The Healthcare Cost and Utilization The Healthcare Cost and Utilization Project (HCUP) Project (HCUP) Overview Overview Agency for Healthcare Research and Quality Agency for Healthcare Research and Quality APHA CEI Session APHA CEI Session November 2006 November 2006
28
Embed
The Healthcare Cost and Utilization Project (HCUP) Overview Agency for Healthcare Research and Quality APHA CEI Session November 2006.
This document is posted to help you gain knowledge. Please leave a comment to let me know what you think about it! Share it to your friends and learn new things together.
Transcript
The Healthcare Cost and Utilization The Healthcare Cost and Utilization Project (HCUP)Project (HCUP)
OverviewOverview
Agency for Healthcare Research and QualityAgency for Healthcare Research and Quality
APHA CEI Session APHA CEI Session November 2006 November 2006
2
Advancing Advancing Excellence in Excellence in Health CareHealth Care
Healthcare Cost and Healthcare Cost and Utilization Project (HCUP)Utilization Project (HCUP)
THE LARGEST COLLECTION OF MULTI-STATE, THE LARGEST COLLECTION OF MULTI-STATE, ALL-PAYER, ENCOUNTER-LEVEL, HEALTH CARE DATAALL-PAYER, ENCOUNTER-LEVEL, HEALTH CARE DATA
3
Advancing Advancing Excellence in Excellence in Health CareHealth Care
HCUP Data Are HCUP Data Are Unique and PowerfulUnique and Powerful
38 State Partners Representing 90% of U.S. Population38 State Partners Representing 90% of U.S. Population
90% of Hospital Discharges in U.S.90% of Hospital Discharges in U.S.
Census of Hospital Care—NOT a SampleCensus of Hospital Care—NOT a Sample
4
Advancing Advancing Excellence in Excellence in Health CareHealth Care
HCUP Supports High Impact Research and Policy Analyses
5
Advancing Advancing Excellence in Excellence in Health CareHealth Care
HCUP Is a Family of Databases, Tools, and Products
HCUP Databases
Research Publications
User Support
Software Tools
6
Advancing Advancing Excellence in Excellence in Health CareHealth Care HCUP Is NOT a Black Box
?
7
Advancing Advancing Excellence in Excellence in Health CareHealth Care
Overview of HCUP Data
8
Advancing Advancing Excellence in Excellence in Health CareHealth Care
HCUP Data Mostly HCUP Data Mostly from Community Hospitalsfrom Community Hospitals
Typically not included in HCUP data Community
Federal
Other/LTC
Source: American Hospital Association (AHA), 2004
Included in HCUP data
85%(N=4,919)
15% (N=840)
9
Advancing Advancing Excellence in Excellence in Health CareHealth Care
AHA definition of community hospitals: Non-Federal, short-term, AHA definition of community hospitals: Non-Federal, short-term, general, and other specialty hospitals, excluding hospital units of other general, and other specialty hospitals, excluding hospital units of other
OutpatientOutpatientEmergency Room Visits Emergency Room Visits State Emergency DepartmentState Emergency Department Database (SEDD)Database (SEDD)Ambulatory SurgeriesAmbulatory Surgeries State Ambulatory Surgery State Ambulatory Surgery Database (SASD)Database (SASD)[Office Visits][Office Visits]
[Pharmacy/Lab/Radiology][Pharmacy/Lab/Radiology]
Capture [and Not]?Capture [and Not]?
