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HCUP Frequently Asked Questions
This page provides answers to commonly asked questions about HCUP databases, software tools, supplemental files, and other products.
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The Healthcare Cost and Utilization Project (called "H-CUP") is a family of health care databases, software tools, and products developed through a Federal-State-Industry partnership and sponsored by the Agency for Healthcare Research and Quality (AHRQ). 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 health care data. HCUP includes the largest collection of longitudinal hospital care data in the United States, with all-payer, encounter-level information beginning in 1988. These databases enable research on a broad range of health policy topics, including cost and quality of health services, medical practice patterns, access to health care, and outcomes of treatments at the national, state, and local levels. For additional information, please visit the Overview of HCUP page and HCUP's Online Overview Course. The HCUP databases are built from hospital administrative data (i.e., hospital billing records). HCUP's databases cover hospital inpatient care, outpatient emergency department care, and hospital-affiliated and some free-standing ambulatory surgery care data. HCUP does not cover services provided in physician offices, and it does not include complete or reliable pharmacy, laboratory, pathology, or radiology information. The HCUP databases are consistent with the definition of "limited data sets" under the HIPAA Privacy Rule and contain no direct patient identifiers. HCUP Data Use Agreement (DUA) training and a signed DUA are required to order the HCUP databases. The unit of analysis in the HCUP databases is the discharge record, not individual patients. | ||||
HCUP's Online Tutorial Series is a set of free, interactive training modules that are designed to provide data users with information about HCUP data and tools, as well as training on technical methods for conducting research using HCUP datasets. Topics in the Online Tutorial Series include an HCUP overview, the sample designs of the databases, techniques for loading and checking data, methods for producing national estimates, guidance for calculating standard errors, and performing trends analysis over multiple years of data. | ||||
Users first complete an application and take the Data Use Agreement (DUA) training. Data can then be obtained by purchasing the full HCUP databases from the HCUP Central Distributor. Statistics and data tables from HCUP's nationwide and select state databases can be obtained from HCUPnet, a free online query system. Many HCUP Partners participate in the Central Distributor and HCUPnet, however not all do. If a state of interest does not release their full dataset through the Central Distributor, contact the HCUP Partner directly for the data's availability. | ||||
HCUPnet is a free, online query system that provides instant access to statistics and data tables from HCUP. Its easy, step-by-step process allows users to explore many health care topics relating to inpatient hospital services and emergency department encounters. Users may also generate graphs of national and regional statistics and trends from community hospitals in the United States. HCUPnet can access statistics from five of its hospital databases: the Nationwide Inpatient Sample (NIS), Kids' Inpatient Database (KID), Nationwide Emergency Department Sample (NEDS), selected State Inpatient Databases (SID), and selected State Emergency Department Databases (SEDD). HCUPnet produces output by accessing pre-calculated statistical tables of HCUP data to produce quick results. For this reason, and to protect patient confidentiality, not all types of queries are possible using HCUPnet. The full HCUP databases are purchased from the HCUP Central Distributor and require a statistical software package (such as SAS, SPSS, or Stata) for use. Researchers are able to program the software to extract the type of information they are seeking from the databases. HCUP Partners decide if they want to release their state-level data through the Central Distributor or have state-level statistics on HCUPnet; because of this, data may be available through one or both sources, and the years of participation can vary. Please review the SID/SASD/SEDD Application Kit and HCUPnet for a list of available states and their years of participation. Additionally, national statistics are not available for all NIS years on HCUPnet. Yes. Unlike the full HCUP databases that are purchased from the HCUP Central Distributor, HCUPnet's statistics have had the weighting applied. The data from HCUPnet are national estimates. HCUPnet is updated as databases are released. The national statistics are updated annually, and state statistics are updated as new state data are processed. Available data states and years are listed on the HCUPnet pathways. | ||||
