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documentation:next_cdm:single_cost [2016/02/10 17:51]
jenniferduryea
documentation:next_cdm:single_cost [2016/03/08 19:09]
jenniferduryea
Line 8: Line 8:
 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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 |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]].|
 +|total_cost_type_concept_id|Yes|integer|Shows the provenance or the source of the total_cost data: Calculated from provider revenue, calculated from cost-to-charge ratio, reported from accounting database, etc.|
 |total_paid|No|float|The total amount paid from all payers for the expenses of the service/​device/​drug. ​ This field is calculated using the following formula: paid_by_payer + paid_by_patient + paid_by_primary. ​ In claims data, this field is considered the calculated field the payer expects the provider to get reimbursed for the service/​device/​drug from the payer and from the patient, based on the payer'​s contractual obligations.| |total_paid|No|float|The total amount paid from all payers for the expenses of the service/​device/​drug. ​ This field is calculated using the following formula: paid_by_payer + paid_by_patient + paid_by_primary. ​ In claims data, this field is considered the calculated field the payer expects the provider to get reimbursed for the service/​device/​drug from the payer and from the patient, based on the payer'​s contractual obligations.|
 |paid_by_payer|No|float|The amount paid by the Payer for the service/​device/​drug. ​ In claims data, generally there is one field representing the total payment from the payer for the service/​device/​drug. ​ However, this field could be a calculated field if the source data provides separate payment information for the ingredient cost and the dispensing fee.  If the paid_ingredient_cost or paid_dispensing_fee fields are populated with nonzero values, the paid_by_payer field is calculated using the following formula: ​ paid_ingredient_cost + paid_dispensing_fee. ​  If there is more than one Payer in the source data, several cost records indicate that fact.  The Payer reporting this reimbursement should be indicated under the payer_plan_id field.| |paid_by_payer|No|float|The amount paid by the Payer for the service/​device/​drug. ​ In claims data, generally there is one field representing the total payment from the payer for the service/​device/​drug. ​ However, this field could be a calculated field if the source data provides separate payment information for the ingredient cost and the dispensing fee.  If the paid_ingredient_cost or paid_dispensing_fee fields are populated with nonzero values, the paid_by_payer field is calculated using the following formula: ​ paid_ingredient_cost + paid_dispensing_fee. ​  If there is more than one Payer in the source data, several cost records indicate that fact.  The Payer reporting this reimbursement should be indicated under the payer_plan_id field.|
documentation/next_cdm/single_cost.txt · Last modified: 2016/03/08 19:09 by jenniferduryea