11
Advancing Advancing Excellence in Excellence in Health CareHealth Care
The Foundation of HCUP Data The Foundation of HCUP Data is Billing Datais Billing Data
Demographic Demographic DataData
Diagnoses Diagnoses
ProceduresProcedures
ChargesCharges
Billing UB-92 Form
12
Advancing Advancing Excellence in Excellence in Health CareHealth Care
Hospital Billing Data Have Hospital Billing Data Have Benefits and LimitationsBenefits and Limitations
BenefitsBenefits
SizeSize Uniformity of codesUniformity of codes Regularity of Regularity of
collectioncollection Ease of accessEase of access All-payerAll-payer
LimitationsLimitations
Limited clinical detailLimited clinical detail Variable accuracy of Variable accuracy of
codingcoding No data on individuals No data on individuals
outside hospital systemoutside hospital system
13
Advancing Advancing Excellence in Excellence in Health CareHealth Care Current HCUP PartnersCurrent HCUP Partners
ArizonaArizona Department of Health ServicesDepartment of Health Services
Arkansas Arkansas Department of Health & Human ServicesDepartment of Health & Human Services
CaliforniaCalifornia Office of Statewide Health Planning & Development Office of Statewide Health Planning & Development
ColoradoColorado Health & Hospital Association Health & Hospital Association
ConnecticutConnecticut Chime, Inc. Chime, Inc.
FloridaFlorida Agency for Health Care Administration Agency for Health Care Administration
Georgia Georgia GHA An Association of Hospitals & Health SystemsGHA An Association of Hospitals & Health Systems
HawaiiHawaii Health Information CorporationHealth Information Corporation
Indiana Indiana Hospital&Health AssociationHospital&Health Association
IllinoisIllinois Department of Public HealthDepartment of Public Health
IowaIowa Hospital Association Hospital Association
KansasKansas Hospital AssociationHospital Association
14
Advancing Advancing Excellence in Excellence in Health CareHealth Care Current HCUP PartnersCurrent HCUP Partners
KentuckyKentucky Department for Public HealthDepartment for Public Health
MaineMaine Health Data Organization Health Data Organization
MarylandMaryland Health Services Cost Review Commission Health Services Cost Review Commission
MassachusettsMassachusetts Division of Health Care Finance and Policy Division of Health Care Finance and Policy
MichiganMichigan Health & Hospital Association Health & Hospital Association
MinnesotaMinnesota Hospital AssociationHospital Association
MissouriMissouri Hospital Industry Data Institute Hospital Industry Data Institute
NebraskaNebraska Hospital AssociationHospital Association
NevadaNevada Department of Human Resources Department of Human Resources
New Hampshire New Hampshire Department of Health & Human ServicesDepartment of Health & Human Services
New JerseyNew Jersey Department of Health & Senior Services Department of Health & Senior Services
15
Advancing Advancing Excellence in Excellence in Health CareHealth Care Current HCUP PartnersCurrent HCUP Partners
New YorkNew York State Department of Health State Department of Health
North CarolinaNorth Carolina Department of Health and Human Services Department of Health and Human Services
OhioOhio Hospital AssociationHospital Association
Office for Office for OregonOregon Health Policy & Research Health Policy & Research
OregonOregon Association of Hospitals and Health Systems (1996 Association of Hospitals and Health Systems (1996 data and forward)data and forward)
Rhode IslandRhode Island Department of Health Department of Health
South CarolinaSouth Carolina State Budget and Control Board State Budget and Control Board
South DakotaSouth Dakota Association of Health Care OrganizationsAssociation of Health Care Organizations
TennesseeTennessee Hospital Association Hospital Association
16
Advancing Advancing Excellence in Excellence in Health CareHealth Care Current HCUP PartnersCurrent HCUP Partners
TexasTexas Department of State Health ServicesDepartment of State Health Services
UtahUtah Department of Health Department of Health
VermontVermont Association of Hospitals and Health Systems Association of Hospitals and Health Systems
