The Healthcare Cost and Utilization Project (HCUP) Overview Agency for Healthcare Research and Quality APHA CEI Session November 2006

The Healthcare Cost and Utilization The Healthcare Cost and Utilization Project (HCUP)Project (HCUP)

OverviewOverview

Agency for Healthcare Research and QualityAgency for Healthcare Research and Quality

APHA CEI Session APHA CEI Session November 2006 November 2006

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Advancing Advancing Excellence in Excellence in Health CareHealth Care

Healthcare Cost and Healthcare Cost and Utilization Project (HCUP)Utilization Project (HCUP)

THE LARGEST COLLECTION OF MULTI-STATE, THE LARGEST COLLECTION OF MULTI-STATE, ALL-PAYER, ENCOUNTER-LEVEL, HEALTH CARE DATAALL-PAYER, ENCOUNTER-LEVEL, HEALTH CARE DATA

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HCUP Data Are HCUP Data Are Unique and PowerfulUnique and Powerful

38 State Partners Representing 90% of U.S. Population38 State Partners Representing 90% of U.S. Population

90% of Hospital Discharges in U.S.90% of Hospital Discharges in U.S.

Census of Hospital Care—NOT a SampleCensus of Hospital Care—NOT a Sample

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HCUP Supports High Impact Research and Policy Analyses

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HCUP Is a Family of Databases, Tools, and Products

HCUP Databases

Research Publications

User Support

Software Tools

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Advancing Advancing Excellence in Excellence in Health CareHealth Care HCUP Is NOT a Black Box

?

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Overview of HCUP Data

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HCUP Data Mostly HCUP Data Mostly from Community Hospitalsfrom Community Hospitals

Typically not included in HCUP data Community

Federal

Other/LTC

Source: American Hospital Association (AHA), 2004

Included in HCUP data

85%(N=4,919)

15% (N=840)

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Include these hospitalsInclude these hospitals

OB-GYNOB-GYN

ENTENT

Orthopedic Orthopedic

PediatricPediatric

PublicPublic

Academic medical Academic medical CentersCenters

Short-term rehabilitationShort-term rehabilitation

Exclude these hospitalsExclude these hospitals

Long-term careLong-term care

PsychiatricPsychiatric

Alcoholism/chemicalAlcoholism/chemicaldependencydependency

RehabilitationRehabilitation

AHA definition of community hospitals: Non-Federal, short-term, AHA definition of community hospitals: Non-Federal, short-term, general, and other specialty hospitals, excluding hospital units of other general, and other specialty hospitals, excluding hospital units of other

institutions (e.g., prisons)institutions (e.g., prisons)

What Are Community What Are Community Hospitals?Hospitals?

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What Types of Care Does HCUPWhat Types of Care Does HCUP

InpatientInpatient State Inpatient Databases (SID)State Inpatient Databases (SID) Nationwide Inpatient Sample (NIS)Nationwide Inpatient Sample (NIS) Kids’ Inpatient Database (KID)Kids’ Inpatient Database (KID)

OutpatientOutpatientEmergency Room Visits Emergency Room Visits State Emergency DepartmentState Emergency Department Database (SEDD)Database (SEDD)Ambulatory SurgeriesAmbulatory Surgeries State Ambulatory Surgery State Ambulatory Surgery Database (SASD)Database (SASD)[Office Visits][Office Visits]

[Pharmacy/Lab/Radiology][Pharmacy/Lab/Radiology]

Capture [and Not]?Capture [and Not]?

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The Foundation of HCUP Data The Foundation of HCUP Data is Billing Datais Billing Data

Demographic Demographic DataData

Diagnoses Diagnoses

ProceduresProcedures

ChargesCharges

Billing UB-92 Form

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Hospital Billing Data Have Hospital Billing Data Have Benefits and LimitationsBenefits and Limitations

BenefitsBenefits

SizeSize Uniformity of codesUniformity of codes Regularity of Regularity of

collectioncollection Ease of accessEase of access All-payerAll-payer

LimitationsLimitations

Limited clinical detailLimited clinical detail Variable accuracy of Variable accuracy of

codingcoding No data on individuals No data on individuals

outside hospital systemoutside hospital system

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Advancing Advancing Excellence in Excellence in Health CareHealth Care Current HCUP PartnersCurrent HCUP Partners

ArizonaArizona Department of Health ServicesDepartment of Health Services

Arkansas Arkansas Department of Health & Human ServicesDepartment of Health & Human Services

CaliforniaCalifornia Office of Statewide Health Planning & Development Office of Statewide Health Planning & Development

ColoradoColorado Health & Hospital Association Health & Hospital Association

ConnecticutConnecticut Chime, Inc. Chime, Inc.

