Cost-to-Charge Ratios for Emergency Department Files

The HCUP Cost-to-Charge Ratios for Emergency Department Files (CCR for ED Files) are hospital-level files designed to supplement the data elements in the State Emergency Department Databases (SEDD). HCUP Cost-to-Charge Ratios for Inpatient Files are also available. The CCR Files are part of a family of databases and software tools developed as part of the Healthcare Cost and Utilization Project (HCUP), a Federal-State-Industry partnership sponsored by the Agency for Healthcare Research and Quality. HCUP databases, tools, and software inform decision making at the national, State, and community levels.

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The HCUP SEDD contain data on total charges for each hospital emergency department (ED) visit in the databases. The charge information for ED visits represents the amount that hospitals billed for services, but does not reflect how much hospital services cost or the specific amounts that hospitals received in payment. For some analyses, users may be interested in estimating how hospital charges translate into actual costs.

The HCUP CCR for ED Files enable this conversion. Each file contains hospital-specific cost-to-charge ratios based on all-payer ED costs for nearly every hospital in the corresponding SEDD. Cost information was obtained from the hospital accounting reports collected by the Centers for Medicare & Medicaid Services. Some imputations for missing values were necessary.

Users can merge the data elements on the appropriate file to the corresponding SEDD by the HCUP hospital identification number (HOSPID). Using the merged data elements from the cost-to-charge ratio files and the total charges reported in the SEDD, users may convert the hospital total charge data to cost estimates by simply multiplying the HCUP total charges element (TOTCHG) by the appropriate cost-to-charge ratio.

HCUP CCR for ED Files are designed to be used exclusively with the HCUP SEDD. The CCR Files are unique by year and database.
 
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The HCUP CCR for ED Files are used to estimate the cost of resource use for ED visits based on the reported total charge and the cost-to-charge ratios provided in the supplemental files. Costs reflect the actual expenses incurred in the production of hospital services, such as wages, supplies, and utility costs; charges represent the amount a hospital billed for the case. Hospital charges reflect the amount the hospital billed for the entire ED visit and do not include professional (physician) fees.

The CCR for ED Files allow researchers to obtain costs using hospital-specific ratios, where provided, or by weighted average ratios for hospitals in peer groups defined by hospital characteristics and State.
 
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The HCUP CCR for ED Files are available for the HCUP SEDD beginning with 2017 data.
 
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The HCUP CCR for ED Files are available in comma-separated values (CSV) format. The SEDD files require a statistical software package such as SAS, SPSS, or Stata to use for analytic purposes.
 
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The User Guides for the HCUP CCR for ED Files contain:
  • A more detailed description of the files' purpose, usage, and format
  • Instructions for linking the files to the SEDD
  • Descriptions of key data elements
  • A summary of State participation
Downloading Information

Web browser download: Your browser may support loading the User Guides from this web page. To download the User Guides from this web page, click on the links below, under Documentation for CCR for ED Files, with the right mouse button and select "Save Link As" (Firefox) or "Save Target As" (Internet Explorer). After saving a file, find it by using File Explorer (Windows® 10), Windows Explorer (Windows 98/95/NT), or File Manager (Windows® 3.x), and then open the file by double-clicking on it.

Documentation for the CCR for ED Files

CCR User Guide for Central Distributor SEDD
 
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The HCUP CCR for ED Files are provided as separate files available from the HCUP Central Distributor. These files are free of charge.

The CCR Files for the SEDD must be requested separately when ordering the accompanying SEDD.
 
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Internet Citation: Cost-to-Charge Ratios for Emergency Department Files. Healthcare Cost and Utilization Project (HCUP). December 2020. Agency for Healthcare Research and Quality, Rockville, MD. www.hcup-us.ahrq.gov/db/ccr/ed-ccr/ed-ccr.jsp.
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Last modified 12/2/20