1. Federal Data Sources for Child Health Services Research Overview Pamela Owens, PhD Jane Sisk, PhD Jessica Banthin, PhD June 2006

2. Advancing Excellence in Health Care 2 Objectives To become familiar with Federal databases available to answer research and policy questions related to children’s health care To become familiar with Federal databases available to answer research and policy questions related to children’s health care To be able to identify the most appropriate database to answer your specific research or policy question To be able to identify the most appropriate database to answer your specific research or policy question

3. Advancing Excellence in Health Care 3 Overview of Panel Choosing the most appropriate database Choosing the most appropriate database – Factor to consider when choosing a database – Examples Data from the National Center for Health Statistics (NCHS) Data from the National Center for Health Statistics (NCHS) – Jane Sisk, PhD Medical Expenditure Panel Survey (MEPS) Medical Expenditure Panel Survey (MEPS) – Jessica Banthin, PhD Healthcare Cost and Utilization Project (HCUP) Healthcare Cost and Utilization Project (HCUP) – Pamela Owens, PhD

4. Advancing Excellence in Health Care 4 Choosing a Database Consider …. What is your research or policy question? What is your research or policy question? Can the question be addressed with survey data? With administrative data? Can the question be addressed with survey data? With administrative data? What perspective are you interested in (e.g., patient, provider, facility, setting, visit)? What perspective are you interested in (e.g., patient, provider, facility, setting, visit)? – Unit of analysis What population are you interested in (e.g., national, regional, state, local)? What population are you interested in (e.g., national, regional, state, local)? – Population, sampling frame What sample size do you need to answer your question? What sample size do you need to answer your question? – Total N – Pooling years

5. Advancing Excellence in Health Care 5 Choosing a Database Consider …. What time frame are you interested in (e.g., specific year, cross-sectional, trends)? What time frame are you interested in (e.g., specific year, cross-sectional, trends)? – Year(s) of data What information do you need to answer your question? What information do you need to answer your question? – Data elements Do you need to bring together several types of data? Do you need to bring together several types of data? – Linkages How much money and time do you have to answer the question? How much money and time do you have to answer the question? – Cost – Availability/Accessibility

6. Advancing Excellence in Health Care 6 Children’s Use of Antibiotics What are the research questions? What are the research questions? – Has there been a change in children’s use of antibiotics across a 5-year time period? – What factors are associated with children’s use of antibiotics? What perspective? What perspective? – Children as the unit of analysis What population? What population? – Children across the US (national) Time: Time: – Trends - 5 consecutive years of data

7. Advancing Excellence in Health Care 7 Children’s Use of Antibiotics What information is needed to answer the question? What information is needed to answer the question? – Antibiotic use (medication use) – Respiratory conditions (disease) – Outpatient visit utilization – Insurer – Demographics – income, race/ethnicity How much money and time should be allocated to the project? How much money and time should be allocated to the project? What database should you choose?

8. Advancing Excellence in Health Care 8 Quality of Health Care What are the research questions? What are the research questions? – Does quality of outpatient and inpatient care vary by insurance? – How does the answer to this question vary by specific conditions or sub-populations (e.g., SCHCN)? What perspective? What perspective? – Children as the unit of analysis – Hospitalizations as the unit of analysis What population? What population? – Children who use health care across the US, across a state, across a county Time: Time: – Cross-sectional (one year) – Trends (multi-year)

9. Advancing Excellence in Health Care 9 Quality of Care What information is needed to answer the question? What information is needed to answer the question? – Quality of care How is it going to be measured? How is it going to be measured? What measures are available? What measures are available? – Insurance/payer – Demographic information on the patient (age, race, income, residence) – Specific conditions – Procedures performed during the visit/hospitalization – Insurer/Payer of the visit/hospitalization – Outcome of the visit/hospitalization How much money and time should be allocated to the project? How much money and time should be allocated to the project? What database should you choose?

10. Advancing Excellence in Health Care 10 IOM Releases Report on Emergency Care for Children: Growing Pains What are the general research questions? What are the general research questions? – How safe is pediatric emergency care? – How equitable is pediatric emergency care? – How much does pediatric emergency care cost? What perspective? What perspective? – Emergency department (ED) visits as the unit of analysis – [Children as the unit of analysis] What population? What population? – Children who use the EDs across the US, across a state, across a county Time: Time: – Cross-sectional (one year) – Trends (multi-year)

11. Advancing Excellence in Health Care 11 IOM Releases Report on Emergency Care for Children: Growing Pains What information is needed to answer the question? What information is needed to answer the question? – Emergency department use – Demographic information on the patient (age, race, income, geographic location) – Reason for ED visit – Procedures performed during the ED visit – Insurer/Payer of the ED visit – Cost, charges, expenditures associated with the ED visit – Outcome of the ED visit (e.g., hospitalized, discharged home) How much money and time should be allocated to the project? How much money and time should be allocated to the project? What database should you choose?