HCUP Quarterly eNews, Summer 2016

 

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Summer 2016 Issue #47


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

Register Today for June 25 HCUP Hands-On Readmissions Workshop at AcademyHealth’s Annual Research Meeting Preconference Methods Seminars!

The Healthcare Cost and Utilization Project (HCUP) is holding a workshop at the preconference Methods Seminar of AcademyHealth’s 2016 Annual Research Meeting.  The workshop, sponsored by the Agency for Healthcare Research and Quality (AHRQ), is entitled HCUP In-Depth: A Hands-on Workshop Using Data from the Healthcare Cost and Utilization Project – Using the Nationwide Readmissions Database. It will provide an overview of the Healthcare Cost and Utilization Project (HCUP), with specific hands-on opportunities to use the 2013 Nationwide Readmissions Database (NRD). The NRD is a new nationwide database used to create estimates of national readmissions rates for all payers, including the uninsured. HCUP faculty will describe the design of the NRD and provide step by step instructions on producing national readmission rates for a condition as well as examining characteristics of hospital stays.

To register for this preconference workshop, which takes place Saturday, June 25 at 1:00 pm Eastern Time in Boston, Massachusetts, please download the registration form and submit via email at registrations@academyhealth.org or fax to AcademyHealth at 202.292.6891.

Workshop participants not familiar with HCUP are encouraged to view two HCUP online tutorials prior to attending the seminar: the HCUP Overview Course and NRD Tutorial.

HCUP’s 2015 Outstanding Article of the Year Awards

Two studies will receive the sixth annual HCUP Outstanding Article of the Year Award at the AcademyHealth Annual Research Meeting. The Award honors articles published in peer-reviewed journals in 2015 that used HCUP data to explore and address health care research topics and issues.

Since 2010, The Agency for Healthcare Research and Quality (AHRQ) has recognized exceptional research conducted using the HCUP databases in the clinical and health policy arenas. This research continues to enhance public conversation about health care costs, outcomes, and trends. Over the past 6 years, the Awards have come to be recognized as a distinguished honor among health services researchers with a variety of clinical insights, economic interests, and policy backgrounds. AHRQ is proud of the important work being done with HCUP data, and AHRQ staff members look forward to future exciting research using HCUP data.

Learn About HCUP at the American Society of Health Economists’ Sixth Biennial Conference and AcademyHealth’s Annual Research Meeting

HCUP will be hosting a number of events at two upcoming conferences: The American Society of Health Economists’ Sixth Biennial Conference (ASHEcon) and the AcademyHealth Annual Research Meeting (ARM).

ASHEcon will be held June 12–15 at the University of Pennsylvania in Philadelphia. Activities will include a preconference workshop on the use of HCUP databases for health economics research, numerous podium and poster presentations, and an exhibit booth.

ARM will be held June 26–28 in Boston, Massachusetts. Activities will include a 4-hour preconference workshop on the use of HCUP databases with a hands-on opportunity to use the HCUP Nationwide Readmissions Database (described above), an adjunct session announcing the HCUP Outstanding Article of the Year Award recipients, numerous podium and poster presentations, and an exhibit booth.

A complete list of HCUP sessions is available in the HCUP Events section of this newsletter. Additional information is available on the HCUP-US Web site. We hope to see you at these conferences!

HCUP Fast Stats Update

AHRQ has again updated the first topic in HCUP Fast Stats, Effect of Medicaid Expansion on Hospital Use, to include newly received quarterly and annual inpatient data. Since the last update in December 2015, the tool has been updated to include 2015 data (for a total of 15 States) and to augment 2014 data (for a total of 39 States). The 15 States with 2015 data are Arizona, California, Colorado, Florida, Georgia, Hawaii, Iowa, Indiana, Kentucky, Michigan, Minnesota, Missouri, New Jersey, Virginia, and Wisconsin.

In addition, AHRQ plans to expand the Effect of Medicaid Expansion on Hospital Use to include State-level trends in hospital emergency department visits by expected payer. With this new release, the topic will be renamed Effect of Health Insurance Expansion on Hospital Use to account for the growth of Medicaid and private insurance marketplaces.

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

Now Available: The 2015 National Healthcare Quality and Disparities Report

AHRQ has released the 2015 National Healthcare Quality and Disparities Report (QDR). Beginning with the 2014 report, the National Healthcare Quality Report and National Healthcare Disparities Report was combined into a single report, the National Healthcare Quality and Disparities Report (QDR). The report measures and tracks trends in quality and disparities in seven key areas of health care: patient safety, person-centered care, care coordination, effective treatment, healthy living, care affordability, and access to health care. It also 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.  National and State-level HCUP estimates included in the report are available on the National Healthcare Quality and Disparities Reports Web site. For questions, please contact AHRQ User Support.

