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HCUP Overview Course - Accessible Version
Researcher 1: Do admission rates for preventable hospitalizations vary across the U.S.? Researcher 2: What percentage of hospitalizations for children are covered by Medicaid in my state? Researcher 3: What are the most common conditions treated in the Emergency Department? Researcher 4: Will there be enough cases for my analysis? Researcher 5: What are the latest trends in ambulatory surgery for knee injuries? Researcher 6: What tools are available to help me in my research?
Lauren: HCUP. Powerful Data. Meaningful answers. Contents:
Sean: Welcome to the Healthcare Cost and Utilization Project Overview Course. My name is Sean. I am a researcher who is studying a number of different healthcare research and policy topics. My current research interests include looking at the rise in the number of obesity-related procedures in recent years. I'm not overly familiar with HCUP. I've heard that it's a valuable resource. I've accessed publications and resources available through HCUP, and I'd like to learn about using HCUP databases and tools to support my research. My colleague, Lauren, has worked with HCUP products for years. Lauren: Yes, hi, I'm Lauren. Sean, you're right, I've had significant exposure to HCUP and am happy to give you an overview of the databases, software tools, and research products included in HCUP. During my research career, I've used HCUP to support various healthcare analyses. Most recently, I used HCUP to identify trends in preventable asthma hospitalizations. There is a wealth of information available through HCUP.
I estimate that this course will take about 90 minutes to complete and will be covering a lot of information about the HCUP project and databases. While the course is designed to present a comprehensive overview of HCUP, we understand that you may be interested in accessing only certain information.
Introduction/AHRQ and DHHS Lauren: The Healthcare Cost and Utilization Project or HCUP, is a family of healthcare databases and related software tools and products developed through a Federal-State-Industry partnership and sponsored by the Agency for Healthcare Research and Quality or AHRQ. HCUP databases bring together the data collection efforts of State data organizations, hospital associations, and private data organizations to create a national information resource of record-level healthcare data. HCUP data are collected as part of AHRQ's mission: "To produce evidence to make healthcare safer, higher quality, more accessible, equitable, and affordable, and to work within the U.S. Department of Health and Human Services and with other partners to make sure that the evidence is understood and used." AHRQ is a federal agency in the Department of Health and Human Services. The Department of Health and Human Services is the principal department for improving the health of all Americans and providing essential human services, especially for those who are least able to help themselves. There are many agencies within DHHS. A few examples are the National Institutes of Health (NIH), the Centers for Medicare and Medicaid Services (CMS), the Food and Drug Administration (FDA), and the Centers for Disease Control and Prevention (CDC).
Introduction/What is HCUP? Lauren: HCUP provides a wealth of information to enhance your research and promote positive changes in healthcare. HCUP is a family of healthcare databases, software tools, and products that support cutting edge research. The HCUP databases include discharges for inpatient care and components of outpatient care, such as emergency care and ambulatory surgeries. These data are collected from community hospitals in participating States. HCUP consists of a family of related databases, tools, and products. HCUP supports cutting edge research.
HCUP also supports Congressionally-mandated reports, such as the National Healthcare Quality and Disparities Report (NHQDR) HCUP data captures all discharges for inpatient care and components of outpatient care from community hospitals in participating States. HCUP data capture all inpatient discharges from community hospitals in participating States, as well as components of outpatient care (i.e., emergency care and ambulatory surgeries and services). Also, the HCUP State-level databases capture all discharges, making them unique and powerful. These databases are the only collection of publicly available, all-payer hospital data. Introduction/Overview of HCUP Data At the center of the HCUP project are the data. HCUP data are derived from hospital billing information and include both inpatient and outpatient care. HCUP State Databases:
HCUP Nationwide Databases:
Introduction/Data Sources: Community Hospitals I understand that HCUP data are largely hospital and hospital affiliated data, but what types of hospitals are included? What types of hospital care are captured and how do hospitals collect all these data?The American Hospital Association (AHA) categorizes hospitals into the following categories:
The data in the HCUP databases primarily include data from non-federal community hospitals. Federal, long-term care, psychiatric, and tuberculosis hospitals are generally excluded. As you can see, the majority of hospitals in the United States are categorized as "community hospitals." Examples of non-Federal community hospitals include (84%):
The following hospitals are generally excluded (15%):
Introduction/Data Sources: Types of Care Captured Lauren: Generally, the care provided at community hospitals can be divided into three main categories: inpatient; outpatient; and ancillary services (such as pharmacy, laboratory, and radiology). HCUP data capture records of inpatient care services and two types of outpatient care services - ambulatory surgery and emergency department. HCUP does not collect Ancillary Services such as laboratory or radiology services. Inpatient
Outpatient
Ancillary Services Not collected by HCUP
Introduction/Data Sources: Billing Records Sean: Interesting. So where does it originate and how does it get created? Lauren: That's a good question, and the easiest way to find out is to follow some patients through the process. Let's take a look at three examples to see when data are collected. Jeff is admitted to the hospital for pneumonia. After he is admitted, a medical record is created containing his demographic data. Because Jeff was admitted to the hospital, his treatment will be captured in the SID. Jack arrives at a hospital-owned surgery center for outpatient eye surgery. A medical record is created with Jack's demographic information. Because Jack is being treated and released in an outpatient setting of the hospital for a surgical procedure, his surgery will be included in the SASD. Lizzie arrives at the emergency room with her mom after falling at the playground. A medical record is created with Lizzie's demographic information. If Lizzie is admitted to the hospital because of her fall, her care will be included in the SID. If she is not admitted, her care will be captured in the SEDD. These three patients will receive care and information about that care will be added to their medical records. When each patient is discharged, a bill will be generated and the information included on that bill will become the basis of the HCUP databases. Read about the details of each step below. Receive Care Discharge Bill Generated Data Transmitted
Introduction/Contributing States Lauren: These data are used for many purposes other than billing. Hospitals transmit the data to State-level Data Organizations that utilize the information for things such as public health surveillance, research, and monitoring quality, cost and access to healthcare. The Data Organizations add additional data elements useful to researchers. The Data Organizations that participate in HCUP send their data to AHRQ for inclusion in the HCUP databases. We call the participating States "HCUP Partners". Along with AHRQ, they put a tremendous amount of effort into creating the HCUP databases. Without their support and enthusiasm for this project, the HCUP initiative would not be possible.
Introduction/Comparison to Other Available Databases Sean: I've used other federal databases such as the National Hospital Care Survey, the Medical Expenditure Panel Survey, and the Medicare Provider Analysis and Review in my research before. How are HCUP databases different from these? Lauren: All of these databases are invaluable in conducting meaningful health services research, but specific databases may be more suited for certain types of analyses. Read below to find out how these databases compare to the HCUP databases. The National Hospital Care Survey (NHCS) The Medical Expenditure Panel Survey (MEPS) The Medicare Provider Analysis and Review (MedPAR)
Sean: Okay, I'd like to take a moment to review what HCUP data are and what they aren't before we proceed to learn about each of the HCUP databases. Are these characteristics of HCUP databases? Answer yes or no for each statement listed below. There will be more than 1 right answer for this exercise.
