HCUP e-News: the electronic newsletter of the Healthcare Cost and Utilization Project


Fall 2015
Issue #44


Contents

News and Announcements: Notable news from HCUP
Databases and Products: New database and product releases
Publication Spotlights: Recent works incorporating HCUP data and tools
HCUP Q&A: Answers to your HCUP questions
HCUP Events: Upcoming HCUP conferences and meetings

Missed the last e-News? Read it on the HCUP-US website.


News and Announcements

Learn About HCUP at Its September 16 and 30 Webinars: Registration Now Open!

Two Webinars introducing researchers to HCUP will be held on September 16 and 30. The first, Overview of the HCUP Databases, covers an introduction to the HCUP family of databases. The second, Overview of the HCUP Products and Tools, covers the use of HCUP software tools and supplemental files to facilitate and augment research. The Webinars are open to the public. Registration for both Webinars is now open and will close as soon as capacity has been reached. Additional details are posted on the HCUP Workshops and Webinars page.

Now Available: HCUP Fast Stats, a Quick Visual Tool for the Latest HCUP-Based Statistics

The Agency for Healthcare Research and Quality (AHRQ) has released HCUP Fast Stats, a new online tool that provides easy access to the latest HCUP-based statistics for health information topics. HCUP Fast Stats uses visual statistical displays in stand-alone graphs, trend figures, or simple tables to convey complex information at a glance.

The first topic in HCUP Fast Stats—Effect of Medicaid Expansion on Hospital Use—launched in July. This topic includes statistics from 41 States on the number of hospital discharges by payer group (Medicare, Medicaid, private insurance, and uninsured) for categories of conditions (surgical, mental health, injury, maternal, and medical). Users can run state-by-state comparisons and analyze the effects of Medicaid expansion on hospital utilization levels and payment sources. Information on the effect of Medicaid expansion on hospital use will be updated regularly (quarterly and/or annually, as newer data become available).

For additional information, please refer to the Fast Stats Frequently Asked Questions page or contact HCUP User Support.

New Pathway on HCUPnet for Statistics on Ambulatory Surgery Use

HCUPnet now includes information on ambulatory surgery. This expansion allows users to create their own statistics on ambulatory surgeries for participating States from the HCUP State Ambulatory Surgery and Services Databases (SASD). You can compare the ambulatory surgery information to statistics on inpatient surgeries for participating States from the HCUP State Inpatient Databases (SID). This path of HCUPnet combines all SASD and SID to provide a multi-state view into ambulatory surgery in the U.S. Here is an example of the type of information available:

State statistics - 2012 Ambulatory Surgery Data from all HCUP States - all-listed

Rank order of CCS all-listed procedure category by number of ambulatory surgeries

Rank CCS all-listed procedure category and name Total number of ambulatory surgeries Percent performed as ambulatory surgery (outpatient)
1. 15 Lens and cataract procedures 881,554 99.9
2. 160 Other therapeutic procedures on muscles and tendons 596,415 73.0
3. 162 Other OR therapeutic procedures on joints 455,078 80.3
4. 84 Cholecystectomy and common duct exploration 414,031 56.9
5. 151 Excision of semilunar cartilage of knee 364,502 98.5
6. 30 Tonsillectomy and/or adenoidectomy 332,330 58.5
7. 85 Inguinal and femoral hernia repair 305,930 90.3
8. 175 Other OR therapeutic procedures on skin and breast 258,317 77.2
9. 86 Other hernia repair 256,849 58.2
10. 23 Myringotomy 246,570 97.3
HCUPnet, Healthcare Cost and Utilization Project. Agency for Healthcare Research and Quality, Rockville, MD. http://hcupnet.ahrq.gov/

Please contact HCUP User Support with questions or comments.

Expected Release in October: The 2013 NIS!

The 2013 National Inpatient Sample (NIS) is planned for release next month. The NIS is the largest inpatient care database in the United States that includes all patients, regardless of payer. It contains data from patients covered by Medicare, Medicaid, and private insurance as well as those who are uninsured. Earlier years of the NIS, going back 20 years, are available for trends analyses.

