Fall 2017, Issue #52
Contents
News and Announcements
AHRQ Releases New Interactive Map Depicting Trends in Opioid-Related Hospitalizations
The Agency for Healthcare Research and Quality (AHRQ) has released a new interactive mapthat presents State-specific results for opioid-related hospitalizations based on information presented in HCUP Fast Stats.
After selecting a State of interest, users can obtain information on the change in the rate of hospitalization over a 5-year time frame as well as the patient age, sex, community-level income, and location groups with the highest rates in 2014.
This tool is a valuable resource for understanding how the opioid epidemic is affecting hospital care. Additional information on the importance of this tool for understanding this nation’s opioid crisis is available in a blog post written by AHRQ’s Director.
HCUP Fast Stats Data Update
AHRQ added information on expected payer (Medicare, Medicaid, private insurance, and uninsured) to the Opioid-Related Hospital Use path in HCUP Fast Stats. This Fast Stats path shows national and state trends from 2007 to 2016 (when available) in opioid inpatient stays and emergency department visits.
For additional information, please refer to the Fast Stats Frequently Asked Questions page or contact HCUP User Support.
Coming Soon: The 2015 National Inpatient Sample (NIS)!
The 2015 National Inpatient Sample (NIS) is planned for release this fall. The NIS is the largest inpatient care database in the United States. It contains charge information on all patients, regardless of payer, including individuals covered by Medicare, Medicaid, or private insurance, and those who are uninsured. The NIS is a powerful database that contains data from approximately 7 million hospital stays in 47 States and the District of Columbia. NIS data can be weighted to produce national estimates, allowing researchers and policymakers to identify, track, and analyze national trends in health care utilization, access, charges, quality, and outcomes. Its vast size enables analyses of infrequent conditions, uncommon treatments, and special patient populations.
The 2015 NIS will be available for purchase through the HCUP Central Distributor. Select statistics will be available on HCUPnet, a free online query system that uses HCUP data.
Coming Soon: The 2015 Nationwide Readmissions Database (NRD)!
The 2015 Nationwide Readmissions Database (NRD) is planned for release this fall. The NRD is a unique and powerful database designed to support analyses of national readmission rates for all payers and the uninsured. This database addresses a large gap in health care data—the lack of nationally representative information on hospital readmissions for all ages. Unweighted, the NRD contains data from approximately 15 million discharges each year. Weighted, it estimates roughly 35 million discharges.
The NRD is drawn from the State Inpatient Databases (SID) with reliable, verified patient linkage numbers that could be used to track patients across hospitals within a State while adhering to strict privacy guidelines.
The 2015 NRD will be available for purchase through the HCUP Central Distributor. Select statistics will be available on HCUPnet, a free online query system that uses HCUP data.
HCUP Releases the 2016 National Healthcare Quality and Disparities Report (QDR)
AHRQ has released the 2016 National Healthcare Quality and Disparities Report (QDR). This report measures and tracks trends in quality and disparities in terms of patient safety, person-centered care, care coordination, effective treatment, healthy living, care affordability, and access to health care. In addition, the report provides a comprehensive overview of the quality of health care received by the general population and disparities in care experienced by different racial, ethnic, and socioeconomic groups. Information on additional measures related to specific themes will available through chartbooks, which are posted online several times per year. You may access the report at http://www.ahrq.gov/research/
For questions, please contact AHRQ User Support.
HCUP’s 2016 Outstanding Article of the Year Awards Announced!
Authors of three studies received the seventh annual Outstanding Article of the Year Awards at the AcademyHealth Annual Research Meeting in June. Each year, AHRQ recognizes researchers published in peer-reviewed journals who used HCUP databases to explore and address health care research topics and issues. Honored work demonstrates how HCUP has contributed to these investigations. Users can find a list of the 2016 HCUP Outstanding Article of the Year Award recipients and gain additional information on the selection process by visiting HCUP-US. The award recipients also are showcased in the Publication Spotlights section of this newsletter.