Select this link for the answers to the Overview Knowledge Check: Answers to Overview Knowledge Check Sean: Lauren, thanks for the overview of HCUP. Can you tell me more about each of the HCUP databases?
SID/What are the SID? Lauren: At the center of HCUP's inpatient data are the State Inpatient Databases (SID).
SID/Data Sources Lauren: The SID are derived from hospital billing data. This type of data is also referred to as "administrative data.". To better understand what this means, let's take a look back at the experience of one of our patients.
Sean: So, if I decided that I could use the SID in my research project, what would be included in the actual database itself? Lauren: Each SID contains three types of data files: a core file containing common elements and state-specific variables, a charges file, and an AHA linkage file. The Core and Charges files are discharge-level files. The AHA Linkage file is a hospital-level file. Core File: Core Data Elements
Core File: State-specific Data Elements
Charges File
American Hospital Association (AHA) Linkage File
Sean: My understanding is that AHRQ collects data from State-level data organizations to produce the SID files. Lauren: The HCUP SID contain value-added data elements and pass standard data quality checks. Most important, the HCUP SID are uniformly coded. Uniform coding occurs across States, making State-to-State comparisons much easier. Read more about the key differences below. Have Value-Added Data Elements Pass Standard Data Quality Checks Are Uniformly Coded Across States
SID/Availability and Pricing Lauren: The SID are updated annually, and are released as they become available throughout the year.
SID/Research Topics Lauren: The SID can support many types of health services research.
Sean: I feel like I have a good understanding of what's included in the SID now. Do you? Take a moment to identify what types of care would and would not be captured in the SID by answering the questions below. Jane has a Cesarean section and remains in the hospital for two days. Would this record be included in the SID?
Madison receives routine vaccines and a check-up at her doctor's office. Would this be captured in the SID?
Mark is released after receiving outpatient treatment for a broken leg. Would this record be included in the SID?
Helen is admitted to a hospital with pneumonia. Would the record of her hospital treatment be included in the SID?
Select this link for the answers to the SID Knowledge Check: Answers to SID Knowledge Check
SID/Summary Lauren: To summarize, the SID contain all of the inpatient discharge records from community hospitals in participating States, translated into a uniform format to facilitate multi-State comparisons and analyses. Together the SID encompass about 97 percent of all U.S. community hospital discharges.
Additional information is available on the HCUP User Support website.
NIS/What is the NIS? Sean: The SID sounds invaluable for investigating health issues or trends in a specific market or State, but I need national data for my research on current trends in obesity-related procedures. Lauren: Don't worry. There is an HCUP database for you. HCUP creates the National Inpatient Sample (NIS) to make it possible for researchers to conduct national and regional analyses of hospital use and the hospital charges and costs associated with inpatient care.
NIS/Sample Design Lauren: The NIS is derived from the SID and approximates a 20% sample of discharges from all HCUP community hospitals in the U.S. The SID Sampling Sampling Strata
Sample Size The NIS Prior to the 2012 NIS Lauren: Prior to the 2012 data year, the National Inpatient Sample was called the Nationwide Inpatient Sample. For the 2012 data year, the NIS was redesigned to improve national estimates. To highlight the design change, AHRQ renamed the "Nationwide" Inpatient Sample (NIS) to the "National" Inpatient Sample (NIS). More information on the 2012 NIS Redesign is available on the HCUP-US website. Beginning with the 2012 data year, the NIS contains a sample of discharge records from all hospitals participating in HCUP. Previous versions of the NIS contained all discharge records from a sample of hospitals participating in HCUP. In order to allow more refined analyses of geographic variation in U.S. hospitalizations, the new NIS sampling design includes stratifiers for nine Census Divisions rather than four Census Regions that had been in the earlier NIS. This new sampling strategy results in estimates with more precise statistical properties than the previous NIS design. |
| Pre and Post 2012 NIS Redesign | ||
|---|---|---|
| New NIS (beginning in 2012 Data Year) | Previous NIS (1998-2011 Data Year) | |
| Name | National Inpatient Sample (NIS) | Nationwide Inpatient Sample (NIS) |
| Universe | Removed long-term acute care hospitals | Included long-term acute care hospitals |
| Annual discharge estimates and hospital entities based on information from the SID when available; otherwise based on AHA information | Annual discharge estimates and hospital entities based on information from AHA | |
| Strata | Used hospital census division (9) for stratification | Used hospital census region (4) for stratification |
| Sample Design | 7 million hospital discharge records from more than 4,000 HCUP reporting hospitals | 1,000 sampled hospitals amounting to more than 8 million records |
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Lauren: Let's take a closer look at the differences between the NIS and the SID. All Discharges vs. Sample Data Elements Value-Added Variables: Severity Measures
For further information, refer to the HCUP-US website. Hospital Characteristics
NIS/Availability and Pricing Lauren: The NIS is one of the most popular HCUP databases and is released every year. It is an affordable database that is available through the online HCUP Central Distributor. For more information on the NIS, see the NIS Overview. Price:
Student Price:
NIS/Research Topics Lauren: The NIS can be used to examine many important aspects of healthcare services and healthcare policy, including the use of hospital services, charges and costs for these services, medical practice variation, medical treatment effectiveness, the quality of care and patient safety, the impact of health policy changes, the diffusion of medical technology, and disparities in the use of hospital services.
Sean: The NIS seems like a good choice to study my research topic of interest, national trends in obesity-related procedures, but let's take a moment to identify whether the SID or the NIS would be better for some other research topics by answering the questions below. Anna would like to compare hospitalizations for pneumonia in Maryland with those in Florida. Which database would Anna want to use?
Linda would like to identify national trends in diabetes hospitalizations. Which database would Linda want to use?
Tim would like to identify regional trends in hospitalizations for coronary artery bypass graft (CABG) procedures within the U.S. Which database would Tim want to use?
Select this link for the answers to the NIS Knowledge Check: Answers to NIS Knowledge Check NIS/Summary Lauren: Before we move on, let's review. The NIS is derived from the SID to allow researchers and policymakers to identify, track, and analyze national and regional trends in healthcare utilization, access, charges, quality, and outcomes. The NIS's large sample size enables analyses of rare conditions, such as congenital anomalies; uncommon treatments, such as organ transplantation; and different patient characteristics such as age, gender, geographic region etc. In addition, the NIS is the only national hospital database with charge information on all patients, regardless of payer, including persons covered by Medicare, Medicaid, private insurance, self-pay, or those billed as 'no charge'. Prior to 2012, the NIS included hospital identifiers that permitted linkages to the American Hospital Association Annual Survey of Hospitals and county identifiers that permitted linkages to the Area Resource File. Beginning in the 2012 data year, this was not applicable. Additional information is available on the HCUP User Support website.
