Charles Ornstein
By Charles Ornstein, ProPublica
Charles.ornstein@propublica.org
California journalists are lucky to have the Office of Statewide Health Planning and Development. Despite its bureaucratic and jargony name, it is a terrific resource for facts and figures about health care (particularly hospital care) in the state. A look through its website (www.oshpd.ca.gov) can help you discover which hospitals in your community are most profitable, how much they charge for specific procedures, which perform the most C-sections and which are at the greatest risk of collapsing in powerful earthquakes. OSHPD keeps track of data from every region of California–the most urban and most rural.
Other states have similar health data warehouses. Texas has the Center for Health Statistics (http://www.dshs.state.tx.us/chs/hosp/), Pennsylvania has the Pennsylvania Health Care Cost Containment Council (http://www.phc4.org).
This tipsheet will focus on the hospital financial data on OSHPD’s website and provide tips on how best to use the information. A tipsheet on using the utilization data can be found on AHCJ’s website at: https://healthjournalism.org/resources-tips-details.php?id=483.
To get started, go to the site (www.oshpd.ca.gov), click on Data & Reports in the top line, and then click on Hospitals. The direct link to the page is http://www.oshpd.ca.gov/HID/DataFlow/HospMain.html. A flow chart will appear. (See above)
Hospital finances: All hospitals are required to submit a huge amount of information to OSHPD about their finances. For this reason, the data on hospital finances are OSHPD’s strong suit. From the main hospitals page, click on the Financial box or go directly to http://oshpd.ca.gov/HID/DataFlow/HospFinancial.html (see image on next page).
It is easiest to access each hospital’s financial information through what OSHPD calls a pivot table, essentially an Excel file that customizes reports based on what’s important to you. Click on Annual Financial Data Pivot Profiles. (The page gives you instructions on how to download and open the file.)
Each file contains five worksheets: profile, charts, pivot, data and glossary. You can download the current year’s file or files from previous years. Open the spreadsheet and you’ll see a worksheet with pull down menus (similar to the one below).
Before you do anything else, save a clean copy of the spreadsheet. This is good practice whenever you’re working with data.
Take a look around. Examine the choices in each dropdown menu.
Pick any hospital. Then, click on the profile tab at the bottom of the page.
You’ll find a ton of information, neatly organized and grouped. At the top is information about number of beds, patient days, discharges and average length of stay. Below that are stats about income. In the middle of the page are utilization statistics (i.e. ER vistis, clinic visits, surgeries, natural births, C-sections). You’ll find revenue by payer and also expenses by type.
This data can seem overwhelming, but a couple things to keep in mind:
-
You can select multiple hospitals through the pivot table, not just by name but by a variety of characteristics: for instance all the ones in a particular county, all the hospitals in a particular health system or all the teaching hospitals in the state. The profile page will automatically combine or average each data item.
-
This is a one year (fiscal year) snapshot. You’ll want to look at previous years’ data to spot trends. Is the hospital more or less profitable than in the past? Is the hospital providing less charity care than it once did? These are only questions that you can answer by looking at past pivot tables.
-
Within the file you can find data on every hospital in the state. For that, click on the Data tab at the bottom of the page. And there’s a handy explanation of what each column is online too.
-
Say I am interested in the profitability of Santa Clara County hospitals, I’d filter my data to only show hospitals in the county. Then, I’d look in Column DQ (Net operating revenue, shown as NET_FRM_OP). You’ll see that Stanford had the largest operating profit in its fiscal 2009 (more than $168 million) while Santa Clara Valley Medical Center had the biggest operating loss (more than $141 million.) Can anyone help explain this? Column DW is total net income, including investments and other sources of revenues. In some cases, the figures are quite different. You must consider both.
-
When you look at reports from multiple years, I’d recommend that you can go to the Data tab, copy the rows about your hospital and paste them into a new spreadsheet so you can more easily see the trends over time. (You need to make certain that the header rows are the same from year to year!) -
I would not use the financial pivot profiles to compare use of services at hospitals (ER visits, births, etc.) I find the utilization pivot profiles (discussed in another tip sheet) to be more accurate.
The glossary on the last tab is very helpful, as is the one linked above.
If you are interested in analyzing the data, perhaps by adding columns for calculations, OSHPD offers another spreadsheet with even more information: http://oshpd.ca.gov/HID/Products/Hospitals/AnnFinanData/SubSets/SelectedData/default.asp. You have the option of selecting by calendar year or hospital fiscal year. Calendar year allows you to compare one hospital to another, while fiscal year allows for easier discussions with hospital officials (because this is how they keep their own data.) Be sure to download and read the documentation. It explains the column headers and provides other information on the columns. The complete data set can be downloaded, as well (it’s huge) at: http://oshpd.ca.gov/HID/Products/Hospitals/AnnFinanData/CmplteDataSet/index.asp.
Finally, you can access the original reports submitted by each hospital in PDF format by going here: http://www.oshpd.ca.gov/hid/Products/Hospitals/AnnFinanData/DsclsureRpts/index.html. You can get more current financial information than is in the annual financial tables from the quarterly financial data, which is updated four times a year. That’s available here: http://www.oshpd.ca.gov/hid/Products/Hospitals/QuatrlyFinanData/ProfleCharactrstcs/index.html.
OSHPD offers some overall statistics on the financial health of California hospitals here: http://www.oshpd.ca.gov/HID/Products/Hospitals/AnnFinanData/HospFinanTrends/index.html.
Exercise
Look up hospitals in the counties you cover. Determine which was most profitable and which was least profitable. Look at both operating income and net income. For extra credit, compare the hospitals’ performance to their performance in previous years.
Last but not least, here is contact information for OSHPD Public Affairs. Feel free to tell him I sent you!
David Byrnes
dbyrnes@oshpd.ca.gov
(916) 326-3606
