Description
This report creates the L3 statistics (occupancy data of the departmentor OU-related occupancy statistics) required by the Federal Regulationfor Hospitals (Bundespflegesatzverordnung) 1995 in the country versionGermany.

Precondition
INCLUDE ISH_STAT_SELEKTIONSBILD OBJECT DOKU ID TX
INCLUDE ISH_STAT_FALLPROTOKOLL OBJECT DOKU ID TX
The case log in the L3 statistics is available for the rows Daysnot covered by flat rate per case, Days covered by flat ratesper case, Admissions, and Discharges. Note that caselogging is only possible for the complete figures. For this reason, youmust not flag the option Totals sheet when evaluating a singlespeciality/organizational unit to be able to call the case log for thisone specialty/organizational unit.
INCLUDE ISH_STAT_STATISTIKSPERRE OBJECT DOKU ID TX
You can execute the statistics program in three different variants:

• For specialties (actually L3 statistics according to BPflV 1995 LKA)

The figures are output according to specialty. If you want to executethe evaluation only for particular specialties, specify theseaccordingly.

• For departmental OUs

The figures are output according to organizational units assigned on anursing basis. The figures are additionally extrapolated and output forthe higher-level organizational units in the organizational hierarchy.If you want to execute the evaluation only for particularorganizational units, specify these accordingly.

• For nursings OUs

The figures are output according to organizational units assigned on anursing basis. The figures are additionally extrapolated and output forthe higher-level organizational units in the organizational hierarchy.This means that the nursing evaluation contains the figures from thedepartmental evaluation. If you want to execute the evaluation only forparticulare organizational units, specify these accordingly. This alsoapplies for departmental organizational units, if the figures are to beextrapolated for them.
INCLUDE ISH_STAT_FALLNUMMERN OBJECT DOKU ID TX
INCLUDE ISH_STAT_AUSLANDSFAELLE OBJECT DOKU ID TX
By means of the flag
Display intensive care stays for transferring specialty/OU, you
can control how the program is to handle figures from intensive care.
For further information about this, see the
documentation on the field in question.
If, when the maximum length of stay is reached, the system is to counta discharge from the flat rate per case area and an admission in the"budget" area, flag the option Count case when maximum LOS reached
. Read the documentation on this option.
If you want the program to evaluate only the last departmental stay,orstay in an organizational unit of one day, flag the option Includeonly last stay of day. Read the documen
tation on this option.
To optimize the readability of the statistics, you can output thefigures for each specialty/organizational unit on a separate page. Todo this, flag the option New page on change of specialty/OU.
If you want to output the figures of the specialty-related statisticsin the separate column labeled Actual figures, flag the optionOutput figures in separate column. Read thedocumentation on this option. This flag iswithout effect in the OU-related evaluation.
If a totals sheet is to be output at the end of the statistics, flagthe option Totals sheet. Read the documentation on this option.
INCLUDE ISH_STAT_5AENDVO OBJECT DOKU ID TX

Companion and Newborn
INCLUDE ISH_STAT_NEUGEB_BEGLPERSONEN OBJECT DOKU ID TX LANGUAGE EN

Billing Days and Days Covered by Flat Rate per Case
The billing days in the "budget" area and the days covered by flat ratein the flat rate per case area are determined on the basis of theservice intervals rather than movements. This information is importantsince other statistics in IS-H (midnight census and patient censusstatistics of the old BPflV) determine the billing days on the basis ofthe movement intervals. This rules out any comparison with the billingdays of the "old" statistics.
Days covered by flat rate per case are not determined for day patientcases before IS-H Release 4.01A. As of Release 4.01A, days covered byflat rate per case are output for day hospital cases, if theoption Day hospital is flagged in the corresponding admissiontype.

Figures of an Intensive Care Specialty or Organizational Unit
The program handles the figures of an intensive care specialty ororganizational unit as follows:
In relation to the setting of the option
Display intensive care stays for transferring specialty/OU
If the option is flagged:
The figures of intensive care medicine are not output for the instensive
specialty or organizational unit, but are allocated to other
specialties/organizational units. Two scenarios are possible in such
cases:
During its stay, a case is transferred to an intensive care specialty or
an intensive care organizational unit - the figures of the intensive
care stay are counted for the specialty/organizational unit, from which
the case was transferred.
A case is directly admitted to an instensive care specialty or
organizational unit - the figures of the intensive care stay are
counted for the specialty/organizational unit, to which a subsequent
transfer is made; if the case is not transferred again before being
discharged, the figures are counted in the rows Not assigned to a
specialty or Not assigned to an organizational unit.
The option is not flagged
The figures of intensive care medicine are directly output for thespecialty/organizational unit Intensive care medicine. Note thatthe specialty/organizational unit with beds only counts one caseif the patient is transferred back into the same specialty/organizational unit with beds from which the case was transferred intointensive care medicine.
The figures of intensive care medicine are not transferred to thespecialty/organizational unit with beds (see second ordinance forchanges to the Federal Regulation for Hospitals, Article 1, Section 1,Point 12c, August 95).