KID/What is the KID? Lauren: Much like the NIS, the Kids' Inpatient Database (KID) is derived from the SID. However, the purpose of the KID is to enhance research on inpatient stays for children and to enable researchers to make national estimates. The KID is the only hospital administrative data set designed specifically to assess use of hospital services by newborns, children, and adolescents. It allows researchers to study specific conditions, procedures, and subpopulations that are sometimes difficult to analyze with other databases because children account for a relatively small proportion of hospital stays.
KID/Sample Design Sean: Since the KID is derived from the SID, I'd imagine the creation of it is similar to that of the NIS. Lauren: For the most part it is, but there are a few differences. Both the NIS and the KID are derived from the SID.
KID Strata The KID
KID/Availability and Pricing Lauren: Like the NIS, the KID is affordable and available through the online HCUP Central Distributor, so the purchasing process is straight forward. It is released every three years and pricing is shown below. Like the NIS, AHRQ offers a discounted price for students. For more information on the KID, see the KID Overview. Please note: The KID is released every 3 years. However, since ICD-10-CM/PCS was introduced in October 2015, the KID release was deferred from data year 2015 to data year 2016. Price:
Student Price:
KID/Research Topics and Examples Lauren: There are numerous ways in which the KID can be used to support health services policy decisions and research. The KID enables studies on important topics such as the study of common and rare pediatric conditions, the impact of medical policy changes, variation in medical treatment, congenital abnormalities, and the economic burden of specific conditions. The KID is especially useful in studying rare pediatric conditions.
Sean: So when would a researcher want to use the SID, the NIS, or the KID? Let's take a look at some examples and answer the questions below. You will be presented with different research topics and asked to identify which database or databases would be most appropriate. Select all the databases that apply. Take a moment to read the feedback before moving on. Robert would like to study pediatric heart surgeries in children on a national-level. Which database(s) would Robert want to use?
Juliana would like to identify differences in asthma hospitalizations for children and adults on a national-level. Which database(s) would Juliana want to use?
James would like to identify differences in hospitalization rates of children with complications of diabetes between two neighboring States. Which database(s) would James want to use?
Select this link for the answers to the KID Knowledge Check: Answers to KID Knowledge Check KID/Summary Lauren: The KID is derived from the SID to permit researchers to study a broad range of conditions and procedures related to child health issues. Researchers and policymakers can use the KID to identify, track, and analyze national trends in healthcare utilization, access, charges and costs, quality, and outcomes. It is the only all-payer inpatient care database for children in the United States, and it is designed to permit research on rare pediatric conditions. Sean: And let me guess, we can visit the HCUP User Support website to learn more about the KID? Lauren: Absolutely. You can find more details on the HCUP User Support website.
SASD/What are the SASD? Lauren: Now that we've learned about inpatient data available from HCUP, let's take a look at available outpatient data. Sean: I didn't realize that HCUP had outpatient databases. Lauren: Many researchers don't realize that the HCUP databases include both inpatient and outpatient data. Outpatient data are available in the State Ambulatory Surgery and Services Databases (SASD), the State Emergency Department Databases (SEDD), the Nationwide Emergency Department Sample (NEDS), and the Nationwide Ambulatory Surgery Sample (NASS). We'll discuss the SEDD. NEDS, and NASS shortly. Let's begin by taking a look at the SASD. The SASD include encounter-level data for ambulatory surgery and other outpatient services from hospital-owned facilities. In addition, some States provide ambulatory surgery and outpatient services from nonhospital-owned facilities. *The term "discharge" is reserved to describe inpatient services in which a patient has been admitted for care and subsequently discharged. HCUP uses the term "encounter" in reference to outpatient services.
SASD/Data Sources Lauren: To better understand the SASD, let's take a look at how they are created. Types of Facilities Hospital-Owned Surgery Centers Non-hospital Owned Surgery Centers HCUP Processes Data
Sean: What types of care would and would not be captured in the SASD? You will be presented with different types of care and asked to identify whether each would or would not be captured in the SASD. Select an answer, and then take a moment to read the feedback before moving on. John has a routine colonoscopy at a hospital-owned outpatient surgery center. Would this be captured by the SASD?
Mary has an elective skin biopsy performed in her physician's office. Would this be captured by the SASD?
David has an elective knee arthroplasty done in a nonhospital-owned surgery center. Would this be captured by the SASD?
Select this link for the answers to the SASD Knowledge Check: Answers to SASD Knowledge Check
Sean: If I wanted to compare inpatient and outpatient obesity-related surgeries, would the file structure of the SASD be similar to that of the SID? Lauren: Yes, let's take a look. Core Variables *ICD-9-CM prior to October 1, 2015 State-Specific Variables
SASD/Availability and Pricing Lauren: The SASD are updated annually, and additional States participating in the SASD are added when new collections become available. Like the SID, each State sets its own price for the SASD, and prices can vary. Many of the States have agreed to allow the online HCUP Central Distributor to distribute their SASD. The HCUP Central Distributor handles these transactions as a service to the States and payments for the SASD are returned directly to the States. For more information on the SASD, see the SASD Overview.
Lauren: The SASD can help address a number of research topics that pertain to ambulatory surgeries. Sean could expand his research to include both inpatient and ambulatory surgery data. There has been some talk about bariatric surgeries being performed in the outpatient setting of the hospital in the near future. You could use these data to identify State-specific trends in ambulatory surgery utilization, access, charges, and outcomes. You can also use it to conduct market area research or small area variation analyses. You could even use it in combination with the SID to examine complications of ambulatory surgeries that result in inpatient admissions. SASD/Summary Lauren: To sum it all up, the SASD include data for ambulatory surgery and other outpatient services from hospital-owned facilities. In addition, some States provide ambulatory surgery and outpatient services from non-hospital owned facilities. The SASD files include all patients, regardless of payer, providing a unique view of ambulatory surgeries in a defined market or in a State over time. They contain a core set of uniform clinical and non-clinical data elements common to all SASD, and some include other elements such as the patient's race. Additional information about the SASD is available on the HCUP User Support website.
NASS/What is the NASS? Lauren: The HCUP SASD include encounter-level data for ambulatory surgery and other outpatient services from hospital-owned facilities. The Nationwide Ambulatory Surgery Sample or NASS is derived from the SASD. If you want to research national estimates of ambulatory surgery encounters, you would use the NASS.
