December 2004
Issue #1
Contents
Welcome to HCUP e-News: A brief introduction to this newsletter
News and Announcements: Information on newly released databases, reports, data elements, and tools
Publications: A listing of recent peer-reviewed journal articles that have utilized HCUP data
Users´ Tech Tip: Answers to commonly asked questions when working with HCUP data
HCUP Calendar: Recent and upcoming conferences or meetings at which HCUP was/will be represented
This new quarterly publication is intended to provide updates on recent Healthcare Cost and Utilization Project (HCUP) activities. Within this newsletter you will find information on newly released HCUP databases and tools, as well as on publications and technical information related to the use of HCUP data. Given that HCUP e-News has just been launched, we are eager to hear your comments about the newsletter and any suggestions for improvement. Are there topics you would like to see included in future editions? Would changes in format be useful to you? Please let us know your thoughts by e-mailing Carol Stocks at cstocks@ahrq.gov or Pam Owens at powens@ahrq.gov.
Announcing the Release of the State Emergency Department Databases (SEDD)
What illnesses account for the majority of urgent emergency department (ED) visits within a particular state? Has there been an increased demand for ED services by those on Medicaid, Medicare, or by the uninsured? Until now, questions like these have been difficult to answer given the limited sources of state-specific ED information. A new set of databases released by the Agency for Healthcare Research and Quality (AHRQ) provides the data necessary to begin investigating questions about ED services. The State Emergency Department Databases (SEDD) are offered through the Agency´s Healthcare Cost and Utilization Project (HCUP). The SEDD includes discharge information on ED visits that do not result in admission to a hospital. Databases are available for Maine (1999-2002), Maryland (1999-2002), and Nebraska (2001-2002). Future releases of the SEDD from additional states will be announced as they become available. To learn more about the release of the SEDD, including information on ordering and data availability, please see the full SEDD Release Announcement.
National Healthcare Quality Report 2004 and National Healthcare Disparities Report 2004 to be Released
The second annual release of the National Healthcare Quality Report (NHQR) and the National Healthcare Disparities Report (NHDR), developed by the Agency for Healthcare Research and Quality (AHRQ) for the U.S. Congress, is planned for mid-January 2005. The NHQR and NHDR are part of a comprehensive effort to measure the quality of health care in America. The reports include a broad set of performance measures that serve as baselines and track trends in the quality of health care and in racial and socioeconomic health care disparities nationwide. The reports present data on the quality of services for seven clinical conditions, including cancer, diabetes, end-stage renal disease, heart disease, HIV and AIDS, mental health, and respiratory disease. They also include data on patient safety, maternal and child health care quality, and nursing home and home health care quality. HCUP data were used in combination with AHRQ´s Quality Indicators (QIs) to provide statistical information for many of the measures included in both reports. More information, as well as the complete reports, can be found on the Agency´s Website at http://www.ahrq.gov.
New Urban-Rural Data Elements Included in 2002 State Inpatient Databases (SID), State Ambulatory Surgery Databases (SASD), and State Emergency Department Databases (SEDD)
Beginning in 2002, the State Inpatient Databases (SID), State Ambulatory Surgery Databases (SASD), and State Emergency Department Databases (SEDD) will include data elements that characterize the urban-rural location of a patient´s residence. Researchers often need a means of identifying "urban" and "rural" populations to investigate disparities in the availability of and access to health care services. Adding these indicators to HCUP data increases the research value of HCUP databases. These measures, which categorize counties or ZIP Codes by population density and proximity to urban areas, include: Metropolitan Statistical Areas, Core-Based Statistical Areas, Urban Influence Codes, Rural Urban Continuum Codes, and Rural Urban Commuting Areas. Thirteen (13) states have allowed the inclusion of urban-rural indicators in the Central Distributor collection of databases, including: Florida (SID, SASD), Iowa (SID), Kentucky (SID, SASD), Massachusetts (SID), Maryland (SID, SASD, SEDD), Maine (SID, SASD, SEDD), Michigan (SID), North Carolina (SID, SASD), Nebraska (SID, SASD, SEDD), New Jersey (SID, SASD), New York (SID, SASD), Utah (SID, SASD), and Washington (SID). For more information on these and other data elements contained within publicly released databases, please see the State-Specific HCUP Databases available on the HCUP-US Website.