Output
The output from the specialty-related evaluation corresponds to theform of the BPflV 1995 - L3 Statistics according to the Service andPricing Listing (Leistungs- und Kalkulationsaufstellung (LKA)).
The column Agreement for the current nursing charge period isnot filled in the first year. In the subsequent years, you have toenter the figures from the column Agreement of the LKA of theprevious year here.
The figures of the rows for the evaluation period or for the comparisonperiod are output in the column Request for the nursing chargeperiod, if you haven't flagged the option Output figures inseparate column. If you have flagged this option, the figures areoutput in the column labeled Actual figures.
The column Agreement for the nursing charge period is not filledby the hospital.
In the OU-related evaluation, the figures are not output in accordancewith the LKA form, but without a heading and to the right of therelevant row text.
The following rows are output:


• Planned beds w/o intensive care

The planned beds are determined from the specifications made for thestatistical bed figures (Hospital -> Basic data administration ->Hospital structure -> Organizational structure -> Statistical beds,field Total planned beds. Note here that the bed figures mustalways be specified for the organizational units located at the lowestlevel in the hierarchy only. The bed figures are extrapolated fororganizational units located higher up in the hierarchy, however onlyas far as the highest organizational unit that has departmentalassignment authority. If you specify bed figures for an organizationalunit located higher up in the hierarchy, the figures of theorganizational units below it will be ignored completely.
INCLUDE ISH_STAT_BETTENZAHLEN_FACHR OBJECT DOKU ID TX LANGUAGE EN

• Planned beds with intensive care

Two scenarios are possible here:
The figures for intensive care medicine are re-assigned to the
transferring specialty/organizational unit. In such cases, the intensive
care beds are also determined using the re-assignment of the planned
beds of an intensive care specialty/organizational unit in relation to
the billing days and days covered by flat rate per case re-assigned from
intensive care to the transferring specialty/organizational unit.The
intensive care beds determined in this way are added to the number in
the row Planned beds w/o intensive care, and output as
Planned beds with intensive care.
The figures for intensive care medicine are directly output in the
specialty/organizational unit Intensive medicine. In this case,
the intensive care beds are also directly output in the
specialty/organizational unit Intensive medicine.
In this scenario, the number of planned beds with and without intensive
care in all specialties/organizational units except for intensive care
medicine is the same. Intensive care medicine only displays planned beds
with intensive care; the row Planned beds w/o intensive care is
empty.
The number of planned beds without intensive care plus thenumber of intensive care beds is output in this row. An intensive carebed is a planned bed within the statistical bed figures (Hospital

-> Basic data administration -> Hospital structure -> Organizationalstructure -> Statistical beds, field Total planned beds) thatis assigned to a departmental or nursing organizational unit or to aspecialty flagged as providing intensive care.

• Rate of use of planned beds

The rate of use results from dividing the sum of the billing days inthe budget area and the days covered by a flat rate per case by theproduct of the planned bed figures with intensive care and the numberof days in the evaluation period or in the comparison period.
BD in budget area + days covered by FR
-------------------------------------------------
Planned beds with intensive care x number of days

• BD in budget area

Billing days are determined in accordance with §14 Sections 2 and 7BPflV 1995.
Two attributes of a case are relevant for outputting the billing days:The length of stay in the specialty/organizational unit and the serviceintervals. The length of stay, which is defined via the inpatientmovements of a case, decides whether billing days will be determinedfor a caes. The stay in a specialty/organizational unit must occurcompletely or partially within the evaluation period or comparisonperiod. The actual calculation is based on the service intervals,whereby only services of the charge type general nursing charge (10
), departmental per diem (12 and 13), and day
patient nursing charge(14) are considered. Only the billing daysthat occur within the evaluation period or the comparison period areoutput.
including BD for patients with PS
This row indicates the number of billing days for which a surgicalprocedures surcharge or a general procedures surcharge (20 and21) gives rise to a discount on the departmental per diemcharge.
including BD for day patients
This row indicates the number of billing days that is calculated forday patients.

• Length of stay

The length of stay results from dividing the inpatient billing days inthe budget area by the inpatient case figures.
BD in budget area - BD for day patients
------------------------------------------------
Impatient cases

• Days covered by flat rate per case

Days covered by flat rate per case are determined in the same manner asbilling days with the exception that the maximum length of stayrelating to services of the charge type flat rate per case (30)is used instead of the service validity. When the maximum length ofstay covered by a flat rate per case is reached, the period as of thisdate is transferred to the row BD in Budget Area only if theperiod id covered by a general nursing charge(
10), a departmental per diem (12 and 13) or aday-patient nursing charge (14).

