Concept: Hospital Service Codes

Introduction

This concept identifies service codes that appear in hospital discharge abstracts as well as related notes that are relevant for programmers.

Service codes identify the hospital service to which patients are admitted. PSVC1 is the service designated on admission. PSVC1-PSVC6 are used to record a transfer in service or subservice during one hospitalization. The first two positions are mandatory.

If a patient transfers between services in the course of an admission, primary service code PRIMPSVC refers to the service on which the patient was treated for the greatest length of time, which is not necessarily the first service on admission.

Codes must correspond to the Patient Service codes in Appendix E of the Hospital Abstracts Users Manual (HAUM).

Sub-service codes are reserved for the latter two characters, and must be added to the main service code where applicable.

Disclaimer: Service codes should be used with caution because the way in which they are applied or defined may differ between hospitals. Two possible approaches to deal with this:


1. speak with personnel from each hospital to clarify their definition of the codes, or
   
2. use two methods to identify patients - e.g. check correspondence between service and diagnostic codes.

Abstracting Systems Comparison - Identifying Patient Services

1. for Fiscal Year 2000/2001
   
   
2. for Fiscal Years 1998/99 and 1999/2000

Programmer's Notes

Patients in Medical Units:

The following codes were used for patients staying in medical units.

- Family medicine (01)
- Palliative Care (05)
- Internal Medicine (10)
- Allergy (11)
- Cardiology (12)
- Dermatology (13)
- Endocrinology (14)
- Gastroenterology (15)
- Neurology (17)
- Respirology (18)
- Rheumatology (19)
- Oncology (59)
- Hematology (66)

Source: Bruce, S. et al. (2001)


ICU Code:

The macro used to determine days in ICU looks for PSVC codes ending in '90'. If there are other ICU codes that do not end in '90' then the macro will not pick them up (e.g. some neonates are dropped).

Source: Programmer's Meeting, April 19, 2000
See concept: Intensive Care Unit (ICU) Days


Mental Health Disorders:

Service codes in the range of '6400'- '6599' were defined as psychiatric services. All other services were defined as 'non-psychiatric'.

Source: Tataryn, D. et al. (1994)
See concept: Mental Health Disorder / Illness Classification


Physician Visits - from ambulatory care claims.

Visits with diagnosis codes from 290-319 were used.


Acute versus Long-Term Inpatients - in the general hospital sector

All admissions to acute care hospitals where primary service code was between '0900' and '0999' or '7300' and '7399' were classified as long-term admissions. All others were defined as acute admissions.


Chronic vs. Acute care

The following codes were used to define chronic care:

09 - personal care unit
70 - physical medicine and rehabilitation
72 - geriatrics
73 - long term care

along with sub-service codes:

99 - paneled for PCH
97 - chronic - this was picked up with the first 2 digits of 70, 72, 73 in a subset of data.


NOTE: There are 6 services codes ( PSVC1-6 ) and PRIMPSVC that denote the service code with longest stay within the same admission. If a patient transfers between services in the course of an admission, PRIMPSVC refers to the service on which the patient was treated for the greatest length of time, which is not necessarily the first service on admission.

Source: Programmer's Meeting Sept. 1, 1993
Hospital Abstract Users Manual


Inpatient care

Two choices:



1. ADSTAT 1-3 - captures only Manitoba hospital inpatients
   
   
2. TRANSACT=1 - includes all ADSTAT 1-3, brain death, and out-of-province or non-budget hospitals.


Note: in 91-92 hospital claims (N=289 403) there were 5 brain deaths and 4,196 out-of-province or non-budget hospitals.

Source: Programmer's Meeting Sept. 1, 1993