Health Costs and Utilization Projects ( HCUP , pronounced "H-Cup" ) is a family of health care database and software tools and related products from The United States is developed through the Federal-State-Industry partnership and is sponsored by the Research and Quality Health Agency (AHRQ).
Video Healthcare Cost and Utilization Project
General Information
HCUP provides access to health care databases for policy research and analysis, as well as tools and products to improve data capabilities.
The HCUP database combines data collection efforts from State data organizations, hospital associations, personal data organizations, and the Federal government to create national information sources of patient-level health care data. The state organization that provides data for HCUP is called Partners.
HCUP includes the largest collection of multi-year (inpatient, ambulatory, and emergency care) hospital data in the United States, with payer-level information, an initial level meeting in 1988. This database enables research into health research and problems policies at the national, state and local market levels, including the costs and quality of health services, the patterns of medical practice, access to health care, and care outcomes.
In addition, AHRQ has developed a comprehensive set of software tools to use when evaluating hospital data. The free AHRQ software can be used not only with the HCUP database, but also with other administrative databases. HCUP Additional Files are only for use with HCUP databases.
HCUP User Site (HCUP-US)
The HCUP User Support Website is the primary repository for HCUP. This is designed to answer questions related to HCUP; provide detailed information on HCUP databases, tools and products; and offer technical assistance to HCUP users. The tools, publications, documentation, news, services, and HCUPnet HCUPnet (free online data query system) are all accessible via HCUP-AS. The website also provides information on obtaining a HCUP database.
HCUP-US is located at http://www.hcup-us.ahrq.gov .
Course Overview HCUP
To help researchers and policymakers find and use HCUP data, tools and products for their full potential, HCUP develops a free online interactive course that provides an overview of HCUP features, capabilities and potential. The course is modular, so users can move through the entire course or access the resources they like the most. Course Overview works well as an introduction to HCUP data and HCUP tools and refreshes for established users.
HCUP Online Tutorial Series
HCUP Online Tutorial Series is a series of interactive and free training courses that provide users with information about HCUP data, software products, and tools and provide guidance on technical methods for conducting research with HCUP data. The online courses are modular, so users can move through the entire course or access the parts they care about most. Available topics of tutorial features such as loading HCUP data, HCUP sampling design, weighing the database, calculating standard errors, generating national estimates, performing multi-year analyzes, and how to use national database readmissions.
Maps Healthcare Cost and Utilization Project
HCUP Overview of HCUP Databases
The HCUP database brings together data collection efforts from State data organizations, hospital associations, personal data organizations, and the Federal government to source information from patient-level health care data.
The HCUP database dates back to 1988 data files. The database contains meeting-level information for all payers that are compiled in uniform format with on-site privacy protection. Researchers and policy makers can use their notes to identify, track and analyze national trends in the use, access, cost, quality, and outcomes of health care. The database is suitable for a variety of analyzes - including rare conditions and special patient populations.
The HCUP database is released approximately 6-18 months after the end of a given calendar year, with State databases available earlier than the national dataset. For example, 2014 Country data is available starting 2015, and national data is available starting July 2016.
There are currently seven types of HCUP databases: four with national and regional level data and three with state and local data.
National Databases - for national and regional analysis - National Inpatient Sample (NIS): The annual inpatient data from systematic samples of all hospitals in HCUP, equals about 20 percent of all disposal at US community hospitals, excluding rehabilitation and acute long-term care hospitals. Data is available from 1988 onwards, and new databases are released each year, approximately 18 months after the end of the calendar year. The NIS overview and the NIS Data Documentation Documentation page of the HCUP-US website contain additional information. Data is available from 1988 onwards, and new databases are released each year, approximately 18 months after the end of the calendar year. NIS 2012 redesign: Beginning with 2012 data, new sampling methods are applied to increase national forecasts. Prior to 2012, NIS included all discharges from 20 percent of US hospital community samples, excluding rehabilitation hospitals. Beginning with 2012 data, the NIS comprises samples of discharge from all participating hospitals in HCUP, equivalent to about 20 percent of all discharges in US community hospitals, excluding rehabilitation and long-term acute care hospitals. The revised sample design provides a reduction of error margin. To highlight design changes, beginning with 2012 data, AHRQ renames NIS from the National Inpatient Sample to National Inpatient Samples National. . More information about NIS redesign can be found in the NIS Redesign Final Report.
- Child Inpatient Data (KID): National examples of inpatient outpatient care designed specifically for users to learn about the various conditions and procedures related to child health problems. The KID is released every three years, from 1997 to the next.
- Example of the National Emergency Department (NEDS): A database of over 31 million records generating a national estimate of 134 million emergency department (ED) visits. The NEDS captures meetings in which patients are treated for inpatient care, as well as those in which patients are treated and released. NEDS is released annually and available from 2006 onwards.
- National Database Readmissions (NRD): NRD is a unique and robust database designed to support various types of national re-registration analyzes for all payers and non-insured. This database discusses a large gap in health care data - a lack of national representative information about hospitalizations for all ages. NRD is released every year from 2013 onwards.
State Databases - for state and local analysis - State Inpatient Database (SID): Databases of abstract inpatient universes from participating countries are released annually. Data is available from 1995 onwards. SID is released on a rolling basis, as early as six months after the end of the calendar year.
