Summer 2022
Issue #71

Contents

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

Fast Stats Data Update

The Agency for Healthcare Research and Quality (AHRQ) has released new information in the Healthcare Cost and Utilization Project (HCUP) Fast Stats.

• The National Hospital Utilization and Costs topic has been updated to include national statistics through 2019. This topic presents national statistics on inpatient stays-trends, most common diagnoses, and most common operations-and trends in emergency department visits.
• The Severe Maternal Morbidity (SMM) Among In-Hospital Deliveries topic has been updated to include new inpatient data. Since its release in September 2021, the SMM topic now includes 2019 national inpatient statistics and 2020 State inpatient data (40 States).

For additional information, please refer to the Fast Stats Frequently Asked Questions page or contact HCUP User Support

New HCUP Findings-At-A-Glance Report

A new data brief from AHRQ has been added to HCUP Findings-At-A-Glance, Emergency Department Visits for Diagnoses Directly Indicating Heat Exposure: Variation Across Counties in the United States, 2016�2020. HCUP Findings-At-A-Glance reports provide a focused look at different topics across a broad range of health policy issues related to hospital use and costs. This report presents county- and State-level population rates of emergency department visits with a diagnosis directly indicating heat exposure. Diagnoses include those for heat-related syncope, cramps, exhaustion, fatigue, and edema, in addition to effects of heat and light and exposure to excessive natural heat and sunlight.

The following figure displays the county-level population rates of emergency department visits with a diagnosis directly indicating heat exposure per 100,000 population for the years 2016�2019 combined. A map of the United States shows rates of heat exposure by county and State. Higher levels are observed in southern States compared with northern States. Data are unavailable for Alabama, Delaware, Idaho, Louisiana, New Hampshire, New Mexico, Pennsylvania, Oklahoma, Virginia, Washington, and West Virginia.

Some Findings-At-A-Glance reports will be a one-time examination of a specific topic. Others will be updated periodically with the latest data. This data brief and others can be accessed from the Reports & Publications section of the HCUP-US website.

HCUP Tool Updates

The following HCUP tools have been updated for calendar year 2022 and are designed for use with Healthcare Common Procedure Coding System (HCPCS) Level I (Current Procedural Terminology [CPT®]) and HCPCS Level II codes:

• Surgery Flags Software for Services and Procedures identifies a subset of HCPCS Level I codes, commonly referred to as CPT codes, as narrowly defined therapeutic invasive surgeries or more broadly defined surgeries that include diagnostic invasive procedures.
• Clinical Classifications Software (CCS) for Services and Procedures provides a method for classifying HCPCS codes into more than 240 clinically meaningful categories. The procedure categories are similar to those in the Clinical Classifications Software (CCS) for ICD-9-CM (International Classification of Diseases, Ninth Revision, Clinical Modification) procedure classification, with the addition of specific categories unique to the professional service and supply codes in 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-US Website Redesign

We are pleased to announce that the navigation on HCUP-US (www.hcup-us.ahrq.gov/) has been updated to improve usability across the website.

All of the website content remains the same, but if you experience difficulty finding any HCUP-US resources or if you wish to provide any feedback, you may contact HCUP Technical Assistance at hcup@ahrq.gov.

Databases and Products

Recently Released: 2021 and 2020 State Databases

Since April 2022, the following State databases have been released:

• State Inpatient Databases (SID)
  • 2021: Iowa
  • 2020: Alaska, Arkansas, Delaware, District of Columbia, Florida, Kansas, Michigan, Nevada, New Mexico, North Carolina, South Dakota, Utah, Vermont, West Virginia
• State Ambulatory Surgery and Services Databases (SASD)
  • 2021: Iowa
  • 2020: District of Columbia, Florida, Indiana, Kansas, Nevada, New Jersey, North Carolina, Utah, Vermont
• State Emergency Department Databases (SEDD)
  • 2021: Iowa
  • 2020: Arkansas, District of Columbia, Florida, Indiana, Kansas, Nevada, New Jersey, North Carolina, Utah, Vermont

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.

Publication Spotlights

New HCUP Statistical Briefs Posted on HCUP-US

Since April 2022, the following HCUP Statistical Briefs have been released:

• #295: Changes in Hospitalizations and In-Hospital Deaths for Patients From Rural Areas in the Initial Period of the COVID-19 Pandemic (April�December 2020), 29 States
• #294: Changes in Hospitalizations and In-Hospital Deaths for Patients From Urban Areas in the Initial Period of the COVID-19 Pandemic (April�December 2020), 29 States

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

HCUP Q&A

Question: My research team is preparing to submit a study that used HCUP databases and tools for publication, but we have a few questions before we do so.

