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Overview of HCUPnet

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On January 17, 2008, Anne Elixhauser gave an overview of HCUPnet at the State Healthcare Quality Improvement Workshop. This is the text version of the event's slide presentation. Please select the following link to access the slides: (PowerPoint® file, 6.9 MB; PDF File, 3.5 MB; PDF Help).

Slides: 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 | 11 | 12 | 13 | 14 | 15 | 16 | 17 | 18 | 19 | 20 | 21 | 22 | 23 | 24 | 25 | 26 | 27 | 28 | 29 | 30


Slide 1: Healthcare Cost and Utilization Project (HCUP) Healthcare Data and Tools. And an Overview of HCUPnet

Anne Elixhauser, Ph.D.
State Healthcare Quality Improvement Workshop
January 17, 2008 -- Phoenix, AZ

On the top of the slide are the logos for the Department of Health & Human Services and the AHRQ logo. The Department of Health & Human Services logo is an artistic image of an eagle with the outlined profile of faces. The AHRQ logo reads, "AHRQ — Agency for Healthcare Research and Quality: Advancing Excellence in Health Care, www.ahrq.gov."

This presentation uses a template with a blue background and a header with the AHRQ and Department of Health & Human Services logos on the left and the HCUP logo on the right.

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Slide 2: The HCUP Partnership: A Voluntary Federal-State-Private Sector Collaboration

The body of the slide shows a map of the United States. States are color coded according to their HCUP partnership status.

  • Hawaii, Washington, Oregon, California, Nevada, Utah, Arizona, Colorado, Texas, Oklahoma, Kansas, Nebraska, South Dakota, Minnesota, Iowa, Missouri, Arkansas, Tennessee, Kentucky, Indiana, Illinois, Wisconsin, Ohio, Michigan, West Virginia, Florida, Georgia, South Carolina, North Carolina, Virginia, Maryland, New Jersey, New York, Connecticut, Rhode Island, Massachusetts, New Hampshire, and Vermont are HCUP Partners.
  • New Mexico is not an HCUP partner due to a legal barrier.
  • Alabama, Mississippi, Idaho, Montana, and Wyoming do not collect inpatient data.
  • Alaska, Louisiana, Pennsylvania, North Dakota, Maine, Delaware, and the District of Columbia are not HCUP partners.

The box below the map contains the following text: 38 states in partnership and 90% of all discharges.

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Slide 3: The Foundation of HCUP is Billing Data

On the left is a graphic of a UB-92 (UB-04) Billing Form.

To the right of form is a bracket with the following text:

Patient demographics (age, sex)
Diagnoses & procedures
  (ICD-9-CM, DRG)
Expected payer
Length of stay
Patient disposition
Admission source & type
Admission month
Charges

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Slide 4: The Making of HCUP Data

This slide depicts the process of the creation of HCUP Data with text and associated graphics: the patient enters the hospital, a billing record is created, the hospital sends billing data and any additional data elements to data organizations, States store data in varying formats, and AHRQ standardizes data to create uniform HCUP databases.

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Slide 5: What is HCUP? And what is 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, online Just another database

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Slide 6: HCUP is a Family of Databases, Tools, Products

From the HCUP logo in the upper left quadrant, arrows point to graphics of HCUP Databases, Software Tools, HCUPnet, Research Publications, and User Support.

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Slide 7: Types of HCUP Databases

Superimposed on top of a map of the United States are three boxes with a graphic of a disk underneath the text. From right to left, the boxes are labeled: State Emergency Department Databases (SEDD), State Ambulatory Surgery Databases (SASD), and State Inpatient Databases (SID). Two red arrows from the left box point to two more disks underneath the box that are labeled Nationwide Inpatient Sample (NIS) and Kids' Inpatient Database (KID).

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

The following logos appear on this slide: HSR, American Journal of Public Health, The New England Journal of Medicine, Cancer, Health Affairs, JAMA, Annals of Surgery, Journal of General Internal Medicine, Pediatrics, Health Economics, The National Academies, PharmacoEconomics, Newsweek, The Lancet, International Journal of Health Care Finance & Economics, The Journal of Rural Health, Inquiry, Morbidity and Mortality Weekly Report, National Healthcare Disparities Report, and Obstetrics & Gynecology.

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Slide 9: HCUP Supports Federal and Non-Federal Initiatives

The following logos appear on this slide: U.S. Office of Management and Budget, FDA, The Commonwealth Fund, Allies Against Asthma, HRSA, NIAID, Utah Department of Health, CDC, Injury Control Research Center, NASA, SAMHSA, National Institutes of Health, National Oceanic and Atmospheric Administration, U.S. Government Accountability Office, Suicide Prevention Resource Center, American Urological Association, Medpac, CMS, March of Dimes, and Institute of Medicine.

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Slide 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.

To the right of the text are graphics of a motorcycle and a helmet.