- State Ambulatory Operations and Service Database (SASD): Outpatient surgery finds abstracts from affiliated hospitals and sometimes outpatient surgery sites in participating countries. Data available from 1997 onwards. SASD is released on a rolling basis, as early as six months after the end of the calendar year.
- State Emergency Department Databases (SEDD): Hospital-related emergency data for visits in participating countries that do not result in inpatient care. Data is available from 1999 onwards. SID is released on a rolling basis, as early as six months after the end of the calendar year.
Obtain an HCUP database through a Central Distributor
A number of HCUP State Partners make their data available for purchase through the HCUP Distributor Center . Applications for the database are available on the site. Beginning March 1, 2016, Nationwide Databases are delivered via secure digital downloads. Please note, potential buyers and everyone with access to the database are required to take the Data Usage Agreement Training Course and sign the Data Usage Agreement before using the data.
Data rates vary by database and year. The last years of NIS and KID are $ 350 per year-data, with special rates for students $ 100. NEDS is $ 500 per data-year, and $ 75 for students. NRD is $ 500 per data-year, and $ 150 for students. The cost of a State database is governed by each Country Partner that supplies data to HCUP. Prices vary by country and database, and certain Partners may have different pricing for the type of organization requesting data (nonprofit, government, academic, etc.). Purchase and pricing information can be found on the HCUP User Support Website at http://www.hcup-us.ahrq.gov/tech_assist/centdist.jsp.
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HCUP Tools and Tools
To improve the capabilities of the HCUP database, HCUP provides a number of software tools and software programs that can be applied to HCUP and other similar administrative databases. Many are available for download from the HCUP-US Website. Others can be booked through the HCUP Distributor Center. All HCUP software tools and products are free of charge.
HCUPnet
HCUPnet is a free, online online query system based on HCUP data. HCUPnet provides statistics from HCUP's national database (NIS, NEDS, KID, and NRD) and from State databases (SID, SASD, and SEDD) to States that have agreed to participate.
HCUPnet can be used to identify, track, analyze, and compare statistics on hospitals, emergency care, outpatient operations and obtain quality measures based on AHRQ Quality Indicators. Select statistics available at the national and district level. HCUPnet can also be used for trend analysis with available health care data from 1993 in the future.
HCUPnet also includes a feature called hospital readmissions that provides users with multiple statistics on hospital readmissions within 30 days after returning home from the hospital. Information on readingmissions for HCUPnet is available in the HCUP Methods Series report .
HCUP Quick Statistics
HCUP Fast Stats is a web-based tool that provides easy access to the latest HCUP-based statistics for health information topics. HCUP Fast Stats uses the visual statistics view in stand-alone graphics, trend figures, or simple tables to convey complex information in an instant. The first topic in HCUP's Quick Stats - The Effects of Expanding Health Insurance on Hospital Use (previously called Medicaid Exposure Effects on Hospital Use ) - was launched in July 2015, with data updates released quarterly from October 2015 These topics include statistics from up to 42 countries on the number of hospital discharges by paying groups (Medicare, Medicaid, private insurance, and no insurance) for conditions category (surgery, mental health, injury, maternity, and medical). Users can run state-by-state comparisons and analyze the effects of Medicaid expansion on hospital utilization rates and payment sources.
The second topic - Utilization and Cost of National Hospitals - was released in December 2015. This topic focuses on the national statistics on hospitalization: Trends, Most Common Diagnosis, and Most Common Operations.
In July 2016, AHRQ updated HCUP Fast Stats to include state emergency level (ED) visiting trends by payers - Effect of Health Insurance Expansion on Emergency Department Visit. These ED statistics complement the current state-level hospital stay trends that are part of the Impact of Expanding Health Insurance on Hospital Use . The number of ED visits per third is from 2006-2014 to 27 countries in a given year, including 26 countries with 2014 data.
HCUP Fast Stats will continue to be updated on a regular basis (quarterly or annually, as more recent data becomes available) for timely, country-specific statistics and state-level statistics.
Quality Indicators (QI)
AHRQ Quality Indicators (QIs) are a measure of the quality of health services using available hospitalized hospital admissions data. QI AHRQ can be used to highlight potential quality issues, identify areas that require research and further investigation, and track changes over time.
QI AHRQ consists of four modules that measure various aspects of quality:
- Prevention QIs identifies hospital admissions that, according to evidence, may be avoided, at least in part, through high quality outpatient care.
- QI Inpatient reflects the quality of hospitalized care including the death of inpatients for medical conditions and surgical procedures.
- The Patient Safety Indicator also reflects the quality of hospitalized care, but focuses on possible avoidable complications and iatrogenic events.
- Child QIs both reflect the quality of hospital care and identify potential hospital avoidable care among children.
Clinical Classification Software (CCS)
The Clinical Classification Software (CCS) provides a method for classifying diagnoses or procedures into clinically meaningful categories, which can be used for aggregate statistical reporting of various topics, such as identifying populations for diseases or specific procedures , or develop statistical reports that provide information (ie, cost and duration of stay) on relatively specific conditions.
There are three versions of the CCS Software: CCS Beta for ICD-10-CM/PCS, CCS for ICD-9-CM, and CCS for Services and Procedures.