HCUP databases are available from the HCUP Central Distributor; applications are available on the Central Distributor webpage. The Central Distributor may be contacted via e-mail at HCUPDistributor@ahrq.gov. The cost per database varies by state and year (prices are set by HCUP Partners). Many HCUP Partners participate in the Central Distributor, however not all do. If a state of interest does not release their full dataset through the Central Distributor, contact the HCUP Partner directly for the data's availability. HCUP's nationwide databases (the Nationwide Inpatient Sample [NIS], Kids' Inpatient Database [KID], and Nationwide Emergency Department Sample [NEDS]), and select state databases (the State Inpatient Databases [SID], State Ambulatory Surgery Databases [SASD], and State Emergency Department Databases [SEDD]) are available for purchase through the HCUP Central Distributor. Available states and their years of participation are listed in each specific database's Application Kit. HCUP does not offer customized datasets - the data are offered as standard databases. No elements beyond those that are already included in the standard databases are available to the public. HCUP's state databases are released on a rolling basis - typically beginning six to nine months following the end of a calendar year. Databases are listed in the HCUP Database and Product Release Calendar as they become available for purchase from the HCUP Central Distributor. The NIS and NEDS are released approximately18-22 months following the end of a calendar year. Data years begin with 1988 for the NIS and 2006 for the NEDS. The KID is released every three years, beginning with 1997 data. Review the HCUP Central Distributor Application Kits for a list of years that the databases are available. As with the state databases, the HCUP Central Distributor Application Kits have the most up-to-date lists of available years of the national databases. Recent releases are also noted in the HCUP Database and Product Release Calendar. Once you have taken the online HCUP Data Use Agreement (DUA) Training Course, please fax, e-mail, or mail your completed DUA form to the HCUP Central Distributor: HCUP Central Distributor Social & Scientific Systems, Inc. 8757 Georgia Avenue, 12th Floor Silver Spring, MD 20910 E-mail: HCUPDistributor@ahrq.gov Fax: (866) 792-5313. | ||||
HCUP''s nationwide databases provide estimates for hospital stays or emergency department encounters across the United States. Comprised of the Nationwide Inpatient Sample (NIS), the Kids' Inpatient Database (KID), and the Nationwide Emergency Department Sample (NEDS), the nationwide databases are built from stratified, random samples of HCUP's state databases. The nationwide databases include stays for all payers (Medicare, Medicaid, private insurance, and the uninsured). The databases can be used to create national estimates in health care utilization, access, charges, quality, and outcomes. The HCUP nationwide databases are available for purchase through the HCUP Central Distributor. Statistics from the databases are available on HCUPnet. Yes, HCUP's nationwide databases need to be weighted to produce national estimates. HCUP's free online tutorial called Producing National HCUP Estimates provides instruction on the process. The NIS and NEDS are released annually, approximately 18-22 months following the end of a calendar year. Data years begin with 1988 for the NIS and 2006 for the NEDS. Review page 3 of both the NIS and NEDS Application Kits for the current availability of data. The KID is released every three years, approximately 18 months following the end of a data year. Data years begin with 1997. Review page 4 of the KID Application Kit for the current availability of data. Database releases are also noted on a monthly basis in the HCUP Database and Product Release Calendar. | ||||
The Nationwide Inpatient Sample (NIS) is the largest all-payer inpatient care database in the United States, yielding national estimates of hospital inpatient stays. Unweighted, it contains data from approximately 8 million hospital stays each year. Weighted, it estimates roughly 40 million hospitalizations. Sampled from the State Inpatient Databases (SID), the NIS contains all discharge data from about 1,050 hospitals each year, approximating a 20 percent stratified sample of U.S. community hospitals. The NIS contains charge information on all patients, regardless of payer, including persons covered by Medicare, Medicaid, private insurance, and the uninsured. The most recent version of the NIS (data year 2009) includes discharges from 1,050 hospitals in 44 states, representing 95 percent of all discharges in the U.S. Additional information on the NIS, including a description of data elements and summary statistics, can be found on the NIS Database Documentation page. The database can be purchased from the HCUP Central Distributor, and statistics from the NIS are available on HCUPnet. Because the sampling methodology used to create the NIS does not include state as a stratifier, analysts cannot generate state-level estimates using the database. Although the NIS includes weights to allow researchers to generate national estimates from the raw counts, no weights are included for the calculation of state-level estimates. For information on state-specific inpatient stays, we recommend that you work with the HCUP State Inpatient Databases (SID). NIS purchased through the HCUP Central Distributor have not been weighted; weighting will need to be applied by the user. To learn how to properly weight data, HCUP's free online tutorial called Producing National HCUP Estimates describes the process of applying the weighting to your data. Please note that if you are using HCUPnet (our free, online query system), the weighting has already been applied - the statistics produced are national estimates. The NIS is released annually, approximately 18 months after the end of a calendar year. Data years begin with 1988. Review page 3 of the NIS Application Kit for the current availability of data. Prices are located on page 3 of the NIS Application Kit. Cost may vary by year of data. Student pricing is available. Additionally, statistics and data tables from the NIS are available on HCUPnet, HCUP's free, online query system. | ||||
