A method to report utilization for quality initiatives in medical facilities

We undertook this project to outline a methodology for quantifying aggregate health care utilization of medical "technologies" that could be rank ordered by volume. The identification of specific high-volume technologies could guide future efforts for quality initiatives such as program planning, preventive services implementation, quality improvement activities, and innovative and cost-effective technology development.

This study utilized a retrospective cross-sectional study design.

We generated combined ranks for the top 200 high-volume procedures from three data sources that incorporated in- and outpatient procedures. Data were collected using primarily ICD-9 and CPT-4 codes; all codes were translated into CPT-4 codes and collapsed into categories using truncated three-digit CPT-4 codes. Frequencies for each collapsed code were determined with each dataset; procedures were reranked based on the mean rank of the three sources.

We itemized the individual procedure codes making up each of the top 20 categories and reported the unique codes making up at least 80% of the procedure code category.

The top five procedure categories identified in this study were patient visits (inpatient and outpatient), chest x-rays, mammograms, ophthalmological services, and electrocardiograms.

The methodology described provides a new way to combine and concisely report on utilization of procedures that is relevant to data obtained from different sources. This methodology may be of potential benefit to health care administrators, technology developers, and other planners as they contemplate ways to identify quality and technology development initiatives that can have a broad impact on populations served by health care organizations.