Data and Products
Recently Released: 2015 State Databases and Additional 2013 and 2014 Databases
Since June 2017, the following State Databases have been released:
o 2013: Maine
o 2014: Maine
o 2015: Colorado, Florida, Kentucky, Michigan, Minnesota, North Carolina, and South Dakota
o 2013: Maine
o 2014: Maine
o 2015: Colorado, Florida, Iowa, Michigan, Minnesota, Kentucky, and North Carolina
o 2013: Maine
o 2014: Maine
o 2015: Florida, Iowa, Kentucky, Minnesota, and North Carolina
Complete listings of available databases by year can be found in the Database Catalog on the HCUP-US Web site. Databases can be purchased online through the HCUP Central Distributor, and aggregated national and selected State statistics can be accessed via HCUPnet.
For database purchasing questions, please contact the HCUP Central Distributor. this placeholder text.
Publications Spotlights
New HCUP Statistical Briefs Posted on HCUP-US
Since June 2017, the following HCUP Statistical Briefs have been released:
- #227 Trends in Emergency Department Visits, 2006–2014
- #226 Patient Residence Characteristics of Opioid-Related Inpatient Stays and Emergency Department Visits Nationally and by State, 2014
- #225 Trends in Hospital Inpatient Stays in the United States, 2005–2014
- #224 Patient Characteristics of Opioid-Related Inpatient Stays and Emergency Department Visits Nationally and by State, 2014
To access these and other Statistical Briefs, please visit the Statistical Briefs page on the HCUP-US Web site.
New HCUP Methods Series Report Now Available
Since June 2017, the following Methods Series Report has been released:
Method Series Report #2017-03: Methods Applying the AHRQ Quality Indicators to Healthcare Cost and Utilization (HCUP) Project Data for the 2016 National Healthcare Quality and Disparities Report (QDR) provides methods for applying the AHRQ Quality Indicators (QIs) to HCUP discharge data for the 2016 HCUP QDR.
This report and other HCUP reports can be found on the HCUP Reports page.
Authors of the following studies were recipients of the Outstanding Article of the Year Awards at the AcademyHealth Annual Research Meeting. Congratulations to all for these excellent contributions.
Armstrong JC, Kozhimannil KB, McDermott P, et al. Comparing variation in hospital rates of cesarean delivery among low-risk women using 3 different measures. Am J Obstet Gynecol. 2016 Feb;214(2):153-63.
This study used the 2011 Nationwide Inpatient Sample (NIS) to analyze a refined measure of low-risk cesarean delivery that was designed to expand clinical information. The measure was developed by the Society for Maternal-Fetal Medicine Health Policy Committee to enhance existing definitions of low risk from the Joint Commission and AHRQ. Results were stratified by hospital bed size, teaching status, urban-rural location, and payer mix. This article abstract is available via PubMed.
Ho V, Ross JS, Steiner CA, Mandawat A, et al. A nationwide assessment of the association of smoking bans and cigarette taxes with hospitalizations for acute myocardial infarction, heart failure, and pneumonia. Med Care Res Rev. 2016 Sep 12. [Epub ahead of print]
This study uses the 2001–2008 State Inpatient Databases (SID) to examine the association between county-level smoking-related hospitalization rates and smoking bans. This article abstract is available via PubMed.
Thompson MP, Kaplan CM, Cao Y, et al. Reliability of 30-day readmission measures used in the Hospital Readmission Reduction Program. Health Serv Res. 2016 Dec;51(6):2095-2114.
This study uses the 2011–2013 State Inpatient Databases (SID) to determine the reliability of 30-day readmission measures for certain medical conditions and surgical procedures used in the Hospital Readmission Reduction Program (HRRP). This article abstract is available via PubMed.
To read additional recently published articles featuring HCUP data, please visit the Research Spotlights page on the HCUP-US Web site.
