Value, 2008

Centers for Disease Control and Prevention

July 2008

Research using the Nationwide Inpatient Sample (NIS) data from the Healthcare Cost and Utilization Project (HCUP) has been influential in guiding the Centers for Disease Control and Prevention (CDC) in monitoring the burden of pneumococcal disease, one of the most common causes of death in America from a vaccine-preventable disease. The research is also helping the CDC update national pneumonia and acute respiratory infection hospitalization rates in children.

Marie Griffin, MD, MPH, at the Department of Preventive Medicine at Vanderbilt University Medical Center, used the HCUP-NIS to compare the rates of pediatric all-cause and pneumococcal pneumonia admissions before and after introduction of the pneumococcal conjugate vaccine (PCV7). This vaccine is recommended for all children younger than 59 months old.

The CDC had been conducting surveillance for invasive pneumococcal diseases—primarily bacteremia and meningitis—in conjunction with the Tennessee Department of Health and other sites throughout the U.S. The CDC approached Vanderbilt's Department of Preventive Medicine regarding access to data that could answer questions about pneumonia cases that could not be answered with their laboratory-based surveillance.

Griffin found the HCUP-NIS data especially useful for analysis of the impact of the PCV7 on hospital admissions for this disease. She states, "The HCUP databases are wonderful tools for those interested in health services research. The size of the NIS is appealing and great to analyze trends in large populations over time."

Her research, funded by CDC and performed in collaboration with Vanderbilt and CDC investigators, assessed the effect that the routine immunization of children with the vaccine has had on the rate of all-cause and pneumococcal pneumonia admissions. Among the findings were that national rates of pneumonia hospitalizations had declined substantially since 2000, when the PCV7 vaccine was introduced in the U.S.

Tracking rates allows the CDC to monitor the burden of pneumoccal disease hospitalizations over time. As additional years of NIS data become available, the CDC will be able to continue updating its analyses. According to Pekka Nuorti, MD, DSc, of CDC's National Center for Immunization and Respiratory Diseases, "We are developing a reproducible methodology for routine monitoring and reporting of trends in pneumonia hospitalizations."

Pneumococcal disease is a leading cause of serious illness among all ages throughout the world. It is caused by a common bacteria, the pneumococcus, which can attack different parts of the body. In the lungs, these bacteria can cause the most common form of community-acquired bacterial pneumonia. When the bacteria invade the bloodstream, they cause bacteremia; and when they invade the covering of the brain, they cause meningitis. According to the CDC, invasive pneumococcal disease causes more than 6,000 deaths annually.

Impact Case Study Identifier: CDOM 08-05
AHRQ Product: Healthcare Cost & Utilization Project—Nationwide Inpatient Sample (HCUP-NIS)
Topic(s): Pediatrics
Scope: National

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Current as of September 2009

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Internet Citation:

Impact Case Studies and Knowledge Transfer Case Studies: Value, 2008. September 2009. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/about/casestudies/value/val2008.htm

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