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

Beginning with data year 2016, the Oregon Association of Hospitals and Health Systems (OAHHS) supplies separate ambulatory surgery (AS) and emergency department (ED) source files to HCUP. Prior to data year 2016, the Office for Oregon Health Policy & Research supplied AS source files to HCUP, while OAHHS supplied ED source files (for data year 2015). Both OAHS and the Office for Oregon Health Policy & Research define ambulatory surgery as having a revenue center code of 036x, 0481x, 049x, 0511, 0723, 075x, or 079x.

The following hierarchy was used by both organizations to identify each outpatient record with a place of service:

• Outpatient surgery (value 1)
• Emergency room (value 2)
• Observation (value 3)
• Therapies (value 4)
• Outpatient (Lab/radiology) only (value 5)
• Other outpatient (value 6)

Because of the hierarchical assignment for the place of service, an outpatient surgery record that also includes evidence of observation services (OS) will only be flagged as outpatient surgery. However, outpatient surgery records with evidence of observation services can be identified by HCUP data element HCUP_OS.

Outpatient Data File Provided to HCUP by the Partner

Beginning with data year 2016, OAHHS provides separate ED and AS source files to HCUP. Prior to data year 2016, the Office for Oregon Health Policy & Research provided HCUP with their complete ambulatory surgery file.

Selection of Records for Inclusion in the SASD

All records identified by Oregon as ambulatory surgery (AS) (i.e., included in the separate AS data file provided to HCUP) are included in the SASD (HCUP data element STATE_AS=1 based on place of service value 1).

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

Starting with data year 2015, reporting is limited to ambulatory surgeries performed in hospital-owned facilities. Information from ambulatory surgery facilities that are not owned by a hospital is not collected.

Prior to data year 2015, all facilities licensed in Oregon to perform ambulatory surgery were required to submit data on surgical or diagnostic procedure treatment in a hospital outpatient setting or an ambulatory surgical facility setting. A hospital was defined as a facility that was licensed under Oregon Revised Statue (ORS) 441.015 to provide diagnosis and medical or surgical treatment and that had (1) an organized medical staff, (2) permanent facilities that include inpatient beds, (3) medical services, including physician services and continuous nursing services under the supervision of registered nurses. An ambulatory surgical facility was defined as a facility that was licensed under ORS 441.015 to perform outpatient surgery not routinely or customarily performed in a physician or dental office.

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.

Starting in data year 2018, 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^TM.
• 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.

From data year 1998-2018, the HCUP data element was called FREESTANDING. A facility is considered hospital-owned (FREESTANDING = 0) if any one of the following is true:

• The facility is listed in the American Hospital Association (AHA) Annual Survey Database^TM.
• 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 (FREESTANDING = 1). Not all hospitals report to the AHA, so there is a possibility that some facilities marked with FREESTANDING=1 are hospital-owned.

Exclusion of Records During HCUP Processing

Beginning with 2016 data, records with a discharge disposition of "still a patient" are retained in the HCUP SASD. Prior to 2016 data, these records were excluded.

Beginning in 2010, records with a designation of "admitted as an inpatient" are retained in the SASD, even though this rarely occurs. Prior to 2010, records with a designation of "admitted as an inpatient" were excluded from the files.