VirginiaVirginia Health Information Health Information
WashingtonWashington State Department of HealthState Department of Health
West VirginiaWest Virginia Health Care Authority Health Care Authority
WisconsinWisconsin Department of Health and Family Services Department of Health and Family Services
17
Advancing Advancing Excellence in Excellence in Health CareHealth Care The Making of HCUP DataThe Making of HCUP Data
Patient enters Patient enters hospitalhospital
Hospital sends Hospital sends billing data and any billing data and any
additional data additional data elements toelements to
Data OrganizationsData Organizations
States store data States store data in varying formatsin varying formats
Billing Billing record record createdcreated
AHRQ AHRQ standardizes data standardizes data to create uniform to create uniform HCUP databasesHCUP databases
18
Advancing Advancing Excellence in Excellence in Health CareHealth Care 38 States Contribute Data38 States Contribute Data
HCUP Process
HCUP Uniform DataHCUP Uniform DataHCUP Uniform DataHCUP Uniform Data
19
Advancing Advancing Excellence in Excellence in Health CareHealth Care
KIDKIDKIDKID
SIDSIDSIDSID
SASDSASDSASDSASD
NISNISNISNIS
SEDDSEDDSEDDSEDD
AHRQ HCUP Databases
Data Use Data Use AgreementAgreementData Use Data Use AgreementAgreement
HCUP Central Distributor
20
Advancing Advancing Excellence in Excellence in Health CareHealth Care Data Use AgreementData Use Agreement
The HCUP Data Use The HCUP Data Use Agreement implements Agreement implements the data protections of the the data protections of the Health Insurance Health Insurance Portability and Portability and Accountability Act (HIPAA) Accountability Act (HIPAA) of 1996 (Public Law 104-of 1996 (Public Law 104-191) and the Agency for 191) and the Agency for Healthcare Research and Healthcare Research and Quality (AHRQ) Quality (AHRQ) confidentiality statute. confidentiality statute.
21
Advancing Advancing Excellence in Excellence in Health CareHealth Care Data Use AgreementData Use Agreement
NONO identification of identification of persons – patients or persons – patients or doctorsdoctors
Hospital identifiers can be Hospital identifiers can be used for research, but used for research, but hospitals can not be hospitals can not be identified in any identified in any publications (directly or publications (directly or indirectly)indirectly)
22
Advancing Advancing Excellence in Excellence in Health CareHealth Care
New Requirement: New Requirement: Electronic DUA CourseElectronic DUA Course
PURPOSE OF THE COURSE
• Emphasize the importance of data protection
Reduce the risk of inadvertent violations
Describe your individual responsibility when using HCUP data.
http://www.hcup-us.ahrq.gov/tech_assist/dua.jsp
Takes 15 minutes to Complete
23
Advancing Advancing Excellence in Excellence in Health CareHealth Care
HCUP Has Five Types of HCUP Has Five Types of DatabasesDatabases
State Inpatient Databases Nationwide Inpatient Sample Kids’ Inpatient Database
State Ambulatory Surgery Databases State Emergency Department Databases
24
Advancing Advancing Excellence in Excellence in Health CareHealth Care HCUP DatabasesHCUP Databases
State State Ambulatory Ambulatory
Surgery Surgery Databases Databases
(SASD)(SASD)
State State Inpatient Inpatient
Databases Databases (SID)(SID)
State State Emergency Emergency Department Department Databases Databases
Step 3:Step 3: Read and sign the Data Use Agreement (DUA) Read and sign the Data Use Agreement (DUA)
Step 4:Step 4: Fax or mail the order form, DUA, and payment to Fax or mail the order form, DUA, and payment to HCUP Central Distributor HCUP Central Distributor
27
Advancing Advancing Excellence in Excellence in Health CareHealth Care
How to Learn More How to Learn More About HCUPAbout HCUP
Advancing Advancing Excellence in Excellence in Health CareHealth Care
Healthcare Cost and Healthcare Cost and Utilization Project (HCUP)Utilization Project (HCUP)
THE LARGEST COLLECTION OF MULTI-STATE, THE LARGEST COLLECTION OF MULTI-STATE, ALL-PAYER, ENCOUNTER-LEVEL, HEALTH CARE DATAALL-PAYER, ENCOUNTER-LEVEL, HEALTH CARE DATA