2005 Updates Now Available for the Clinical Classifications Software (CCS) and Procedure Classes Software
The most recent updates for the Clinical Classifications Software (CCS) and Procedure Classes software are now available for use with HCUP databases. The CCS provides a method for classifying diagnoses or procedures into clinically meaningful categories, useful for aggregate statistical reporting. The CCS can be used with data available on the HCUPnet Website, as well as with other administrative data. The Procedure Classes tool identifies whether ICD-9-CM procedure codes are (a) diagnostic or therapeutic, and (b) minor or major in terms of invasiveness and/or resource use. Both the Procedure Classes table and the CCS tool can be adapted to work with the particular software a researcher is using. For more information on these products or other tools available through HCUP, please see the Tools & Software section of HCUP-US.
Davis MM, Patel MS, Gebremariam A. Decline in varicella-related hospitalizations and expenditures for children and adults after introduction of varicella vaccine in the United States. Pediatrics, 2004; 114(3):786-92.
Using data from the HCUP Nationwide Inpatient Sample (NIS) (1993-2001), the authors found a significant reduction in the population-adjusted rates of varicella-related hospitalizations and a corresponding decrease in hospital charges. Using data from the National Immunization Survey (1996-2001), the authors suggested that the decline in hospitalization rates and charges were associated with the increased immunization rates against varicella. The complete abstract from which this brief description was adapted is available online via PubMed.
Gresenz CR, Rogowski J, Escarce JJ. Updated variable-radius measures of hospital competition. Health Services Research, 2004; 39(2):417-30.
Using a combination of discharge abstracts from nine 1997 State Inpatient Databases (SID) and other national databases, the authors calculated variable-radius measures of hospital market size and hospital competition measures. To create these measures, the authors linked the SID to the American Hospital Association (AHA) Annual Survey, the Area Resource File (ARF), the InterStudy Regional Market Analysis database, and Medicare's Prospective Payment System Impact Files. The complete abstract, from which the brief description was adapted, is available online via PubMed.
For more publications featuring HCUP data, please see the AHRQ Website.
Using Weights with the Nationwide Inpatient Sample (NIS)
The Nationwide Inpatient Sample (NIS) and the Kids' Inpatient Database (KID) are stratified probability samples. Thus, simple statistics, including variances, need to take into account the sampling design and sample discharge weights in order to reflect the larger universe of discharges in the United States. Discharge weight (DISCWT, and in 2000 DISCWTCHARGE for total charges) and stratification variables (HOSPID, NIS_STRATUM, KID_STRATUM) are used to adjust, or weight, statistical results to create national estimates for all analyses. For further description and information on calculating adjusted estimates using SAS, SUDAAN, STATA, or SPSS, please refer to the report, "Calculating Nationwide Inpatient Sample Variances" located on the HCUP-US Website ( http://www.hcup-us.ahrq.gov/reports/methods/CalculatingNISVariances200106092005.pdf).
December 3-5, 2004: National Association of Health Data Organizations 19th Annual Meeting.
******************************************************
This publication and previous editions of HCUP e-News are available online at the HCUP User Support (HCUP-US) Website.
Instructions on how to subscribe to the HCUP LISTSERV® and receive information on new HCUP data, tools, and products, in addition to future editions of HCUP e-News, are available on the HCUP-US Website via the HCUP LISTSERV® Web page.
For more information or if you have any questions regarding HCUP e-News, please contact Carol Stocks, RN, MHSA, at cstocks@ahrq.gov, or Pamela Owens, Ph.D., at powens@ahrq.gov.