Introduction to the HCUP Nationwide Inpatient Sample (NIS)

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Table of Contents SUMMARY OF DATA USE LIMITATIONS ................................................................................... 1 HCUP CONTACT INFORMATION ............................................................................................... 2 WHAT’S NEW IN THE 2009 NATIONWIDE INPATIENT SAMPLE (NIS)? ................................. 3 UNDERSTANDING THE NIS ....................................................................................................... 4 ABSTRACT ................................................................................................................................... 5 INTRODUCTION TO THE HCUP NATIONWIDE INPATIENT SAMPLE (NIS) ............................ 6 Overview of NIS Data ........................................................................................................ 6 NIS Data Sources, Hospitals, and Inpatient Stays ................................................ 7 State-Specific Restrictions .................................................................................... 7 Contents of DVD ................................................................................................... 8 NIS Data Elements ................................................................................................ 8 Getting Started .................................................................................................................. 9 Copying and Decompressing the ASCII Files ....................................................... 9 Downloading and Running the Load Programs ..................................................... 9 NIS Documentation ............................................................................................... 9 HCUP On-Line Tutorials ...................................................................................... 10 HOW TO USE THE NIS FOR DATA ANALYSIS ........................................................................ 10 Calculating National Estimates ....................................................................................... 11 Studying Trends .............................................................................................................. 12 Choosing Data Elements for Analysis ............................................................................. 12 Hospital-Level Data Elements ......................................................................................... 13 Constructing Patient Population Characteristics ............................................................. 14 ICD-9-CM Diagnosis and Procedure Codes ................................................................... 14 Missing Values ................................................................................................................ 15 Variance Calculations ..................................................................................................... 15 Computer Software for Variance Calculations ................................................................ 16 Longitudinal Analyses ..................................................................................................... 17 Discharge Subsamples ................................................................................................... 18 SAMPLING OF HOSPITALS ...................................................................................................... 18 Sampling of Hospitals Included in the NIS ...................................................................... 18 The NIS Hospital Universe .................................................................................. 18 Hospital Merges, Splits, and Closures ................................................................ 19 Stratification Data Elements ................................................................................ 19 Hospital Sampling Frame ................................................................................................ 21 Hospital Sample Design .................................................................................................. 22 Design Considerations ........................................................................................ 22 Overview of the Sampling Procedure .................................................................. 23 Subsamples ......................................................................................................... 24 Change to Hospital Sampling Procedure Beginning with the 1998 NIS .............. 24 HCUP NIS (09/06/2011) i Introduction
Zero-Weight Hospitals ......................................................................................... 24 Final Hospital Sample ..................................................................................................... 24 SAMPLE WEIGHTS .................................................................................................................... 27 Hospital Weights ............................................................................................................. 27 Discharge Weights .......................................................................................................... 27 APPENDIX I: TABLES AND FIGURES ...................................................................................... I-1 Table 1: 2009 Data Sources ........................................................................................... I-1 Table 2: Number of NIS States, Hospitals, and Discharges, by Year ............................. I-3 Table 3. Summary of NIS Releases ................................................................................ I-4 Table 4. Summary of NIS Data Sources, Hospitals, and Inpatient Stays, 1988-2009 .... I-6 Table 5. NIS Related Reports and Database Documentation Available on HCUP-US ... I-9 Figure 1: Hospital Universe, by Year ............................................................................ I-10 Figure 2: NIS States, by Region .................................................................................... I-11 Table 6: All States, by Region ....................................................................................... I-11 Table 7: Bed Size Categories, by Region ..................................................................... I-12 Figure 3: NIS Hospital Sampling Frame, by Year ......................................................... I-13 Figure 4: Number of Hospitals in the 2009 Universe, Frame, and Sample for Frame States ............................................................................................................................ I-14 Part A: Arkansas – Indiana ................................................................................ I-14 Part B: Kansas – North Carolina ....................................................................... I-15 Part C: Nebraska – Rhode Island ...................................................................... I-16 Part D: South Carolina – Wyoming ................................................................... I-17 Table 8: Number of Hospitals and Discharges in 2009 AHA Universe, Frame, and NIS, by State ................................................................................................................. I-19 Figure 5: Number of Hospitals Sampled, by Year ......................................................... I-21 Figure 6: Number of NIS Discharges, Unweighted, by Year ......................................... I-22 Figure 7: Number of NIS Discharges, Weighted, by Year ............................................. I-23 Figure 8: Number of Hospitals in the 2009 Universe, Frame, Sample, Target, and Surplus, by Region ........................................................................................................ I-24 Figure 9: Percentage of U.S. Population in the 2009 NIS States, by Region................ I-25 Figure 10: Number of Discharges in the 2009 NIS, by State ........................................ I-26 APPENDIX II: STATE-SPECIFIC RESTRICTIONS ................................................................... II-1 APPENDIX III: DATA ELEMENTS ............................................................................................ III-1 Table 1. Data Elements in the NIS Inpatient Core Files ................................................ III-1 Table 2. Data Elements in the NIS Hospital Weights Files ......................................... III-12 Table 3. Data Elements in the NIS Disease Severity Measures Files......................... III-16 Table 4. Data Elements in the NIS Diagnosis and Procedure Groups Files ............... III-19 ENDNOTES .............................................................................................................................. E-1 HCUP NIS (09/06/2011) ii Introduction
Page 1: HEALTHCARE COST AND UTILIZATION PRO
Page 5 and 6: HCUP CONTACT INFORMATION The NIS Da
Page 7 and 8: UNDERSTANDING THE NIS This document
Page 9 and 10: elease of hospital identifiers. In
Page 11 and 12: Contents of DVD The NIS is distribu
Page 13 and 14: • To locate the NIS documentation
Page 15 and 16: States that have agreed to particip
Page 17 and 18: 1. Some of the new data elements pe
Page 19 and 20: e treated as if they were randomly
Page 21 and 22: One approach to consider in hospita
Page 23 and 24: 3. Location - urban or rural. Gover
Page 25 and 26: that could be matched to the AHA da
Page 27 and 28: calculations, we drew at least two
Page 29 and 30: 2. We adjusted the admission month
Page 31 and 32: number of adjusted discharges from
Page 33 and 34: State NH NJ NM NV NY OH OK OR PA RI
Page 35 and 36: Table 3. Summary of NIS Releases Da
Page 37 and 38: Table 4. Summary of NIS Data Source
Page 39 and 40: Year Data Sources Number of Hospita
Page 41 and 42: Figure 1: Hospital Universe, by Yea
Page 43 and 44: Table 7: Bed Size Categories, by Re
Page 45 and 46: Figure 4: Number of Hospitals in th
Page 47 and 48: Figure 4: Number of Hospitals in th
Page 49 and 50: Return to Introduction HCUP NIS (09
Page 51 and 52: State Number of Hospitals and Disch
Page 53 and 54:
Figure 6: Number of NIS Discharges,
Page 55 and 56:
Figure 8: Number of Hospitals in th
Page 57 and 58:
Figure 10: Number of Discharges in
Page 59 and 60:
Confidentiality of Hospitals - Rest
Page 61 and 62:
Confidentiality of Hospitals - Limi
Page 63 and 64:
Confidentiality of Records - Restri
Page 65 and 66:
Confidentiality of Records - Other
Page 67 and 68:
Appendix III: Data Elements Table 1
Page 69 and 70:
Type of Data Element HCUP Name TRAN
Page 71 and 72:
Type of Data Element HCUP Name Year
Page 73 and 74:
Type of Data Element External cause
Page 75 and 76:
Type of HCUP Data Element Name Medi
Page 77 and 78:
Type of Data Element HCUP Name PRDA
Page 79 and 80:
Type of HCUP Years Coding Notes Una
Page 81 and 82:
Type of Data Element Hospital weigh
Page 83 and 84:
Type of Data Element HCUP Years Cod
Page 85 and 86:
Table 4. Data Elements in the NIS D
Page 87 and 88:
ENDNOTES 1 2 3 Refer to Chapter 10
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Introduction to the HCUP Nationwide Inpatient Sample (NIS)

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