Dimensional Warehouse Model Data Model

Entity

Entity Institutional Provider Quality Analysis

Description

The analysis of the overall performance of the health plan's institutional providers, including outcomes, care and administrative quality, communications, and innovation in patient care and consumer-driven initiatives. A wide variety of dimensions allows the health plan to easily correlate many different factors to better understand the impact of these factors on performance measures. These insights can then be used to tune the networks, and to develop appropriate provider and provider staff training. Provider performance analysis is also relevant to marketing and sales, which depend on the quality of the plan's providers.

Attributes
Average Length Of Stay
Calendar Dk
Geographic Area Dk
Number Of Admissions
Number Of Awards
Number Of Claims Received
Number Of Claims Received Electronically
Number Of Discharges
Number Of Facilities
Number Of Inpatient Days
Number Of Licensed Beds
Number Of Medical Errors
Number Of Members Treated
Number Of Mortalities
Number Of Mortalities Per 1000 Patients Treated
Number Of Negative Incidents In National Provider Database
Number Of Nurses
Number Of Nurses Per Bed
Number Of Outlier Outcomes
Number Of Patients Readmitted Within 30 Days Of Discharge
Number Of Physicians
Number Of Primary Care Practitioners
Number Of Procedures
Number Of Provider Calls To Payer Help Desk
Number Of Providers
Outlier Percentage
Percentage Of Claims Submitted Electronically
Person Dk
Procedure Code Dk
Provider Dk
Readmission Rate

Relationship
Institutional Provider Quality Analysis_Calendar Dimension_FK
Institutional Provider Quality Analysis_Geographic Area Dimension_FK
Institutional Provider Quality Analysis_Provider Dimension_FK
Institutional Provider Quality Analysis_Procedure Code Dimension_FK
Institutional Provider Quality Analysis_Person Dimension_FK

Primary Key
Institutional Provider Quality Analysis PK

Dependencies
NONE

Reverse Dependencies

Attribute Details

Average Length Of Stay

Description	The average number of days patients stayed in a hospital. Formula: [A/B] (see dependencies and their labels for measures used in the formula)
Data Type	Standards - Data Domains.ddm/Data Domains/Decimal Float [FLOAT(15)]
Is Part Of PrimaryKey	false
Is Required	false
Is Derived	false
Is Surrogate Key	false

Calendar Dk

Description	A numeric surrogate key used to uniquely identify entities in the dimensional model.
Data Type	Standards - Data Domains.ddm/Data Domains/Surrogate Key Large [LONG]
Is Part Of PrimaryKey	true
Is Required	true
Is Derived	false
Is Surrogate Key	false

Geographic Area Dk

Description	A numeric surrogate key used to uniquely identify entities in the dimensional model.
Data Type	Standards - Data Domains.ddm/Data Domains/Surrogate Key Large [LONG]
Is Part Of PrimaryKey	true
Is Required	true
Is Derived	false
Is Surrogate Key	false

Number Of Admissions

Description	The total number of patient admissions.
Data Type	Standards - Data Domains.ddm/Data Domains/Count [INTEGER]
Is Part Of PrimaryKey	false
Is Required	false
Is Derived	false
Is Surrogate Key	false

Number Of Awards

Description	Number of awards or other recognition received by a provider.
Data Type	Standards - Data Domains.ddm/Data Domains/Count [INTEGER]
Is Part Of PrimaryKey	false
Is Required	false
Is Derived	false
Is Surrogate Key	false

Number Of Claims Received

Description	Total the number of claims received from the provider.
Data Type	Standards - Data Domains.ddm/Data Domains/Count [INTEGER]
Is Part Of PrimaryKey	false
Is Required	false
Is Derived	false
Is Surrogate Key	false

Number Of Claims Received Electronically

Description	Number of claims received electronically from the provider.
Data Type	Standards - Data Domains.ddm/Data Domains/Count [INTEGER]
Is Part Of PrimaryKey	false
Is Required	false
Is Derived	false
Is Surrogate Key	false

Number Of Discharges

Description	Number of patients discharged.
Data Type	Standards - Data Domains.ddm/Data Domains/Count [INTEGER]
Is Part Of PrimaryKey	false
Is Required	false
Is Derived	false
Is Surrogate Key	false

Number Of Facilities

Description	The number of facilities owned or managed by the institutional provider.
Data Type	Standards - Data Domains.ddm/Data Domains/Count [INTEGER]
Is Part Of PrimaryKey	false
Is Required	false
Is Derived	false
Is Surrogate Key	false

Number Of Inpatient Days

Description	The number of days patients were in hospital.
Data Type	Standards - Data Domains.ddm/Data Domains/Count [INTEGER]
Is Part Of PrimaryKey	false
Is Required	false
Is Derived	false
Is Surrogate Key	false

Number Of Licensed Beds

Description	Number of licensed beds with the provider.
Data Type	Standards - Data Domains.ddm/Data Domains/Count [INTEGER]
Is Part Of PrimaryKey	false
Is Required	false
Is Derived	false
Is Surrogate Key	false