• Admissions

All patients that were admitted for inpatient treatment includinginternal transfers from other departments/organizaional units aretreated as admissions. If a flat rate per case patient reaches themaximum length of stay (MLS), an admission (in the budget area) is onlycounted if you select the option to include the case if the MLS isreached. Read the field documentation. Day-patient admissions are notcounted here.

• Discharges

All departures of patients discharged after an inpatient stay,transferred to another hospital or to an other department/OU or who diein hospital are considered discharges. If a flat rate per case patientreaches the MLS, a discharge (from the flat rate per case area) is onlycounted if you select the option to include the case if the MLS isreached. Refer to the field documentation. Day-patient discharges arenot counted here.
Including: External Transfers
The number of external transfers included as discharges is displayedseparately here. This refers to discharges of discharge typeDischarge to external hospital.

• Cases with Pre-Admission Treatment

This refers to the number of cases that were not admitted as inpatientsdespite pre-admission treatment. In IS-H, this includes outpatientcases or inpatient cases with planned admission and at least one visitor visit type Pre-admission treatment. Cases are also includedin this row that were admitted as inpatients following the evaluationperiod for statistics but with pre-admission visits during this period(e.g. visits at the end of one year and inpatient admission in the newyear). The case is added to the specialty/OU to which the visits areassigned.

• Inpatient Cases in Budget Area

The number of inpatient cases is determined as follows:
Admissions + Discharges + Internal Transfers to/from
-----------------------------------------------------
2
Admissions and discharges (within the MLS) of flat rate per casepatients are not taken into account here. Admissions, when a flat rateper case patient reaches the maximum length of stay (MLS), are includedin these rows.
Including: Short-Stay Patients
Short-stay patients are patients that stay up to and including 3billing days in the specialty/OU. The billing days within theevaluation period are not relevant here but the billing days of theentire stay in the specialty or OU. Note that each stay in a specialtyor OU is counted separately, i.e. several stays in the same specialtyor OU are only combined if they are not separated by a stay in anotherspecialty or OU. This is because this row is a sub-total of theInpatient cases in budget area row, in which several separatestays in one specialty/OU are counted as several internal transfers.
Including: With Pre-Admission Treatment
The number of inpatient cases with pre-admission treatment is shownseparately here. If a patient is transferred internally, thepre-admission treatment is assigned to the first admittingspecialty/OU. In IS-H, pre-admission treatment is defined as aninpatient case with at least one visit with the visit typepre-admission treatment.
Including: Post-Discharge Treatment
The number of inpatient cases with post-discharge treatment is shownseparately here. If a patient is transferred internally, thepost-discharge treatment is assigned to the last dischargingspecialty/OU. In IS-H, post-discharge treatment is defined as aninpatient case with at least one visit with the visit typepost-discharge treatment.
Including: Day-Patient Treatment (5th Ammendment)
The number of inpatient cases with additional day-patient treatment isshown separately here. The day-patient treatment is assigned to eachstay in a specialty/OU. In IS-H, additional day-patient treatment isdefined as an inpatient case with a case to case assignment maintainedfor a day-patient case with the internal role 6 (parallelday-patient case).

• Day-Patient Cases in Budget Area

The number of day-patient cases is determined as follows:
Day-patient adm. + day-patient discharge. + internal trans. to/from
--------------------------------------------------------------------
2
Day-patient admission and discharge refers here to a day-patient staywhich crosses into a new quarter, where the discharge is counted as theend of the quarter (e.g. 06/30) and the admission as the beginning ofthe quarter (e.g. 07/01). The number of cases is assigned to theassignment valid at the end of the quarter.
Day-patient cases that are assigned to an inpatient case via acase-to-case assignment with the internal role 6 (parallelday-patient case) are not counted here.

• Cases with Flat Rates per Case

The number of cases with flat rate per case patients is determined asfollows:
Admissions + discharges + internal transfers to/from
-----------------------------------------------------
2
Only admissions, discharges (within the MLS) and transfers of flat rateper case patients are counted here. (Patients with a service withcharge type 30 flat rate per case). Discharges when the flatrate per case patient reaches the maximum length of stay are includedhere.
Including: Exceeding MLS (5th Ammendment)
If a patient reaches the maximum length of stay, a case is countedhere. From the day of MLS on, the billing days are also counted in theBD in budget area row, but there is no additional budget case.
INCLUDE ISH_STAT_PROTOKOLL OBJECT DOKU ID TX LANGUAGE EN