HCUP e-News: the electronic newsletter of the Healthcare Cost and Utilization Project

Spring 2020
Issue #62


News and Announcements: Notable news from HCUP
Databases and Products: New database and product releases
Publication Spotlights: Recent works incorporating HCUP data and tools
HCUP Q&A: Answers to your HCUP questions
HCUP Events: Upcoming HCUP conferences and meetings

Missed the last HCUP e-News? Read it on the HCUP-US website.

News and Announcements

Now Available: 2017 HCUP Nationwide Readmissions Database (NRD), Nationwide Emergency Department Sample (NEDS), and Nationwide Ambulatory Surgery Sample (NASS)

The Agency for Healthcare Research and Quality (AHRQ) has released the 2017 Nationwide Readmissions Database (NRD), Nationwide Emergency Department Sample (NEDS), and Nationwide Ambulatory Surgery Sample (NASS).

The NRD is a database of all-payer hospital inpatient stays that can be used to generate national estimates of readmissions. It addresses a large gap in healthcare data—the lack of nationally representative information on hospital readmissions for all ages. Unweighted, the 2017 NRD contains data from approximately 18 million discharges each year. Weighted, it estimates roughly 36 million discharges. The NRD uses HCUP State Inpatient Databases (SID) with verified patient linkage numbers and includes discharges from community hospitals, excluding rehabilitation and long-term acute care hospitals. It includes discharges for patients with and without repeat hospital visits and for those who died in the hospital. The NRD is designed to be flexible to various types of readmission analyses. Repeat hospital visits may or may not be related.

The NEDS is the largest publicly available all-payer emergency department (ED) database in the United States. It enables analyses of ED utilization patterns and supports public health professionals, administrators, policymakers, and clinicians in their decision making regarding this critical source of care. Constructed using records from both the HCUP State Emergency Department Databases (SEDD) and the SID, the 2017 NEDS contains data from more than 30 million ED visits in 36 States and the District of Columbia—approximating a 20 percent stratified sample of visits to U.S. hospital-owned EDs. Weights are provided to calculate national estimates pertaining to the roughly 145 million ED visits that took place in 2017. The NEDS provides information on patients admitted to the hospital through the ED and on patients treated and released or transferred to another hospital from the ED.

The NASS, HCUP’s latest nationwide database release, is the largest all-payer ambulatory surgery database in the country. The NASS tracks information about major ambulatory surgery encounters in hospital-owned facilities across the United States and provides information on patient characteristics, clinical diagnostic and surgical procedure codes, total charges and expected source of payment, and facility characteristics. Unweighted, the 2017 NASS contains about 7.5 million ambulatory surgery encounters each year and 9.7 million ambulatory surgery procedures. Weighted, it estimates around 10.3 million ambulatory surgery encounters and 13.5 million ambulatory surgery procedures.

HCUP State and nationwide databases (including the 2017 NRD, NEDS, and NASS) are available for purchase through the HCUP Central Distributor. Earlier years of the NRD, NEDS, and NASS are also available.

To keep informed on HCUP database releases, users can subscribe to the HCUP Mailing List.

2016 State Emergency Department Databases (SEDD) Data Now Available on HCUPnet

State-level statistics from the 2016 SEDD for participating States have been added to HCUPnet, the free online query system that provides statistics and data tables based on HCUP data. The SEDD capture discharge information on all ED visits that do not result in an admission.

HCUPnet’s easy, step-by-step process allows users to explore many healthcare topics relating to hospital inpatient, ED, and ambulatory settings. Users can also generate tables and graphs on national, regional, and county-level statistics, including hospital readmissions and trends in hospital, ED, and ambulatory surgery use in the United States.

To check out the updates and start your own query, visit HCUPnet today at https://hcupnet.ahrq.gov/.

Updated: Clinical Classifications Software Refined (CCSR) for ICD-10-CM Diagnoses

AHRQ has released the Clinical Classifications Software Refined (CCSR) for ICD-10-CM diagnoses, v2020.2. This update includes the ability to assign a single CCSR category for the principal International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) diagnosis. Since individual diagnoses can be assigned to more than one CCSR category, some analyses such as ranking hospitalizations need to prioritize the CCSR selection for the principal diagnosis. This new version also adds a CCSR category for low back pain and aligns the CCSR categories for external cause of morbidity codes to the finalized Centers for Disease Control and Prevention (CDC) External Cause of Morbidity matrix.

The CCSR and other HCUP software tools are available for user download on the HCUP User Support (HCUP-US) website: www.hcup-us.ahrq.gov/tools_software.jsp.

HCUP Fast Stats—New Topic and Data Update

New information has been released in HCUP Fast Stats—Hurricane Impact on Hospital Use. This topic presents the percent change in population-based inpatient and ED utilization rates pre- versus post-hurricane for 11 U.S. hurricanes between 2005 and 2017. Hospital utilization statistics are provided for all conditions and for injuries only, as well as for selected age groups, based on county proximity to the hurricane. This information can be used to help understand medical care utilization during and after hurricanes and to assist in preparing for and deploying medical services in future natural disasters. The utilization counts and rates also are available for separate download. This work is supported by AHRQ and the Patient-Centered Outcomes Research Trust Fund (PCORTF), Exit Disclaimer and created in collaboration with the Office of The Assistant Secretary for Planning and Evaluation (ASPE) and the Office of the Assistant Secretary for Preparedness and Response (ASPR).