- The Beta Clinical Classifications (CCS) Software for ICD-10-CM/PCS is based on the International Classification of Diseases, 10th Revisions, Clinical Modifications (ICD-10-CM) a uniform and standard coding system. CCS for ICD-10-CM/PCS provides a method for classifying diagnosis or ICD-10-CM/PCS procedures into clinically meaningful categories, which can be used for aggregate statistical reporting of various topics and used in many types of projects analyzing data about diagnosis and procedure. It is based on CCS for ICD-9-CM and tries to map ICD-10-CM/PCS codes into the same category.
The large number of ICD-10-CM/PCS codes - currently more than 69,800 diagnostic codes and 71,900 procedural codes - are collapsed into a number of more clinically meaningful categories. The current CCS version for ICD-10-CM/PCS has 285 mutually exclusive categories for diagnosis and 231 for procedures. For a particular research interest, these smaller numbers can be more useful for presenting descriptive statistics than individual ICD-10-CM/PCS codes. Any attempt is made to translate the CCS system to ICD-10-CM/PCS without making changes to the CCS assignment for diagnosis and procedure, but due to the new structure and the availability of expanded code, this is not always possible. Due to the increased specificity of ICD-10-CM/PCS and changes in the structure of two sets of codes, it is not possible to translate multilevel categories into ICD-10-CM/PCS in the current structure - with the exception of the first and second level multilevel categories.
CCS Beta for ICD-10-CM/PCS will be updated annually starting on October 1, 2015.
- Clinical Classification Software (CCS) for ICD-9-CM is based on the International Classification of Diseases, Revisions 9, Clinical Modifications (ICD-9-CM), uniforms and standard coding systems. The CCS for ICD-9-CM provides a method for classifying diagnosis or ICD-9-CM procedures into clinically meaningful categories, which can be used for aggregate statistical reporting of various topics and used in many types of projects that analyze data on diagnosis and procedures.
Since Fiscal Year 2008, CCS for ICD-9-CM belongs to the category of Mental Health and Substance Abuse Clinical Classifications Software (CCS-MHSA). These categories replace the original CCS category for mental health and substance abuse. Specifically, the single-level CCS software belongs to the general category of CCS-MHSA, and the multi-level CCS software belongs to the special category of CCS-MHSA.
The CCS for ICD-9-CM is updated annually from January 1980 to September 30, 2015. The ICD-9-CM code is frozen in preparation for ICD-10-CM implementation and routine maintenance of the codes has been suspended.
- The Clinical Classification Software (CCS) for Services and Procedures gives users the method of classifying the current Procedural Terminology code (CPTÃ,®) and the Public Health System Coding Code (HCPCS) code into in 244 categories of clinically meaningful procedures. More than 9,000 CPT/HCPCS codes and 6,000 HCPC codes are taken into account.
CCS versions and their user guides are available for download from the HCUP-AS Website.
Chronic Condition Indicator
The Chronic Condition Indicator gives researchers a way to facilitate healthcare research on diagnosis using administrative data. There are two versions of CCI software, CCI for ICD-9-CM and CCI for ICD-10-CM . The CCI tool gives users a convenient way of categorizing ICD-9-CM/ICD-10-CM diagnostic codes into two categories: chronic or non-chronic. Currently, there are about 14,000 diagnostic codes in ICD-9-CM versions and 68,000 diagnostic codes in ICD-10-CM versions. Chronic conditions are defined as conditions lasting 12 months or more and meet one or both of the following tests: (a) place limits on self-care, independent living, and social interaction; and (b) it results in a need for ongoing intervention with specialized medical products, services and equipment. The identification of chronic conditions is based on all 5-digit ICD-9-CM or 7-digit ICD-10-CM codes. Code E, or an external cause of the injury code, is not classified, since all injuries are assumed to be acute.
The tool also assigns a diagnosis code into one of 18 categories of body systems, allowing users to create a list of indicators that specific body systems are affected by chronic conditions. Body system indicators are based on the chapters of the ICD-9-CM/ICD-10-CM codebook. This indicator may be useful as a tool for counting the number of body systems that are affected by chronic conditions. Alternatively, Clinical Classification Software (CCS) may be used in conjunction with Chronic Condition Indicators to obtain a number of chronic relatively discrete conditions.
The Chronic Conditions indicator ICD-9-CM is updated annually and applies to codes from 1 January 1980 to 20 September 2015. The ICD-9-CM code is frozen for preparation of ICD-10-CM implementation and the regular maintenance of the code has been suspended. The Chronic Conditions indicator ICD-10-CM is updated annually and applies to codes starting October 1, 2015 forward. The indicators can be downloaded from the HCUP Distributor Center.
Elixhauser Electrical Software establishes variables that identify shared living conditions on hospital outgoing records that may cause death of patients using ICD-9-CM diagnostic coding.
The Elixhauser Comorbidity Software consists of two computer programs. First, the Creation of Format Libraries for Elixhauser's Group of Compilations, produces a format library that maps the diagnostic codes into comorbid indicators. Additional formats are created to exclude conditions that may be complications or that may be related to a primary diagnosis. The second program, Creation of Elixhauser Comorbidity Variables, applies this format to a set of data containing administrative data.