NASS/Sample Design Lauren: The NASS is the largest all-payer publicly available ambulatory surgery database in the United States that is derived from the SASD. The SASD In-Scope Procedures NASS Universe Sampling Frame Encounter Weights
The NASS
NASS/Comparison to the SASD Lauren: Let's take a closer look at differences between the NASS and the SASD. Click each item below to see how they compare. Sample vs. All Encounters The NASS is limited to encounters performed at hospital-owned facilities that involve at least one in-scope major ambulatory surgery. In contrast, the SASD may include encounter-level data for all ambulatory surgeries (including diagnostic procedures) and may also include data for various types of outpatient services (e.g., radiation therapy and imaging). The specific types of surgery and services included in the SASD vary by State and data year. Data Elements The NASS contains fewer data elements than the SASD, but most of these variables are standardized. NASS data elements include patient demographics, clinical diagnostic and surgical procedure codes, total charges and expected source of payment, patient disposition, and facility characteristics. Refer to the NASS documentation available on HCUP-US for more detailed information. Value-Added Variables The NASS contains hospital characteristics derived from the AHA Annual Survey Database. These include:
NASS/Availability and Pricing Lauren: The NASS is released every year through the online HCUP Central Distributor. Pricing is shown below. Like the other HCUP databases, AHRQ offers a discounted price for students. For more information on the NASS, see the NEDS NASS Overview. Please note: The KID is released every 3 years. However, since ICD-10 was introduced in October 2015, the KID release was deferred from data year 2015 to data year 2016. Price:
Student Price:
NASS/Research Topics and Examples Lauren: The NASS can be used for wide-ranging studies of health care services and supports healthcare policy and research on a variety of topics such as:
Lauren: Take a moment to identify whether the SASD, the NIS, or the NASS, would be better for certain research topics by answering the following questions.
Jeremy would like to identify the most common major ambulatory surgeries performed in hospital-owned facilities nationwide. Which database would Jeremy want to use?
Craig is investigating patient characteristics associated with inpatient cholecystectomies performed in U.S. hospital-owned facilities. Which database would Craig use?
Annette is conducting research on total charges for major ambulatory surgery encounters performed in facilities owned by not-for-profit hospitals. Which database would Annette want to use?
Dave is investigating the number of diagnostic ambulatory colonoscopies performed in hospital-owned facilities in California. Which database would Dave use?
Select this link for the answers to the NASS Knowledge Check: Answers to NASS Knowledge Check NASS/Summary Lauren: Before we move on, let's review. The NASS is derived from the SASD. It is the largest all-payer ambulatory surgery database constructed in the United States. The NASS yields national estimates of major ambulatory surgery encounters performed in hospital-owned facilities. It allows researchers to conduct analyses of selected ambulatory surgery utilization patterns and trends. Additional information is available on the HCUP User Support website.
SEDD/What are the SEDD? Sean: Are any other types of outpatient care captured in HCUP databases? Lauren: Yes, the HCUP databases also capture emergency department utilization in three databases. The State Inpatient Databases (SID) contain a universe of the inpatient discharge abstracts in participating States, including those for patients who were admitted to the hospital from the emergency department. The State Emergency Department Databases (SEDD) contain the emergency department encounter abstracts in participating States for patients who were treated in an emergency department and then released. The Nationwide Emergency Department Sample (NEDS) was constructed using records from both the SID and the SEDD. The NEDS yields national estimates of emergency department visits. Let's start by talking about the SEDD.
SEDD/Data Sources Lauren: The SEDD are derived from encounter abstracts and uniform billing data from hospital-owned emergency department visits. Visits that result in an admission to the hospital are not included in the SEDD; rather, they are included in the SID.
Sean: My guess is that the data elements and file structure of the SEDD are similar to that of the SID and the SASD. Core Variables State-Specific Variables
SEDD/Availability and Pricing Lauren: The SEDD are released every year. Like the other State databases, the SID and the SASD, each State sets its own price for the SEDD. The cost of the SEDD varies per data set, per year. Many of the States have agreed to allow the online HCUP Central Distributor to distribute their SEDD. The HCUP Central Distributor handles these transactions as a service to the States—payments for the SEDD are returned directly to the States. For more information on the SEDD, see the SEDD Overview.
SEDD/Research Topics Lauren: There are many interesting ways to use the SEDD. The SEDD can be used to examine State-specific trends in emergency department utilization, access, charges, and outcomes. Researchers can also use the SEDD to conduct market area research or small area variation analyses. The SEDD can be used to identify patterns of care for patients with various demographic and clinical characteristics and to address research topics related to injury surveillance, trends in emergency department use, correlations between ED use and environmental events, and occurrence of non-fatal, preventable illnesses. For certain States, the SEDD can be used to examine emergency department visits and re-visits. Because emergency department visits that result in an admission to the hospital are not included in the SEDD, researchers who are interested in studying all visits that originate in the ED may prefer to work with both the SEDD and the SID. Studying both of these databases will provide a more complete State-level perspective by integrating outpatient and inpatient care data. For a nationwide perspective of ED visits, researchers should use the Nationwide Emergency Department Sample, the NEDS.
Lauren: So HCUP includes three state-level databases: the SID, the SASD, and the SEDD. When would a researcher want to use one over the other, or some combination of two or three? You will be presented with different research topics and asked to identify which database or which databases would be most appropriate. Select all the database that apply. Take a moment to read the feedback before moving on. Michele is studying hospital charges associated with Medicaid emergency department visits that are not hospitalized. Which database(s) would Michele want to use?
John is interested in researching the percentage of emergency room visits for asthma that result in hospitalization in Maryland. Which database(s) would John want to use?
Andrea is conducting research on the frequency of hysterectomies in a specific State. She understands that sometimes hysterectomies are performed in both the inpatient and outpatient settings of the hospital. Which database(s) would Andrea want to use?
Joe would like to identify serious complications resulting from outpatient surgeries that required hospitalization. Which database(s) would Joe want to use?
Select this link for the answers to the SEDD Knowledge Check: Answers to SEDD Knowledge Check SEDD/Summary Lauren: So to summarize, the SEDD capture encounter information on all emergency department visits that do not result in an admission to the same hospital. The SEDD contain the emergency department encounter abstracts in participating States and are translated into a uniform format to facilitate multi-State comparisons and analyses. They contain a core set of clinical and non-clinical information on all patients, regardless of payer, including persons covered by Medicare, Medicaid, private insurance, self-pay, or those billed as 'no charge'. In addition to the core set of uniform data elements common to all SEDD, some State data include other elements, such as the patient's race. More information is available on the HCUP User Support website.
Sean: I know that the HCUP SEDD contain only ED visits that are considered treat-and-release. I am interested in studying all ED visits—those which result in an inpatient admission to the same hospital as well as those that are treat-and-release? Lauren: HCUP creates the Nationwide Emergency Department Sample (NEDS) so that researchers can investigate emergency department utilization patterns—for both types of visits—on a national level. The NEDS includes data on treat-and-release visits and on visits resulting in an inpatient admission to the same hospital. The database enables national and regional analyses of emergency department utilization, charges and outcomes.
