Table 2. Components of the VHA 2005 Facility Complexity Level Model
Component
Patient risk
Definition
Patient risk is a Medicare Relative Risk score calculated from
all VHA patient diagnoses from all sources, benchmarked to
an average expected Medicare costliness of 1.00 for those
diagnoses.
Level of Teaching and
Teaching is based on the number of resident slots and the
Research
Herfindahl index for resident slots. Research is based on the
amount of research dollars managed by a VHA facility divided
by the total number of pro-rated persons as calculated by the
Veterans Equitable Resource Allocation model.
Patient Volume
Patient volume is based on the number of Pro-Rated People
(PRP) seen at each VHA facility based on the Veterans
Equitable Resource Allocation model. Each patient is
classified into a patient class that represents the level of
treatment provided in the preceding year. The class is based on
clinical encounters and treatments. Each patient equates to 1
PRP, which is proportionately distributed among VHA
facilities where treatment occurred, based on costs incurred.
Ratio of physician
Ratio of physician specialists reflects the number of physician
specialists
specialists as calculated according to the Veterans Equitable
Resource Allocation model. This variable uses head count as
the method for determining the number of physician
specialists.
Level of ICU unit
Intensive care unit level of care reflects the level of intensive
care units based on criteria that contribute to the complexity of
intensive care units, such as type of services provided and
availability of subspecialty services. Level 5 represents the
highest level and Level 1 represents the lowest level.
Facility complexity level 1 facilities are characterized by high patient risk, high levels of
teaching and/or research, and high patient volume. Facility complexity level 2 facilities are
characterized by medium patient risk, medium levels of teaching and/or research, medium
patient volume and level 3 and 4 ICU units. Facility complexity level 3 facilities are
characterized by the lowest patient volumes, little or no research and/or teaching, low ratios of
physician specialists, and level 1 or 2 ICU units.