Ten indicators are provided for hospital acute somatic care. Stays in geriatrics, rehabilitation and psychiatric units (Swiss statistical codes, variable 1.4.V01: M500, M900, M950, M990) are not taken into account. Results are provided into two different files, which are synthesized in Synthesis.xlsx.  Global results are provided separately for each hospital and hospital site in .xlsx files, while .txt files correspond to detailed results provided separately for each patient belonging to the eligible population. Name of the different files is given below:

IndicatorExcel fileText file
Inpatient CostsCost.xlsxAnalysis.txt
Length of StayLength.xlsxAnalysis.txt
Day SurgeryDaySurgery.xlsxEligible_surgery.txt
Unjustified StaysUnjustifiedStay.xlsxEligible_cases.txt
More or less justified StaysMoreLessjustifiedStay.xlsxEligible_cases.txt
Premature DeathsDeath.xlsxEligible_death.txt

Results of the hospital planning tool (Beds) are given in the Excel file called Beds.xlsx.

To facilitate further analyses, SQLape® generates four additional data files:

1) Case.txt
FieldVariable name*Variable number*Format
#CaseHospital stay identifier-text
#HospitalHospital identifier0.1.V02text
#PatientPatient identifier0.2.V01text
StayDefinitionStay definition0.2.V02text
GenderGender1.1.V01number (integer)
AgeAge at admission1.1.V03number (integer)
AdmissionDateAdmission date1.2.V01YYYYMMDDhh (text)
StayBefore0Stay before admission1.2.V02number (integer)
AdmissionModeAdmission mode1.2.V03number (integer)
TypeOfStayType of stay1.3.V01number (integer)
VacationVacations1.3.V04number (integer)
DischargeDateDischarge date1.5.V01YYYYMMDDhh (text)
DischargeDecisionDischarge decision1.5.V02number (integer)
StayAfterStay after discharge1.5.V03number (integer)
LengthOfStayLength of stay-number (integer)
CostHospital cost-number (real)
WeightWeight at birth2.2.V04number (integer)
InterruptionDischarge11 st interruption, discharge date4.7.V01YYYYMMDD (text)
InterruptionReadmission11 st interruption, readmission date4.7.V02YYYYMMDD (text)
InterruptionReason1Reason of 1 st interruption4.7.V03number (integer)
InterruptionDischarge22 nd interruption, discharge date4.7.V11YYYYMMDD (text)
InterruptionReadmission22 nd interruption, readmission4.7.V12YYYYMMDD (text)
InterruptionReason2Reason of 2 nd interruption4.7.V13number (integer)
InterruptionDischarge33 rd interruption, discharge date4.7.V21YYYYMMDD (text)
InterruptionReadmission33 rd interruption, readmission4.7.V22YYYYMMDD (text)
InterruptionReason3Reason of 3 rd interruption4.7.V23number (integer)
InterruptionDischarge44 th interruption, discharge date4.7.V31YYYYMMDD (text)
InterruptionReadmission44 th interruption, readmission4.7.V32YYYYMMDD (text)
InterruptionReason4Reason of 4 th interruption4.7.V33number (integer)
Note: *Swiss Federal Statistical Office designation
2) Health.txt
FieldSwiss Federal Statistical Office designationFormat
#CaseHospital stay identifiertext
#HealthICD-10 Diagnostic codetext
Rank1 = main diagnosis, 2-100 (other diagnoses)text
3) Procedure.txt
FieldSwiss Federal Statistical Office designationFormat
#CaseHospital stay identifiertext
#ProcedureICD-9-CM codetext
DayDate of proceduredate
4) Categories.txt
FieldSwiss Federal Statistical Office designationFormat
#CaseHospital stay identifiertext
#CategorySQLape categories*text
Note:  *For more details, see Diagnostic and Procedures categories.


A systematic notation is used for all results, with indices describing observed value (index 1) and expected values (index 0). The two letters before indices correspond to abbreviations of each indicator:

  • CO: hospital costs
  • LS: length of stay
  • DS: one-day surgery
  • UJ: unjustified stays
  • ML: more or less justified stays
  • AR: potentially avoidable readmissions (ARi and ARe for internal and external readmissions respectively)
  • RO: potentially avoidable reoperations
  • CP: iatrogenic complications
  • PD: premature death
  • BE: Potential of beds reduction

For instance, LS1 is the observed average length of stay and RO0 is the expected rate of potentially avoidable reoperations.

Assessing the hospital performances

Performances are based on the ratio of observed vs expected values (for instance, RAR = AR1/AR0). SQLape® also computes the lower and the upper bounds of the 95% confidence interval for this ratio (called Rmin and Rmax, respectively).

For each indicator, the hospital receives a result between A, B and C, which can be interpreted as follows:

  • Rmax < 1 → A = Good
  • Rmax >= 1 & Rmin <= 1.2 → B = Normal
  • Rmin > 1.2 → C = Requiring further analyses

Lower and upper bonds are based on statistical control limits, taking into account both observed and expected values random variations, as described in:
Rousson V, Le Pogram MA, Eggli Y. Control limits to identify outlying hospitals based on risk-stratification. Stat Methods Med Res 2018;27(6):1737-1750.

Expected values are computed from a benchmark setting, including the half of Swiss hospitals having the best performances. This means that if observed values are lower than expected ones, the hospital is doing better than benchmark hospitals in average.

It might be interesting to refer to Swiss average values (all hospitals, without selection). This can be done, in comparing adjusted values (V1a) to the Swiss average (V0CH). If the adjusted value is lower than expected, the hospital performs better than the Swiss average.

As a reminder:
V1          observed value
V0         expected value from benchmark setting
V0CH    expected value from Swiss setting
A0         average value of the benchmark setting
ACH      average value of the Swiss setting

By definition, the adjusted value (V1a) = (V1/V0CH) * ACH

assuming that the relative risks are the same in the Swiss and benchmark settings:
(V0/A0) = V0CH/ACH and thus V0CH = V0 ACH/A0
and V1a = (V1 A0 ACH)/ (V0 ACH ) = V1/V0 * A0

In other words, the adjusted value (V1a) is equal to the ratio of observed/expected values (benchmark) multiplied by the benchmark average value.

Data quality assessment

SQLape® assesses the quality of data provided in the SQLape_input.txt file according to several criteria. Details can be found here.

Stay definition

To be closer to reality and to balance the risk of reducing length of stay with possible further réadmissions, the hospital stay is defined by the period between admission and discharge. Thus we restore the stays in their original and real form, even if SwissDRG rules merged them for billing purpose. This also enables longitudinal comparisons. (Case definition)