The Elixhauser Comorbidity Software is updated annually and is available for download at the HCUP-AS Website.
Procedure Class
The Procedure Class facilitates research on hospital services using administrative data by identifying whether the ICD-9-CM procedure is (a) diagnostic or therapeutic, and (b) minor or major in case of invasive and/or resource use. There are two types of Class Procedure tools, Procedure Class for ICD-9-CM and Class Procedures for ICD-10-CM.
Class Procedure gives users an easy way to categorize procedural code into one of four major categories: Minor Diagnostic, Minor Therapeutic, Major Diagnostic, and Major Therapeutic.
- Minor Diagnostic: Diagnostic non-operating room procedure (e.g., 87.03: CT scan head)
- Minor Therapy: Therapeutic non-surgical space procedure (eg, 02.41: Irrigate the shunt ventricle)
- Primary Diagnosis: All procedures are considered valid operating room procedures by the Related Diagnosis grouper (DRG) and performed for diagnostic reasons (eg, 01.14: Open brain biopsy)
- Major Therapeutic: All procedures are considered valid operating room procedures by the Group-Related Diagnoses Group (DRG) and are performed for therapeutic reasons (eg, 39.24: Aorta-Kidney bypass).
The Procedure Class for ICD-9-CM is updated annually from 1 January 1980 to 30 September 2015. The ICD-9-CM code is frozen in preparation for ICD-10 implementation and regular maintenance of the codes has been suspended. The Procedure Class for ICD-10-CM is updated every year and applies to codes starting October 1, 2015 forward. Procedure Class is available for download from the HCUP-US Website.
Flag Utilization
The Flag of Utilization discloses additional information about the use of health care services by aggregating information from UB-92 income code and ICD-9-CM procedure code to create a flag - or indicator - utilization for a more complete set of service images in hospitals, emergency departments, and outpatient operations centers.
The Utilization Flag can be used to study issues such as the use of intensive care units, as well as to reliably examine the use of diagnostic and therapeutic services - beyond the information that can be obtained from the ICD-9-CM procedure code alone.
Flag Utilization is updated annually and is available for download from the HCUP-AS Website.
Flag of Operation
Flag Operation identifies surgical procedures and meetings at ICD-9-CM or CPT based on inpatient and ambulatory surgery data. Two types of surgical categories are identified: NARROW surgery is based on a narrow, targeted, and limited definition and includes invasive surgical procedures. BROAD surgery includes procedures that fall under the NARROW category but adds less invasive therapeutic and diagnostic procedures that may be frequently performed in surgical settings. The user must approve the license to use the Operation Flag before accessing the software. (Updated for code valid until 2015.)
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HCUP Additional Files
HCUP Additional Files add a valid HCUP database with additional data elements or useful analytical information not available when the HCUP database was originally released. They can not be used with other administrative databases.
Cost-to-Cost Ratio (CCR)
The Cost-to-Charge Ratio (CCR) File is a hospital-level file designed to convert total hospital charge data to cost estimates when combined with data elements in NIS, SID, NRD, and KID.
The HCUP database is limited to information about the total cost of the hospital, which reflects the amounts billed to the payer per patient meeting. The total cost does not reflect the actual cost of providing care or payment received by the hospital for the services provided. This total payload data can be converted to cost estimates using the CCR File, which includes an all-payer hospital's cost-to-hospitalization ratio for virtually every hospital in participating NID, NIS, SID, and KID. Researchers and policy makers can use converted cost estimates to examine various topics, including the use and cost of hospital services, inflation of health care costs, and how certain hospital expense experiences or health plans are compared with national or state trends.
The Cost-to-Cost Ratio file is updated annually. The files can be obtained free of charge from the HCUP Distributor Center, ensuring that users receive the correct version of CCR for the year of interest.
Hospital Structure Structure (HMS) File
The Hospital Structure Structure (HMS) File is a hospital-level file designed to complement data elements in NIS, KID, and SID databases. The HMS file contains various measures of hospital market competition. These measures are aggregated and are intended to broadly characterize the intensity of competition that the organization may encounter under various definitions of the market area.
The hospital market definition is based on the location of the hospital, and in some cases, ZIP Codes patients. The location of the hospital was obtained from the Annual Hospital Database of the American Hospital Association (AHA), the File Area Resource (ARF), the Historical Urban/Rural - County (HURC) HCUP file, and the ArcView GIS. Patient ZIP Code is obtained from SID.
Users can combine data elements on the Hospital Market Structure File to NIS, KID, or SID hospitals that match the hospital identification number (HOSPID). Using the combined data elements, the hospital market structure measurement can then be included in the analysis.
The measurement of the hospital market structure is generally useful for conducting empirical analyzes that examine the effects of hospital competition on cost, access, and quality of hospital services. They are most useful for analysts as secondary control variables (for example, to assess whether there is a statistical relationship between two variables when the hospital market structure is controlled).
Hospital Market Structure files are updated every three years and are available free of charge from the HCUP Distributor Center. HCUP Hospital Market Structure Files are currently available for 1997, 2000, 2003, 2006, and 2009.
