This Guide contains data from Indiana hospitals on their charges and lengths of stay for selected categories of hospitalization and frequently performed procedures. The data are obtained from the Indiana Hospital&Health Association Inpatient Discharge Study database, to which all Indiana hospitals voluntarily submit data.

For comparison, data are also given on average charges and lengths of stay for hospital peer groups -- groups of hospitals that are roughly similar in size and sophistication of service.

The Guide provides information on two gross financial and utilization categories -- average charges and length of stay. It is difficult, however, to draw conclusions from this report on which hospitals may provide superior care or value.

No. The average charge may give you a general idea of what care might cost at a given hospital, but each person and each case is unique. The amount of resources needed to restore your health or deliver your child will vary. Also, charges are "retail prices." Your insurance company or government insurer may not pay full charges, so what the hospital receives for your care could be considerably less than the averages shown in these reports. If your case is highly complex, it could cost more.

In addition, hospitals bundle their charges differently. Some hospitals may include anesthesiology in the charges for a procedure; others will bill anesthesiology separately. There is no way to tell from this data set what costs are included or not included in the total charge category.

What do the Diagnosis-Related Groups mean?

Diagnosis-related groups are a diverse classification concept developed in the 1980s to categorize patients with similar medical conditions. Depending upon the DRG system employed, it reduces the thousands of standard diagnosis and procedure codes in medical records to several hundred categories.

The Indiana Hospital&Health Association uses the advanced All-Patient Refined DRG system developed by 3M to group the more than 750,000 inpatient medical/surgical cases treated by Indiana hospitals each year.

This report focuses on 14 selected APR-DRGs and 16 selected procedures arranged in four sections. Tables within each section list these APR-DRGs or procedures using both their technical names and descriptions and also in familiar terms.

Computer software is used to separate cases with the same principal diagnosis into four categories of complexity --basically, from minor to extremely complicated. This severity adjustment shows that the tougher the case, the longer the stay and higher the cost. Persons trying to get a general idea of how much an average normal delivery might cost or how long the new mother might be hospitalized can look at data from hospitals with average severity levels near one. Without the severity adjustment, all figures become averages of all cases. That data isn't particularly useful to an individual.

Length of Stay, as used in this report, means the number of days a patient is in hospital care, from time of admission to time of discharge. Length of Stay (LOS) is determined by the patient's physician and is based upon the patient's medical condition. This year, both the average LOS and the median LOS are given in the tables. The median (or 50^th percentile) is the value that half the numbers fall below and half above. Median figures may give a better idea of the typical LOS at a hospital when the number of cases is relatively small and the cases contain some unusually long or short values.

The patient bill is much like the retail sticker price on an automobile. It starts with a base daily room rate, and then includes added costs for supplies, drugs, therapies, treatments, facilities, and personnel unique to each patient's medical condition. Median Total Charges have been added to the tables this year to give another estimate of the typical dollar amount billed. Median figures may give a better idea of the typical cost at a hospital when the number of cases is relatively small and the cases contain some unusually large or small billing amounts.

As with sticker prices, few persons or insurers pay retail hospital charges. Private insurance companies representing large numbers of employers negotiate discounts from full charges.

Average charge means very little for patients insured by Medicare or Medicaid. The state and federal governments decide unilaterally how much they will pay for inpatient care for Medicaid and Medicare patients -- regardless of the actual expenses.