The Kids' Inpatient Database (KID) is the only all-payer inpatient care database for children in the United States, yielding national estimates of hospital inpatient stays for patients under younger than 21 years of age. Unweighted, it contains approximately 2-3 million records each year. Weighted, it estimates approximately 7 million hospital stays for children. The KID is built from a sample of pediatric discharges from the State Inpatient Databases (SID). The KID's large sample size enables analyses of both common and rare conditions such as congenital anomalies, uncommon treatments, and organ transplantation. The KID includes charge information on all patients, regardless of payer, including children covered by Medicaid, private insurance, and the uninsured. The most recent version of the KID (data year 2009) includes discharges from 4,121 hospitals in 44 states. Additional information on the KID, including a description of data elements and summary statistics, can be found on the KID Database Documentation page. The database can be purchased from the HCUP Central Distributor, and statistics from the KID are available on HCUPnet. The KID is based on a stratified, random sample of pediatric discharges (younger than 21 years of age) from the State Inpatient Databases (SID). Ten percent of uncomplicated in-hospital births and 80 percent of complicated births and other pediatric cases from each frame hospital are sampled. The chief benefit of using the KID is that, because of its sample design, rare conditions such as congenital anomalies and uncommon treatments such as organ transplantation can be analyzed. The Nationwide Inpatient Sample (NIS) is based on a stratified, random sample of hospitals from the SID. All hospital discharges from selected hospitals are retained, regardless of age or diagnosis. KID data purchased through the HCUP Central Distributor have not been weighted; weighting will need to be applied by the user. To learn how to properly weight data, HCUP's free online tutorial Producing National HCUP Estimates describes the process of weighting your data. Please note that if you are using HCUPnet (our free, online query system), the weighting has already been applied - the statistics produced are national estimates. Unlike HCUP's other databases, which are released annually, the KID is released every three years beginning with 1997 data. Review page 4 of the KID Application Kit for the current availability of data. Prices are located on page 4 of the KID Application Kit. Cost may vary by year of data. Student pricing is available. Additionally, statistics and data tables from the KID are available on HCUPnet, HCUP's free, online query system. | ||||
The Nationwide Emergency Department Sample (NEDS) is the largest all-payer emergency department (ED) database in the United States, yielding national estimates of ED encounters. Unweighted, it contains approximately 25 to 30 million records each year. Weighted, it estimates approximately 130 million ED encounters. The NEDS contains discharges from over 950 hospitals and approximates a 20 percent stratified sample of U.S. hospital-based EDs. It is constructed using records from: (1) the HCUP State Emergency Department Databases (SEDD), which capture information on ED encounters that do not result in an admission (i.e., treat-and-release encounters and transfers to other hospitals), and (2) the State Inpatient Databases (SID), which contain information on patients initially seen in the ED and then admitted to the same hospital. The NEDS includes ED charge information for over 75% of patients, regardless of payer, including persons covered by Medicaid, private insurance, and the uninsured. The most recent version of the NEDS (data year 2010) includes discharges from 961 hospital-based EDs in 28 states. Additional information on the NEDS, including a description of data elements and summary statistics, can be found on the NEDS Database Documentation page. The database can be purchased from the HCUP Central Distributor, and statistics from the databases are available on HCUPnet. The NEDS contains both types of procedure codes; however, the type of code(s) depends on the state and the type of ED encounter. For ED encounters that do not result in hospitalization, procedures may be reported as both ICD-9-CM and HCPCS®/CPT. Information on availability by state can be found under the Availability of Data Elements by Year link located on the SEDD Database Documentation page of the HCUP-US Website. This information may vary by year, so refer to the data year