Healthcare Cost and Utilization Project (HCUP ... - AHRQ Archive
Healthcare Cost and Utilization Project (HCUP ... - AHRQ Archive
Healthcare Cost and Utilization Project (HCUP ... - AHRQ Archive
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<strong>Healthcare</strong> <strong>Cost</strong> <strong>and</strong> <strong>Utilization</strong> <strong>Project</strong><br />
(<strong>HCUP</strong>)<br />
<strong>Healthcare</strong> Data <strong>and</strong> Tools<br />
… And an Overview of <strong>HCUP</strong>net<br />
Anne Elixhauser, Ph.D.<br />
State <strong>Healthcare</strong> Quality Improvement Workshop<br />
January 17, 2008 -- Phoenix, AZ
The <strong>HCUP</strong> Partnership:<br />
A Voluntary Federal-State<br />
State-Private Sector<br />
Collaboration<br />
AK<br />
OR<br />
CA<br />
WA<br />
NV<br />
ID<br />
AZ<br />
UT<br />
MT<br />
WY<br />
CO<br />
NM<br />
ND<br />
SD<br />
NE<br />
TX<br />
KS<br />
OK<br />
MN<br />
IA<br />
MO<br />
WI<br />
AR<br />
LA<br />
IL<br />
MS<br />
IN<br />
TN<br />
MI<br />
AL<br />
KY<br />
OH<br />
WV<br />
SC<br />
GA<br />
PA<br />
FL<br />
VA<br />
NC<br />
VT<br />
NY<br />
ME<br />
NH<br />
MA<br />
RI<br />
CT<br />
NJ<br />
DC<br />
DE<br />
MD<br />
Legend<br />
<strong>HCUP</strong> Partner<br />
Legal Barrier<br />
2<br />
HI<br />
38 states in partnership<br />
90% of all discharges<br />
Does Not Collect<br />
Inpatient Data<br />
Not a Partner
The Foundation of <strong>HCUP</strong> is<br />
Billing Data<br />
3<br />
UB-92 (UB-04) Billing Form<br />
Patient demographics<br />
(age, sex)<br />
Diagnoses & procedures<br />
(ICD-9-CM, CM, DRG)<br />
Expected payer<br />
Length of stay<br />
Patient disposition<br />
Admission source & type<br />
Admission month<br />
Charges
The Making of <strong>HCUP</strong> Data<br />
Billing<br />
record<br />
created<br />
Patient enters<br />
hospital<br />
<strong>AHRQ</strong><br />
st<strong>and</strong>ardizes data<br />
to create uniform<br />
<strong>HCUP</strong> databases<br />
4<br />
States store data<br />
in varying formats<br />
Hospital sends<br />
billing data <strong>and</strong> any<br />
additional data<br />
elements to<br />
Data Organizations
What is <strong>HCUP</strong>?<br />
And what is it not?<br />
Hospital, ambulatory surgery,<br />
emergency department data<br />
All claims<br />
Accessible multiple ways: raw<br />
data, regular reports, on-line<br />
5<br />
What it is<br />
Claims (bills) for health care<br />
encounters<br />
All payer, including the uninsured<br />
A survey<br />
Specific to a single<br />
payer, e.g. Medicare<br />
Outpatient visits,<br />
pharmacy, laboratory<br />
A sample<br />
What it is not<br />
Just another database
<strong>HCUP</strong> is a Family of<br />
Databases, Tools, Products<br />
<strong>HCUP</strong> Databases<br />
Software Tools<br />
6<br />
User Support<br />
Research Publications<br />
<strong>HCUP</strong>net
Types of <strong>HCUP</strong> Databases<br />
State<br />
Inpatient<br />
Databases<br />
(SID)<br />
State<br />
Ambulatory<br />
Surgery<br />
Databases<br />
(SASD)<br />
State<br />
Emergency<br />
Department<br />
Databases<br />
(SEDD)<br />
Nationwide<br />
Inpatient<br />
Sample<br />
(NIS)<br />
7<br />
Kids’<br />
Inpatient<br />
Database<br />
(KID)
8<br />
<strong>HCUP</strong> Supports High Impact<br />
Health Services, Policy , <strong>and</strong><br />
Clinical Research
9<br />
<strong>HCUP</strong> Supports Federal <strong>and</strong><br />
Non-Federal Initiatives
Supports Policy Deliberations<br />
<strong>and</strong> Legislation<br />
<strong>HCUP</strong> was used to<br />
determine national <strong>and</strong><br />
state burden of hospital<br />
care following motorcycle<br />
injuries<br />
Analyses used in West<br />
Virginia’s hearings to<br />
remove their motorcyclehelmet<br />
law<br />
10
<strong>AHRQ</strong> Quality Indicators<br />
• Most widely used<br />
<strong>HCUP</strong> tool<br />
• Used for reporting<br />
hospital quality of care<br />
• <strong>AHRQ</strong> provides<br />
benchmarks against<br />
which to compare your<br />
numbers<br />
11
