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


Fall 2021
Issue #68


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

Now Available: 2019 National Inpatient Sample (NIS)

The Agency for Healthcare Research and Quality (AHRQ) has released the 2019 National Inpatient Sample (NIS). A powerful database that contains data from more than 7 million hospital inpatient records, the NIS is drawn from 48 States and the District of Columbia, covering more than 98 percent of the U.S. population. NIS data can be weighted to produce national estimates, allowing researchers and policymakers to identify, track, and analyze national trends in healthcare utilization, access, charges, quality, and outcomes. The NIS is the largest publicly available inpatient healthcare database in the United States. It includes all patients, regardless of expected payer for the hospital stay. The 2019 NIS can be purchased through the HCUP Central Distributor. Earlier years of the NIS also are available.

Coming Soon: The 2019 Kids' Inpatient Database (KID), Nationwide Ambulatory Surgery Sample (NASS), Nationwide Emergency Department Sample (NEDS), and Nationwide Readmissions Database (NRD) are scheduled to be released later this year. Users are encouraged to sign up for the HCUP Mailing List to be notified of upcoming database releases.

Releasing Next Month: 2019 KID, NASS, NEDS, and NRD Databases

In October, AHRQ is scheduled to release the 2019 Kids' Inpatient Database (KID), Nationwide Ambulatory Surgery Sample (NASS), Nationwide Emergency Department Sample (NEDS), and Nationwide Readmissions Database (NRD). The 2019 nationwide databases are annual calendar year, all-payer files with diagnoses and procedures reported using the International Classification of Diseases, Tenth Revision, Clinical Modification/Procedure Coding System (ICD-10-CM/PCS) and, for outpatient procedures, Current Procedural Terminology® codes. Beginning with data year 2019, data elements derived from the following HCUP software tools will be available in the Diagnosis and Procedure Groups files of the nationwide databases: the Elixhauser Comorbidity Software Refined for ICD-10-CM, the Clinical Classifications Software Refined (CCSR) for ICD-10-CM diagnoses and ICD-10-PCS procedures, and Procedure Classes Refined for ICD-10-CM.

The HCUP nationwide databases can be used for analysis of special populations or healthcare settings:

The 2019 KID, NASS, NEDS, and NRD will be available for purchase through the HCUP Central Distributor. Earlier years of the nationwide databases also are available.

HCUP Visualization of Inpatient Trends in COVID-19 and Other Conditions

AHRQ has released the HCUP Visualization of Inpatient Trends in COVID-19 and Other Conditions, an interactive visualization displaying State-specific monthly trends in inpatient stays related to COVID-19 and other conditions. The graphs, which show trends starting 2018 through the first quarter of 2021, are drawn from the HCUP Summary Trend Tables. The new visualization facilitates comparisons of the number of hospital discharges, the average length of stays, and in-hospital mortality rates across medical conditions and admission type, patient/stay characteristics, and States.

HCUP Data Visualizations provide access to interactive visual displays of select HCUP data and can be accessed from the Data Visualizations page of the HCUP-US website.

Statistical Briefs on COVID-19-Related Hospitalizations

HCUP has released nine Statistical Briefs (#272-#276 and #282–#285) that highlight health disparities in COVID-19-related hospitalizations. Using quarterly inpatient data from 9 States for #272 and 13 States for #273-#276 and #282-#285, these HCUP Statistical Briefs show the 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). The data displayed in the Statistical Briefs are also available in the HCUP Summary Trend Tables on the HCUP-US website. Some statistical highlights from four of the nine reports are listed below:

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

New HCUP Fast Stats Topic and Data Update

AHRQ has released a new topic in HCUP Fast Stats, Severe Maternal Morbidity (SMM) Among In-Hospital Deliveries, which provides trends in SMM-related in-hospital deliveries at the national level and for 47 States and the District of Columbia. SMM refers to unexpected outcomes of labor and delivery that result in significant short- or long-term consequences to a woman’s health. Rates of SMM per 10,000 in-hospital deliveries are presented overall as well as by various patient and hospital characteristics such as age, race, expected payer, community-level income, patient location, safety-net hospital status, hospital location/teaching status, hospital ownership, and hospital delivery volume. The topic includes an interactive national map and State-level graphs that display data from 2010 through 2018.