corresponding to the NEDS of interest. For ED encounters resulting in hospitalization, procedures are coded as ICD-9-CM codes, but are sometimes also available in HCPCS®/CPT. Information on availability by state can be found under the Availability of Data Elements by Year link located on the SID Database Documentation page on the HCUP-US Website. This information may vary by year, so refer to the data year corresponding to the NEDS of interest. NEDS data purchased through the HCUP Central Distributor have not been weighted; weighting will need to be applied by the user. To learn how to properly weight data, HCUP's free online tutorial Producing National HCUP Estimates describes the process of weighting your data. Please note that if you are using HCUPnet (our free, online query system), the weighting has already been applied - the statistics produced are national estimates. The NEDS is released annually, approximately 18-22 months after the end of a calendar year. Data years begin with 2006. Review page 3 of the NEDS Application Kit for the current availability of data. Prices are located on page 3 of the NEDS Application Kit. Student pricing is available. Additionally, statistics and data tables from the NEDS are available on HCUPnet, HCUP's free, online query system. | ||||
HCUP's state databases are a collection of all-payer datasets from participating states that can be used to investigate state-specific and multi-state trends in health care utilization, access, charges, quality, and outcomes. The HCUP state databases are comprised of the State Inpatient Databases (SID), State Ambulatory Surgery Databases (SASD), and the State Emergency Department Databases (SEDD). Some HCUP State Databases are available for purchase through the HCUP Central Distributor; listings of the states that release their databases through the Central Distributor are on pages 6-9, 11, and 13, respectively of the SID/SASD/SEDD Application Kits. Statistics from select states and settings are available on HCUPnet. No, HCUP's state databases do not need to be weighted. HCUP's state databases provide a census (not an estimate) of inpatient stays, ambulatory surgery encounters, or emergency department encounters occurring in a state's community hospitals. For additional information, please review the HCUP Methods Series Report #2010-05: Inferences with HCUP State Databases Final Report. HCUP Partners decide whether or not to distribute their public-release databases through the HCUP Central Distributor and statistics on HCUPnet. Many HCUP Partners participate in the Central Distributor and/or HCUPnet. The Application Kits provide information regarding the state databases available by year from the Central Distributor and the cost for each dataset. HCUPnet provides a list of the available state statistics and years included in the query system on the State Statistics pathways. If a state of interest does not release their full dataset through the Central Distributor or participate in HCUPnet, contact the HCUP Partner directly for the data's availability. HCUP's state databases (the SID, SASD, and SEDD) are released on a rolling basis - typically beginning six to nine months following the end of a calendar year. The most up-to-date lists of available state databases are located on pages 6-9, 11, and 13, respectively of the SID/SASD/SEDD Application Kits. The document is updated monthly. Recent releases are also noted on a monthly basis in the HCUP Database and Product Release Calendar. | ||||
The State Inpatient Databases (SID) are a set of all-payer inpatient care databases from participating HCUP Partners that capture hospital inpatient stays in a given state. They contain the universe of inpatient discharge abstracts in participating states that are translated into a uniform format to facilitate multi-state comparisons and analyses. The SID contain a core set of clinical and nonclinical information on all patients, regardless of payer, including persons covered by Medicare, Medicaid, private insurance, and the uninsured. Together, the SID encompass more than 97 percent of all U.S. community hospital discharges. The SID are the building blocks of the Nationwide Inpatient Sample (NIS), the Kids' Inpatient Database (KID), and the Nationwide Emergency Department Sample (NEDS). All SID include a core set of variables that are commonly included on inpatient discharge abstracts, along with some state-specific data elements. Additional information on the SID, including a description of data elements with participation by state and year and summary statistics for select states, can be found on the SID Database Documentation page. Select SID can be purchased from the HCUP Central Distributor, and statistics from select states are available on HCUPnet. Key differences exist between the SID and the Nationwide Inpatient Sample (NIS). Foremost, the SID contains the universe of inpatient discharge abstracts in a state, while the NIS consists of a sample of hospitals in the United States. Additionally, the NIS contains fewer data elements than the SID. The common data elements on the SID become the NIS core data elements and are standardized. The NIS still contains some state-specific elements (such as race), but they are not always complete. The availability and cost of the full SID vary by state and year. The earliest available SID begin in 1990; however, not all states provide data from every year. Each HCUP Partner sets its own pricing, and some charge by applicant affiliation. A complete listing of availability and pricing by state and year are located on pages 6-9 of the SID Application Kit. Additionally, statistics and data tables from select SID are available on HCUPnet, HCUP's free, online query system. Many HCUP Partners participate in the HCUP Central Distributor and HCUPnet, however not all do. To obtain state-level data from states that do not participate, contact the HCUP Partner directly for the data's availability. | ||||