Coming this Fall: The 2014 National Inpatient Sample (NIS)

The 2014 National Inpatient Sample (NIS) is planned for release this fall. The NIS is the largest all-payer inpatient care database in the United States. The NIS contains charge information on all patients, regardless of payer, including persons covered by Medicare, Medicaid, private insurance, and the uninsured. The NIS can be used by 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 2014 NIS will be available for purchase through the HCUP Central Distributor, and select statistics will be available on HCUPnet.

HCUP Job Opening: Social Science Analyst/Health Services Researcher

The Agency for Healthcare Research and Quality is recruiting an experienced Social Science Analyst or Health Services Researcher to serve as a Staff Service Fellow on the Healthcare Cost and Utilization Project (HCUP) team. The Staff Service Fellow will assist in managing tasks for creation of databases and tools for research and policy and conduct and oversee health research using HCUP and other data, as well develop analytical techniques; conduct special analyses and studies; and write, edit, and coordinate major reports.  

The position is a two-year renewable Staff Service Fellow appointment, at the civil service equivalent of a GS 12 or 13, depending on qualifications and experience. For more information about the position or application procedures, please contact:  Dawn.Hudson@ahrq.hhs.gov


Databases and Products     

Recently Released: Additional State Databases

Since March 2016, 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 Web site. 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 March 2016, the following HCUP Statistical Briefs have been released:

  • #202 Mental and Substance Use Disorders Among Hospitalized Teenagers, 2012
  • #203 Emergency Department Visits for Children and Young Adults With Diabetes, 2012
  • #204 National Inpatient Hospital Costs: The Most Expensive Conditions by Payer, 2013
  • #205 An All-Payer View of Hospital Discharge to Postacute Care, 2013

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

New HCUP Method Series Report Now Available

Methods Series Report #2016-01: Methods Applying AHRQ Quality Indicators to Healthcare Cost and Utilization Project (HCUP) Data for 2015 National Healthcare Quality and Disparities Report (QDR) provides methods for applying the AHRQ Quality Indicators (QIs) to HCUP discharge data for the HCUP National Healthcare Quality and Disparities Report (QDR).

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

Publications Using HCUP Data

In-hospital outcomes and costs among patients hospitalized during a return visit to the emergency department. Sabbatini, A, Kocher, K, Basu, A, Hsia, RY. JAMA. 2016;315(7):663-671.

This study uses the 2013 State Inpatient Databases (SID) and State Emergency Department Databases (SEDD) from Florida and New York to track outcomes of short-term emergency department readmissions. An article abstract is available via Pubmed.

Unintentional injuries treated in hospital emergency departments among persons aged 65 years and older, United States, 2006–2011. DeGrauw X, Annest JL, Stevens JA, Xu L, Coronado V.
J Safety Res. 2016 Feb;56:105-109.

This special report from the Centers for Disease Control and Prevention (CDC) uses the 2006–2011 Nationwide Emergency Department Sample (NEDS) to investigate the increasing rates of unintentional injuries, such as those related to falls, and their effects on related costs among the population of adults aged 65 years and older who are treated in an emergency department. An article abstract is available via Pubmed.

Hospital charges for pediatric heart failure-related hospitalizations from 2000 to 2009.
Nandi D, Lin KY, O'Connor MJ, Elci OU, Kim JJ, Decker JA, et al. Pediatr Cardiol. 2016 Mar;37(3):512-518.

This study uses data from the 2000, 2003, 2006, and 2009 Kids’ Inpatient Database (KID) to explore costs for pediatric heart failure-related hospitalizations (HFRH) over time. 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 conducting an analysis that tracks patients over time on the HCUP State Databases, but have a few questions about the HCUP Supplemental Files for Revisit Analyses.

  • How do I obtain the Supplemental Variables for Revisit Analyses, and how much do they cost?
  • Which States and years have Revisit Variables?
  • Do the Revisit Variables allow you to track the same patient across years within the same State, or do they change each year?
  • Do the Revisit Variables allow you to track patients if they go to different hospitals, or can patients only be tracked within the same hospital system?
  • Are the Supplemental Variables for Revisit Analyses available for HCUP's Nationwide Databases?

Answers

How do I obtain the Supplemental Variables for Revisit Analyses, and how much do they cost?
Beginning with 2009 data, the Revisit Variables are included in the Core file of the SID, SASD, and SEDD databases that are purchased through the HCUP Central Distributor. For 2003–2008 data, the Revisit Variables are provided free of charge as a separate file with the applicable State Databases. If the HCUP State Databases were purchased prior to the release of the Revisit Variables, then these supplemental files are available free of charge from the Central Distributor.

Which States and years have Revisit Variables?
The HCUP Revisit Variables are available for the SID, SASD, and SEDD in select States starting in 2003. Appendix A of the HCUP Supplemental Variables for Revisit Analyses User Guide provides a detailed list of which States, years, and types of data are available. The Revisit Variables are designed to be used exclusively with the HCUP State databases and are unique by State and data year.