HCUP Q&A
Question: I am interested in conducting a State-level analysis that follows patients across multiple settings of care. I see that HCUP offers three types of State databases. I am interested in purchasing them to perform this analysis. However, before I move forward, I have some questions.
- What pathways of care are represented in each of the State databases? I am particularly interested in the following cases:
o If a patient was initially seen in the emergency department and then subsequently admitted to the hospital, will the record be included in the State Inpatient Databases (SID) or the State Emergency Department Databases (SEDD)?
o If a patient received both ambulatory surgery and emergency department services within a single hospital encounter, will the record be included in the State Ambulatory Surgery and Services Databases (SASD) or the SEDD?
o If a patient received both emergency department services and observation services, which State database will include the record? Also, is there any information available indicating the combined service?
o In looking at the Summary Statistics for several SASD, I observed several States with substantial increases in the total number of records from one year to the next. What is the reason for this increase?
Answers
What pathways of care are represented in each of the State Databases? I am particularly interested in the following cases:
The following graphic provides a visual representation of the various pathways of care that will be represented in each of the HCUP State Databases. Additional details pertaining to the specific cases in which you are interested are located below the graphic.
If a patient was initially seen in the emergency department and then subsequently admitted to the same hospital, will the record be included in the State Inpatient Databases (SID) or the State Emergency Department Databases (SEDD)?
Records for patients initially seen in the emergency department (ED) and then subsequently admitted to the same hospital are included in the SID. The SEDD include information on ED encounters that do not result in admission to the same facility (i.e., ED treat-and-release). Both the SID and SEDD are needed to analyze all ED encounters in a State.
If a patient received both ambulatory surgery and emergency department services within a single hospital encounter, will the record be included in the State Ambulatory Surgery and Services Databases (SASD) or the SEDD?
A record in the SASD that also has evidence of ED services is included in both the SASD and the SEDD. Evidence of ED services is based on the HCUP data element HCUP_ED and can be identified when the value is greater than zero. These combined ambulatory surgery and ED records with have the same value for the HCUP data element KEY in both the SASD and SEDD.
If a patient received both emergency department services and observation services, which State database will include the record? Also, is there any information available indicating the combined service?
Records for patients that received both ED services and observation services (OS) typically would be included in the SEDD. For additional information on the capture of combination ED-OS records, refer to the State-specific SEDD File Composition Notes.
Evidence of OS on an ED record in the SEDD can be identified using the HCUP variable HCUP_OS, specifically when the value is greater than zero. The availability of information on ED encounters involving OS varies substantially across States and data years because it is dependent on inclusion of the necessary underlying data in the SEDD, such as revenue center codes. For additional information, refer to HCUP Method Series Report #2016-05, Identifying Observation Services in the HCUP State Databases.
In looking at the Summary Statistics for several SASD, I observed several States with substantial increases in the total number of records from one year to the next. What is the reason for this increase?
The increase in the total number of records is due to inclusion of other outpatient services in the SASD. The specific types of records included in each SASD vary by State and data year and depend on information provided by the HCUP Partner data organizations. The SASD include encounter-level data for ambulatory surgeries and may include various types of outpatient services such as observation stays, lithotripsy, radiation therapy, imaging, chemotherapy, and labor and delivery. For additional information, refer to the State-specific SASD File Composition Notes.
HCUP Events
For a complete list of HCUP presentations and events, visit the HCUP Events Calendar.
- October 2–4, 2017: National Association of Health Data Organizations Annual Meeting
o Exhibit BoothOn October 2–4, 2017, HCUP staff will sponsor an exhibit booth. Representatives will be available to provide information and answer questions.
- October 23–25, 2017: National Academy for State Health Policy Annual Conference
o Exhibit BoothOn October 23–25, 2017, HCUP staff will sponsor an exhibit booth. Representatives will be available to provide information and answer questions.
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