The 2003 Index of Hospital Quality

2) Volume:
The volume measure reflects total medical and surgical discharges in the
appropriate specialty-specific DRG groupings submitted for CMS reimbursement.
The measure is incorporated into the structure score for all data-driven
specialties other than Geriatrics and Rheumatology.
In the Heart and Heart Surgery specialty, surgical discharges indicated volume
until 2002, when the volume variable was changed to include both medical and
surgical discharges. The methodology now matches the other specialties in this
respect.
Volumes at the extreme for particular hospitals and specialties were trimmed to
eliminate the influence of very wide variation. Figure 4 shows the percentile at
which each of the volume distributions was trimmed.
3) RNs to beds:
A hospital’s number of beds is defined by the AHA as beds set up and staffed at
the end of the reporting period. Only nurses with RN degrees from approved
schools of nursing and currently registered by their state are considered. Nurses
must be full-time (35 hours/week or more), and on staff. Private-duty nurses,
staff nurses whose salary is financed entirely by outside sources (e.g., an agency
or a research grant), and LPNs are not counted. Registered nurses more
appropriately classified in other occupational categories (e.g., supervisory
nurses, facility administrators) are also not counted.
As with volume, RNs to beds ratios were trimmed to eliminate the influence of
very wide variation. Figure 4 shows the percentiles at which each of the RNs to
beds distributions was trimmed.
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