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National Healthcare Disparities Report, 2003

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Data Sources: Agency for Healthcare Research and Quality


(HCUP)

Sponsor

U.S. Department of Health and Human Services, Agency for Healthcare Research and Quality (AHRQ).

Mode of Administration

HCUP databases bring together the data collection efforts of State data organizations, hospital associations, private data organizations, and the Federal government to create a national information resource of discharge-level health care data.

Survey Sample Design

HCUP includes a collection of longitudinal hospital care data, with all-payer, discharge-level information beginning in 1988. These databases enable research on a broad range of health policy issues, including cost and quality of health services, medical practice patterns, access to health care programs, and outcome of treatment at the national, State, and local market levels.

Primary Survey Content

The Nationwide Inpatient Sample (NIS) includes inpatient data from a national sample of over 1,000 hospitals.

The State Inpatient Databases (SID) cover inpatient care in community hospitals in participating States that represent more than half of all U.S. hospital discharges.

The State Ambulatory Surgery Databases (SASD) contain data from ambulatory care encounters.

The Kids' Inpatient Database (KID) contains hospital inpatient stays for children 18 years of age and younger.

The NHQR measures are based on the following AHRQ Quality Indicators:

  1. Inpatient Quality Indicators (IQI), which reflect quality of care in hospitals, include 13 mortality indicators for conditions or procedures for which mortality can vary from hospital to hospital; 9 utilization indicators for procedures for which utilization varies across hospitals or geographic areas; and 7 volume indicators for procedures for which outcomes may be related to the volume of those procedures performed.
  2. Prevention Quality Indicators (PQI) identify hospital admissions for 16 ambulatory care sensitive conditions, which evidence suggests could have been avoided, in part, through high-quality outpatient care.
  3. Patient Safety Indicators (PSI) reflect potential inpatient complications and other patient safety concerns following surgeries, other procedures, and childbirth.

Population Targeted

U.S. civilian, noninstitutionalized, population.

Demographic Data

Age, gender, race, insurance coverage or income.

Years Collected

Since 1988.

Schedule

Annual.

Geographic Estimates

National, regional, and State levels.

Contact Information

Agency homepage: http://www.ahrq.gov.

Data system homepage: http://www.ahrq.gov/data/hcup.

AHRQ Quality Indicators: http://www.qualityindicators.ahrq.gov.

References

  1. Inpatient Quality Indicators [IQI]

    AHRQ Quality Indicators' Guide to Inpatient Quality Indicators: Quality of Care in Hospitals' Volume, Mortality, and Utilization. Rockville, MD: Agency for Healthcare Research and Quality, 2002. AHRQ Pub. No. 02-RO204.

  2. Prevention Quality Indicators [PQI]

    AHRQ Quality Indicators' Guide to Prevention Quality Indicators: Hospital Admission for Ambulatory Care Sensitive Conditions. Rockville, MD: Agency for Healthcare Research and Quality, 2001. AHRQ Pub. No. 02-R0203.

  3. Patient Safety Indicators [PSI]

    AHRQ Quality Indicators – Patient Safety Indicators: Software Documentation, Version 2.1 – SAS. Rockville, MD: Agency for Healthcare Research and Quality, 2003. AHRQ Pub. 03-R203.

  4. Use of AHRQ Quality Indicator Software in Generating NHQR Tables

Note: For measures using HCUP data, the following AHRQ QI software versions were used as the basis for generating the tables in this report: IQI: Version 2.1; PQI: Version 2.1; PSI: beta test version. For more information, refer to the following references:

Barrett ML, Houchen R, Coffey RM, Kelley E, Andrews R, Moy E, Kosiak B, Remus D. Technical Specifications for the National Healthcare Quality Report. HCUP Contract Task 290-00-004 Deliverable #179. Washington, DC: The Medstat Group, Inc. January 2003.

Coffey RM, Barrett ML, Houchens R, Kelley E, Andrews R, Moy E, Kosiak B, Remus D, Methods Applying AHRQ Quality Indicators to Healthcare Cost and Utilization Project (HCUP) Data.

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HIV Research Network (HIVRN)

Sponsors

U.S. Department of Health and Human Services: Agency for Healthcare Research and Quality (AHRQ), Health Resources and Services Administration (HRSA), HIV/AIDS Bureau (HAB); Substance Abuse and Mental Health Services Administration, Center for Substance Abuse Treatment (SAMHSA/CSAT); and Office of AIDS Research, National Institutes of Health (OAR/NIH).

