HCUP Quarterly eNews, Spring 2016

 

Healthcare Cost and Utilization Project e-News bulletin logo
 

 

Spring 2016 Issue #46


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 Web site.


News and Announcements

HCUP Statistical Briefs Reach 3 Million Visits!

HCUP Statistical Briefs provide health care statistics on hospital inpatient stays, emergency department visits, and ambulatory surgeries, and cover a wide array of topics including medical conditions treated, hospital readmissions, patient populations, and quality of care. To date, more than 200 Statistical Brief reports have been posted on the HCUP User Support (HCUP-US) Web site. The Agency for Healthcare Research and Quality (AHRQ) started tracking visits to both the PDF and HTML versions of the reports in 2008. As of the end of 2015, there have been over 3 million visits to view HCUP Statistical Briefs (in PDF or HTML).

The following HCUP Statistical Briefs had the highest number of visits in the last year:

• #146, Costs for Hospital Stays in the United States, 2010
• #149, Most Frequent Procedures Performed in U.S. Hospitals, 2010
• #160, National Inpatient Hospital Costs: The Most Expensive Conditions by Payer, 2011
• #172, Conditions With the Largest Number of Adult Hospital Readmissions by Payer, 2011
• #174, Overview of Emergency Department Visits in the United States, 2011

HCUP Statistical Brief on Mastectomies Receives Wide Media Coverage

Findings from most recently released HCUP Statistical Brief #201, Trends in Bilateral and Unilateral Mastectomies in Hospital Inpatient and Ambulatory Settings, 2005-2013, comprised the lead news story on the NBC Today Show. CBS Evening News, ABC News and Fox News also covered the Statistical Brief. Kaiser Health News featured a written story on it. In total, more than 200 news articles were published about the report’s data.

The Statistical Brief found that while breast cancer rates have remained constant, the rate of women undergoing mastectomies increased 35 percent between 2005 and 2013, which includes more than a tripling of bilateral mastectomies.

Nationwide Databases Now Available Via Secure Digital Download

Previously, all HCUP databases and supplemental files were shipped to approved purchasers on DVD. On March 1, 2016, AHRQ introduced secure download delivery of the HCUP Nationwide Databases. Purchased State Databases will continue to be delivered on DVD.

HCUP databases and supplemental files continue to be available for purchase online through the HCUP Central Distributor. All users must complete the online HCUP Data User Agreement (DUA) training course and read and sign the Nationwide DUA and/or State DUA. Users interested in purchasing the HCUP State Databases also must complete the Statement of Intended Use.

For additional information regarding the new download feature, visit the Purchasing Frequently Asked Questions (FAQs), which are available through the Online HCUP Central Distributor.

Apply Today for the HCUP Outstanding Article of the Year Award

Nominations are being accepted until Thursday, March 18, 2016, for the HCUP Outstanding Article of the Year Award. The Award will recognize up to three researchers published in peer-reviewed journals in 2015 who used HCUP databases to explore and address health care research topics and issues.

The chosen recipients will receive complimentary registration and a travel stipend to attend the AcademyHealth Annual Research Meeting, to be held June 26–28 in Boston, Massachusetts.

Visit the HCUP Outstanding Article of the Year Awards page for complete information. For questions, please contact HCUP User Support.

Now Available: The 2013 Nationwide Emergency Department Sample (NEDS)

The 2013 Nationwide Emergency Department Sample (NEDS) is now available. The NEDS is the largest all-payer emergency department database in the United States and contains information about geographic, hospital, patient, and visit characteristics.

The NEDS enables analyses of emergency department utilization patterns and yields information that supports public health professionals, administrators, policymakers, and clinicians as they make decisions regarding this critical source of care.

Select aggregated statistics from the 2013 NEDS can be accessed via HCUPnet. For example, HCUPnet shows that there were approximately 135 million emergency department visits in 2013, 14.3 percent of which resulted in a hospital admission.

The 2013 NEDS is available for purchase through the HCUP Central Distributor.

Learn About HCUP at its April 6 and 13 Webinars—Registration Required

Webinars introducing researchers to HCUP will be held on April 6 and 13. On April 6, Overview of the HCUP Databases will cover an introduction to the HCUP family of databases. On April 13, Overview of the HCUP Products and Tools will cover the use of HCUP software tools and supplemental files to facilitate and augment research. The webinars are open to the public. Each requires separate advance registration, which will open on March 30. Additional details on the webinars are posted on the HCUP Workshops and Webinars page.


Databases and Products

Recently Released: Additional 2008, 2013, and 2014 State Databases

Since December 2015, the following 2008, 2013, and 2014 State databases have been released:

In addition, the 2013 Nationwide Emergency Department Sample (NEDS) has been released.

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.