Number Of Medical Errors

Description	Number of medical errors during the measurement period.
Data Type	Standards - Data Domains.ddm/Data Domains/Count [INTEGER]
Is Part Of PrimaryKey	false
Is Required	false
Is Derived	false
Is Surrogate Key	false

Number Of Members Treated

Description	Number of members who received care.
Data Type	Standards - Data Domains.ddm/Data Domains/Count [INTEGER]
Is Part Of PrimaryKey	false
Is Required	false
Is Derived	false
Is Surrogate Key	false

Number Of Mortalities

Description	Number of patient mortalities.
Data Type	Standards - Data Domains.ddm/Data Domains/Count [INTEGER]
Is Part Of PrimaryKey	false
Is Required	false
Is Derived	false
Is Surrogate Key	false

Number Of Mortalities Per 1000 Patients Treated

Description	A quality measure for institutional providers reflecting its mortality experience with a given disease, case mix, etc. Formula: [(A/B)*1000] (see dependencies and their labels for measures used in the formula)
Data Type	Standards - Data Domains.ddm/Data Domains/Count [INTEGER]
Is Part Of PrimaryKey	false
Is Required	false
Is Derived	false
Is Surrogate Key	false

Number Of Negative Incidents In National Provider Database

Description	The number of negative incidents that are recorded in the National Provider Data Bank and Healthcare Integrity & Protection Data Bank.
Data Type	Standards - Data Domains.ddm/Data Domains/Count [INTEGER]
Is Part Of PrimaryKey	false
Is Required	false
Is Derived	false
Is Surrogate Key	false

Number Of Nurses

Description	The number of nurses on staff.
Data Type	Standards - Data Domains.ddm/Data Domains/Count [INTEGER]
Is Part Of PrimaryKey	false
Is Required	false
Is Derived	false
Is Surrogate Key	false

Number Of Nurses Per Bed

Description	The number of nurses on staff for each licensed bed. Formula: [A/B] (see dependencies and their labels for measures used in the formula)
Data Type	Standards - Data Domains.ddm/Data Domains/Decimal Float [FLOAT(15)]
Is Part Of PrimaryKey	false
Is Required	false
Is Derived	false
Is Surrogate Key	false

Number Of Outlier Outcomes

Description	The number of times that the outcomes a provider achieves are more than 2 standard deviations from the outcomes of all providers for the same procedures, treatment or diagnosis.
Data Type	Standards - Data Domains.ddm/Data Domains/Count [INTEGER]
Is Part Of PrimaryKey	false
Is Required	false
Is Derived	false
Is Surrogate Key	false

Number Of Patients Readmitted Within 30 Days Of Discharge

Description	The number of patient readmissions to the hospital within 30 days discharge.
Data Type	Standards - Data Domains.ddm/Data Domains/Count [INTEGER]
Is Part Of PrimaryKey	false
Is Required	false
Is Derived	false
Is Surrogate Key	false

Number Of Physicians

Description	The number of physician staff with admitting privileges.
Data Type	Standards - Data Domains.ddm/Data Domains/Count [INTEGER]
Is Part Of PrimaryKey	false
Is Required	false
Is Derived	false
Is Surrogate Key	false

Number Of Primary Care Practitioners

Description	The number of primary care practitioners in a particular network or geographic area. Primary care practitioners generally would include physicians with taxonomy types general practice, family practice, internal medicine, pediatrics, obstetrics and gynecology OBGYN, geriatrics and may include advance practice nurses or other mid-level practitioners with similar taxonomy.
Data Type	Standards - Data Domains.ddm/Data Domains/Count [INTEGER]
Is Part Of PrimaryKey	false
Is Required	false
Is Derived	false
Is Surrogate Key	false

Number Of Procedures

Description	Number of procedures performed.
Data Type	Standards - Data Domains.ddm/Data Domains/Count [INTEGER]
Is Part Of PrimaryKey	false
Is Required	false
Is Derived	false
Is Surrogate Key	false

Number Of Provider Calls To Payer Help Desk

Description	The number of times a healthcare provider has contacted a help desk or provider relations area made available by a health plan organization during the measurement period.
Data Type	Standards - Data Domains.ddm/Data Domains/Count [INTEGER]
Is Part Of PrimaryKey	false
Is Required	false
Is Derived	false
Is Surrogate Key	false

Number Of Providers

Description	The number of providers who participate in the networks of the health plan organization.
Data Type	Standards - Data Domains.ddm/Data Domains/Count [INTEGER]
Is Part Of PrimaryKey	false
Is Required	false
Is Derived	false
Is Surrogate Key	false

Outlier Percentage

Description	The percentage of times that the outcomes a provider achieves are more than 2 standard deviations from the outcomes off all providers for the same procedures, treatment or diagnosis. Formula: [(A/B)*100] (see dependencies and their labels for measures used in the formula)
Data Type	Standards - Data Domains.ddm/Data Domains/Percentage [FLOAT(2)]
Is Part Of PrimaryKey	false
Is Required	false
Is Derived	false
Is Surrogate Key	false

