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How the Tribune-Review's readmissions probe worked

| Sunday, March 6, 2011, 11:20 a.m.

The Tribune-Review analyzed data on readmissions for complication or infection within 30 days that hospitals reported to the Pennsylvania Health Care Cost Containment Council. The data cover the federal fiscal year 2009 (Oct. 1, 2008, to Sept. 30, 2009).

Readmissions: The council provided the number of actual readmissions because of complication or infection for 29 conditions. To reach the total number of readmissions for each hospital, the Trib totaled the number of readmissions for each condition.

Expected readmissions: The council calculates the number of readmissions that might be expected for each of the conditions. When a hospital had fewer than five cases for any condition, the council did not calculate an expected number of readmissions. To reach the total number of expected readmissions, the Trib totaled the expected number of readmissions for each condition. When the council did not calculate an expected number, the Trib counted that as zero expected readmissions.

Charge: Hospitals report charges, but the council notes the figures might not reflect the actual amount of money a hospital receives. Typically, hospitals receive less than the charge amount. Government programs such as Medicare and Medicaid pay set amounts for services, but private insurers can negotiate reimbursement rates that are lower than charges. Hospitals and insurers are not required to disclose actual costs or reimbursements.

For more information: The technical notes included in the council's Hospital Performance Report 2009 explain how the council derives estimates, why it excludes some cases, and how it trims and adjusts charge information. The report is available here .

To read the Trib's "Code Green: Bleeding Dollars" series on waste in national health care costs, click here .

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