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documentation:next_cdm:single_cost [2016/02/10 00:12]
jenniferduryea
documentation:next_cdm:single_cost [2016/03/02 16:46]
cgreich
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 Proposal to consolidate all current cost tables (Procedure_Cost,​ Drug_Cost, Device_Cost,​ Visit_Cost) in V5.0 into one single table. The table could be connected to any of the Domain tables (Procedure_Occurrence,​ Condition_Occurrence,​ Drug_Exposure,​ Device_Exposure,​ Observation,​ Measurement). ​ Proposal to consolidate all current cost tables (Procedure_Cost,​ Drug_Cost, Device_Cost,​ Visit_Cost) in V5.0 into one single table. The table could be connected to any of the Domain tables (Procedure_Occurrence,​ Condition_Occurrence,​ Drug_Exposure,​ Device_Exposure,​ Observation,​ Measurement). ​
  
-Instead of generating additional cost tables, each tied to a specific domain, perhaps we create a single, unified cost table to capture costs for all domains. visit_cost and device_cost share identical columns for tracking costs. ​+Instead of generating additional cost tables, each tied to a specific domain, perhaps we create a single, unified cost table to capture costs for all domains. visit_cost and device_cost share identical columns for tracking costs
 + 
 +Change at last minute: the cost_type_concept_id field will use new concepts in the Vocabulary to designate the source of the cost data.
  
 The following description below is the proposed additional specification to the CDM. The following description below is the proposed additional specification to the CDM.
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 |cost_domain_id|Yes|string(20)|The concept representing the domain of the cost event, from which the corresponding table can be inferred.| |cost_domain_id|Yes|string(20)|The concept representing the domain of the cost event, from which the corresponding table can be inferred.|
 |currency_concept_id|No|integer|A concept representing the 3-letter code used to delineate international currencies, such as USD for US Dollar.| |currency_concept_id|No|integer|A concept representing the 3-letter code used to delineate international currencies, such as USD for US Dollar.|
 +|cost_type_concept_id|Yes|integer|Shows the provenance or the source of the cost data: Claims, provider revenue, etc.|
 |total_charged|No|float|The total amount charged by the provider of the good/​service (e.g. hospital, physician pharmacy, dme provider) billed to a payer. ​ This information is usually provided in claims data.| |total_charged|No|float|The total amount charged by the provider of the good/​service (e.g. hospital, physician pharmacy, dme provider) billed to a payer. ​ This information is usually provided in claims data.|
 |total_cost|No|float|Cost of service/​device/​drug incurred by provider/​pharmacy. ​ This field is more commonly derived from charge information. ​ Use case:  The resulting amount after the hospital charges are multiplied by the cost-to-charge ratio. ​ This data is currently available for [[https://​www.hcup-us.ahrq.gov/​db/​nation/​nis/​nisdbdocumentation.jsp|NIS]] datasets, or any other [[https://​www.hcup-us.ahrq.gov/​databases.jsp|HCUP]] datasets. ​ See cost calculation explanation from AHRQ [[https://​www.hcup-us.ahrq.gov/​db/​state/​costtocharge.jsp|here]].| |total_cost|No|float|Cost of service/​device/​drug incurred by provider/​pharmacy. ​ This field is more commonly derived from charge information. ​ Use case:  The resulting amount after the hospital charges are multiplied by the cost-to-charge ratio. ​ This data is currently available for [[https://​www.hcup-us.ahrq.gov/​db/​nation/​nis/​nisdbdocumentation.jsp|NIS]] datasets, or any other [[https://​www.hcup-us.ahrq.gov/​databases.jsp|HCUP]] datasets. ​ See cost calculation explanation from AHRQ [[https://​www.hcup-us.ahrq.gov/​db/​state/​costtocharge.jsp|here]].|
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 |paid_dispensing_fee|No|float|The amount paid by the Payer to a pharmacy for dispensing a drug, excluding the amount paid for the drug ingredient. ​ paid_dispensing_fee contributes to the paid_by_payer field if this field is populated with a nonzero value.| |paid_dispensing_fee|No|float|The amount paid by the Payer to a pharmacy for dispensing a drug, excluding the amount paid for the drug ingredient. ​ paid_dispensing_fee contributes to the paid_by_payer field if this field is populated with a nonzero value.|
 |payer_plan_period_id|No|integer|A foreign key to the PAYER_PLAN_PERIOD table, where the details of the Payer, Plan and Family are stored. ​ Record the payer_plan_id that relates to the payer who contributed to the paid_by_payer field.| |payer_plan_period_id|No|integer|A foreign key to the PAYER_PLAN_PERIOD table, where the details of the Payer, Plan and Family are stored. ​ Record the payer_plan_id that relates to the payer who contributed to the paid_by_payer field.|
-|amount_allowed|No|float|The contracted amount agreed between the payer and provider. ​ This information is generally available in claims data.  This is similar to the total_paid amount in that it shows what the payer expects the provider to be reimbursed after the payer and patient pay.  This differs from the total_paid amount in that it is not a calculated field, but a field available directly in claims data.  Use case: This will capture non-covered services. ​ Noncovered services are indicated by and amount allowed and patient responsibility variables (copay, coinsurance,​ deductible) will be set to $0 in the source data. This means the patient is responsible for the total_charged value. ​ The amount_allowed field is payer specific and the payer should be indicated by the payer_plan_id field.|+|amount_allowed|No|float|The contracted amount agreed between the payer and provider. ​ This information is generally available in claims data.  This is similar to the total_paid amount in that it shows what the payer expects the provider to be reimbursed after the payer and patient pay.  This differs from the total_paid amount in that it is not a calculated field, but a field available directly in claims data.  Use case: This will capture non-covered services. ​ Noncovered services are indicated by an amount allowed and patient responsibility variables (copay, coinsurance,​ deductible) will be equal $0 in the source data. This means the patient is responsible for the total_charged value. ​ The amount_allowed field is payer specific and the payer should be indicated by the payer_plan_id field.|
 |revenue_code_concept_id|No|integer|A foreign key referring to a Standard Concept ID in the Standardized Vocabularies for Revenue codes.| |revenue_code_concept_id|No|integer|A foreign key referring to a Standard Concept ID in the Standardized Vocabularies for Revenue codes.|
 |revenue_code_source_value|No|string(50)|The source code for the Revenue code as it appears in the source data, stored here for reference.| |revenue_code_source_value|No|string(50)|The source code for the Revenue code as it appears in the source data, stored here for reference.|
documentation/next_cdm/single_cost.txt · Last modified: 2016/03/08 19:09 by jenniferduryea