In addition, AHRQ has released an update of the HCUP Fast Stats topic on State Trends in Hospital Use by Payer. This update adds 2017–2019 inpatient and 2017–2018 ED data for several States.

More information is available at www.hcup-us.ahrq.gov/faststats/landing.jsp.

Learn About HCUP at April 22 and 29 Webinars—Required Registration Opens April 15

Webinars introducing and explaining HCUP will be held on April 22 and 29. On April 22, HCUP Database Overview will include an introduction to the HCUP family of databases and a discussion of how to obtain and access the data as well as other HCUP resources. On April 29, Overview of the HCUP Products and Tools will cover the use of HCUP software tools and supplemental files, such as HCUPnet and Fast Stats, to facilitate and augment research. Additional time will be dedicated to reviewing HCUP's newest tool, the CCSR for ICD-10-CM diagnoses.

The webinars are 1 hour and open to the public. Each webinar requires separate advance registration, which will open on April 15. Additional details about the webinars are posted on the HCUP Workshops and Webinars page of the HCUP-US website.

HCUP Outstanding Article of the Year (AOTY) Award

A record number of nominations were received for the 11th Annual AHRQ-AcademyHealth Outstanding AOTY Award, and applications currently are being reviewed for the Clinical and Policy-focused honors, which will recognize two researchers published in peer-reviewed journals in 2019 who used HCUP databases to explore and address healthcare research topics and issues.

Award recipients will receive certificates and present posters of their work during AcademyHealth’s 2020 Annual Research Meeting Exit Disclaimer on June 13–16 in Boston, Massachusetts. AHRQ will contact the winning authors via email in April 2020.

For more information on the award and to view past recipients, please visit the HCUP-US website at www.hcup-us.ahrq.gov/news/awards.jsp.

Databases and Products

Recently Released: 2018 State Databases and Additional 2016–2017 Databases

Since December 2019, the following State databases have been released:

In addition, the 2017 NRD, NEDS, and NASS were released in December. For database purchasing questions, please contact the HCUP Central Distributor.

Complete listings of available databases by year can be found in the Database Catalog on the HCUP-US website. Databases can be purchased online through the HCUP Central Distributor, and aggregated national and selected State statistics can be accessed via HCUPnet.

***Please note, some HCUP Central Distributor operations have been affected by the current national emergency related to COVID-19. Please refer to the notice posted on the HCUP Central Distributor for current status information.

Publication Spotlights

New HCUP Statistical Briefs Posted on HCUP-US

Since December 2019, the following HCUP Statistical Briefs have been released:

To access these and other Statistical Briefs, please visit the Statistical Briefs page on the HCUP-US website.

New HCUP Methods Series Reports Now Available

Since September 2019, the following Method Series Reports have been released:

These reports and other HCUP reports can be found on the HCUP Reports page on the HCUP-US website.


Question: : I have been working with the HCUP Clinical Classifications Software Refined (CCSR) tool on a recent data project and noticed that a new version was released. I have some questions about the new tool before I begin using it in my analysis.


What updates were made to the CCSR v2020.2?

The CCSR v2020.2 update includes the ability to assign a single CCSR category for principal diagnosis. Since individual diagnoses can be assigned to more than one CCSR category, some analyses such as ranking hospitalizations need to prioritize the CCSR selection for the principal diagnosis. This version also adds a new CCSR category for low back pain and aligns the CCSR categories for external cause of morbidity codes to the finalized CDC External Cause of Morbidity matrix.

What resources are available to researchers utilizing the CCSR?

An overview of the CCSR for ICD-10-CM is provided on the HCUP-US website at www.hcup-us.ahrq.gov/toolssoftware/ccsr/ccs_refined.jsp. A User Guide for the CCSR for ICD-10-CM diagnoses is also provided with the online documentation of the tool. Additional information, including answers to common user questions, is provided in the HCUP Frequently Asked Questions (FAQs) at www.hcup-us.ahrq.gov/tech_assist/faq.jsp#ccs.

In addition, a new resource is available on HCUP-US to help users understand the differences between the CCSR and the beta version of the CCS for ICD-10-CM. The comparison report and supplemental Microsoft® Excel file can be found at www.hcup-us.ahrq.gov/toolssoftware/ccsr/ccs_refined.jsp#user.

Is the CCSR for ICD-10-CM diagnoses v2020.2 compatible for all ICD-10-CM diagnosis codes?

Yes, the CCSR for ICD-10-CM diagnoses v2020.2 software is backward compatible to include all years of ICD-10-CM diagnosis codes.

Is an updated CCS for ICD-10-PCS available?

HCUP is working on a fully refined version of the CCS for ICD-10-PCS procedures for release sometime by the end of 2020. The tool will include new and revised fiscal year 2021 codes.

If you are signed up on our HCUP Mailing List, you will be notified about the release of databases, tools, and other HCUP products. Instructions for joining the Mailing List are available at www.ahrq.gov/research/data/hcup/index.html. You can also check the HCUP-US News and Events page for updates: www.hcup-us.ahrq.gov/news.jsp.

HCUP Events

For a complete list of HCUP presentations and events, visit the HCUP Events Calendar.

The HCUP e-News is available online at the HCUP-US website and distributed via the HCUP Mailing List.

For more information and questions regarding the HCUP e-News, please email hcup@ahrq.gov