The Agency for Healthcare Research and Quality (AHRQ) recently released its 20th year of data from the Healthcare Cost and Utilization Project (HCUP). To celebrate this milestone, AHRQ honored three researchers who have used HCUP data to address healthcare research and policy issues.

Out of a highly competitive pool, a review committee selected three published researchers based on several criteria:

The winners spoke about their research at the 2010 AHRQ Annual Meeting.

Congratulations to the winners and to the researchers who submitted their work for consideration. We are humbled by the exceptional work being produced by HCUP researchers.

2010 Award Recipients

• Outstanding Achievement in Healthcare Research Using HCUP Data: Jay Berry, M.D., M.P.H.
• Outstanding Achievement in Healthcare Student Research Using HCUP Data: Ya-Lin Aileen Huang, Ph.D.
• Outstanding Achievement in Healthcare Policy Research Using HCUP Data: Carlos Grijalva, M.D., M.P.H.
• Marie Griffin, M.D., M.P.H.
• J. Pekka Nuorti, M.D., D.Sc.

Outstanding Achievement in Healthcare Research Using HCUP Data

Jay Berry, M.D., M.P.H., is a Professor of Pediatrics at Harvard Medical School and a General Pediatrician and Junior Health Services Researcher at the Children's Hospital Boston. Dr. Berry obtained a B.A. and M.D. from the University of Alabama and completed his residency at the University of Utah Medical Center. He also received a fellowship in Health Services Research at the Children’s Hospital Boston and an M.P.H. from Harvard School of Public Health.

Dr. Berry’s innovative research with the HCUP Kids’ Inpatient Database (KID) has contributed significantly to the understanding and appreciation of healthcare quality issues among children. Using the 2003 KID, Dr. Berry evaluated the relationship between the number of operations (hospital volume) commonly performed on children with special healthcare needs and their corresponding healthcare outcomes. This includes children undergoing spinal fusion for scoliosis, ventricular shunt placement for hydrocephalus, and tracheotomy for respiratory insufficiency. Using the KID, Dr. Berry found that one-quarter of hospitals performed these operations on a yearly basis at a low volume (i.e., fewer than one case per year). Furthermore, children who underwent a tracheotomy were more likely to experience postoperative complications in low-volume hospitals compared with high-volume hospitals. This work was published in Archives of Pediatrics and Adolescent Medicine.

More recently, Dr. Berry expanded his research to evaluate the use of Web-based integrated healthcare plans to reduce hospitalizations in children with chronic lung disease who receive a tracheotomy. Using the 2006 KID, he found that among these children, the highest in-hospital mortality (40 percent) following a tracheotomy was among premature children with a neurological impairment and congenital heart disease who did not have an upper airway anomaly. His unique methodological approach and the KID’s large sample size enabled him to uncover this important association that had not been detected before. This work was published in Archives of Diseases in Childhood.

Dr. Berry currently lectures research fellows at Harvard University on how best to use the KID. He has also written analyses based on HCUP data to improve inpatient resource utilization for children with special needs. Dr. Berry is partnering with NASA and the Agency for Healthcare Research and Quality (AHRQ) to link the State Inpatient Databases (SIDs) and climate data to better predict the spread of influenza across the United States.



Outstanding Achievement in Healthcare Student Research Using HCUP Data

Ya-Lin Aileen Huang, Ph.D., recently joined the Division of HIV/AIDS Prevention within the Centers for Disease Control and Prevention in Atlanta, GA, as a research fellow. Dr. Huang graduated from National Taiwan University with a B.A. in Public Health and Economics and an M.S. in Health Policy and Management. In May 2010, she obtained a Ph.D. in Health Economics and Health Policy Research from the Department of Health Policy and Management at Emory University.

Dr. Huang used multiple years of data from HCUP’s State Inpatient Database and Nationwide Inpatient Sample to write her dissertation, Three Essays on Births After Cesarean. This work investigated birth outcomes after repeated cesarean section (C-section) and vaginal births after cesarean section (VBACs). Birth outcomes included any adverse events or complications experienced by the mother or newborn—such as uterine rupture, hysterectomy, transfusion, birth trauma, respiratory distress syndrome, or neonatal infection. Overall, her study found that birth outcomes for repeat C-sections and VBACs improved over time. However, women undergoing repeat C-sections had a lower rate of maternal complications but a higher rate of neonatal complications than those undergoing VBACs. Dr. Huang’s work has important implications for medical practice and health policy: The findings suggest that the use of C-sections can be decreased without compromising birth outcomes by focusing on decreasing elective first-time C sections. However, her findings also provide reassurance to patients and their healthcare providers who may have preferences for certain types of birth procedures or practices.

Dr. Huang has presented her research at several nationwide conferences, including the Annual Research Meeting of AcademyHealth and the Annual Meeting of the Society of Medical Decision Making.



Outstanding Achievement in Healthcare Policy Research Using HCUP Data

Carlos Grijalva, M.D., M.P.H., is an Assistant Professor in the Department of Preventive Medicine at Vanderbilt University School of Medicine in Nashville, TN. Dr. Grijalva received a B.A. and M.D. from La Universidad Nacional San Luis Gonzaga in Peru. He obtained an M.P.H. from Vanderbilt University.

Dr. Grijalva and his team (Drs. Marie Griffin and J. Pekka Nuorti) used data from HCUP’s Nationwide Inpatient Sample (NIS) to evaluate the effects of a routine infant vaccination program on the incidence of pneumonia. Seven-valent pneumococcal conjugate vaccine (PCV7) was the vaccine administered. Using the NIS, the team found a substantial reduction in pneumonia rates (39 percent) among children younger than 2 years old. The team also showed protective effects, potentially through indirect or herd protection, among nonimmunized 18- to 39-year-old adults. This study was published in The Lancet in 2007, and the research was one of three studies selected for oral presentation at the 2007 Annual Meeting of the Presidential Plenary of the Pediatric Associations Societies. With more than 100 citations to date, this study is an important resource for vaccine policy and program evaluations.

Dr. Grijalva and his team continue to use HCUP to examine vaccination programs. Recently, the team studied the impact of the PCV7 vaccination program on hospitalizations from pneumococcal meningitis. The study demonstrated a substantial benefit to the PCV7 vaccination program. The article was published in Clinical Infectious Diseases (2008), and the findings were presented at the 2008 National Immunization Conference.



Team Members

Marie Griffin, M.D., M.P.H., is Professor of Medicine and Preventive Medicine at Vanderbilt University School of Medicine in Nashville, TN. Dr. Griffin is the principal investigator of the Agency for Healthcare Research and Quality (AHRQ) funded Vanderbilt Health Services Research Training Grant and the principal investigator of the AHRQ-funded DEcIDE (Developing Evidence to Inform Decisions about Effectiveness) Research Center at Vanderbilt University Medical Center.



J. Pekka Nuorti, M.D., D.Sc., is a Senior Medical Epidemiologist with the Respiratory Diseases Branch, Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention in Atlanta, GA. He is also Professor of Epidemiology at Tampere School of Public Health in Finland. He received an M.D. from the University of Tampere, and a D.Sc. in Epidemiology from the University of Helsinki, Finland. He also holds an M.S. in Medical Sociology from Boston University and a diploma in Tropical Medicine from the University of Copenhagen, Denmark.