The State Ambulatory Surgery Databases (SASD) are a set of all-payer ambulatory surgery databases from participating HCUP Partners that capture surgeries performed on the same day in which patients are admitted and discharged in a given state. All of the SASD include abstracts from hospital-based ambulatory surgery sites; some contain the universe of ambulatory surgery encounter abstracts for that state, including records from both hospital-affiliated and non-hospital-affiliated freestanding surgery centers. Composition and completeness of data variables on the file may vary from state to state. The SASD contain a core set of clinical and non-clinical information on all patients, regardless of payer, including persons covered by Medicare, Medicaid, private insurance, and the uninsured. Additional information on the SASD, including a description of data elements with participation by state and year and summary statistics for select states, can be found on the SASD Database Documentation page. Select SASD can be purchased from the HCUP Central Distributor. Statistics from the SASD are not yet available on HCUPnet. The types of facilities (hospital-affiliated, freestanding non-hospital-affiliated) included in the SASD depend on information provided by the HCUP Partner. Some HCUP Partners provide data only from hospital-based ambulatory surgery facilities, while others also include non-hospital-affiliated, freestanding ambulatory surgery facilities. A complete list of the types of facilities included in the SASD can be found on the SASD File Composition page. The availability and cost of the SASD vary by state and year. The earliest available SASD begin in 1997; however, not all states provide data from every year. Each HCUP Partner sets its own pricing, and some charge by applicant affiliation. A complete listing of availability and pricing by state and year are located on page 11 of the SASD Application Kit. | ||||
The State Emergency Department Databases (SEDD) are a set of all-payer emergency department (ED) databases from participating HCUP Partners that capture discharge information on all ED encounters that do not result in an admission to the same facility. They include universe of abstracts from hospital-affiliated ED encounters from community hospitals. Composition and completeness of the variables on the file may vary from state to state. The SEDD contain a core set of clinical and non-clinical information on all patients, regardless of payer, including persons covered by Medicare, Medicaid, private insurance, and the uninsured. Additional information on the SEDD, including a description of data elements with participation by state and year and summary statistics for select states, can be found on the SEDD Database Documentation page. Select SEDD can be purchased from the HCUP Central Distributor, and statistics from select states are available on HCUPnet. No. The SEDD provide ED encounter-level information where the emergency department encounter does not result in an admission to the same facility (i.e., patients in the SEDD were treated and released). Records for inpatient stays that began in the ED are found in the State Inpatient Databases (SID). Both the SEDD and SID are needed to analyze all ED encounters in a state. The availability and cost of the SEDD vary by state and year. The earliest available SEDD begin in 1999; however, not all states provide data from every year. Each HCUP Partner sets its own pricing, and some charge by applicant affiliation. A complete list of availability and pricing by state and year is located on page 13 of the SEDD Application Kit. Additionally, statistics and data tables from select SEDD are available on HCUPnet, HCUP's free, online query system. Many HCUP Partners participate in the HCUP Central Distributor and HCUPnet, however not all do. To obtain state-level data from states that do not participate, contact the HCUP Partner directly for the data's availability. | ||||