Lauren: The NEDS, which is the largest all-payer emergency department database that is publicly available in the United States, is derived from the SID and the SEDD. The SID The SEDD The SEDD capture discharge information on all the emergency department visits that do not result in an admission to that hospital—in other words, those in which the patient is treated and released. Sampling Sampling Strata
Sample Size The NEDS
NEDS/Comparison to the SID and SEDD Lauren: Let's take a closer look at the differences between the NEDS, SID, and the SEDD to see how they compare. All Discharges vs. Sample Data Elements Hospital Characteristics
Trauma Center Designation
NEDS/Availability and Pricing Lauren: The NEDS is released every year through the online HCUP Central Distributor. Pricing is shown below. Like the other HCUP databases, AHRQ offers a discounted price for students. For more information on the NEDS, see the NEDS Overview. Price:
Student Price:
NEDS/Research Topics and Examples Lauren: The NEDS can be used to investigate many aspects of emergency department utilization, including quality of emergency care, differences in use of ED services in rural and urban areas, impact of health policy changes, differences in admission rates, access to care, and the use of ED services by special populations.
Sean: Take a moment to identify whether the SID, the SEDD, the NIS or the NEDS would be better for certain research topics by answering the following questions. You will be presented with different research topics and asked to identify which database would be more appropriate. Select an answer, and then take a moment to read the feedback before moving on. Chris is investigating how nationwide emergency department visits that result in hospital admission differ from treat-and-release visits in terms of patient characteristics such as age, gender, or income level of their community. Which database would Chris want to use?
Jacob would like to identify regional trends in emergency department use for asthma within the U.S. Which database would Jacob want to use?
Katheryn is conducting research on how treat-and-release emergency department visits vary for motor vehicle accidents differ between California and New York. Which database would Kathryn want to use?
Amy is interested in examining national trends in costs associated with inpatient admissions that originated in the ED and those that were routinely admitted. Which database should Amy use in her research?
Select this link for the answers to the NEDS Knowledge Check: Answers to NEDS Knowledge Check NEDS/Summary Sean: Before we move on, let's review. The NEDS is derived from the SID and the SEDD to allow researchers and policymakers to identify, track, and analyze national and regional trends in emergency department utilization, access, charges, quality, and outcomes. The NEDS' large sample size enables analyses of relatively uncommon disorders and procedures and special patient populations treated in the emergency department. The NEDS is the largest all-payer database in the United States containing information on emergency department care. Lauren: Of course, you can find this and more information about the NEDS on the HCUP User Support website.
NRD/What is the NRD? Lauren: Much like the NIS, the Nationwide Readmissions Database (NRD) is derived from the SID. However, the purpose of the NRD is to enhance research on hospital readmissions. The NRD addresses a large gap in healthcare data—the lack of nationally representative information on hospital readmissions for all types of patients, regardless of the expected payer for the hospital stay. The NRD is designed to allow users to investigate various types of analyses of readmissions. Criteria to determine the relationship between multiple hospital admissions for an individual patient in a calendar year is left to the analyst using the NRD.
NRD/Sample Design Lauren: The NRD is derived from the SID with verified patient linkage numbers that can be used to track a patient across hospital stays, while adhering to strict privacy guidelines. The NRD was created to enable analyses of national readmission rates. The SID Some SID include synthetic patient linkage numbers that can be used to track patients within and across hospitals in a particular State. States selected for the NRD have verified patient linkage numbers on at least 90 percent of adult discharges. Sampling The NRD includes community hospitals, excluding rehabilitation or long-term acute care hospitals. All discharges from the SID are included except the following:
After exclusions, the NRD contains about 85% of SID discharges from the participating States. Sampling Strata NRD Sampling Strata Variables Discharges are post-stratified in the NRD on the basis of five hospital characteristics (referred to as "strata" in HCUP) and two patient characteristics.
Stratification variables include:
Sample Size The NRD contains over 14 million hospital discharge records from community hospitals excluding rehabilitation or long-term acute care hospitals. The NRD includes discharges for patients with and without repeat hospital visits in a year and those who have died in the hospital. Repeat visits may or may not be related. The criteria to determine the relationship between hospital admissions is left to the analyst using the NRD. The NRD The NRD is designed to be flexible to various types of analyses of national readmissions for all types of payers including Medicare, Medicaid, private insurance, self-pay, or those billed as 'no charge'. Outcomes of interest include national readmission rates, reasons for returning to the hospital for care, and the hospital costs for discharges with and without readmissions. The NRD is not designed to support regional, State, or hospital-specific readmission analyses. If you are interested in analyses by State, obtain the State-specific SID.
Lauren: Let's take a closer look at the differences between the NRD and the SID. Refer to the documentation on the HCUP-US website for more detailed information. All Discharges in a State vs. Discharges Pooled Across States The NRD is a sample from the SID with patient linkage numbers on at least 90 percent of adult discharges. After exclusions for missing or questionable patient linkage numbers and patients aged 0 years in some States, the NRD contains about 85 percent of SID discharges from the participating States. In contrast, the SID captures all discharges from community hospitals in each State. Only some SID include patient linkage numbers. Data Elements The NRD and some SID include the HCUP revisit variables that contain verified synthetic linkage numbers that can be used to track a patient across hospital stays within a State. There are two key revisit variables:
Hospital Characteristics and Discharge Weights The NRD contains hospital characteristics derived from the AHA Annual Survey Database. These include:
The NRD also include discharge weights that allow the user to calculate national estimates of readmission counts and rates. The NRD is not designed to support regional, State, or hospital-specific readmission analyses. The SID can be used to examine State-level or local-area readmission rates.
Lauren: The NRD is released every year through the online HCUP Central Distributor. Similar to the other HCUP databases, AHRQ offers a discounted price for students. For more information on the NRD, see the NRD Overview. Price:
Student Price
NRD/Research Topics and Examples Lauren: The NRD can be used to investigate national readmission rates by diagnosis, procedure, patient demographics, or expected payment source, costs associated with readmissions, and reasons for readmissions, and impact of health policy changes.
Lauren: Take a moment to identify whether the SID, the NIS, the KID, or the NRD would be better for certain research topics by answering the questions below. You will be presented with different research topics and asked to identify which database would be more appropriate. Select an answer, and then take a moment to read the feedback before moving on. Dan is investigating how national readmission rates for heart attack vary by hospital characteristics such as teaching status and ownership. Which database would Dan want to use?
Frank would like to examine differences in readmission rates for hospitals in the Northeast. Which database would Frank want to use?
Katie is conducting research on hospital stays for pneumonia including total utilization in the U.S. and variation by age. Which database would Katie want to use?
Steven is interested in pediatric readmissions for sickle cell anemia in the U.S. Which database should Steven use in his research?
Select this link for the answers to the NRD Knowledge Check: Answers to NRD Knowledge Check NRD/Summary Lauren: Before we move on, let's review. The NRD is derived from the SID that contain reliable, verified patient linkage numbers that can be used to track a person across hospitals within a State, while adhering to strict privacy guidelines. The NRD was created to enable analyses of national readmission rates. The NRD addresses a large gap in healthcare data—the lack of nationally representative information on hospital readmissions for all patients. The NRD is designed to be flexible to various types of analyses of national readmissions for all patients, regardless of the expected payer for the hospital stay. The criteria to determine the relationship between multiple hospital admissions for an individual patient is left to the analyst using the NRD. Outcomes of interest include national readmission rates, reasons for returning to the hospital for care, and the hospital costs for discharges with and without readmissions. The NRD is not designed to support regional, State, or hospital-specific readmission analyses and cannot be used to track patients across States or years. Additional information is available on the HCUP User Support website.