HCUP Additional Files for Revisit Analysis
HCUP Additional Files for Revisit Analysis allows users to track consecutive visits for patients in all settings and facilities and hospital settings while following strict privacy guidelines. Available clinical information may determine whether these consecutive visits are unrelated, expected follow-up, complications from previous treatments, or unexpected re-visit or rehospitalization. Users must combine additional files with SID, SASD, or SEDD as appropriate for any analysis. Data is available from 2003 onwards.
NIS & amp; KID File Trend
The NIS-Trends and KID-Trends files are available to help researchers perform longitudinal analyzes. They are debit level files that provide researchers with trending weights, and data elements in the case of NIS-Trends , which are consistently defined throughout the year.
American Hospital Association (AHA) Linkage Association
The AHA Linkage Files is a file-level hospitals that contain a small number of data elements that allow researchers to link identifier hospital on HCUP State Databases to the American Hospital Association Annual Survey Databases (Health Forum, LLC Â © 2012). Linkages are only possible in countries that allow the release of the identity of the hospital.
Archives National Inpatient Sample (NIS) Ownership Hospital
NIS Hospital Ownership Files are file-level hospitals designed to facilitate NIS analysis based on hospital ownership categories. This additional HCUP file allows users to identify within the NIS 1998-2007 the following three types of hospitals: government, nonfederal; personal, non-profit; and personal, investors themselves.
src: www.ahrq.gov
HCUP News and Reports
HCUP produces material for reporting new findings based on HCUP data and announcing HCUP news.
- HCUP's eNews summarizes the HCUP project activity quarterly.
- HCUP email updates on news, product releases, events and quarterly eNews to email lists
- HCUP Statistics Summary presents descriptive health care statistics on health care topics based on the HCUP database.
- HCUP infographs display data from the HCUP Statistical Brief series. Topics include inpatient vs outpatient in US hospitals, neonatal hospital care related to drug use, and hospital characteristics involving malnutrition.
- The HCUP Report method offers methodological information in the HCUP database and software tools.
- The HCUP Projection Report uses longitudinal HCUP data to project national and regional estimates of health care priorities.
src: www.latimes.com
See also
- Body of Research and Quality of Health
- United States Department of Health and Human Services
- MONAHRQ
- Classification of International Statistics of Diseases and Related Health Problems
- Medicine
- Patient safety
- Emergency Department
- Hospital
- Hospitalized
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References
src: www.latimes.com
External links
- Agents for Health Research and Quality Sites
- HCUP User Support Website (HCUP-US)
- HCUPnet
- United States Department of Health and Human Services
Source of the article : Wikipedia
Overview of HCUP Databases
The HCUP database brings together data collection efforts from State data organizations, hospital associations, personal data organizations, and the Federal government to source information from patient-level health care data.
The HCUP database dates back to 1988 data files. The database contains meeting-level information for all payers that are compiled in uniform format with on-site privacy protection. Researchers and policy makers can use their notes to identify, track and analyze national trends in the use, access, cost, quality, and outcomes of health care. The database is suitable for a variety of analyzes - including rare conditions and special patient populations.
The HCUP database is released approximately 6-18 months after the end of a given calendar year, with State databases available earlier than the national dataset. For example, 2014 Country data is available starting 2015, and national data is available starting July 2016.
There are currently seven types of HCUP databases: four with national and regional level data and three with state and local data.
National Databases - for national and regional analysis
State Databases - for state and local analysis
Obtain an HCUP database through a Central Distributor
A number of HCUP State Partners make their data available for purchase through the HCUP Distributor Center . Applications for the database are available on the site. Beginning March 1, 2016, Nationwide Databases are delivered via secure digital downloads. Please note, potential buyers and everyone with access to the database are required to take the Data Usage Agreement Training Course and sign the Data Usage Agreement before using the data.
Data rates vary by database and year. The last years of NIS and KID are $ 350 per year-data, with special rates for students $ 100. NEDS is $ 500 per data-year, and $ 75 for students. NRD is $ 500 per data-year, and $ 150 for students. The cost of a State database is governed by each Country Partner that supplies data to HCUP. Prices vary by country and database, and certain Partners may have different pricing for the type of organization requesting data (nonprofit, government, academic, etc.). Purchase and pricing information can be found on the HCUP User Support Website at http://www.hcup-us.ahrq.gov/tech_assist/centdist.jsp.
HCUP Tools and Tools
To improve the capabilities of the HCUP database, HCUP provides a number of software tools and software programs that can be applied to HCUP and other similar administrative databases. Many are available for download from the HCUP-US Website. Others can be booked through the HCUP Distributor Center. All HCUP software tools and products are free of charge.
HCUPnet
HCUPnet is a free, online online query system based on HCUP data. HCUPnet provides statistics from HCUP's national database (NIS, NEDS, KID, and NRD) and from State databases (SID, SASD, and SEDD) to States that have agreed to participate.
HCUPnet can be used to identify, track, analyze, and compare statistics on hospitals, emergency care, outpatient operations and obtain quality measures based on AHRQ Quality Indicators. Select statistics available at the national and district level. HCUPnet can also be used for trend analysis with available health care data from 1993 in the future.
HCUPnet also includes a feature called hospital readmissions that provides users with multiple statistics on hospital readmissions within 30 days after returning home from the hospital. Information on readingmissions for HCUPnet is available in the HCUP Methods Series report .
