals with 6 to 24 beds: 91
Hospitals with 25 to 49 beds: 165
Hospitals with 50 to 99 beds: 273
Hospitals with 100 to 199 beds: 609
Hospitals with 200 to 299 beds: 1,126
Hospitals with 300 to 399 beds: 1,670
Hospitals with 400 to 499 beds: 2,388
Hospitals with 500 or more beds: 4,565
FTE per hospital: 908
FTE per bed: 5.6
Average part-time staff
Hospitals with 6 to 24 beds: 43
Hospitals with 25 to 49 beds: 73
Hospitals with 50 to 99 beds: 126
Hospitals with 100 to 199 beds: 264
Hospitals with 200 to 299 beds: 440
Hospitals with 300 to 399 beds: 601
Hospitals with 400 to 499 beds: 813
Hospitals with 500 or more beds: 1,238
Average admissions per year
Hospitals with 6 to 24 beds: 443
Hospitals with 25 to 49 beds: 997
Hospitals with 50 to 99 beds: 2,203
Hospitals with 100 to 199 beds: 5,992
Hospitals with 200 to 299 beds: 11,106
Hospitals with 300 to 399 beds: 16,574
Hospitals with 400 to 499 beds: 20,994
Hospitals with 500 or more beds: 33,710
Average inpatient surgeries per year
Hospitals with 6 to 24 beds: 80
Hospitals with 25 to 49 beds: 205
Hospitals with 50 to 99 beds: 522
Hospitals with 100 to 199 beds: 1,513
Hospitals with 200 to 299 beds: 3,006
Hospitals with 300 to 399 beds: 4,469
Hospitals with 400 to 499 beds: 6,251
Hospitals with 500 or more beds: 10,533
Average outpatient surgeries per year
Hospitals with 6 to 24 beds: 610
Hospitals with 25 to 49 beds: 922
Hospitals with 50 to 99 beds: 1,616
Hospitals with 100 to 199 beds: 3,449
Hospitals with 200 to 299 beds: 5,184
Hospitals with 300 to 399 beds: 6,941
Hospitals with 400 to 499 beds: 8,826
Hospitals with 500 or more beds: 14,014
Hospital adjusted expenses per inpatient day
Source: Kaiser State Health Facts, accessed 2013 and based on 2011 data.
Nonprofit hospitals: $2,088
State/local government hospitals: $1,667
For-profit hospitals: $1,628
Finance
Source: Moody's Investors Service, "U.S. Not-for-Profit Hospital 2012 Medians" Report, August 2013.
Key ratios
Maintained bed occupancy: 63.5 percent
Operating margin: 2.5 percent
Excess margin: 5.2 percent
Operating cash flow margin: 9.5 percent
Return on assets: 4.3 percent
Cash-to-debt ratio: 126.2 percent
Debt-to-capitalization ratio: 38.9 percent
Debt-to-total revenue: 37.6 percent
Three-year operating revenue CAGR: 5.1 percent
Current ratio: 1.9x
Cushion ratio: 16.2x
Annual debt service coverage: 4.6x
Maximum annual debt service coverage: 4.3x
Debt-to-cash flow: 3.4x
Capital spending ratio: 1.2x
Cash on hand: 185.3 days
Accounts receivable: 49.9 days
Average payment period: 64.3 days
Average age of plant: 10.6 years
Patient revenue sources by gross revenue
Medicare: 44.1 percent
Medicaid: 13.1 percent
Blue Cross/commercial/managed care: 33.4 percent
Self-pay and other: 7.6 percent
Financial medians related to healthcare reform
Reimbursement methods (% of net patient revenue)
DRG: 38.9 percent
Percent of charges: 19.8 percent
Fee schedule: 19 percent
Per diem: 4.3 percent
Risk-based: 1.8 percent
Traditional capitation: 0.7 percent
Other: 8 percent
Number of covered lives
Medicare: 30,440
Medicaid: 26,988
Commercial: 53,728
New hospital utilization data
Unique patients: 121,689
Medicare readmission rate: 12.1 percent
Overall readmission rate: 9.8 percent
Total case mix index: 1.4
Number of employed physicians: 171
Worked RVUs for employed physicians: 182,154
Active medical staff (independent and employed): 575
Hospital margins by credit rating group
Source: Fitch Ratings, "2013 Median Ratios for Nonprofit Hospitals and Healthcare Systems" Report, August 2013.
Median
Operating margin: 3 percent
Operating EBITDA margin: 10.3 percent
Excess margin: 4.6 percent
EBITDA margin: 11.6 percent
"AA" rating
Operating margin: 4.2 percent
Operating EBITDA margin: 11.8 percent
Excess margin: 6.6 percent
EBITDA margin: 13.6 percent
"A" rating
Operating margin: 3.3 percent
Operating EBITDA margin: 10.7 percent
Excess margin: 4.7 percent
EBITDA margin: 11.8 percent
"BBB" rating
Operating margin: 1.8 percent
Operating EBITDA margin: 9 percent
Excess margin: 3.2 percent
EBITDA margin: 10.4 percent
Below "BBB" rating, or non-investment grade
Operating margin: -1.3 percent
Operating EBITDA margin: 6 percent
Excess margin: 0 percent
EBITDA margin: 7.4 percent
Charity care
Source: American Hospital Association, "Schedule H Project Benchmark" Report, April 2013.
Charity care includes total unreimbursed means-tested government programs and other benefits.
Total charity care as an average percent of total expense
Small hospitals (less than $100 million in total expenses): 7.3 percent
Medium hospitals ($100 million to $299 million in total expenses): 7.5 percent
Large hospitals ($300 million or more in total expenses): 9.2 percent
Systems (more than one licensed hospital): 8.1 percent
General medical/surgical hospital: 7.7 percent
Teaching hospital: 9.7 percent
Critical access hospital: 8.1 percent
Children's hospital: 12.6 percent
Urban/suburban hospital: 8.2 percent
Rural hospital: 7.2 percent
Total benefits to the community
Small hospitals: 11.1 percent
Medium hospitals: 10.8 percent
Large hospitals: 12.2 percent
Systems: 11.6 percent
General medical/surgical hospital: 11.3 percent
Teaching hospital: 12 percent
Critical access hospital: 9.7 percent
Children's hospital: 15 percent
Urban/suburban hospital: 11.7 percent
Rural hospital: 10.5 percent