Using HCUP Data/Benefits and Limitations Lauren: Now that we've learned about each of databases, let's take a closer look at the benefits and limitations of HCUP data. Sean: Since HCUP databases include all discharge data from community hospitals in participating States, a large number of patients are represented, making national or regional estimates possible and allowing for the study of rare diseases. Lauren: That's true. HCUP databases represent a large number of records which allows for national, regional, and state estimates. HCUP data is collected on a regular basis due to regular, routine standard hospital operations. HCUP databases also include all-payer information so groups like Medicare beneficiaries can be studied. The databases have been evaluated against other sources of data to ensure accuracy. Because the databases are uniform and have been available for some time, the databases are useful for trend analysis. HCUP databases are easily accessible, and available for purchase through the HCUP Central Distributor. HCUP databases are available for State analyses, and nationwide analyses of regional and nationwide estimates. Lastly, Supplemental files augment applicable HCUP databases with additional data elements and useful information. Sean: All-payer information, ease of access, large number of records. Those benefits make a strong case for using HCUP databases. What are the limitations? Lauren: HCUP databases have limited clinical details and differences in coding across hospitals. HCUP data only include non-federal community hospitals. While these community hospitals account for 85% of hospitals in the U.S., HCUP does not include all hospitals. None of the HCUP databases currently include outpatient office visit data, so it's not possible to show a complete episode of care. HCUP data does not include data on individuals outside the hospital system. HCUP national databases cannot be linked to external data such as the American Hospital Association Annual Survey of Hospitals and the Area Resource File. Read the items below for more detail. Benefits: Large number of records Benefits: Regular, routine collection Benefits: All payers, so groups like Medicare beneficiaries can be studied. Benefits: Uniformity in coding Benefits: Ease of access Benefits: Available at local, State, regional, and national level Benefits: Supplemental files available to facilitate research Limitations: Limited clinical detail Limitations: Differences in coding across hospitals Limitations: Does not include all hospital types (e.g., VA and DOD) Limitations: Does not show complete episode of care Limitations: No data on individuals outside of the hospital system Limitations: Cannot link national databases to external sources
Using HCUP Data/Which database should I use? Lauren: Once you decide that the HCUP databases can help with your research, you then need to determine which of the databases will be most suited for your analysis. It is important to ask the right questions to decide whether HCUP can help address your research topic. Let's take a look at Sean's research topic — national trends in obesity-related procedures — and determine which HCUP database will best fit his needs. Sean has already answered the first question:
Sean, are you looking at inpatient or outpatient data? Sean: Currently, most obesity-related procedures are inpatient so I plan on focusing my research there.
Lauren: That eliminates outpatient databases: the SASD, the SEDD, the NEDS, and the NASS. The next question to ask is what variables you need for your analysis. We've talked about common data elements included in all the databases and State-specific variables that are only included when released by the States. It sounds like you'll mainly be looking at diagnoses, procedures, and possibly patient demographics.
Next you'll need to determine if you want national estimates. Sean: Since I'm looking for national trends, I certainly will want national estimates. That would eliminate the SID. Lauren: Correct, and if you are not specifically interested in readmission analyses, that will eliminate the NRD. Sean: That leaves just the NIS and the KID, but I'm interested in adults. That eliminates the KID and leaves the NIS as the best database for my research topic.
Using HCUP Data/Obtaining HCUP Data Lauren: Earlier in the course, we talked about how you would access the HCUP databases. To summarize, national and State databases, are available directly through the online HCUP Central Distributor. Before purchasing any data files from the HCUP Central Distributor, individuals must complete the HCUP Data Use Agreement Training Course. This training outlines important points in the DUA. After completing the training, you will receive a certification code. Use this code in your application for purchasing HCUP databases. Refer to the online HCUP Central Distributor to review available State data, purchase price, and years available. Lauren: The DUA is a legally binding agreement with AHRQ that defines how you can use the HCUP data. When you sign the agreement you agree to comply with the requirements listed. If you violate the DUA, the following consequences may occur:
The DUA outlines Protection of Individual Identities by adhering to guidelines:
The DUA outlines Restrictions of Hospital Identification by not publishing or reporting data that could identify individual establishments directly or by inference. The DUA outlines appropriate Use of HCUP data. You are responsible for how you and others use the data to which you have access.
The DUA outlines Data Use Restrictions. You are prohibited by the HCUP DUA from:
The HCUP DUA is consistent with HIPAA requirements for use of a limited data set. The DUA has specific Publishing Recommendations: It is important that you properly acknowledge AHRQ and the specific database(s) used in your publication.
Using HCUP Data/Knowledge Check Sean: I'll be using the NIS through the HCUP Central Distributor for my research, but one of my colleagues, Jamie, is comparing hernia inpatient and outpatient surgeries in three different States. Can you help Jamie access the HCUP data that she'll need for her research? Jamie will need to use the SID and the SASD for three different States. She has checked the HCUP User Support website and knows that two of the States are available through the HCUP Central Distributor and one is available through the State. What should she contact to begin this process?
Select this link for the answers to the Using HCUP Data Knowledge Check: Answers to Using HCUP Data Knowledge Check
Using HCUP Data/Statistical Programming Software Lauren: To work effectively with the HCUP databases, you will need to use a statistical software package. SAS, SUDAAN, Stata, SPSS and R are some of the most frequently used packages, but many such products are available. Working with these software tools requires some programming expertise. Because of the size and complexity of the HCUP databases, they cannot be analyzed using desktop spreadsheets or database applications. AHRQ provides example programs in SAS, SPSS, Stata, SUDAAN, and R. Example programs include database load programs, format programs, examples of statistical coding, and programs designed to help users apply the HCUP tools. |
| Example Programs Provided by AHRQ | |||||
|---|---|---|---|---|---|
| SAS® | SPSS® | Stata® | SUDAAN® | R® | |
| Load Programs | Yes | Yes | Yes | ||
| Format Programs | Yes | ||||
| Example Statistical Coding Statement | Yes | Yes | Yes | Yes | |
| HCUP Tool Programs | Yes | Yes | Yes | ||
|
Tools and Reports/HCUPnet Overview Lauren: A convenient and valuable way to access HCUP statistics is through a free online querying system known as HCUPnet. HCUPnet provides free and immediate access to national, regional, and State-level and county-level hospital inpatient statistics based on HCUP pre-aggregated statistical data.