Researchers and policymakers can use the NIS to identify, track, and analyze national trends in healthcare utilization, access, charges, quality, and outcomes. Its vast size enables analyses of infrequent conditions, uncommon treatments, and special patient populations.

The 2013 NIS will be available for purchase through the HCUP Central Distributor, and select statistics will be available on HCUPnet, a free online query system that uses HCUP data.

New: Online Execution of the HCUP Data Use Agreement

As a part of ongoing efforts to streamline the application process for HCUP databases through the online HCUP Central Distributor, data purchasers now execute the required HCUP Data Use Agreement (DUA) online. The terms and conditions of the DUA remain the same, and acknowledgement of the DUA continues to be required for each purchase. Researchers also continue to be required to complete the online Data Use Agreement Training Course before they can place an order for HCUP data.

During the online "checkout" process, all data purchasers are required to read and acknowledge the online DUA. The executed DUAs are retained by the HCUP Central Distributor, and users are able to access their DUA(s) in PDF format by logging into their Account and viewing their Order History. If there are additional members of the research team, they will continue to sign the hard copy DUA and return it to the Central Distributor.

For any questions related to the purchase of HCUP databases, please contact the HCUP Central Distributor.

HCUP's Outstanding Article of the Year Award

Each year, AHRQ recognizes researchers published in peer-reviewed journals that used HCUP databases to explore and address healthcare research topics and issues. Honored work demonstrates how HCUP has contributed to these areas. Users can find a list of the 2014 HCUP Outstanding Article of the Year Award recipients as well as gain additional information on the HCUP Outstanding Article of the Year Award selection process by visiting HCUP-US.

Register for AHRQ's 2015 Research Conference!

The 2015 AHRQ Research Conference, Producing Evidence and Engaging Partners to Improve Health Care, will be held October 4–6, 2015 at the Crystal Gateway Marriot Hotel and Convention Center in Crystal City, Virginia. The conference, which is co-hosted by AcademyHealth, will bring together authorities in healthcare research policy to participate in sessions focused on addressing today’s challenges in improving quality, safety, access, and value in healthcare.

AHRQ HCUP staff will present seven posters and three podium presentations describing some of the research investigations that use recent HCUP data. AHRQ will provide an overview presentation that discusses how HCUP and the Medical Expenditure Panel Survey (MEPS) data can be used as resources to inform research and policy. In addition, AHRQ will provide a demonstration of HCUP Fast Stats, a new online tool that provides easy access to the latest HCUP-based statistics for health information topics.

A complete list of the research topics to be presented at the 2015 AHRQ Research Conference is featured below in HCUP Events.

Please contact AHRQ with questions or comments.


Databases and Products

Recently Released: Additional State Databases

Since June 2015, the following State databases have been released:

Complete listings of available databases by year can be found in the Database Catalog on the HCUP-US website. Databases can be purchased online through the HCUP Central Distributor, and aggregated statistics for selected States can be accessed via HCUPnet.

For database purchasing questions, please contact the HCUP Central Distributor.


Publication Spotlights

New HCUP Statistical Briefs Posted on HCUP-US

Since June 2015, the following HCUP Statistical Briefs have been released:

To read these and other Statistical Briefs, please visit the Statistical Briefs page on the HCUP-US website.

Three New HCUP Method Series Reports Now Available

Methods Series Report #2015-05: Identifying Observation Services in the HCUP State Databases provides information on the reporting of observation services (OS) across HCUP States using records from State Inpatient Databases (SID), State Emergency Department Databases (SEDD) and State Ambulatory Surgery Department Databases (SASD) as well as dedicated outpatient files specific to OS provided by several HCUP Partners.

Methods Series Report #2015-06: Examination of the Coding of Present-on-Admission Indicators in the HCUP State Inpatient Databases explores the coding of present-on-admission (POA) on the HCUP SID in 2011 and discusses the development of hospital and discharge-level edits on the reporting of POA indicators.