HCUP Quick Statistics
HCUP Fast Stats is a web-based tool that provides easy access to the latest HCUP-based statistics for health information topics. HCUP Fast Stats uses the visual statistics view in stand-alone graphics, trend figures, or simple tables to convey complex information in an instant. The first topic in HCUP's Quick Stats - The Effects of Expanding Health Insurance on Hospital Use (previously called Medicaid Exposure Effects on Hospital Use ) - was launched in July 2015, with data updates released quarterly from October 2015 These topics include statistics from up to 42 countries on the number of hospital discharges by paying groups (Medicare, Medicaid, private insurance, and no insurance) for conditions category (surgery, mental health, injury, maternity, and medical). Users can run state-by-state comparisons and analyze the effects of Medicaid expansion on hospital utilization rates and payment sources.
The second topic - Utilization and Cost of National Hospitals - was released in December 2015. This topic focuses on the national statistics on hospitalization: Trends, Most Common Diagnosis, and Most Common Operations.
In July 2016, AHRQ updated HCUP Fast Stats to include state emergency level (ED) visiting trends by payers - Effect of Health Insurance Expansion on Emergency Department Visit. These ED statistics complement the current state-level hospital stay trends that are part of the Impact of Expanding Health Insurance on Hospital Use . The number of ED visits per third is from 2006-2014 to 27 countries in a given year, including 26 countries with 2014 data.
HCUP Fast Stats will continue to be updated on a regular basis (quarterly or annually, as more recent data becomes available) for timely, country-specific statistics and state-level statistics.
Quality Indicators (QI)
AHRQ Quality Indicators (QIs) are a measure of the quality of health services using available hospitalized hospital admissions data. QI AHRQ can be used to highlight potential quality issues, identify areas that require research and further investigation, and track changes over time.
QI AHRQ consists of four modules that measure various aspects of quality:
- Prevention QIs identifies hospital admissions that, according to evidence, may be avoided, at least in part, through high quality outpatient care.
- QI Inpatient reflects the quality of hospitalized care including the death of inpatients for medical conditions and surgical procedures.
- The Patient Safety Indicator also reflects the quality of hospitalized care, but focuses on possible avoidable complications and iatrogenic events.
- Child QIs both reflect the quality of hospital care and identify potential hospital avoidable care among children.
Clinical Classification Software (CCS)
The Clinical Classification Software (CCS) provides a method for classifying diagnoses or procedures into clinically meaningful categories, which can be used for aggregate statistical reporting of various topics, such as identifying populations for diseases or specific procedures , or develop statistical reports that provide information (ie, cost and duration of stay) on relatively specific conditions.
There are three versions of the CCS Software: CCS Beta for ICD-10-CM/PCS, CCS for ICD-9-CM, and CCS for Services and Procedures.
- The Beta Clinical Classifications (CCS) Software for ICD-10-CM/PCS is based on the International Classification of Diseases, 10th Revisions, Clinical Modifications (ICD-10-CM) a uniform and standard coding system. CCS for ICD-10-CM/PCS provides a method for classifying diagnosis or ICD-10-CM/PCS procedures into clinically meaningful categories, which can be used for aggregate statistical reporting of various topics and used in many types of projects analyzing data about diagnosis and procedure. It is based on CCS for ICD-9-CM and tries to map ICD-10-CM/PCS codes into the same category.
The large number of ICD-10-CM/PCS codes - currently more than 69,800 diagnostic codes and 71,900 procedural codes - are collapsed into a number of more clinically meaningful categories. The current CCS version for ICD-10-CM/PCS has 285 mutually exclusive categories for diagnosis and 231 for procedures. For a particular research interest, these smaller numbers can be more useful for presenting descriptive statistics than individual ICD-10-CM/PCS codes. Any attempt is made to translate the CCS system to ICD-10-CM/PCS without making changes to the CCS assignment for diagnosis and procedure, but due to the new structure and the availability of expanded code, this is not always possible. Due to the increased specificity of ICD-10-CM/PCS and changes in the structure of two sets of codes, it is not possible to translate multilevel categories into ICD-10-CM/PCS in the current structure - with the exception of the first and second level multilevel categories.
CCS Beta for ICD-10-CM/PCS will be updated annually starting on October 1, 2015.
- Clinical Classification Software (CCS) for ICD-9-CM is based on the International Classification of Diseases, Revisions 9, Clinical Modifications (ICD-9-CM), uniforms and standard coding systems. The CCS for ICD-9-CM provides a method for classifying diagnosis or ICD-9-CM procedures into clinically meaningful categories, which can be used for aggregate statistical reporting of various topics and used in many types of projects that analyze data on diagnosis and procedures.
Since Fiscal Year 2008, CCS for ICD-9-CM belongs to the category of Mental Health and Substance Abuse Clinical Classifications Software (CCS-MHSA). These categories replace the original CCS category for mental health and substance abuse. Specifically, the single-level CCS software belongs to the general category of CCS-MHSA, and the multi-level CCS software belongs to the special category of CCS-MHSA.