Additionally, AHRQ has updated two other Fast Stats topics with new information. The Opioid-Related Hospital Use topic now includes 2018–2020 inpatient and emergency department data, and the Neonatal Abstinence Syndrome (NAS) Among Newborn Hospitalizations topic features 2018 and 2019 inpatient data.

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

AHRQ Quality Indicator (QI) Software v2021 Released

AHRQ is pleased to announce that v2021 of the AHRQ Quality Indicator™ (QI) Software has been launched. The AHRQ QIs are measures of healthcare quality that can be used with readily available hospital inpatient administrative data to measure and track clinical performance and outcomes. The AHRQ QI modules represent aspects such as Prevention, Inpatient, Patient Safety, and Pediatric quality of care.

The new software update includes fiscal year (FY) 2021 ICD-10-CM/PCS coding updates and is backwards compatible through FY 2016. The v2021 software will calculate risk-adjusted rates based on 1 full year of ICD-10-CM/PCS-coded all-payer data from the 2018 HCUP State Inpatient Database (SID). The software is available for download in both SAS® QI and WinQI format from the AHRQ QI website at https://qualityindicators.ahrq.gov/Software/Default.aspx.

Learn About HCUP During the Fall Webinar Series—Required Registration Opens September 28

On October 5, 6, and 7, AHRQ will host a 3-day webinar series for users interested in learning more about HCUP. The series will begin on October 5 with the HCUP Database Overview, a presentation that will include an introduction to the HCUP family of databases and software tools and a discussion of how to obtain and access the data as well as other HCUP resources. On October 6, HCUP staff will present An In-Depth Exploration of the HCUP Nationwide Emergency Department Sample (NEDS), which can be used to produce national estimates about emergency department visits across the country. The NEDS describes emergency department visits, regardless of whether they result in admission. On October 7, the series will conclude with An In-Depth Exploration of the HCUP Nationwide Ambulatory Surgery Sample (NASS), which can be used to create national and regional estimates of major ambulatory surgery encounters in hospital-owned facilities.

The webinars last 1 hour and are open to the public. Each webinar requires separate advance registration, which will open on September 28. Additional details about the webinars are posted on the HCUP Workshops and Webinars page of the HCUP-US website.

Join Us for a Virtual HCUP Data Analytic Tools Workshop in October

AHRQ will sponsor an intermediate-level 2-day virtual HCUP Data Analytic Tools workshop on October 27–28, 2021. This virtual workshop will teach health services researchers and analysts how to use the HCUP analytic tools to facilitate their research on administrative data. Participants will learn how to categorize diagnosis and procedure codes into clinically meaningful categories, as well as identify comorbidities, chronic conditions, and operating room procedures. For participants who are not familiar with HCUP databases and tools, we highly recommend attending the HCUP Fall Webinar Series presentation on October 5 or reviewing the Online HCUP Overview Course and HCUP Software Tools Tutorial prior to attending the workshop.

2018 Nationwide Emergency Department Sample (NEDS) 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 Nationwide Emergency Department Sample (NEDS). This update features information summarized by the Clinical Classifications Software Refined (CCSR) for ICD-10-CM diagnoses.

Users can follow HCUPnet's easy, step-by-step process to explore many healthcare topics relating to hospital inpatient discharges and emergency department 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.


Databases and Products

Recently Released: 2019–2020 and Additional 2017–2018 State Databases

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

In addition, the 2019 NIS has been released. The 2019 KID, NRD, NEDS, and NASS are scheduled for release later this year. 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 July 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.