Tools and Reports/Using HCUPnet Lauren: Here we are at the HCUPnet home page. Follow the directions to use HCUPnet to get a national perspective on how the number of obesity-related procedures has changed in the past few years. Sean will appreciate the help. Use HCUPnet to obtain a national perspective on how the number of obesity-related procedures has changed in the past few years. Several options exist for assessing different types of statistics available on the HCUPnet home page. You will have the choice to select setting of care by Inpatient, Emergency Department, Readmissions or Community. For this example, click the Inpatient Setting option. Before moving forward, you will also need to accept the terms of the HCUP Data Use Agreement. Using the top menu on next screen, you will customize how you would like to analyze the data by choosing either the All Stays or Diagnoses and Procedures designation under the National Inpatient setting drop-down. Because we are interested in seeing how the number of obesity-related procedures has changed through the years, we will first select Diagnoses and Procedures from the drop-down. Next, we will choose Trends from the options "Trends" or "Cross-Sectional" to view our analysis. The menu located on the left-hand side of the screen will allow you to further determine different analyses of the data such as by classification types for diagnosis or procedure codes. Under the Classification Types heading, - click on the drop-down arrow. From here, select Medicare-Severity Diagnosis Related Groups (MS-DRG). Next, the analysis can be run by Principal or All-Listed Diagnoses/Procedures. For this query, we will retain the default Principal designation. Under the Diagnoses/Procedures drop-down, we will change the default from (All) to MS-DRG 619: o.r. procedures for obesity with mcc. As the selections are made to customize a query, results will be updated and displayed in a table in the lower-hand half of the screen. Users have the option to graph results from the table(s) by selecting the query in the Diagnoses/Procedures to Graph legend on the upper right-hand side of the screen. The interactive graph feature allows users to hover over data points of interest to reveal their values. Click "Show 95% CI" to display confidence intervals and standard errors on the query. A free Z-Test Calculator is available for users along the top menu bar. Under Z Test Calculator, ESTIMATE 1 and ESTIMATE 2 appear. The blank boxes allow the user to put in discharges and standard errors. Under ESTIMATE 1 and ESTIMATE 2, use the numbers from the analyses. For this example, we will fill in years 2008 and 2019 discharges and standard errors. Click "Calculate". The standard errors results will display below the calculate button. All years of data - 2008 through 2019 will appear in a graphical format. Users have the option to download the statistics from their query in Excel or PDF format.
Sean: Lauren, HCUPnet seems very useful. It's a nice way to get a feel for the HCUP data before purchasing the full files. Lauren: Yes, in addition to HCUPnet, AHRQ has developed many free software tools to help researchers make the most of HCUP data. AHRQ has developed software tools to enhance a researcher's ability to conduct analyses with HCUP and other administrative databases. For additional information, refer to the HCUP Tools & Software page of the HCUP-US website. The HCUP Software Tools for ICD-10-CM Diagnoses include:
These tools are designed for use with ICD-10-CM diagnosis codes, which are reported in both inpatient and outpatient administrative data as of October 1, 2015. The HCUP Software Tools for ICD-10-PCS Procedures include:
These tools are designed for use with ICD-10-PCS procedure codes, which are only reported in inpatient administrative data as of October 1, 2015. The HCUP Software Tools for CPT/HCPCS Level II Procedures include:
Tools for ICD-9-CM Diagnoses and Procedures The HCUP Software Tools for ICD-9-CM Diagnoses and Procedures include:
These tools are designed for use with ICD-9-CM diagnosis and procedure codes, which were reported in inpatient and outpatient administrative data through September 30, 2015. AHRQ Quality Indicators (QIs) include:
These tools are measures of healthcare quality that utilize readily available hospital inpatient administrative data.
Tools and Reports/HCUP Supplemental Files Lauren: Along with the various HCUP tools, AHRQ provides supplemental files for use in conjunction with the HCUP databases. Cost-to-Charge Ratio (CCR) Files
Hospital Market Structure (HMS) Files
American Hospital Association (AHA) Linkage Files
HCUP Supplemental Variables for Revisit Analysis
Trend Weights Files
Tools and Reports/HCUP Fast Stats Lauren: AHRQ has another on-line tool to help users analyze the data, which is called HCUP Fast Stats. Fast Stats is based on the latest HCUP data. This tool provides:
Currently, Fast Stats includes six topics, including statistics, at the State and National levels.
Tools and Reports/HCUP Reports & Publications Lauren: AHRQ also offers a number of publications useful to researchers. I initially learned about HCUP data after seeing references in publications released by AHRQ such as the The National Healthcare Quality and Disparities Report (NHQDR). HCUP data have also been used extensively in articles published in peer-reviewed journals. Information about the latest HCUP publications and citations for journal articles based on HCUP data, tools, or products, appear on the HCUP User Support website. See the examples below to learn more about HCUP publications:
This web page summarizes key issues for researchers using HCUP and other administrative databases that include International Classification of Diseases, 10th Revision, Clinical Modification/Procedure Coding System (ICD-10-CM/PCS) coding. The page documents key differences in the structure of HCUP databases, provides general guidance to users analyzing outcomes that may be affected by the transition to the ICD-10-CM/PCS coding system, and lists other related resources.
Congressionally Mandated Report: The National Healthcare Quality and Disparities Report
Lauren: HCUP Data Visualizations and Infographics present graphic representations of statistics and findings from HCUP data, reports, and publications.
Sean: Lauren, AHRQ provides so many resources for health researchers like me, but what if I need help later using HCUPnet on my own? Or what if I need specific help finding out how to purchase a database? Lauren: HCUP provides user support services to help you with questions about the various HCUP products and tools. There are a number of ways to access technical assistance.
General Information on the HCUP-US Website General information
HCUP Online Tutorial Series provides HCUP data users with information about HCUP data and tools, as well as training on technical methods for conducting research with HCUP data. www.hcup-us.ahrq.gov/tech_assist/tutorials.jsp
Technical Assistance - HCUP User Support: Email: hcup@ahrq.gov HCUP Frequently Asked Questions (FAQs) The online HCUP Central Distributor Lauren: The HCUP Central Distributor is an online website that accepts, processes, and fulfills applications for the purchase of HCUP databases. HCUP Nationwide and State Databases are available for purchase online through the HCUP Central Distributor to applicants who complete the HCUP Data Use Agreement (DUA) Training and sign an HCUP DUA. Nationwide databases are delivered via secure digital download. State databases are delivered on CD/DVD. Email: hcup@ahrq.gov www.hcup-us.ahrq.gov/tech_assist/centdist.jspHCUP User Support Website Lauren: The HCUP User Support website is a great resource. You can use it to:
Online Tutorial Series Lauren: The HCUP Online Tutorial Series provides HCUP data users with information about HCUP data and tools, and training on technical methods for conducting research with HCUP data. The courses in the HCUP Online Tutorial Series are designed to answer technical questions you may have related to HCUP data and programs. Available tutorials are:
Technical Assistance Sean: Is HCUP Technical Assistance like the technical assistance I've called to try to fix my computer? Lauren: HCUP Technical Assistance is similar, but better! HCUP Technical Assistance is provided by research personnel trained in epidemiology, health services research, statistics, economics, and medicine. While they cannot provide detailed programming or analytic support, they do provide detailed, expert advice on HCUP databases and other related products. They usually respond within three business days. Contact Technical Assistance: hcup@ahrq.gov
User Support/Knowledge Check Lauren: Let's review what HCUP User Support does and what it doesn't do. Read each statement below and determine whether or not it is provided by HCUP User Support.