The CCS for ICD-9-CM is updated annually from January 1980 to September 30, 2015. The ICD-9-CM code is frozen in preparation for ICD-10-CM implementation and routine maintenance of the codes has been suspended.
- The Clinical Classification Software (CCS) for Services and Procedures gives users the method of classifying the current Procedural Terminology code (CPTÃ,®) and the Public Health System Coding Code (HCPCS) code into in 244 categories of clinically meaningful procedures. More than 9,000 CPT/HCPCS codes and 6,000 HCPC codes are taken into account.
CCS versions and their user guides are available for download from the HCUP-AS Website.
Chronic Condition Indicator
The Chronic Condition Indicator gives researchers a way to facilitate healthcare research on diagnosis using administrative data. There are two versions of CCI software, CCI for ICD-9-CM and CCI for ICD-10-CM . The CCI tool gives users a convenient way of categorizing ICD-9-CM/ICD-10-CM diagnostic codes into two categories: chronic or non-chronic. Currently, there are about 14,000 diagnostic codes in ICD-9-CM versions and 68,000 diagnostic codes in ICD-10-CM versions. Chronic conditions are defined as conditions lasting 12 months or more and meet one or both of the following tests: (a) place limits on self-care, independent living, and social interaction; and (b) it results in a need for ongoing intervention with specialized medical products, services and equipment. The identification of chronic conditions is based on all 5-digit ICD-9-CM or 7-digit ICD-10-CM codes. Code E, or an external cause of the injury code, is not classified, since all injuries are assumed to be acute.
The tool also assigns a diagnosis code into one of 18 categories of body systems, allowing users to create a list of indicators that specific body systems are affected by chronic conditions. Body system indicators are based on the chapters of the ICD-9-CM/ICD-10-CM codebook. This indicator may be useful as a tool for counting the number of body systems that are affected by chronic conditions. Alternatively, Clinical Classification Software (CCS) may be used in conjunction with Chronic Condition Indicators to obtain a number of chronic relatively discrete conditions.
The Chronic Conditions indicator ICD-9-CM is updated annually and applies to codes from 1 January 1980 to 20 September 2015. The ICD-9-CM code is frozen for preparation of ICD-10-CM implementation and the regular maintenance of the code has been suspended. The Chronic Conditions indicator ICD-10-CM is updated annually and applies to codes starting October 1, 2015 forward. The indicators can be downloaded from the HCUP Distributor Center.
Elixhauser Electrical Software establishes variables that identify shared living conditions on hospital outgoing records that may cause death of patients using ICD-9-CM diagnostic coding.
The Elixhauser Comorbidity Software consists of two computer programs. First, the Creation of Format Libraries for Elixhauser's Group of Compilations, produces a format library that maps the diagnostic codes into comorbid indicators. Additional formats are created to exclude conditions that may be complications or that may be related to a primary diagnosis. The second program, Creation of Elixhauser Comorbidity Variables, applies this format to a set of data containing administrative data.
The Elixhauser Comorbidity Software is updated annually and is available for download at the HCUP-AS Website.
Procedure Class
The Procedure Class facilitates research on hospital services using administrative data by identifying whether the ICD-9-CM procedure is (a) diagnostic or therapeutic, and (b) minor or major in case of invasive and/or resource use. There are two types of Class Procedure tools, Procedure Class for ICD-9-CM and Class Procedures for ICD-10-CM.
Class Procedure gives users an easy way to categorize procedural code into one of four major categories: Minor Diagnostic, Minor Therapeutic, Major Diagnostic, and Major Therapeutic.
- Minor Diagnostic: Diagnostic non-operating room procedure (e.g., 87.03: CT scan head)
- Minor Therapy: Therapeutic non-surgical space procedure (eg, 02.41: Irrigate the shunt ventricle)
- Primary Diagnosis: All procedures are considered valid operating room procedures by the Related Diagnosis grouper (DRG) and performed for diagnostic reasons (eg, 01.14: Open brain biopsy)
- Major Therapeutic: All procedures are considered valid operating room procedures by the Group-Related Diagnoses Group (DRG) and are performed for therapeutic reasons (eg, 39.24: Aorta-Kidney bypass).
The Procedure Class for ICD-9-CM is updated annually from 1 January 1980 to 30 September 2015. The ICD-9-CM code is frozen in preparation for ICD-10 implementation and regular maintenance of the codes has been suspended. The Procedure Class for ICD-10-CM is updated every year and applies to codes starting October 1, 2015 forward. Procedure Class is available for download from the HCUP-US Website.
Flag Utilization
The Flag of Utilization discloses additional information about the use of health care services by aggregating information from UB-92 income code and ICD-9-CM procedure code to create a flag - or indicator - utilization for a more complete set of service images in hospitals, emergency departments, and outpatient operations centers.
The Utilization Flag can be used to study issues such as the use of intensive care units, as well as to reliably examine the use of diagnostic and therapeutic services - beyond the information that can be obtained from the ICD-9-CM procedure code alone.
Flag Utilization is updated annually and is available for download from the HCUP-AS Website.
Flag of Operation
Flag Operation identifies surgical procedures and meetings at ICD-9-CM or CPT based on inpatient and ambulatory surgery data. Two types of surgical categories are identified: NARROW surgery is based on a narrow, targeted, and limited definition and includes invasive surgical procedures. BROAD surgery includes procedures that fall under the NARROW category but adds less invasive therapeutic and diagnostic procedures that may be frequently performed in surgical settings. The user must approve the license to use the Operation Flag before accessing the software. (Updated for code valid until 2015.)