Study Design

The HIV Research Network is comprised of 20 data collection sites. Each site is a provider of HIV care and treatment to a substantial number of patients with HIV infection. Primary data collection occurs through abstraction of information in the patients' medical records. Data, without any identifying information, are sent to the data coordinating center at Johns Hopkins Medical Institutions.

Data abstracted from records include: number and length of inpatient admissions, number of outpatient visits to the HIVRN site, gender, age, race/ethnicity, HIV transmission risk group, insurance status, lowest CD4 count, highest viral load. Data have been abstracted and analyzed covering 1999 and 2000.

Population Targeted

Data from the HIVRN are not nationally representative.

Years Collected

1999, 2000.

Schedule

Annual abstraction of medical records.

Geographic Estimates

Although the data collection sites are located in every region of the country, regional projections cannot be made from HIVRN data.

Contact Information

Agency homepage: http://www.ahrq.gov.

Data querying page: http://www.ahrq/gov/data/hivnet.htm

References

The HIV Research Network. Hospital and Outpatient Health Services utilization among HIV-Infected Patients in Care in 1999. Journal of Acquired Immune Deficiency Syndromes, 2002, 30: 21-26.

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Medical Expenditure Panel Survey (MEPS)

Sponsor

U.S. Department of Health and Human Services: Agency for Healthcare Research and Quality (AHRQ) and Centers for Disease Control and Prevention (CDC), National Center for Health Statistics (NCHS).

Mode of Administration

MEPS is a family of surveys. The MEPS Household Component (HC) is the core survey and uses computer-assisted, in-person, interviews. The data for this report are from the MEPS HC.

In addition, data from three MEPS supplements were used:

  1. Diabetes Care Survey (DCS)

    This was a paper-and-pencil questionnaire administered to household respondents who answered "Yes" to a question which asked whether or not the respondent was ever told by a doctor or other health professional that he/she had diabetes.

  2. 2000 Self-Administered Questionnaire (SAQ)

    This was a pencil-and-paper questionnaire designed to collect a variety of health status and health care quality measures of adults. The health care quality measures in the SAQ were taken from the health plan version of CAHPS, an AHRQ sponsored family of survey instruments designed to measure quality of care from the consumer's perspective.

  3. 2000 Parent Administered Questionnaire (PAQ)

    This was a pencil-and-paper questionnaire designed to collect a variety of health status and health care quality measures of children from CAHPS and from the Children with Special Health Care Needs (CSHCN) screener.

The SAQ and PAQ population totals are adjusted for non-response to screener and measure-specific questions.

Survey Sample Design

Each year, the MEPS HC sample is a nationally representative subsample of the National Health Interview Survey (NHIS). It uses a stratified multistage probability design.

Primary Survey Content

Medical expenditure data as well as detailed data on health conditions, health status, use of medical care services, charges and payments, access to care, satisfaction with care, health insurance coverage, income, and employment.

Population Targeted

The MEPS HC is a nationally representative survey of the U.S. civilian non-institutionalized population.

Demographic Data

Age, race, ethnicity, region, occupation, employment status, and household composition.

Years Collected

1996 to present.

Schedule

Annual.

Geographic Estimates

National. The HC data also can be shown for the four Census regions (Northeast, Midwest, South, and West).

Notes

AHRQ fields a new MEPS panel each year. In this design, two calendar years of information are collected from each household in a series of five rounds of data collection over a 2 1/2-year period. These data are then linked with additional information collected from the respondents' medical providers, employers, and insurance providers. This series of data collection activities is repeated each year on a new sample of households, resulting in overlapping panels of survey data.

Contact Information

Agency homepage: http://www.ahrq.gov.

Data system homepage: http://www.meps.ahrq.gov.

References

Cohen, J. Design and Methods of the Medical Expenditure Panel Survey Household Component. MEPS Methodology Report No. 1. AHCPR Pub. No. 97-0026. Rockville, MD: AHCPR, 1997.

Cohen, S. Sample Design of the 1996 Medical Expenditure Panel Survey Household Component. MEPS Methodology Report No. 2. AHCPR Pub. No. 97-0027. Rockville, MD: AHCPR, 1997.

Cohen, J.W.; Monheit, A.C.; Beauregard, K.M.; et al. The Medical Expenditure Panel Survey: A National Health Information Resource. Inquiry 33:373-389, 1996/1997. Also available as AHCPR Pub. No. 97-R043. Washington, DC: AHCPR, 1997.

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