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Slide 11: AHRQ Quality Indicators

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

To the left of the text are images of AHRQ Guide to Prevention Quality Indicators, AHRQ Guide to Patient Safety Indicators, AHRQ Guide to Inpatient Quality Indicators, and a Pediatric Quality Indicators Fact Sheet.

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Slide 12: HCUP Fact Books

This slide shows cover images of HCUP Fact Book 5, HCUP Fact Book 8, and HCUP Fact Book 10.

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Slide 13: HCUP Statistical Briefs

The image on the left is of HCUP Statistical Brief #36. The image on the right is a bar graph labeled Figure 1. Trends of total hospital stays for potentially preventable conditions, 1997-2004.

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Slide 14: Other Statistical Briefs Include:

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

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Slide 15: Facts and Figures

The image on the left is a bar graph entitled "Discharge Prevalence for All-listed Diabetes by Median Income of Patients' Zip Code, 2005." The image on the right is the cover of "HCUP Facts and Figures: Statistics on Hospital-Based Care in the United States, 2005."

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Slide 16: HCUPnet: Quick, Free Access to HCUP Data

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

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Slide 17: What types of questions can HCUPnet answer?

  • What are the most common conditions treated in hospitals in my state?
  • What are the most expensive conditions? procedures?
  • How many CABGs were performed in 2003?
  • What percentage of hospitalizations are uninsured?
  • For what conditions are uninsured patients hospitalized? patients covered by Medicaid?
  • What is the trend in hospitalizations for MRSA?
  • What is the cost of C-section versus vaginal deliveries?
  • 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?

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Slide 18: Welcome to HCUPnet

This slide is a screen shot of the HCUPnet home page: http://hcupnet.ahrq.gov/.

Superimposed on the screenshot are two yellow boxes. The upper right box contains the following text: HCUPnet is a powerful online query tool that gives you free, instant access to healthcare statistics. The other dialogue box points to the National Statistics on All Stays section of the screenshot and says: HCUPnet provides national information on hospital stays based on the Nationwide Inpatient Sample.

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Slide 19: Select State and Year:

This slide is a screenshot of the HCUPnet online database. The yellow dialogue box on the lower right contains the following text: ...and it gives access to data from participating states from HCUP's State Inpatient Databases.

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Slide 20: Select the type of query you want:

This slide is a screenshot of the HCUPnet online database. The text in the yellow dialogue box in the lower right says: HCUPnet takes you through a step-by-step process to select the information you want.

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Slide 21: Do you want information on:

This slide is a screenshot of the HCUPnet online database. The yellow dialogue box in the lower right contains the following text: You select the level of diagnosis and procedure information: ICD codes, Clinical Classifications, DRGS.

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Slide 22: Select outcomes and measures for which you want statistics

This slide is a screenshot of the HCUPnet online database. The yellow dialogue box in the lower right contains the following text:
HCUPnet provides information on:

  • Numbers of discharges.
  • Hospital LOS and charges.
  • Discharge status.
  • How patients were admitted.

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Slide 23: Select patient and hospital characteristics

This slide is a screenshot of the HCUPnet online database. The text in the yellow dialogue box in the middle on the right says: Are you interested in particular patient groups? Specific hospital characteristics?

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Slide 24: State statistics - 2005 New York - principal procedure only

This slide is a data table that contains data for principal procedure performed in New York State in 2005.

The yellow dialogue box in the lower right has the following text: You get your results instantly. HCUPnet is based on aggregated statistics to speed data transfer and protect patient confidentiality.

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Slide 25: State Statistics - New York - all-listed

This slide is a line graph entitled "Total number of discharges CCS all-listed procedure category 158, Spinal Fusion." The x-axis is labeled with consecutive years from 1997 until 2005. The y-axis is labeled with the total number of discharges in 2,000 increments from zero until 18,000. The points along the line from left to right are: 8,701 in 1997, 10,306 in 1998, 10,827 in 1999, 12,008 in 2000, 12,968 in 2001, 13,793 in 2002, 15,342 in 2003, 16,195 in 2004, and 16,808 in 2005. The bottom of the page has a table with corresponding values of the points on the graph.

Superimposed on the line graph is a yellow dialogue box pointing to the line with the following text: You can request information on trends for the nation and for any participating state.

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Slide 26: Repeat this query on another database

This slide is a screenshot of the HCUPnet online database. The text in the yellow dialogue box says: You can repeat your query instantly on another database.

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Slide 27: Results

This slide is a screenshot of the HCUPnet online database. The yellow dialogue box contains the following text: HCUPnet also provides information on ED visits for some states.

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Slide 28: Indicator Selection

This slide is a screenshot of the HCUPnet online database. The yellow dialogue box on the lower right contains the following text: .and on national-level information on quality of care, based on the AHRQ Quality Indicators.

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Slide 29: Welcome to HCUPnet

This slide is a screenshot of the HCUPnet online database. The yellow dialogue box points to Welcome to HCUPnet and contains the following text: Visit HCUPnet at: http://hcupnet.ahrq.gov

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Slide 30: For more information

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