La. Admin. Code tit. 48 § V-15103

Current through Register Vol. 50, No. 9, September 20, 2024
Section V-15103 - Definitions
A. For the purposes of these regulations, the following words and phrases, when used herein, shall be construed as listed below.

Act-the Act 622 of the 1997 Regular Legislative Session, R.S. 40: 1300.111 et seq.

Aggregate Data Set-an array of counts of patient level records, or of totals of patient level record quantities (example: Total Charges), classified by data categories (example: "year of discharge"). Aggregate data sets may be used to present health data usefully, yet in a manner which can minimize potential for identification of confidential information, since they can be assured to have any necessary minimum cell size. Aggregate data sets shall not include the following information:

a. facility identifiers;

b. patient or insured identifiers;

c. physician or other health care service provider identifiers;

d. payor identifiers;

e. employer identifiers.

a. employer identifiers, facility identifiers, patient or insured identifiers, payor identifiers, or physician or other service provider identifiers;

b. information identified by the identifiers;

c. combinations of data categories derived from part or all of the hospital discharge database information that would identify or tend to identify an employer, facility, patient or insured person, payor, or physician or other service provider; and

d. information identified by combinations of these data categories.

Data Base-a structured repository of data, consisting of one or more related structured data tables.

Data Category-one of the typically (though not necessarily) non-unique data values of a data element, or to equivalent labels for these values. For example, the data categories of the data element years may be three in number: "98," "99," and "00," and may be labeled "1998," "1999," and "2000," whereas the data categories of the data element patient birth date may have thousands of possible values, some of which are probably uniquely associated with exactly one person.

Data Element-a logical field of a data record or a column of a data table, and includes both the named data elements in this rule, and any other data elements obtained or created by analytic or synthetic methods. Examples: discharge year, age group, sex, or disease group.

Data Record-the row of a data table, or the set of related rows from related tables in a database.

Data Set-a structured subset of data from a database.

Department-the Louisiana Department of Health and Hospitals.

Employer Identifier-employer name, employer location/address excluding the first three digits of the ZIP code, or other information that identifies an employer.

Facility Identifier-provider name, provider telephone number, provider fax number, federal tax number or ein, federal tax sub ID, Medicare provider number, national provider identifier, mailing address excluding the first three digits of the ZIP code, or other information that identifies a facility.

Guide-the Hospital Discharge Data Submittal Guide included in §15113-15129 of this rule.

Health Research-the study of patterns or trends in health or health care.

Hospital-any institution, place, building or agency, public or private, whether organized for profit or not-for-profit, which is subject to licensure as a hospital by the Louisiana Department of Health and Hospitals.

Hospital Discharge Information-all billing, medical, and personal information describing a patient, the services received, and charges billed, associated with a single inpatient hospital stay, including all elements of the Uniform Billing form, UB-92.

Hospital Discharge (Data) Record-the structured document, in paper or electronic form, of all the UB 92 data for a single hospital stay, or the data content of that document. This often will include more than one data record.

Hospital Stay or Inpatient Hospital Stay-the period, activities, events, and conditions associated with a patient, from the time of admission to a hospital, to the time of discharge from that hospital. Facilities licensed as hospitals and having different provider numbers are, for the purpose of this definition, distinct hospitals having discrete hospital stays and hospital discharges.

Intermediary-a data processing agent of a hospital, who is contracted or employed by that hospital to relay their Hospital Discharge Records to OPH in compliance with these rules.

Office, also OPH-the Louisiana Office of Public Health;

Panel or Research Panel-the Hospital Discharge Data Research Panel as described in §15007 of this rule.

Patient or Insured Identifier-patient name, insured's name, patient address or insured's address (specifically including P.O. Box or street address, but not city, 5-digit ZIP Code, or state), patient control number, SSN, medical record number, health insurance claim identification number, or information that would identify or tend to identify an individual patient or insured person under whom the patient may be covered.

Patient Level Data-the non-aggregate, one logical record per discharge, form of data submitted by hospitals which includes part or all of the submitted data elements or recoded data derived from submitted data elements. This term refers to both the raw patient level data still in the form in which it is submitted, and the cleaned patient level data which may have had error checking or edits applied or which may have been separated into the specifically named patient or insured identifier data elements and the remaining data elements. Patient level data may include all or part of the hospital discharge data record.

Payor Identifier-the payor name, payor identification, insured group name, insurance group number, or other information that identifies a payor.

Physician and Other Service Provider Identifier-attending physician name, attending physician number, operating physician name, operating physician number, other physician name, other physician number, or other information that identifies a physician or other service provider.

Publish-to make any hospital discharge information available in paper or electronic form to person(s) who are not:

a. part of the research group authorized to use that information by the research panel as described in §15109; or

b. OPH staff authorized to use that information.

Release-a conditional distribution of hospital discharge information for purposes authorized by this rule.

Secure Information-that information which is not subject to release by OPH or the research panel, and will not be released for any purpose. Secure information includes patient and insured identifiers.

Submit-(with respect to a submission date, and data, reports, surveys, statements or documents required to be submitted to the Louisiana Office of Public Health) to deliver, or to cause to be delivered, to the Office of Public Health, in the form and format specified, by the close of business on the prescribed date.

La. Admin. Code tit. 48, § V-15103

Promulgated by the Department of Health and Hospitals, Office of Public Health, LR 2419340 (October 1998).
AUTHORITY NOTE: Promulgated in accordance with R.S. 40:1300.112(D).