For a more technical look at user population processing rules, read on, but read the overview page first!

As discussed on the user pop overview page, NPIRS is the Indian Health Service (IHS) statistical database that stores workload, both registration and clinical. NPIRS uses this data to generate the annual IHS active user pop.

Here are the steps in the calculating the annual user pop:

1. American Indian/Alaska Native (AI/AN) person visits or uses services funded by the IHS at least once in the last three year period;
2. Facility exports data (RPMS registration export tape) to NPIRS by cut-off date;
3. NPIRS runs patient registration reports to calculate user pop;
4. IHS Division of Program Statistics publishes Annual User Population Reports.

Fifteen (15) of the possible ninety-nine (99) NPIRS registration fields are essential to discretely identify a user:

1. Unique registration ID (unique by registration record, not necessarily by patient)
2. Registration create date (date record created at local system)
3. Date last modified
4. Registering facility code (ASUFAC)
5. Chart/health record number
6. First name
7. Middle name
8. Last name
9. Birth date
10. Gender code
11. Social Security number
12. Beneficiary classification code
13. Tribe code
14. Blood quantum code
15. Community of residence code (from the IHS standard table, state/county/community of residence)

Don't forget: To be included in the annual user pop, the registration files must be successfully and timely submitted to NPIRS by the official cut-off date.

User pop calculations are RESIDENCE based looking to the COMMUNITY OF RESIDENCE field to determine where to count the user by area and service unit.  The community of residence value is derived from the IHS Standard Codebook table, state/county/community of residence.  In Resource Patient Management System (RPMS) software, the community of residence value is located under the Current Community field on the first page of patient registration.  Facilities that do not use RPMS can also use the IHS Standard Tables to record this value properly.

Each person registered in a given IHS Area will be counted just once somewhere within that Area’s Active User Population report. The four key elements that determine who gets credit are:

1.      AI/AN Status determination is made based upon current values for each patient. A patient will be considered AI/AN if they meet one of the following criteria:

o        Member of a federally recognized Tribe (Tribe Code = 000 – 997, and Indian indicator = Yes)

o        Tribe Code = 998 or 999 and Beneficiary Code = 01

o        Tribe Code = 998 or 999 and Indian Blood Quantum = 1, 2, 3, or 4

2.      Active Flag identifies a patient who has had at least one workload reportable encounter record in the last three fiscal years from at least one of the following:

o        direct outpatient

o        direct inpatient

o        Contract Health Service (CHS) outpatient

o        CHS inpatient

o        dental

3.      Community of residence is the key element in deciding under what area and service unit a user will be counted. This value is retrieved from the Community of Residence field in Patient Registration.

4.      Duplicate Flag consists of a two-step process to un-duplicate registration records so that the Active User Population Report counts one person just once within a region.