HCUP Additional Files
HCUP Additional Files add a valid HCUP database with additional data elements or useful analytical information not available when the HCUP database was originally released. They can not be used with other administrative databases.
Cost-to-Cost Ratio (CCR)
The Cost-to-Charge Ratio (CCR) File is a hospital-level file designed to convert total hospital charge data to cost estimates when combined with data elements in NIS, SID, NRD, and KID.
The HCUP database is limited to information about the total cost of the hospital, which reflects the amounts billed to the payer per patient meeting. The total cost does not reflect the actual cost of providing care or payment received by the hospital for the services provided. This total payload data can be converted to cost estimates using the CCR File, which includes an all-payer hospital's cost-to-hospitalization ratio for virtually every hospital in participating NID, NIS, SID, and KID. Researchers and policy makers can use converted cost estimates to examine various topics, including the use and cost of hospital services, inflation of health care costs, and how certain hospital expense experiences or health plans are compared with national or state trends.
The Cost-to-Cost Ratio file is updated annually. The files can be obtained free of charge from the HCUP Distributor Center, ensuring that users receive the correct version of CCR for the year of interest.
Hospital Structure Structure (HMS) File
The Hospital Structure Structure (HMS) File is a hospital-level file designed to complement data elements in NIS, KID, and SID databases. The HMS file contains various measures of hospital market competition. These measures are aggregated and are intended to broadly characterize the intensity of competition that the organization may encounter under various definitions of the market area.
The hospital market definition is based on the location of the hospital, and in some cases, ZIP Codes patients. The location of the hospital was obtained from the Annual Hospital Database of the American Hospital Association (AHA), the File Area Resource (ARF), the Historical Urban/Rural - County (HURC) HCUP file, and the ArcView GIS. Patient ZIP Code is obtained from SID.
Users can combine data elements on the Hospital Market Structure File to NIS, KID, or SID hospitals that match the hospital identification number (HOSPID). Using the combined data elements, the hospital market structure measurement can then be included in the analysis.
The measurement of the hospital market structure is generally useful for conducting empirical analyzes that examine the effects of hospital competition on cost, access, and quality of hospital services. They are most useful for analysts as secondary control variables (for example, to assess whether there is a statistical relationship between two variables when the hospital market structure is controlled).
Hospital Market Structure files are updated every three years and are available free of charge from the HCUP Distributor Center. HCUP Hospital Market Structure Files are currently available for 1997, 2000, 2003, 2006, and 2009.
HCUP Additional Files for Revisit Analysis
HCUP Additional Files for Revisit Analysis allows users to track consecutive visits for patients in all settings and facilities and hospital settings while following strict privacy guidelines. Available clinical information may determine whether these consecutive visits are unrelated, expected follow-up, complications from previous treatments, or unexpected re-visit or rehospitalization. Users must combine additional files with SID, SASD, or SEDD as appropriate for any analysis. Data is available from 2003 onwards.
NIS & amp; KID File Trend
The NIS-Trends and KID-Trends files are available to help researchers perform longitudinal analyzes. They are debit level files that provide researchers with trending weights, and data elements in the case of NIS-Trends , which are consistently defined throughout the year.
American Hospital Association (AHA) Linkage Association
The AHA Linkage Files is a file-level hospitals that contain a small number of data elements that allow researchers to link identifier hospital on HCUP State Databases to the American Hospital Association Annual Survey Databases (Health Forum, LLC Â © 2012). Linkages are only possible in countries that allow the release of the identity of the hospital.
Archives National Inpatient Sample (NIS) Ownership Hospital
NIS Hospital Ownership Files are file-level hospitals designed to facilitate NIS analysis based on hospital ownership categories. This additional HCUP file allows users to identify within the NIS 1998-2007 the following three types of hospitals: government, nonfederal; personal, non-profit; and personal, investors themselves.
HCUP News and Reports
HCUP produces material for reporting new findings based on HCUP data and announcing HCUP news.
- HCUP's eNews summarizes the HCUP project activity quarterly.
- HCUP email updates on news, product releases, events and quarterly eNews to email lists
- HCUP Statistics Summary presents descriptive health care statistics on health care topics based on the HCUP database.
- HCUP infographs display data from the HCUP Statistical Brief series. Topics include inpatient vs outpatient in US hospitals, neonatal hospital care related to drug use, and hospital characteristics involving malnutrition.
- The HCUP Report method offers methodological information in the HCUP database and software tools.
- The HCUP Projection Report uses longitudinal HCUP data to project national and regional estimates of health care priorities.
See also
- Body of Research and Quality of Health
- United States Department of Health and Human Services
- MONAHRQ
- Classification of International Statistics of Diseases and Related Health Problems
- Medicine
- Patient safety
- Emergency Department
- Hospital
- Hospitalized
References
External links
- Agents for Health Research and Quality Sites
- HCUP User Support Website (HCUP-US)
- HCUPnet
- United States Department of Health and Human Services
Source of the article : Wikipedia
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