Percentage Of Claims Submitted Electronically

Description	Percent of claims submitted electronically. Formula: [(A/B)*100] (see dependencies and their labels for measures used in the formula)
Data Type	Standards - Data Domains.ddm/Data Domains/Percentage [FLOAT(2)]
Is Part Of PrimaryKey	false
Is Required	false
Is Derived	false
Is Surrogate Key	false

Person Dk

Description	A numeric surrogate key used to uniquely identify entities in the dimensional model.
Data Type	Standards - Data Domains.ddm/Data Domains/Surrogate Key Large [LONG]
Is Part Of PrimaryKey	true
Is Required	true
Is Derived	false
Is Surrogate Key	false

Procedure Code Dk

Description	A numeric surrogate key used to uniquely identify entities in the dimensional model.
Data Type	Standards - Data Domains.ddm/Data Domains/Surrogate Key Large [LONG]
Is Part Of PrimaryKey	true
Is Required	true
Is Derived	false
Is Surrogate Key	false

Provider Dk

Description	A numeric surrogate key used to uniquely identify entities in the dimensional model.
Data Type	Standards - Data Domains.ddm/Data Domains/Surrogate Key Large [LONG]
Is Part Of PrimaryKey	true
Is Required	true
Is Derived	false
Is Surrogate Key	false

Readmission Rate

Description	The rate of patient readmissions to the hospital within 30 days discharge. Formula: [A/B] (see dependencies and their labels for measures used in the formula)
Data Type	Standards - Data Domains.ddm/Data Domains/Decimal Float [FLOAT(15)]
Is Part Of PrimaryKey	false
Is Required	false
Is Derived	false
Is Surrogate Key	false

Relationship Details

Institutional Provider Quality Analysis_Calendar Dimension_FK

Is Identifying Relationship	true
Child Table	Institutional Provider Quality Analysis
Child Multiplicity	ZERO_TO_MANY
Child Referential Integrity: On Delete	NONE
Child Referential Integrity: On Insert	NONE
Child Referential Integrity: On Update	NONE
Parent Table	Calendar Dimension
Parent Multiplicity	ONE
Parent Referential Integrity: On Delete	NONE
Parent Referential Integrity: On Insert	NONE
Parent Referential Integrity: On Update	NONE

Institutional Provider Quality Analysis_Geographic Area Dimension_FK

Is Identifying Relationship	true
Child Table	Institutional Provider Quality Analysis
Child Multiplicity	ZERO_TO_MANY
Child Referential Integrity: On Delete	NONE
Child Referential Integrity: On Insert	NONE
Child Referential Integrity: On Update	NONE
Parent Table	Geographic Area Dimension
Parent Multiplicity	ONE
Parent Referential Integrity: On Delete	NONE
Parent Referential Integrity: On Insert	NONE
Parent Referential Integrity: On Update	NONE

Institutional Provider Quality Analysis_Provider Dimension_FK

Is Identifying Relationship	true
Child Table	Institutional Provider Quality Analysis
Child Multiplicity	ZERO_TO_MANY
Child Referential Integrity: On Delete	NONE
Child Referential Integrity: On Insert	NONE
Child Referential Integrity: On Update	NONE
Parent Table	Provider Dimension
Parent Multiplicity	ONE
Parent Referential Integrity: On Delete	NONE
Parent Referential Integrity: On Insert	NONE
Parent Referential Integrity: On Update	NONE

Institutional Provider Quality Analysis_Procedure Code Dimension_FK

Is Identifying Relationship	true
Child Table	Institutional Provider Quality Analysis
Child Multiplicity	ZERO_TO_MANY
Child Referential Integrity: On Delete	NONE
Child Referential Integrity: On Insert	NONE
Child Referential Integrity: On Update	NONE
Parent Table	Procedure Code Dimension
Parent Multiplicity	ONE
Parent Referential Integrity: On Delete	NONE
Parent Referential Integrity: On Insert	NONE
Parent Referential Integrity: On Update	NONE

Institutional Provider Quality Analysis_Person Dimension_FK

Is Identifying Relationship	true
Child Table	Institutional Provider Quality Analysis
Child Multiplicity	ZERO_TO_MANY
Child Referential Integrity: On Delete	NONE
Child Referential Integrity: On Insert	NONE
Child Referential Integrity: On Update	NONE
Parent Table	Person Dimension
Parent Multiplicity	ONE
Parent Referential Integrity: On Delete	NONE
Parent Referential Integrity: On Insert	NONE
Parent Referential Integrity: On Update	NONE

Primary Key Details

Institutional Provider Quality Analysis PK

Key Attribute	Calendar Dk
Key Attribute	Geographic Area Dk
Key Attribute	Provider Dk
Key Attribute	Procedure Code Dk
Key Attribute	Person Dk

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