Do the Revisit Variables allow you to track the same patient across years within the same State, or do they change each year?
The visit linkage variable (VisitLink) can be used to track patient admissions and visits across years. VisitLink is assigned within States, and it can be used in tandem with the timing variable (DaysToEvent) to study multiple visits for the same patient across hospitals and time. VisitLink does not carry over to other States—it is assigned based on each State’s encrypted person numbers and other information supplied to HCUP.

HCUP Partner organizations sometimes change their coding scheme between data years, which in turn causes a discontinuity in VisitLink that does not allow the user to track across the “before” and “after” periods. Appendix C of the User Guide provides information about these discontinuities.

Do the Revisit Variables allow you to track patients if they go to different hospitals, or can patients only be tracked within the same hospital system?
The Revisit Variables can be used to track sequential visits for a patient within a State and across facilities and hospital settings (inpatient, emergency department, and ambulatory surgery).

Are the Supplemental Variables for Revisit Analyses available for HCUP's Nationwide Databases?
Revisit Variables are only available in one Nationwide Database – the HCUP Nationwide Readmissions Database (NRD). The NRD is drawn from the HCUP SID and can be used to create estimates of national readmission rates for all payers and the uninsured. The 2013 NRD was constructed from 21 States with reliable, verified patient linkage numbers in the SID that could be used to track the patient across hospitals within a State, while adhering to strict privacy guidelines.  The NRD is designed to support national readmission analyses and cannot be used for regional, State-, or hospital-specific analyses.  If you are interested in conducing analyses of readmission rates at the State level, the HCUP Revisit Variables are on some State Databases. 

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


HCUP Events

    • HCUP Preconference Workshop
      On June 12, HCUP staff will present a preconference workshop titled Agency for Healthcare Research and Quality: Research Databases for Health Economics.
    • Podium Presentation
      On June 14, HCUP staff will present a podium presentation titled Hospital Cost and Quality Trends Before and After ACO Adoption.
    • Poster Presentations
      On June 14, HCUP staff will present five posters:

      • Large-Scale Impact of the Dependent Care Coverage Expansion to Age 26
      • The Impact of Health System Affiliation on Hospital Resource Use Intensity and Quality of Care
      • The Affordable Care Act Medicaid Coverage Expansion and Changes in Hospital Inpatient Utilization
      • Discharge-Level Planning and Hospital Readmissions
      • Geographic Variation in Uninsurance and Changes in Hospital Inpatient Utilization in the Pre-ACA vs. Post-ACA Periods 

    • Exhibit Booth
      On June 12–15, AHRQ will sponsor an exhibit booth where representatives will be available to provide information and answer questions.
    • HCUP Preconference Workshop
      On June 25, HCUP staff will present a 4-hour preconference workshop titled HCUP In-Depth: A Hands-on Workshop Using National Data from the Healthcare Cost and Utilization Project.
    • Interest Group Sessions
      On June 25, HCUP staff will present four interest group podium presentations:
      • The Impact of Health Information Exchanges on Emergency Department Length of Stay
      • Association Between the Opening of Retail Clinics and Low-Acuity Emergency Department Visits
      • The Affordable Care Act Medicaid Coverage Expansion and Changes in Hospital Inpatient Utilization
      • Geographic Variation in Uninsurance and Changes in Hospital Inpatient Utilization: Pre-ACA vs. Post-ACA Analysis
    • Podium Presentations
      On June 26, HCUP staff will present two podium presentations:
      • Comorbidity Indices for Identifying Increased Risk of Readmission or In-Hospital Mortality Using Hospital Administrative Data
      • Comparing Resource Use Between Medicare Advantage and Traditional Medicare. Do Service Lines Matter?
    • Poster Presentations
      On June 26–27, HCUP staff will present 10 posters:
      • Impact of Race/Ethnicity and Socioeconomic Status on Risk-Adjusted Readmission Rates: Implications for the CMS Hospital Readmissions Reduction Program
      • Growth of Observation Services in Hospital-Based Acute Care: Trends Across Payers
      • Inpatient Admissions After Discharge From an Emergency Department for Chest Symptoms
      • Association Between the Opening of Retail Clinics and Low-Acuity Emergency Department Visits
      • Features of Prescription Drug Monitoring Programs and Their Relationship to Hospital Utilization for Opioid-Related Diagnoses
      • Racial/Ethnic Disparities in Sepsis-Related In-Hospital Mortality: The Role of Patient and Hospital Characteristics
      • Age-Related Disparities in Access to Trauma Centers for Patients With Severe Head Injuries Following the Release of the Updated Field Triage Guidelines
      • The Association of Patients' Primary Language With Readmission for High-Volume Hospital Conditions
      • Geographic Variation in Uninsurance and Changes in Hospital Inpatient Utilization: Pre-ACA vs. Post-ACA Analysis
      • Differences in Use of High- and Low-Quality Hospitals Among Working-Age Americans By Insurance Type
    • Exhibit Booth
      On June 26–28, AHRQ will sponsor an exhibit booth where representatives will be available to provide information and answer questions. 

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


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