Publication Spotlights

New HCUP Statistical Briefs Posted on HCUP-US

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

  • #198, Hospital Stays in Medicare Advantage Plans Versus the Traditional Medicare Fee-for-Service Program, 2013
  • #199, All-Cause Readmissions by Payer and Age, 2009–2013
  • #200, Procedures to Treat Benign Uterine Fibroids in Hospital Inpatient and Hospital-Based Ambulatory Surgery Settings, 2013
  • #201, Trends in Bilateral and Unilateral Mastectomies in Hospital Inpatient and Ambulatory Settings, 2005–2013

To access these and other Statistical Briefs, please visit the Statistical Briefs page on the HCUP-US Web site.

New and Updated HCUP Methods Series Reports Now Available

Since December 2015, the following Methods Series Reports have been released:

Methods Series Report #2015-09, Calculating National Inpatient Sample (NIS) Variances for Data Years 2012 and Later, presents detailed information on the calculation of simple statistics, including variances, from the NIS while also taking into account the sampling design and sample discharge weights.

Methods Series Report #2006-05, Using the HCUP Nationwide Inpatient Sample to Estimate Trends, was recently revised to account for the redesign of the 2012 NIS. The report describes the changes that occurred in the redesign, provides information on the impact these changes have on estimates of numbers of discharges and other key variables, and contains recommendations for trend analyses.

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

Publications Using HCUP Data

Selvarajah S, Haider AH, Schneider EB, Sadowsky CL, Becker D, Hammond ER. Traumatic Spinal Cord Injury Emergency Service Triage Patterns and the Associated Emergency Department Outcomes. J Neurotrauma 2015 Dec 15;32(24):2008–2016.

This study uses the 2006-2011 Nationwide Emergency Department Sample (NEDS) to investigate triage patterns and the associated emergency department outcomes for patients with acute traumatic spinal cord injury. An article abstract is available via PubMed.

Zakhari A, Czuzoj-Shulman N, Spence AR, Gotlieb WH, Abenhaim HA. Laparoscopic and robot-assisted hysterectomy for uterine cancer: a comparison of costs and complications. Am J Obstet Gynecol 2015 Nov;213(5):665.e1–e7.

This study uses the 2008-2012 National (Nationwide) Inpatient Sample (NIS) to compare the costs and complications among women who undergo robotic and laparoscopic hysterectomy for uterine cancer. An 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 obtaining cost and charge information from various HCUP databases, but I have a few questions before I get started.

 

  • What is the difference between hospital charges and costs?
  • Does a Cost-to-Charge Ratio (CCR) file get created for every HCUP database?
  • Do HCUP databases include information on reimbursement?
  • Can I obtain cost or charge information for a specific procedure within a stay?

 

Answers:

What is the difference between hospital charges and costs?

Generally speaking, costs tend to reflect the actual costs of production, whereas charges represent what the hospital billed for the case. Charges are the total amount billed by the hospital for the encounter, but not the actual cost of providing care or the payment received by the hospital (e.g., hospital reimbursement).

To facilitate the conversion from charges to costs, HCUP has developed Cost-to-Charge Ratio (CCR) files.

Does a Cost-to-Charge Ratio (CCR) file get created for every HCUP database?

HCUP Cost-to-Charge Ratio (CCR) files are hospital-level files designed to supplement the data elements in the NIS, the Kids’ Inpatient Database (KID), the Nationwide Readmissions Database (NRD), and SID. These files can be used to estimate the resource cost of inpatient care and its variation across hospitals and conditions.

HCUP does not provide a CCR file for the SASD, SEDD, or NEDS, so it is currently not possible to estimate ambulatory surgery and emergency department costs. The availability of charge data on the HCUP SASD, SEDD, and NEDS varies over time and across States. If available on the record, the HCUP variable TOTCHG (on the SASD and SEDD) and TOTCHG_ED (on the NEDS) contain all charges billed during a hospital stay, as reported by the facility.

Do HCUP databases include information on reimbursement?

Although the HCUP databases contain information on what was billed for a stay, they do not have information on what is reimbursed.

Can I obtain costs or charge information for a specific procedure within a stay?

The HCUP data provide total charges billed by facilities for inpatient stays and ambulatory surgery and emergency department visits; however, these costs are not broken out by ICD-10-PCS, ICD-9-CM, or CPT procedures. Although the charges associated with a specific procedure would be included in the total charges for the stay or visit, there is not a consistent way to break out and identify the specific charges related to the procedure.

For additional information on the CCR Files, please visit the HCUP-US Web site. For other HCUP questions, please contact HCUP User Support.


HCUP Events

• April 6, 2016: HCUP Database Overview Webinar
• April 13, 2016: HCUP Overview of HCUP Products and Tools Webinar

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


The HCUP e-News is available online at the HCUP-US Web site and distributed via the HCUP Mailing List.

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