1. Healthcare Cost and Utilization Project (HCUP) Healthcare Data and Tools … And an Overview of HCUPnet Healthcare Data and Tools … And an Overview of HCUPnet Anne Elixhauser, Ph.D. State Healthcare Quality Improvement Workshop January 17, 2008 -- Phoenix, AZ

2. 2 AZ CA UT CT FL GA IA IL KS MA MD MO NJ NY OR PA SC TN CO WA WI VA ME MI TX WV KY NC VT RI NE MN AL DC MT ID MS HI NV ND SD NM OH IN LA AR OK NH The HCUP Partnership: A Voluntary Federal-State-Private Sector Collaboration AK WY HCUP Partner Does Not Collect Inpatient Data Legend DE Legal Barrier Not a Partner 38 states in partnership 90% of all discharges

3. 3 The Foundation of HCUP is Billing Data Patient demographics (age, sex) Diagnoses & procedures (ICD-9-CM, DRG) Expected payer Length of stay Patient disposition Admission source & type Admission month Charges UB-92 (UB-04) Billing Form

4. 4 The Making of HCUP Data Patient enters hospital Hospital sends billing data and any additional data elements to Data Organizations States store data in varying formats Billing record created AHRQ standardizes data to create uniform HCUP databases

5. 5 What is HCUP? And what is it not? What it is What it is not Claims (bills) for health care encounters A survey All payer, including the uninsured Specific to a single payer, e.g. Medicare Hospital, ambulatory surgery, emergency department data Outpatient visits, pharmacy, laboratory All claims A sample Accessible multiple ways: raw data, regular reports, on-line Just another database

6. 6 HCUP is a Family of Databases, Tools, Products HCUP Databases Research Publications User Support Software Tools HCUPnet

7. 7 Types of HCUP Databases State Ambulatory Surgery Databases (SASD) State Inpatient Databases (SID) State Emergency Department Databases (SEDD) Nationwide Inpatient Sample (NIS) Kids’ Inpatient Database (KID)

8. 8 HCUP Supports High Impact Health Services, Policy, and Clinical Research

9. 9 HCUP Supports Federal and Non-Federal Initiatives

10. 10 Supports Policy Deliberations and Legislation HCUP was used to determine national and state burden of hospital care following motorcycle injuries Analyses used in West Virginia’s hearings to remove their motorcycle- helmet law

11. 11 AHRQ Quality Indicators Most widely used HCUP tool Most widely used HCUP tool Used for reporting hospital quality of care Used for reporting hospital quality of care AHRQ provides benchmarks against which to compare your numbers AHRQ provides benchmarks against which to compare your numbers

12. 12 HCUP Fact Books

13. 13 HCUP Statistical Briefs

14. 14 Other Statistical Briefs Include: Hospital stays related to depression Hospital stays related to depression Trends in risk-adjusted mortality Trends in risk-adjusted mortality Trends in preventable hospitalizations Trends in preventable hospitalizations Infections with MRSA in U.S. hospitals Infections with MRSA in U.S. hospitals Childbirth-related stays in U.S. hospitals Childbirth-related stays in U.S. hospitals Adverse drug events Adverse drug events Admissions for traumatic brain injury Admissions for traumatic brain injury Bariatric surgery utilization and outcomes Bariatric surgery utilization and outcomes The national hospital bill The national hospital bill …

15. 15 Facts and Figures

16. 16 HCUPnet: Quick, Free Access to HCUP Data Free, interactive online query system Free, interactive online query system Users generate tables of outcomes by diagnoses and procedures Users generate tables of outcomes by diagnoses and procedures Data can be cross-classified by patient and hospital characteristics Data can be cross-classified by patient and hospital characteristics http://hcupnet.ahrq.gov

17. 17 What types of questions can HCUPnet answer? What are the most common conditions treated in hospitals in my state? What are the most common conditions treated in hospitals in my state? What are the most expensive conditions? procedures? What are the most expensive conditions? procedures? How many CABGs were performed in 2003? How many CABGs were performed in 2003? What percentage of hospitalizations are uninsured? What percentage of hospitalizations are uninsured? For what conditions are uninsured patients hospitalized? patients covered by Medicaid? For what conditions are uninsured patients hospitalized? patients covered by Medicaid? What is the trend in hospitalizations for MRSA? What is the trend in hospitalizations for MRSA? What is the cost of C-section versus vaginal deliveries? What is the cost of C-section versus vaginal deliveries? What types of hospitals treat what kinds of patients? What types of hospitals treat what kinds of patients? What types of patients are seen in the emergency department and then admitted to the hospital? What types of patients are seen in the emergency department and then admitted to the hospital?

18. 18 HCUPnet is a powerful online query tool that gives you free, instant access to healthcare statistics. HCUPnet provides national information on hospital stays based on the Nationwide Inpatient Sample.

19. 19 … and it gives access to data from participating states from HCUP’s State Inpatient Databases.

20. 20 HCUPnet takes you through a step-by-step process to select the information you want.

21. 21 You select the level of diagnosis and procedure information: ICD codes, Clinical Classifications, DRGS.

22. 22 HCUPnet provides information on: numbers of discharges hospital LOS and charges discharge status how patients were admitted HCUPnet provides information on: numbers of discharges hospital LOS and charges discharge status how patients were admitted

23. 23 Are you interested in particular patient groups? Specific hospital characteristics?

24. 24 You get your results instantly. HCUPnet is based on aggregated statistics to speed data transfer and protect patient confidentiality. You get your results instantly. HCUPnet is based on aggregated statistics to speed data transfer and protect patient confidentiality.

25. 25 You can request information on trends for the nation and for any participating state.

26. 26 You can repeat your query instantly on another database.

27. 27 HCUPnet also provides information on ED visits for some states.

28. 28 … and on national-level information on quality of care, based on the AHRQ Quality Indicators.

29. 29 Visit HCUPnet at: http://hcupnet.ahrq.gov

30. 30 For more information General Technical Assistance—HCUP User Support – E-mail: hcup@ahrq.gov hcup@ahrq.gov – Phone: 1-866-290-HCUP (4287) Anne Elixhauser— Anne Elixhauser— – E-mail: anne.elixhauser@ahrq.hhs.gov anne.elixhauser@ahrq.hhs.gov