Facility Patient Flow: Where Did Patients Come From, How Long Did They Stay, Where Did They Go and Why Were They There?

Statewide, a majority of facility patients were admitted from a home/non-healthcare setting (71.7 percent) and had a routine discharge (66.8 percent).

Why Publish Facility Patient Flow Information?#

The Facility Patient Flow visualization shows the numbers and percentages of where facility patients come from (based on the patient point of origin), where they go (based on the patient disposition), and the median length of stay by facility for 2022. For a given facility, hovering over each patient point of origin category or disposition category will display the top five inpatient diagnosis groups based on Major Diagnosis Categories (MDC) for that category in the tooltip. Each MDC corresponds to a major organ system (e.g., Respiratory System, Circulatory System, Digestive System) rather than a specific disease (e.g., cancer, sepsis).

The arrows in the visualization compare the 2022 percentages to the 2021 percentages for each of the point of origin and disposition categories. The blue up arrows represent an increase in percentage from 2021 to 2022, orange down arrows represent a decrease in percentage from 2021 to 2022, and grey equal signs represent equal percentages in 2021 and 2022. Hovering over the arrows or equal signs will display the 2021 numbers and percentages. Hovering over the Overall Median Length of Stay will display the Median Length of Stay by Type of Care in the tooltip.

Key Findings#

• 11.2 percent of statewide admissions were newborns. 
• Statewide, Acute Care patients had the shortest median length of stay (3 days), while Skilled Nursing/Intermediate Care patients had the longest median length of stay (15 days).
• Diseases & Disorders of the Circulatory System was the most common diagnosis for patients who were transferred to a short-term hospital and Diseases & Disorders of the Circulatory System was the most common diagnosis for patients who left against medical advice.

*Note: SNF refers to Skilled Nursing Facility, ICF to Intermediate Care Facility, and IRF to Inpatient Rehabilitation Facility.

How HCAI Created This Product#

The Facility Patient Flow: Where Did Patients Come From, How Long Did They Stay, Where Did They Go and Why Where They There? visualization is based on point of origin, length of stay, disposition and diagnosis data reported to HCAI by each facility in California in the 2022 Patient Discharge Data. To assure that patient identity is protected, newborn categories with less than 11 encounters were removed. In addition, the top five Major Diagnosis Categories (MDC) lists have been removed for the newborn category and any category with less than 11 encounters. The list of MDCs can be found on HCAI’s Data Documentation page. 

Methods for Creating Point of Origin Categories & Disposition Categories#

Both the patient type of admission and point of origin were used to identify from where the patient came, and the patient disposition was used to identify where the patient went after discharge.

Point of Origin Category	Source of Admission(s) included
Newborns	Admission Type = Newborn
From Home/Non-Health Care Setting	Point of Origin = Non-Healthcare Facility
	Point of Origin = Court/Law Enforcement
From Hospital or Surgical Setting	Point of Origin = Clinic or Physician’s Office
	Point of Origin = Hospital (Different Facility)
	Point of Origin = Ambulatory Surgery Center
From Other Healthcare Settings	Point of Origin = Skilled Nursing Facility (SNF), Intermediate Care Facility (ICF), or Inpatient Rehabilitation Facility (IRF)
	Point of Origin = Another Health Care Facility
	Point of Origin = One Distinct Unit to another Distinct Unit of the Same Hospital
	Point of Origin = Hospice

Disposition Categories	Disposition(s) Included
Routine Discharge	Disposition = Discharged to home or self care
	Disposition = Discharged/transferred to court/law enforcement
Transferred to a Short-term Hospital	Disposition = Discharged/transferred to a short-term general hospital for inpatient care
Transferred to Other Type of Facility (Including Skilled Nursing Facility (SNF), Intermediate Care Facility (ICF), and Inpatient Rehabilitation Facility (IRF))	Disposition = Discharged/transferred to skilled nursing facility (SNF) with Medicare certification in anticipation of skilled care
	Disposition = Discharged/transferred to a facility that provides custodial or supportive care (includes Intermediate Care Facility)
	Disposition = Discharged/transferred to an inpatient rehabilitation facility (IRF) including a rehabilitation distinct part unit of a hospital
Discharged to Home Health Care (HHC)	Disposition = Discharged/transferred to home under care of an organized home health service organization in anticipation of covered skilled care
Left Against Medical Advice (AMA)	Disposition = Left against medical advice or discontinued care of an organized home health service organization in anticipation of covered skilled care
Inpatient Deaths	Disposition = Expired

Additional Information#

Topic: Healthcare Utilization
Source Link: Healthcare Utilization – Patient-Level Administrative Data
Citation: HCAI — Patient Discharge Data – Hospital Inpatient – Characteristics by Facility (Pivot Profile), 2021–2022
Temporal Coverage: 2021–2022
Geographic Granularity: Facility
Spatial/Geographic Coverage: Statewide
Frequency: Annual