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

Summer 2021
Issue #67


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

HCUP's Outstanding Article of the Year Award Winners Announced!

Three studies received the twelfth annual HCUP Outstanding Article of the Year Award at the AcademyHealth Virtual 2021 Annual Research Meeting.Exit Disclaimer The award honors articles published in peer-reviewed journals in 2020 that used HCUP data to explore and address healthcare research topics and issues. The award recipients were announced during the HCUP Overview presentation on June 16 at 12:15 p.m. ET. Additional information is available in the HCUP Calendar of Events. The winning authors will also have posters of their work showcased during the conference. Descriptions of the winning articles appear in the Publication Spotlights section of this eNews.

Since 2010, the Agency for Healthcare Research and Quality (AHRQ) has recognized exceptional research conducted using the HCUP databases in the clinical and health policy arenas. This research continues to enhance public conversation about healthcare costs, outcomes, and trends. Over the past 12 years, the awards have come to be recognized as a distinguished honor among health services researchers with a variety of clinical insights, economic interests, and policy backgrounds. AHRQ is proud of the important work being done with HCUP data, and AHRQ staff members look forward to future exciting research using HCUP data.

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.

Access HCUP Sessions During AcademyHealth's Virtual Annual Research Meeting

HCUP will be taking part in AcademyHealth's 2021 Annual Research Meeting (ARM),Exit Disclaimer held virtually online. The conference is taking place now through June 17, 2021. This year's conference theme is leading with evidence in a time of change. HCUP activities during ARM include a poster presentation, policy roundtables, special sessions, and research panels. For those interested in COVID-19 research, on June 17 at 2:30 p.m. ET, HCUP staff will present a session titled "Learn About HCUP's Powerful Emergency Department Database & COVID-19 Resources."

A complete list of upcoming HCUP-related activities is available in the HCUP Events section of this newsletter. Additional information is available on the HCUP Calendar of Events page of the HCUP-US website.

New HCUP Statistical Briefs on COVID-19-Related Hospitalizations

HCUP recently released four Statistical Briefs (#273-#276) that highlight health disparities in COVID-19-related hospitalizations. The data displayed in the Statistical Briefs are available in the HCUP Summary Trend Tables on the HCUP-US website. Using quarterly inpatient data from 13 States, these HCUP Statistical Briefs show the monthly variation in COVID-19-related hospitalizations, average length of stay, and in-hospital mortality by various patient characteristics (race/ethnicity, urban/rural residence, community-level income, and expected payer).

A full listing of these HCUP Statistical Brief titles and links to the reports are provided in the Publication Spotlights section of this eNews. A comprehensive list of HCUP Statistical Briefs can be found on the HCUP Statistical Briefs page of the HCUP-US website.

2018 National Inpatient Sample (NIS) Statistics Added to HCUPnet

HCUPnet, the free, online query system that provides statistics and data tables based on HCUP data, has been updated to include the 2018 National Inpatient Sample (NIS). This update includes information summarized by the Clinical Classifications Software Refined (CCSR) for ICD-10-CM diagnoses and ICD-10-PCS procedures.

Users can follow HCUPnet's easy, step-by-step process to explore many healthcare topics relating to hospital inpatient discharges and ED visits. Users can also generate tables and graphs on national, regional, and county-level statistics, including hospital readmissions and trends in the United States.

Visit HCUPnet to explore the updates and start your own query.

HCUP Findings-At-A-Glance

AHRQ has released an updated report as part of the HCUP Findings-At-A-Glance series, which provides a focused look at different topics across a broad range of health policy issues related to hospital use and costs. The report, Adult, Nonmaternal Inpatient Stays Related to Clostridioides difficile: National Trends, 2011-2016 and 2019, focuses on the burden to hospitals of one type of healthcare-associated infection. It examines the changes in rates of hospitalizations related to C. diff, including those in which C. diff is not present on admission (hospital onset) and those present on admission (community acquired).

Some Findings-At-A-Glance will report a one-time examination of a specific topic. Others will be updated periodically with the latest data. The HCUP Findings-At-A-Glance reports can be accessed from the Reports section of HCUP-US.

HCUP Tool Updates

The following HCUP tools have been updated for calendar year 2021 and are designed for use with Healthcare Common Procedure Coding System (HCPCS) Level I (Current Procedural Terminology [CPT®]) and HCPCS Level II codes:

For more information on the changes to each tool, please see the Tools & Software page of the HCUP-US website.

HCUP Fast Stats Data Update

AHRQ has released new information in HCUP Fast Stats. The National Hospital Utilization and Costs topic has been updated to include national statistics through 2018. This topic presents national statistics on inpatient stays—trends, most common diagnoses, and most common operations—and trends in ED visits.

More information is available at on the HCUP Fast Stats page of the HCUP-US website.

Databases and Products

Recently Released: 2019 State Databases and Additional2017- 2018 Databases

Since April 2021, the following State databases have been released:

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.

