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Healthcare Cost and Utilization Project (HCUP)
U.S. Department of Health and Human Services, Agency for Healthcare Research and Quality (AHRQ).
Mode of Collection
HCUP databases bring together the data collection efforts of State government data organizations, hospital associations, private data organizations, and the Federal government to create a national information resource of discharge-level health care data. The number of participating States increased to 36 in 2002. See "Sources of HCUP Data" below.
HCUP includes a collection of longitudinal hospital care data, with all-payer, discharge-level information beginning in 1988. Two HCUP discharge datasets were used in this report: 1) The HCUP Nationwide Inpatient Sample (NIS) is a nationally stratified sample of hospitals (with all of their discharges) from States that contribute data to the NIS dataset. Weights are used to develop national estimates. NIS 2002 contains data for approximately 7 million discharges from 995 hospitals located in 35 States, approximating a 20 percent stratified sample of U.S. community hospitals. 2) The 2002 HCUP Statewide Inpatient Databases (SID) include all hospitals (with all of their discharges) from 36 participating States. In aggregate, the SID represent approximately 90 percent of all U.S. hospital discharges, totaling over 28 million inpatient discharge abstracts.
The HCUP NIS and SID contain over 100 clinical and nonclinical data variables, including age, gender; race; ethnicity; length of stay; discharge status; source of payment; total charges, hospital size, ownership, region, teaching status; diagnoses and procedures.
Some NHDR measures that use HCUP data are based on the following AHRQ Quality Indicators:
- 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.
- 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.
- Patient Safety Indicators (PSI) reflect potential inpatient complications and other patient safety concerns following surgeries, other procedures, and childbirth.
Any person, U.S. citizen or foreign, using non-Federal, non-rehabilitation, community hospitals in the United States as defined by the American Hospital Association (AHA).
The AHA defines community hospital as "all non-Federal, short-term, general, and other specialty hospitals, excluding hospital units of institutions." Included among community hospitals are specialty hospitals, such as obstetrics-gynecology, ear-nose-throat, short-term rehabilitation, orthopedic, and pediatric institutions. Also included are public hospitals and academic medical centers. The NIS and analyses of the SID for this report excluded short-term rehabilitation hospitals (beginning with 1998 data), long-term hospitals, psychiatric hospitals, and alcoholism/chemical dependency treatment facilities.
Although not all States participate in the HCUP database, the NIS is weighted to give national estimates using weights based on all U.S. community, non-rehabilitation hospitals in the American Hospital Association Annual Survey of Hospitals.
Age, gender, race, insurance coverage, median household income of the patient's ZIP Code, urbanized location, and region of the United States.
National, four U.S. Census Bureau regions, and State levels (for States participating in SID).
Use of AHRQ Quality Indicator Software in Generating NHQR Tables
The following AHRQ QI software versions were used for generating the HCUP tables in this report: IQI: Version 2.1, revision 3 (July 2004); PQI: Version 2.1, revision 3 (January 2004); PSI: Version 2.1, revision 2 (October 2004). For more information, see the methods section for each quality report, available at http://qualitytools.ahrq.gov.
For detailed information about each measure, see the individual guides to the quality indicators listed below, available from the archives at http://www.qualityindicators.ahrq.gov.
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. Revision 3 (July 21, 2004). AHRQ Pub. No. 02-RO204.
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. Revision 3. (January 9, 2004). AHRQ Pub. No. 02-R0203.
Patient Safety Indicators [PSI]
AHRQ Quality Indicators—Guide to Patient Safety Indicators. Rockville, MD: Agency for Healthcare Research and Quality, 2003. Version 2.1, Revision 2, (October 22, 2004). AHRQ Pub.03-R203.
Sources of HCUP Data
Arizona Department of Health Services
California Office of Statewide Health Planning & Development
Colorado Health & Hospital Association
Florida Agency for Health Care Administration
Georgia—GHA: An Association of Hospitals & Health Systems
Hawaii Health Information Corporation
Illinois Department of Public Health
Indiana Hospital & Health Association
Iowa Hospital Association
Kansas Hospital Association
Kentucky Department for Public Health
Maine Health Data Organization
Maryland Health Services Cost Review Commission
Massachusetts Division of Health Care Finance and Policy
Michigan Health & Hospital Association
Minnesota Hospital Association
Missouri Hospital Industry Data Institute
Nebraska Hospital Association
Nevada Department of Human Resources, Center for Health Information Analysis
New Hampshire Department of Health & Human Services
New Jersey Department of Health & Senior Services
New York State Department of Health
North Carolina Department of Health and Human Services
Ohio Hospital Association
Oregon Association of Hospitals & Health Systems
Pennsylvania Health Care Cost Containment Council
Rhode Island Department of Health
South Carolina State Budget & Control Board
South Dakota Association of Healthcare Organizations
Tennessee Hospital Association
Texas Department of State Health Services
Utah Department of Health
Vermont Association of Hospitals and Health Systems
Virginia Health Information
Washington State Department of Health
West Virginia Health Care Authority
Wisconsin Department of Health & Family Services