The Ask the Analyst series is a deep dive into the data by those most familiar with the CO APCD – the analysts themselves. We’ll hear about their experiences with recent analyses and answer any pressing questions that come up. Have a question for the CIVHC Analyst Team? Email it to info@civhc.org.
Analyst Name: Tim Ginader, MS
Featured Project: Emergency Department Visits Prior to Labor and Delivery
The purpose of this project was to get a better idea of the number of women that were charged an emergency room fee when they received labor and delivery care at a hospital.
What were your first steps when beginning this analysis?
The first step was to define the parameters of the project. For example, I needed to clarify what codes to use to identify a labor and delivery claim and what codes to use to identify claims related emergency department (ED) visits. Then I needed to determine how an ED claim could be matched to a labor and delivery claim.
Were there specific considerations you needed to consider based on the data?
Yes. We found early on in the analysis that ED charges rarely appeared on the same claim as labor and delivery charges. Therefore, it became necessary to define the methodology accordingly.
What challenges did you encounter while performing the analysis? How did you overcome them?
Since the ED charges did not appear on the same claim as the labor and delivery, it was important to define a methodology to be able to match ED claims to corresponding labor and delivery claims. With the information on the claims, it was impossible to know with certainty whether an ED claim for a patient was related to her pregnancy. However, we felt that the methodology we designed, matching ED claims to labor and delivery claims based on member ID and admission date, assured that these claims were most likely related.
Without delving into results, did anything surprise you about this analysis or the process of executing it?
I was surprised at the number of matches we found for patients who had an emergency department claim with the same date of service as the date of their admission to the hospital for labor and delivery.
What did you learn while performing this analysis?
I learned that defining a methodology and creating a framework for the analysis before even touching the data is very important. Having a defined methodology to begin makes pulling and analyzing the data much more efficient.