FloridaFlorida Agency for Health Care Administration Agency for Health Care Administration

Georgia Georgia GHA An Association of Hospitals & Health SystemsGHA An Association of Hospitals & Health Systems

HawaiiHawaii Health Information CorporationHealth Information Corporation

Indiana Indiana Hospital&Health AssociationHospital&Health Association

IllinoisIllinois Department of Public HealthDepartment of Public Health

IowaIowa Hospital Association Hospital Association

KansasKansas Hospital AssociationHospital Association

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KentuckyKentucky Department for Public HealthDepartment for Public Health

MaineMaine Health Data Organization Health Data Organization

MarylandMaryland Health Services Cost Review Commission Health Services Cost Review Commission

MassachusettsMassachusetts Division of Health Care Finance and Policy Division of Health Care Finance and Policy

MichiganMichigan Health & Hospital Association Health & Hospital Association

MinnesotaMinnesota Hospital AssociationHospital Association

MissouriMissouri Hospital Industry Data Institute Hospital Industry Data Institute

NebraskaNebraska Hospital AssociationHospital Association

NevadaNevada Department of Human Resources Department of Human Resources

New Hampshire New Hampshire Department of Health & Human ServicesDepartment of Health & Human Services

New JerseyNew Jersey Department of Health & Senior Services Department of Health & Senior Services

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New YorkNew York State Department of Health State Department of Health

North CarolinaNorth Carolina Department of Health and Human Services Department of Health and Human Services

OhioOhio Hospital AssociationHospital Association

Office for Office for OregonOregon Health Policy & Research Health Policy & Research

OregonOregon Association of Hospitals and Health Systems (1996 Association of Hospitals and Health Systems (1996 data and forward)data and forward)

Rhode IslandRhode Island Department of Health Department of Health

South CarolinaSouth Carolina State Budget and Control Board State Budget and Control Board

South DakotaSouth Dakota Association of Health Care OrganizationsAssociation of Health Care Organizations

TennesseeTennessee Hospital Association Hospital Association

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TexasTexas Department of State Health ServicesDepartment of State Health Services

UtahUtah Department of Health Department of Health

VermontVermont Association of Hospitals and Health Systems Association of Hospitals and Health Systems

VirginiaVirginia Health Information Health Information

WashingtonWashington State Department of HealthState Department of Health

West VirginiaWest Virginia Health Care Authority Health Care Authority

WisconsinWisconsin Department of Health and Family Services Department of Health and Family Services

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Advancing Advancing Excellence in Excellence in Health CareHealth Care The Making of HCUP DataThe Making of HCUP Data

Patient enters Patient enters hospitalhospital

Hospital sends Hospital sends billing data and any billing data and any

additional data additional data elements toelements to

Data OrganizationsData Organizations

States store data States store data in varying formatsin varying formats

Billing Billing record record createdcreated

AHRQ AHRQ standardizes data standardizes data to create uniform to create uniform HCUP databasesHCUP databases

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Advancing Advancing Excellence in Excellence in Health CareHealth Care 38 States Contribute Data38 States Contribute Data

HCUP Process

HCUP Uniform DataHCUP Uniform DataHCUP Uniform DataHCUP Uniform Data

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KIDKIDKIDKID

SIDSIDSIDSID

SASDSASDSASDSASD

NISNISNISNIS

SEDDSEDDSEDDSEDD

AHRQ HCUP Databases

Data Use Data Use AgreementAgreementData Use Data Use AgreementAgreement

HCUP Central Distributor

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Advancing Advancing Excellence in Excellence in Health CareHealth Care Data Use AgreementData Use Agreement

The HCUP Data Use The HCUP Data Use Agreement implements Agreement implements the data protections of the the data protections of the Health Insurance Health Insurance Portability and Portability and Accountability Act (HIPAA) Accountability Act (HIPAA) of 1996 (Public Law 104-of 1996 (Public Law 104-191) and the Agency for 191) and the Agency for Healthcare Research and Healthcare Research and Quality (AHRQ) Quality (AHRQ) confidentiality statute. confidentiality statute.