The Clinical Classifications Software (CCS) is a categorization scheme that was developed by the Agency for Healthcare Research and Quality (AHRQ). It can be used to classify similar diagnosis or procedure coding (such as ICD-9-CM codes) and collapse them into a smaller number of clinically meaningful categories. The CCS categories may be more useful for presenting descriptive statistics than individual codes. There are three types of CCS tools. The CCS for ICD-9-CM and the CCS for ICD-10 provide a method for classifying ICD-9-CM or ICD-10 (respectively) diagnosis and procedure codes into a smaller number of clinically meaningful categories. The CCS for ICD-9-CM is the main and most frequently used version of the CCS tool. Most users employ the single-level CCS categorization scheme for diagnoses or procedures. A more detailed, multi-level scheme is available for ICD-9-CM diagnoses and procedures, but is not as commonly used. The CCS for ICD-10 is currently only for mortality codes; in the future the tool will cover all ICD-10 codes, including ICD-10-CM (diagnoses) and ICD-10-PCS (procedures). The CCS-Services and Procedures provides a method for classifying Current Procedural Terminology (CPT®) codes and Healthcare Common Procedure Coding System (HCPCS) codes into clinically meaningful procedure categories. The procedure categories are identical to the CCS for ICD-9-CM, with the addition of specific categories unique to professional service codes in CPT/HCPCS. Users must agree to a license to use the CCS-Services and Procedures prior to accessing the software. The CCS is updated annually, as ICD-9-CM, CPT, and HCPCS codes are revised. Updates typically are released between October and April, and the software is valid for codes from January 1, 1980 through September 30 of the designated fiscal year. The CCS may be downloaded free of charge from the HCUP-US Website. Select the type of CCS tool in which you are interested, and click on the "Downloading Information" link. | ||||
The Cost-to-Charge Ratio (CCR) Files are linkable files developed by the Agency for Healthcare Research and Quality (AHRQ) that enable the conversion of total charges - defined as what a hospital billed for services - into how much the hospital services actually cost. Each CCR contains hospital-specific cost-to-charge ratios based on all-payer inpatient cost for nearly every hospital in the corresponding NIS, SID, or KID databases. Cost information was obtained from the hospital cost reports (HCRIS) collected by the Centers for Medicare & Medicaid Services (CMS). Some imputations for missing values were necessary. The CCR is designed to be used exclusively with the NIS, SID, or KID, and is unique by year. The CCR is not available for the NEDS, SASD, or SEDD. Corresponding with database releases, the CCR is updated annually for the NIS and SID and every three years for the KID. The CCR is available shortly after the second release of the HCRIS database in May. The CCR is unique by year. Use the CCR that corresponds with the year of data. The CCR is available free of charge from the HCUP Central Distributor. | ||||
The HCUP Supplemental Variables for Revisit Analyses, or Revisit Variables, are additional variables that were developed by the Agency for Healthcare Research and Quality (AHRQ) They facilitate analyses to track patients across time and hospital settings exclusively in the SID, SASD, and SEDD. Each record in an HCUP database represents one discharge abstract from a hospital setting (inpatient, emergency department, or ambulatory surgery). Therefore, if an individual visited the hospital three times in a given year, the HCUP databases would include three separate records in the respective database. The Revisit Variables allow researchers to uniformly identify sequential visits for an individual in a single state across the SID, SASD, and SEDD, and to use the available clinical information to determine if the visits are unrelated, an unexpected revisit or re-hospitalization, or an expected follow-up. The HCUP Revisit Variables are available for the SID, SASD, and SEDD in select states starting in 2003. Appendix A of the HCUP Supplemental Variables for Revisit Analyses User Guide provides a detailed list of which states, years, and types of data are available. The Revisit Variables are designed to be used exclusively with the HCUP state databases and are unique by state and data year. No. Revisit Variables are not available for the nationwide databases; they are only for use with the state databases. The HCUP Revisit Variables are updated annually. The Revisit Variables are unique by state and year. Use the Revisit Variables that correspond with the year of data. Beginning with 2009 data, the Revisit Variables are included in the Core file of the SID, SASD, and SEDD databases that are purchased through the HCUP Central Distributor. For 2003-2008 data, the Revisit Variables are provided free of charge as a separate file with the applicable state databases. If the HCUP state databases were purchased prior to the release of the Revisit Variables, then these supplemental files are available free of charge from the Central Distributor. | ||||
The Chronic Condition Indicator (CCI) is a tool developed by the Agency for Healthcare Research and Quality (AHRQ) that categorizes ICD-9-CM diagnoses codes into one of two categories: chronic or not chronic. Examples of chronic conditions include malignancies, diabetes, most forms of mental illness, hypertension, many forms of heart disease, and congenital anomalies. Non-chronic conditions include infections, pregnancy, many neonatal conditions, non-specific symptoms, and injuries. The CCI is updated annually. Updates typically are released between October and April, and the tool is valid for codes from January 1, 1980 through September 30 of the designated fiscal year. The CCI can be downloaded free of charge from the HCUP-US Website. | ||||