• How do we acknowledge the HCUP databases and cite the HCUP tools used in our study?
• Are there guidelines we need to follow in presenting data in our publication?
• If the journal requests a copy of our analytic data file, can we post our data on the site or provide our data to readers?

Answers:

How do we acknowledge the HCUP databases and cite the HCUP tools used in our study?

As specified in the HCUP nationwide and State Data Use Agreements (DUAs), be sure to acknowledge the source of the data by referencing the database name, HCUP, and AHRQ. The following example illustrates the correct way to acknowledge a study�s use of the NIS for data year 2019.

"The study examined regional cost differences for congestive heart failure admissions using discharge data from the 2019 National Inpatient Sample (NIS), Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality."

For reports of studies using State data, the acknowledgment must also specify the State(s) used in the analysis, as shown below. If space allows, please mention the specific HCUP Partners that provided the State data by name somewhere in the manuscript.

"We estimated total charges of hospital stays for total knee arthroplasty using the 2016�2018 New York State Inpatient Databases (SID), Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality."

You should acknowledge the HCUP database(s) used in your analysis in both the abstract and the main text and include a corresponding citation in the reference list.

When citing HCUP software tools in the reference list, please include the name of the tool along with the tool�s version (as applicable), refer to HCUP and AHRQ, and provide the related web link. You can find a list of Suggested Citations for HCUP Databases and Tools on the HCUP-US website. Additional information can be found on the HCUP Publishing Requirements page.

Are there guidelines we need to follow in presenting data in our publication?

When presenting HCUP data in your publication, there are some important privacy protection considerations to keep in mind. Please ensure your publication adheres to the following HCUP DUA requirements:

• You have not identified individuals in your publication, either directly or indirectly.
• You have not identified hospitals in your publication. All aggregate statistical reporting has at least two hospitals in any individual table cell.
• You have avoided reporting counts of less than 11 discharges in the tables, figures, and text. This requirement applies to both unweighted (raw) counts and weighted data. The table below shows a proper way to mask small cell sizes.
  
  For tables, you can note "<11" in the cell, or you can use a symbol to mask those cells and add a footnote to indicate that the HCUP DUA prohibits the reporting of <11 observations. Please note that it is acceptable for observations of "0" to be reported in a table or the text because no individuals are represented by that count.

If the journal requests a copy of our analytic data file, can we post our data on the site or provide our data to readers?

No, it is a direct violation of your signed DUA to post data to a public website or provide the data to readers. Re-releasing data is not permitted under the HCUP DUA. In general, users are not allowed to share the HCUP data, including subsets, with anyone outside their research group who has not signed the HCUP DUA. This includes journals, journal reviewers and editors, and people accessing the article on a journal website. HCUP data results can be displayed in published materials and tables as long as they follow the DUA restrictions noted above with respect to avoiding identification of individuals and institutions and reporting counts no less than 11 discharges.

If a journal requests that you provide your data file (for review or to upload to a repository), the DUA instructs authors to cite the restrictions on data sharing and provide information for how the publicly available HCUP data may be accessed. Many journals also require that a data availability statement be published with an article. The following examples illustrate correct and incorrect data availability statements:

• Correct: "Data from the 2002�2015 National Inpatient Sample (NIS), Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality (AHRQ) are available to all researchers following a standard application process and signing of the HCUP Data Use Agreement. Instructions for submitting an application to purchase HCUP databases can be found at www.hcup-us.ahrq.gov/tech_assist/centdist.jsp."
• Incorrect: "Raw data that support the findings of this study are available from the corresponding author upon request."

HCUP Events

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

• June 26�29, 2022: Eleventh Annual Conference of the American Society of Health Economists (ASHEcon)

  • Exhibit booth

    AHRQ will sponsor a virtual exhibit booth. Representatives will be available to provide information and answer questions during dedicated timeframes.

• October 18, 2022: HCUP Database Overview Webinar
• October 19, 2022: Overview of HCUP Products and Tools Webinar
• October 20, 2022: Using the HCUP Supplemental Files Webinar
• November 2�3, 2022: Data Users� Workshop: Planning Your HCUP Analysis

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