Types of Ambulatory Surgery and Other Outpatient Services Collected by the Partner

The Alaska Department of Health and Social Services collects data on ambulatory surgery and other outpatient services such as outpatient clinic and emergency department visits. Alaska uses the following hierarchy to identify each outpatient record with a patient type of:

• Emergency room (value 1)
• Outpatient surgery/ASC Patients (value 2)
• Observation only (value 3)
• Other outpatient (value 4)

Outpatient Data File Provided to HCUP by the Partner

Alaska provides HCUP with a combined outpatient file, which includes encounter-level data for ambulatory surgery and other outpatient services (patient type 2 or 4), observation services (encounter type 3), and emergency room services (encounter type 1).

Selection of Records for Inclusion in the SASD

All records identified by the Partner as ambulatory surgery are included in the SASD (STATE_AS=1 based on patient type). Any other nonemergent outpatient services (STATE_ED not equal to 1) also are included in the SASD.

Additionally, any record in the SASD that also have evidence of ED services based on the HCUP criteria (HCUP data element HCUP_ED > 0), are also included in the HCUP State Emergency Department Databases (SEDD). These records will have the same value for the HCUP data element KEY.

Types of Facilities Included in the Files Provided to HCUP by the Partner

Alaska collects data on ambulatory surgery and other outpatient services performed in hospital-owned and nonhospital-owned facilities.

About half the facilities provided by the Partner were not in the American Hospital Association (AHA) Annual Survey. These facilities are mostly nonhospital-owned surgery centers. There are a few laser institutes, endoscopy centers, pain centers, and imaging centers.

Identification of Hospital-Owned Ambulatory Surgery and Other Types of Outpatient Facilities in the SASD

The designation of a facility as hospital-owned is specific to its financial relationship with a hospital that provides inpatient care and not related to its physical location. Hospital-owned ambulatory surgery and other outpatient care facilities may be contained within the hospital, physically attached to the hospital, or located in a different geographic area. The designation as hospital-owned means that HCUP can identify that the hospital is billing for this service.

The HCUP data element HOSPITAL_OWNED can be used to identify hospital-owned facilities with ambulatory surgery and possibly other outpatient care data in the SASD. A facility is considered hospital-owned (HOSPITAL_OWNED = 1) if any one of the following is true:

• The facility is listed in the American Hospital Association (AHA) Annual Survey Database.
• The facility is not listed in the AHA database, but the facility provides inpatient discharge data to HCUP.
• Documentation provided by the data source clearly indicates that the facility is hospital-owned. If the facility in the SASD does not meet any of the above criteria, it is marked as not being owned by a hospital (HOSPITAL_OWNED = 0). Not all hospitals report to the AHA, so there is a possibility that some facilities marked with HOSPITAL_OWNED=0 are hospital-owned.

Exclusion of Records During HCUP Data Processing

Records with a discharge disposition of "still a patient" are excluded in the HCUP SASD.

Records with a designation of "admitted as an inpatient" are retained in the SASD, although this rarely occurs.