HCUP Q&A

Question: I am a graduate student looking to do an analysis on COVID-19. I've been consulting the HCUP Central Distributor catalog to understand what HCUP databases are currently available. I have some questions about the HCUP data that I am hoping can be answered.

Answers:

What are the most recent HCUP data available?

HCUP has many different types of data available for researchers. Through the online HCUP Central Distributor, researchers can purchase nationwide and State-level databases with data from inpatient, ambulatory surgery, or emergency department settings. Data year 2019 for the NIS is now available, and the remaining 2019 nationwide databases are scheduled to be released later this year. For State-level databases, data year 2020 is currently available for a number of HCUP States.

Frequencies of ICD-10-CM/PCS codes (individually and by the Clinical Classifications Software Refined [CCSR] categories) are also available in the Documentation section for each nationwide database on the HCUP-US website. As an example, frequencies of ICD-10-CM/PCS codes reported in the 2016–2018 NIS are available here: Frequencies by Diagnosis and Procedure Codes, NIS 2016–2018.

In addition to the full databases available for purchase through the HCUP Central Distributor, HCUP also offers statistics based on HCUP data through a variety of HCUP products, including HCUP Fast Stats and HCUPnet. HCUP Fast Stats provides easy access to the latest HCUP-based statistics for healthcare information topics. HCUP Fast Stats uses visual statistical displays in stand-alone graphs, trend figures, or simple tables to convey complex information at a glance. Fast Stats contains quarterly data through 2020 and is updated regularly as new quarterly or annual data become available for timely, topic-specific national and State-level statistics.

HCUPnet is a free, online query system that provides statistics and data tables based on HCUP data. Its easy, step-by-step process allows users to explore many healthcare topics relating to hospital inpatient services and emergency department settings. Users also may generate tables and graphs on national, regional, and county-level statistics, including hospital readmissions and trends on hospital and emergency department use in the United States. In addition, State-specific statistics are available for States that have agreed to participate in HCUPnet.

Why is HCUP considered a limited data set?

The HCUP databases are consistent with the definition of a limited data set under the Health Insurance Portability and Accountability Act Privacy Rule and contain no direct patient identifiers.

Can I receive a sample of the data to ensure they will work for my research?

Due to restrictions regarding data confidentiality, HCUP cannot provide a sample dataset. We suggest reviewing data in HCUPnet to explore topics of interest and become familiar with the content. HCUPnet is a free, online query system that provides instant access to statistics and data tables from HCUP. HCUP also provides extensive online documentation of each database at www.hcup-us.ahrq.gov/databases.jsp. This includes information on the data elements available in each database, data element descriptions, file size, file specifications, and record layouts.

What resources does HCUP have to study COVID-19?

A recently released HCUP product, HCUP Summary Trend Tables, provides State-specific monthly trends in hospital utilization accessed through downloadable tables. The Summary Trend Tables are based on the 2018–2019 HCUP State Inpatient Databases (SID) for 46 States and the District of Columbia, plus 2020 quarterly inpatient data, if available. The Inpatient Stays by Priority Conditions topic has been expanded to include COVID-19. Other priority conditions in this topic include "influenza" and "other acute or viral respiratory infection."

The HCUP Visualization of Inpatient Trends in COVID-19 and Other Conditions is an interactive visualization that displays State-specific monthly trends in inpatient stays related to COVID-19 and other conditions and facilitates comparisons across patient/stay characteristics and States. Trends are reported beginning with January 2018, except that COVID-19 trends are reported beginning with April 2020. This information is derived from the HCUP Summary Trend Tables.

In addition, nine HCUP Statistical Briefs showing the 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) for timeframes ranging from April 2020 to September 2020 have been published using quarterly inpatient data from 9 States for #272 and 13 States for #273–#276 and #282–#285. Users can access the full list of HCUP Statistical Briefs related to COVID-19 on the HCUP-US website here: www.hcup-us.ahrq.gov/reports/statbriefs/sb_covid.jsp.


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