Descriptive Statistics by Insurance Status for Most Frequent Hospital Diagnoses and Procedures

Below is a summary of HCUP-3 Research Note 5 (AHCPR Pub. No. 97-0009), which is available from the AHCPR Publications Clearinghouse. Call toll free 800-358-9295.

Overview

This publication presents descriptive statistics by insurance status for the top 50 diagnoses and top 50 procedures in U.S. hospitals, based on a nationwide administrative database from 1993. Results are presented for privately insured, Medicare, Medicaid, and self-pay patients; all other patients; and all patients combined. This information can be used as a starting point for more in-depth analyses aimed at assessing differences in the process of care and outcomes by insurance status.

Source of Data

The statistics in this report are based on data on hospital inpatient stays from the Nationwide Inpatient Sample Release 2, a component of the Agency for Health Care Policy and Research's Healthcare Cost and Utilization Project (HCUP-3). The NIS is designed to approximate a 20-percent sample of U.S. community hospitals. NIS Release 2 includes 6,538,976 discharges from 913 hospitals in 17 States.

Highlights

This publication examines differences by insurance status for a wide range of conditions from a nationwide sample of hospitals. Information includes data on: sex and age, process of care (such as whether major therapeutic or diagnostic procedures were performed), and outcome of care (such as discharge status), whether complications occurred during hospitalization, total charges, and total length of stay. This information can be compared across payer groups, resulting in information that can help to generate hypotheses for further research.

How Can This Information Be Used?

A variety of studies can use the information in this publication. Third-party payers and managed care organizations can use this information as a starting point for examining the impact of payment policies and insurance status on practice patterns. Numerous topics warranting additional study by health services researchers can be identified, including the following:

• What is the distribution of cases across payer categories for particular diagnoses?
• Are there differences among payer categories in the incidence of complications while in the hospital?
• Are there differences by payer status in resource utilization within diagnosis and procedure categories?
• Are there differences among payer categories in the percentage of cases that receive major therapeutic or diagnostic procedures—or in the percentage of cases that receive no procedures or only minor procedures—while in the hospital?

More Diagnosis-Procedure Information

Diagnosis and Procedure Combinations in Hospital Inpatient Data contains information on the most frequent combinations of diagnoses and procedures for inpatients in U.S. community hospitals. The analysis is based on data from the 1992 NIS.

For More Information About the NIS

Contact:

Agency for Health Care Policy and Research
Healthcare Cost and Utilization Project
540 Gaither Road, Suite 5000
Rockville, MD 20850
Phone: 866-290-HCUP (4287), toll-free
E-mail: hcup@ahrq.gov

Current as of November 1998

Internet Citation:

Descriptive Statistics by Insurance Status for Most Frequent Hospital Diagnoses and Procedures. Abstract of Research Note 5, Healthcare Cost and Utilization Project (HCUP-3). Agency for Health Care Policy and Research, Rockville, MD. http://www.hcup-us.ahrq.gov/reports/natstats/rn5.htm

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