12<br />
<strong>HCUP</strong> Fact Books
13<br />
<strong>HCUP</strong> Statistical Briefs
14<br />
Other Statistical Briefs<br />
Include:<br />
• Hospital stays related to depression<br />
• Trends in risk-adjusted mortality<br />
• Trends in preventable hospitalizations<br />
• Infections with MRSA in U.S. hospitals<br />
• Childbirth-related related stays in U.S. hospitals<br />
• Adverse drug events<br />
• Admissions for traumatic brain injury<br />
• Bariatric surgery utilization <strong>and</strong> outcomes<br />
• The national hospital bill<br />
• …
15<br />
Facts <strong>and</strong> Figures
<strong>HCUP</strong>net: Quick, Free Access<br />
to <strong>HCUP</strong> Data<br />
• Free, interactive online query system<br />
• Users generate tables of outcomes by<br />
diagnoses <strong>and</strong> procedures<br />
• Data can be cross-classified classified by patient <strong>and</strong><br />
hospital characteristics<br />
http://hcupnet.ahrq.gov<br />
16
17<br />
What types of questions<br />
can <strong>HCUP</strong>net answer?<br />
• What are the most common conditions treated in<br />
hospitals in my state?<br />
• What are the most expensive conditions? procedures?<br />
• How many CABGs were performed in 2003?<br />
• What percentage of hospitalizations are uninsured?<br />
• For what conditions are uninsured patients hospitalized?<br />
patients covered by Medicaid?<br />
• What is the trend in hospitalizations for MRSA?<br />
• What is the cost of C-section C<br />
versus vaginal deliveries?<br />
• What types of hospitals treat what kinds of patients?<br />
• What types of patients are seen in the emergency<br />
department <strong>and</strong> then admitted to the hospital?
<strong>HCUP</strong>net is a powerful online<br />
query tool that gives you<br />
free, instant access to<br />
healthcare statistics.<br />
<strong>HCUP</strong>net provides national<br />
information on on hospital stays<br />
based on on the the Nationwide<br />
Inpatient Sample.<br />
18
… <strong>and</strong> <strong>and</strong> it it gives access to to<br />
data data from participating<br />
states from <strong>HCUP</strong>’s State<br />
Inpatient Databases.<br />
19
20<br />
<strong>HCUP</strong>net takes you you through a<br />
step-by-step process to to select<br />
the the information you you want.
You You select the the level of of<br />
diagnosis <strong>and</strong> <strong>and</strong> procedure<br />
information: ICD ICD codes,<br />
Clinical Classifications, DRGS.<br />
21
22<br />
<strong>HCUP</strong>net provides<br />
information on: on:<br />
•• numbers of of discharges<br />
•• hospital LOS LOS <strong>and</strong> <strong>and</strong> charges<br />
•• discharge status<br />
•• how how patients were admitted
Are Are you you interested in in particular<br />
patient groups? Specific<br />
hospital characteristics?<br />
23
24<br />
You You get get your your results instantly.<br />
<strong>HCUP</strong>net is is based on on<br />
aggregated statistics to to speed<br />
data data transfer <strong>and</strong> <strong>and</strong> protect<br />
patient confidentiality.
You You can can request information<br />
on on trends for for the the nation <strong>and</strong> <strong>and</strong><br />
for for any any participating state.<br />
25
You You can can repeat your your query<br />
instantly on on another<br />
database.<br />
26
<strong>HCUP</strong>net also also provides<br />
information on on ED ED<br />
visits for for some states.<br />
27
… <strong>and</strong> <strong>and</strong> on on national-level information<br />
on on quality of of care, based on on the the<br />
<strong>AHRQ</strong> Quality Indicators.<br />
28
Visit Visit <strong>HCUP</strong>net <strong>HCUP</strong>net at: at:<br />
http://hcupnet.ahrq.gov<br />
29
For more information<br />
• General Technical Assistance—<strong>HCUP</strong> User Support<br />
– E-mail:<br />
hcup@ahrq.gov<br />
– Phone: 1-8661<br />
866-290-<strong>HCUP</strong> (4287)<br />
• Anne Elixhauser—<br />
– E-mail:<br />
anne.elixhauser@ahrq.hhs.gov<br />
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