The Comorbidity Software is a product developed by the Agency for Healthcare Research and Quality (AHRQ) that identifies comorbidities in hospital discharge records using ICD-9-CM diagnosis codes. Currently the Comorbidity Software creates 29 variables that identify major comorbidities (e.g., congestive heart failure, HIV/AIDS) in hospital discharge records. The Comorbidity Software is based on the Elixhauser Comorbidities. The most recent versions of the Comorbidity Software contain 29 comorbidity indicators — not the 30 presented in the Elixhauser et al. (1998) article. Beginning with the Fiscal Year 2004 version 2.0 of the Comorbidity Software, Dr. Elixhauser removed the cardiac arrhythmias indicator because of concerns about reliability. In addition, some original labels changed and some indicators began sharing duplicate ICD-9-CM codes in later versions. Each year, efforts are made to enhance the Comorbidity Software with better methods of identifying the Elixhauser Comorbidities. The Comorbidity Software is updated each year. Each version is based on ICD-9-CM and MS-DRG codes that are valid through September 30 of the designated fiscal year. To ensure that the codes included in your datasets are included in the Comorbidity Software, we recommend you use the corresponding Comorbidity Software for each year of data. The Comorbidity Software can be downloaded free of charge from the HCUP-US Website. | ||||
The Procedure Classes are a tool developed by the Agency for Healthcare Research and Quality (AHRQ) that categorizes procedure codes into one of four broad categories: Minor Diagnostic, Minor Therapeutic, Major Diagnostic, and Major Therapeutic. Procedure codes for this tool are based on the ICD-9-CM codes. The Procedure Classes are updated each year. The current version is based on ICD-9-CM procedure codes that are valid for January 1, 1980 through September 30 of the designated fiscal year. The Procedure Classes can be downloaded free of charge from the HCUP-US Website. | ||||
The Utilization Flags are software developed by the Agency for Healthcare Research and Quality (AHRQ). The software creates 30 data elements that reveal additional information about use of health care services by combining information from UB-04 revenue codes, ICD-9-CM procedure codes, and Clinical Classification Software (CCS) procedure categories to create indicators (or flags) of utilization. Use of procedures and services such as the Intensive Care Unit (ICU), Coronary Care Unit (CCU), Neonatal Intensive Care Unit (NICU), and specific diagnostic tests and therapies in HCUP's state databases can be assessed with the Utilization Flags. For additional information, the HCUP Methods Series Report #2006-04: Development of Utilization Flags for Use with UB-92 Administrative Data has detailed documentation about the initial development of the Utilization Flags. No. Utilization Flags can only be used on HCUP's state databases. The Utilization Flags use Revenue Codes, which are not reported in the nationwide databases. In most HCUP state databases, Revenue Codes are stored in an array (REVCD1-REVCDn, where n indicates the dimension of the array) with a corresponding array of associated charges. The number of Revenue Codes reported on an individual record varies; not all participating HCUP Partners provide Revenue Codes in their state databases. Composition and completeness vary by state, year, and database. Revenue code categories are reviewed annually and updated in the Utilization Flags, as appropriate. The Utilization Flags can be downloaded free of charge from the HCUP-US Website. | ||||
HCUP produces a number of publication series featuring HCUP data and tools. These publications and reports provide people with ready-made sources of statistics and guidance on a range of health care related subjects. Examples include: | ||||
HCUP Q&A (formerly called Users' Tech Tips) can be found in HCUP's quarterly eNews. Topics have included:
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HCUP User Support can help you: find, select, and access the appropriate HCUP databases, tools, and documentation; navigate and use the HCUP-US and HCUPnet Websites; troubleshoot HCUP tools; answer questions about programming the data; investigate possible data or documentation errors; support in the interpretation of your HCUP data output; and guide you in the appropriate use and reporting of HCUP data. Yes. HCUP User Support cannot answer questions related to programming software services or support; data coding; complex analyses; research design; or running, revising, or customizing HCUP tools. Staff may be able to guide you to other resources that are specific to your needs. User Support cannot assist with HCUP research designs. However, many users have found HCUP's Publication Search page helpful in learning how other researchers have constructed their methodology. Yes. Before publishing with HCUP data, User Support recommends reviewing the Requirements for Publishing with HCUP Data page. | ||||
| Internet Citation: HCUP Frequently Asked Questions. Healthcare Cost and Utilization Project (HCUP). January 2013. Agency for Healthcare Research and Quality, Rockville, MD. www.hcup-us.ahrq.gov/tech_assist/faq.jsp. |
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