Method Series Report #2015-07: Population Denominator Data for Use with the HCUP Databases (Updated with 2014 Population Data) identifies relevant sources of population data that can be used with the HCUP databases to calculate rates of hospital care events per population.

These and other HCUP Reports can be found on the HCUP Reports page.

Notable Publications Using HCUP Data

Henke RM, Karaca Z, Lin H, Wier LM, Marder W, Wong HS. Patient factors contributing to variation in same-hospital readmission rate. Med Care Res Rev 2015 Jun;72(3):338-358.

This study uses the 2010-2011 State Inpatient Databases (SID) for 16 States to describe the variation in same-hospital readmissions across various hospitals in the United States for selected conditions. The authors also examine the patient characteristics associated with these readmissions. An article abstract is available via PubMed.

Schmidt ML, Barritt AS, Orman ES, Hayashi PH. Decreasing mortality among patients hospitalized with cirrhosis in the United States from 2002 through 2010. Gastroenterology 2015 May;148(5):967-977.e2.

This study uses the 2002-2010 Nationwide Inpatient Sample (NIS) to investigate the mortality of patients hospitalized with and without cirrhosis as well as those with congestive heart failure over a 9-year period. The goal was to examine the effectiveness of cirrhosis care. An article abstract is available via PubMed.

Leshem E, Tate JE, Steiner CA, Curns AT, Lopman BA, Parashar UD. Acute gastroenteritis hospitalizations among US children following implementation of the rotavirus vaccine. JAMA 2015 Jun 9;313(22):2282-2284.

This study uses the 2000-2012 State Inpatient Databases (SID) for 24 States to examine all-cause acute gastroenteritis hospitalizations among children younger than 5 years who received routine rotavirus vaccination. An article abstract is available via JAMA.

To read additional recently-published articles featuring HCUP data, please visit the Research Spotlights page on the HCUP-US website.


HCUP Q&A

I am using the HCUP Clinical Classifications Software (CCS) in my analysis with HCUP data and I have a few questions about the software before I get started.

I noticed that the current CCS for the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) has been updated for codes valid through fiscal year (FY) 2015. Do I need older versions of the CCS for ICD-9-CM software if I am using older years of HCUP data in my analysis?


The Clinical Classifications Software (CCS) are updated annually; however, the software is valid for codes from January 1, 1980 through September 30 of the current fiscal year (FY 2015). You will not need the previous versions of the CCS because the software is cumulative, which is why users can work with back years of HCUP data. You can download the most recent version available on HCUP-US.

Has there been a change in the categorization scheme with the CCS for ICD-10-CM or ICD-10 Procedure Coding System (PCS)?

No, the CCS categories have not changed. The CCS for the ICD-10-CM/PCS tool is based on the CCS for ICD-9-CM, and it attempts to map ICD-10-CM/PCS codes into the same categories.

It looks like there are four multi-levels for the ICD-9-CM version of CCS, whereas there are two multi-levels for the ICD-10-CM/PCS version of CCS. Are there any plans in place to add the additional two levels to CCS for ICD-10-CM/PCS?

AHRQ does not have plans to develop the full four CCS levels for ICD-10/CM/PCS. Because of the increased specificity of ICD-10-CM/PCS and the changes in the two Code Set structures, it was not possible to translate most multi-level categories to ICD-10-CM/PCS within the current structure. The exceptions are the first- and second-level multi-level categories. These categories work with ICD-10-CM/PCS structure and have been added to the CCS tool files.

For more information and documentation on the CCS, please visit the Tools & Software page of HCUP-US.

For other HCUP questions, please contact HCUP User Support.


HCUP Events

For a complete list of HCUP presentations and events, visit the HCUP Events Calendar.


HCUP e-News is available online on the News and Events page at the HCUP-US website and distributed via the HCUP Mailing List.

For more information and questions regarding the HCUP e-News, please email hcup@ahrq.gov