***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 online HCUP Central Distributor for current status information.

Publication Spotlights

New HCUP Statistical Briefs Posted on HCUP-US

Since April 2021, the following HCUP Statistical Briefs have been released:

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

Publications Using HCUP Data

HCUP Outstanding Article of the Year Award: Policy Winner

Buhr RG, Jackson NJ, Kominski GF, Dubinett SM, Mangione CM, Ong MK. Readmission rates for chronic obstructive pulmonary disease under the Hospital Readmissions Reduction Program: an interrupted time series analysis. J Gen Intern Med. 2020;35(12):3581-90.

This study won the HCUP Outstanding Article of the Year Award in the policy category and used the 2010–2016 Nationwide Readmissions Database (NRD) to address an important gap in health policy research with regard to the effect of the Medicare Hospital Readmissions Reduction Program (HRRP). The study aimed to determine whether HRRP penalties influenced chronic obstructive pulmonary disease readmissions among Medicare, Medicaid, or privately insured patients.

An abstract of the article is available on PubMed.

HCUP Outstanding Article of the Year Award: Clinical Winners

Halleran DR, Minneci PC, Cooper JN. Association between age and umbilical hernia repair outcomes in children: a multistate population-based cohort study. J Pediatr. 2020;217:125-30.

This study won the HCUP Outstanding Article of the Year Award in the clinical category and used the 2010–2014 State Inpatient Databases (SID), State Ambulatory Surgery and Services Databases (SASD), and State Emergency Department Databases (SEDD) for seven States (Florida, Georgia, Iowa, Nebraska, New York, Vermont, and Wisconsin) to evaluate whether patient age or other sociodemographic and clinical characteristics are associated with recurrence or unplanned related hospital revisits after pediatric umbilical hernia repair. The retrospective cohort study investigated pediatric umbilical hernia repairs performed at any hospital or surgery center, evaluating hernia recurrences and occurrences of unplanned and related hospital revisits within 30 days.

An abstract of the article is available on PubMed.

Pollack LM, Olsen MA, Gehlert SJ, Chang SH, Lowder JL. Racial/ethnic disparities/differences in hysterectomy route in women likely eligible for minimally invasive surgery. J Minim Invasive Gynecol. 2020;27(5):1167-77.

This study won the HCUP Outstanding Article of the Year Award in the clinical category and used the 2010–2014 SID and SASD for five States (Colorado, Florida, Maryland, New Jersey, and New York) to evaluate whether hysterectomy rates vary by surgical route and race/ethnicity over time in a population of women likely eligible for minimally invasive surgery, as well as whether evidence for racial/ethnic disparity in surgical route remained after controlling for patient and hospital characteristics.

An abstract of the article is available on PubMed.

To read article abstracts from past award recipients, please visit the HCUP Outstanding Article of the Year Awards Archive of Recipients page on the HCUP-US website.


Question: I am working on a large research project with my graduate students using the 2018 HCUP Nationwide Emergency Department Sample (NEDS). We are using the Clinical Classifications Software Refined (CCSR) for International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) diagnoses and have some questions:


The CCSR for ICD-10-CM diagnoses includes separate default categorization schemes for use with inpatient and outpatient data. Which one should I use for the HCUP NEDS?

The NEDS is sampled from the State Inpatient Databases (SID) and the State Emergency Department Databases (SEDD). The SID contain information on patients initially seen in the ED and subsequently admitted to the same hospital. The SEDD capture information on ED visits that do not result in an admission (i.e., treat-and-release visits and transfers to another hospital). You should use the inpatient default categorization scheme for ED admissions from the SID and the outpatient default categorization scheme for ED treat-and-release visits from the SEDD. The NEDS data element HCUPFILE can be used to identify these records.

Additional information on the specific differences between the inpatient and outpatient default categorization schemes is available in the CCSR for ICD-10-CM diagnoses User Guide, specifically Appendices B and C.

How do I modify the CCSR for ICD-10-CM diagnoses SAS program to ensure that the correct default categorization scheme is used?

Within the SAS program is a specific section with required macro statements that the user must modify to ensure that the CCSR for ICD-10-CM diagnoses is applied correctly. The macro statements specific to application of the correct default categorization scheme(s) are found in the section “Input Data Characteristics.” Given that the NEDS includes a mixture of inpatient and outpatient records (i.e., ED admissions from the SID and ED treat-and-release visits from the SEDD), you will need to modify all four of these macro statements in this section as follows (changes are in bold):

Is there an HCUP resource available to validate my results (i.e., the number of ED visits for each CCSR for ICD-10-CM diagnosis category)?

Yes, frequencies of ICD-10-CM/PCS codes (by the CCSR categories and individually) are available on the NEDS Database Documentation page under “Data Elements.” This file provides both weighted and unweighted record counts by individual CCSR categories based on both the principal diagnosis as well as any-listed diagnosis on the record. Additionally, you will find counts for all ED visits as well as separate counts for ED admissions and ED treat-and-release visits.

HCUP Events

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

The HCUP e-News is available online on 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