Sean: Thanks, Lauren. I've certainly learned a lot about HCUP today. Let's review some of the key topics that we discussed. HCUP Databases
Learn more about these databases on the HCUP User Support website. Software Tools and Supplemental Files Research Publications AHRQ-authored publications and reports that rely on HCUP data, such as HCUP Method Series and Statistical Briefs, are also available on the User Support website. Technical Assistance Learn more about user support on the HCUP User Support website.
Lauren: Thank you for completing the course! I hope that I've answered your questions about the HCUP project and databases. If I haven't, remember that HCUP provides user support and additional information online. Check the HCUP-US website or contact Technical Assistance for answers to your questions. Please take a moment to provide AHRQ with course feedback. Click the link below to email us your comments:
Answers: Introduction/Knowledge Check Are these characteristics of HCUP databases? Yes or no?
Good job! You've identified all of the HCUP data characteristics. The foundations of HCUP data are derived from non-Federal community hospital billing data and include inpatient care and certain components of outpatient care. To return to the Overview Knowledge Check, select this link: Return to Overview Knowledge Check
Jane has a Cesarean section and remains in the hospital for two days. Would this record be included in the SID?
Madison receives routine vaccines and a check-up at her doctor's office. Would this be captured in the SID?
Mark is released after receiving outpatient treatment for a broken leg. Would this record be included in the SID?
Helen is admitted to a hospital with pneumonia. Would the record of her hospital treatment be included in the SID?
To return to the SID Knowledge Check, select this link: Return to SID Knowledge Check
Anna would like to compare hospitalizations for pneumonia in Maryland with those in Florida. Which database would Anna want to use?
Linda would like to identify national trends in diabetes hospitalizations. Which database would Linda want to use?
Tim would like to identify regional trends in hospitalizations for coronary artery bypass graft (CABG) procedures within the U.S. Which database would Tim want to use?
To return to the NIS Knowledge Check, select this link: Return to NIS Knowledge Check
Robert would like to study pediatric heart surgeries in children on a national-level. Which database(s) would Robert want to use?
Juliana would like to identify differences in asthma hospitalizations for children and adults on a national-level. Which database(s) would Juliana want to use?
James would like to identify differences in hospitalization rates of children with complications of diabetes between two neighboring States. Which database(s) would James want to use?
To return to the KID Knowledge Check, select this link: Return to KID Knowledge Check
Jeremy would like to identify the most common major ambulatory surgeries performed in hospital-owned facilities nationwide. Which database would Jeremy want to use?
Craig is investigating patient characteristics associated with inpatient cholecystectomies performed in U.S. hospital-owned facilities. Which database would Craig use?
Annette is conducting research on total charges for major ambulatory surgery encounters performed in facilities owned by not-for-profit hospitals. Which database would Annette want to use?
Dave is investigating the number of diagnostic ambulatory colonoscopies performed in hospital-owned facilities in California. Which database would Dave use?
To return to the NASS Knowledge Check, select this link: Return to NASS Knowledge Check
John has a routine colonoscopy at a hospital-affiliated surgery center. Would this be captured by the SASD?
Mary has an elective skin biopsy performed in her physician's office. Would this be captured by the SASD?
David has an elective knee arthroplasty done in a non-hospital owned surgery center. Would this be captured by the SASD?
To return to the SASD Knowledge Check, select this link: Return to SASD Knowledge Check
Michele is studying hospital charges associated with Medicaid emergency department visits that are not hospitalized. Which database(s) would Michele want to use?
John is interested in researching the percentage of emergency room visits for asthma that result in hospitalization in Maryland. Which database(s) would John want to use?
Andrea is conducting research on the frequency of hysterectomies in a specific State. She understands that sometimes hysterectomies are performed in both the inpatient and outpatient settings of the hospital. Which database(s) would Andrea want to use?
Joe would like to identify serious complications resulting from outpatient surgeries that required hospitalization. Which database(s) would Joe want to use?
To return to the SEDD Knowledge Check, select this link: Return to SEDD Knowledge Check
Chris is investigating how nationwide emergency department visits that result in hospital admission differ from treat-and-release visits in terms of patient characteristics such as age, gender, or income level of their community. Which database would Chris want to use?
Jacob would like to identify regional trends in emergency department use for asthma within the U.S. Which database would Jacob want to use?
Kathryn is conducting research on how treat-and-release emergency department visits vary for motor vehicle accidents differ between California and New York. Which database would Kathryn want to use?
Amy is interested in examining national trends in costs associated with inpatient admissions that originated in the ED and those that were routinely admitted. Which database should Amy use in her research?
To return to the NEDS Knowledge Check, select this link: Return to NEDS Knowledge Check
Dan is investigating how national readmission rates for heart attack vary by hospital characteristics such as teaching status and ownership. Which database would Dan want to use?
Frank would like to examine differences in readmission rates for hospitals in the Northeast. Which database would Frank want to use?
Katie is conducting research on hospital stays for pneumonia including total utilization in the U.S. and variation by age. Which database would Katie want to use?
Steven is interested in pediatric readmissions for sickle cell anemia in the U.S. Which database should Steven use in his research?
To return to the NRD Knowledge Check, select this link: Return to NRD Knowledge Check
Answers: Using HCUP Data/Knowledge Check Jamie will need to use the SID and the SASD for three different States.
Jamie will have to contact the HCUP Central Distributor to access two of the States' databases and the Data Organization in the state that does not participate in the CD. What does she need to do to purchase this data?
To return to the Using HCUP Data Knowledge Check, select this link: Return to Using HCUP Data Knowledge Check
Answers: User Support/Knowledge Check
To return to the User Support Knowledge Check, select this link: Return to User Support Knowledge Check
HCUP User Support website: www.hcup-us.ahrq.gov/ HCUP Databases: www.hcup-us.ahrq.gov/databases.jsp HCUP Tools and Software: www.hcup-us.ahrq.gov/tools_software.jsp HCUP Reports & Publications: www.hcup-us.ahrq.gov/reports.jsp HCUP Fast Stats: https://datatools.ahrq.gov/hcup-fast-stats HCUP News and Events: www.hcup-us.ahrq.gov/news.jsp HCUP Technical Assistance: www.hcup-us.ahrq.gov/techassist.jsp For information on obtaining the HCUP databases, please contact the HCUP Central Distributor:
For questions on the HCUP Data Use Agreement, please refer to the Web-based tutorial: HCUP Data Use Agreement Training. To search an HCUP topic, please review the Index Page. To reach HCUP User Support, please contact us via email
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| Internet Citation: HCUP Overview Course - Accessible Version. Healthcare Cost and Utilization Project (HCUP). October 2022. Agency for Healthcare Research and Quality, Rockville, MD. www.hcup-us.ahrq.gov/HCUP_Overview/HCUP_Overview/index508.jsp. |
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