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Advancing Advancing Excellence in Excellence in Health CareHealth Care Data Use AgreementData Use Agreement

NONO identification of identification of persons – patients or persons – patients or doctorsdoctors

Hospital identifiers can be Hospital identifiers can be used for research, but used for research, but hospitals can not be hospitals can not be identified in any identified in any publications (directly or publications (directly or indirectly)indirectly)

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New Requirement: New Requirement: Electronic DUA CourseElectronic DUA Course

PURPOSE OF THE COURSE

• Emphasize the importance of data protection

Reduce the risk of inadvertent violations

Describe your individual responsibility when using HCUP data.

http://www.hcup-us.ahrq.gov/tech_assist/dua.jsp

Takes 15 minutes to Complete

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HCUP Has Five Types of HCUP Has Five Types of DatabasesDatabases

State Inpatient Databases Nationwide Inpatient Sample Kids’ Inpatient Database

State Ambulatory Surgery Databases State Emergency Department Databases

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Advancing Advancing Excellence in Excellence in Health CareHealth Care HCUP DatabasesHCUP Databases

State State Ambulatory Ambulatory

Surgery Surgery Databases Databases

(SASD)(SASD)

State State Inpatient Inpatient

Databases Databases (SID)(SID)

State State Emergency Emergency Department Department Databases Databases

(SEDD)(SEDD)

Nationwide Nationwide Inpatient Sample Inpatient Sample

(NIS)(NIS)

Kids’ Kids’ Inpatient Database Inpatient Database

(KID)(KID)

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HCUP Links to Other HCUP Links to Other DatabasesDatabases

ZIP Code Level Census ZIP Code Level Census

CharacteristicsCharacteristics

Health Resources and Health Resources and

Services Administration’s Services Administration’s

(HRSA) Area Resource (HRSA) Area Resource

File (ARF)File (ARF)

American Hospital Association American Hospital Association

(AHA) Annual Survey(AHA) Annual Survey

Medicare Cost ReportsMedicare Cost Reports

HCUP Databases

NIS KID

SASD SEDD

SID

AHA ID

County

ZIP Code

Medicare ID

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How to Obtain HCUP Data throughHow to Obtain HCUP Data through the HCUP Central Distributor the HCUP Central Distributor

Step 1:Step 1: Request application kit: Request application kit:

http://www.hcup-us.ahrq.gov/tech_assist/centdist.jsphttp://www.hcup-us.ahrq.gov/tech_assist/centdist.jsp

Step 2:Step 2: Obtain more information (if needed): Obtain more information (if needed):

Phone: 866-556-HCUP (4287) toll freePhone: 866-556-HCUP (4287) toll free

E-mail: E-mail: [email protected]@s-3.com

Step 3:Step 3: Read and sign the Data Use Agreement (DUA) Read and sign the Data Use Agreement (DUA)

Step 4:Step 4: Fax or mail the order form, DUA, and payment to Fax or mail the order form, DUA, and payment to HCUP Central Distributor HCUP Central Distributor

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How to Learn More How to Learn More About HCUPAbout HCUP

General Information (or suggestions)

– http://www.hcup-us.ahrq.gov/home.jsphttp://www.hcup-us.ahrq.gov/home.jsp

HCUP Central Distributor

– E-mail: E-mail: [email protected]@s-3.comom; ;

– Phone: 1-866-556-HCUP (4287)Phone: 1-866-556-HCUP (4287)

HCUPnet

– http://hcup.ahrq.gov/HCUPnet.asphttp://hcup.ahrq.gov/HCUPnet.asp

Technical Assistance—HCUP User Support

– E-mail: E-mail: [email protected]@ahrq.gov; ;

– Phone: 1-866-290-HCUP (4287)Phone: 1-866-290-HCUP (4287)

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Healthcare Cost and Healthcare Cost and Utilization Project (HCUP)Utilization Project (HCUP)

THE LARGEST COLLECTION OF MULTI-STATE, THE LARGEST COLLECTION OF MULTI-STATE, ALL-PAYER, ENCOUNTER-LEVEL, HEALTH CARE DATAALL-PAYER, ENCOUNTER-LEVEL, HEALTH CARE DATA

Documents

The Healthcare Cost and Utilization Project (HCUP) Overview Agency for Healthcare Research and Quality APHA CEI Session November 2006