Texas: HCUP Program
Maile Laysa
HI300-01
Purdue University Global
Currently, the State of Texas participates in The Healthcare Cost and Utilization Project (HCUP). The manager and contact information is as follows:
Bruce Burns, Manager
Texas Health Care Information Collection
DSHS - Center for Health Statistics Mail Code - 1898
Department of State Health Services
1100 W. 49th Street, M - 628
Austin, TX 78714-9909
Phone: (512) 776-6431
Fax: (512) 776-7740
E-mail: bruce.burns@dshs.texas.gov
Web site: http://www.dshs.state.tx.us/thcic/ (Texas Department of State Health Services, 2018).
The Texas Department of State Health Services (2018), states that the collection of data called the Texas Health Care Information Collection (THCIC) was created in 1995 and is responsible for the collection of health care activity and health maintenance organizations in the State of Texas. Texas provides reports on statistical data on hospital quality, preventable hospitalizations, utilization, and other topics. As well as data on inpatient and outpatient discharges from hospitals, to include patient and facility characteristics, diagnoses and procedures, and charges (Texas Department of State Health Services, 2018).
The Healthcare Cost and Utilization Project (HCUP) is a group of health care databases, and related software tools and products that are developed through a Federal-State-Industry partnership that is sponsored by the Agency for Healthcare Research and Quality (AHRQ). This group of databases collectively gather information from state data, hospital associations, private data organizations, and the Federal government in efforts to create a national information resource of encounter-level data. HCUP consists of the largest collection of longitudinal hospital care data in the United States with gathered information from 1988. All these databases together aid in research of health policy issues to include cost and quality of health services, medical practice patterns, access to health care programs, and patient outcomes at the national, State, and local market levels (The Healthcare Cost and Utilization Project, 2018).
The group of databases that participate in gathering information are, The National Inpatient Sample (NIS), The Kids’ Inpatient Database (KID), The Nationwide Emergency Department Sample (NEDS), The Nationwide Readmissions Database (NRD), The State Inpatient Databases (SID), The State Ambulatory Surgery and Services Databases (SASD), and The State Emergency Department Databases (SEDD) (Healthcare Cost and Utilization Project, 2018). Discussed below is an overview of select database tools that HCUP utilizes within its program.
The National Inpatient Sample (NIS) is publicly available and provides all payer inpatient healthcare data in the United States. This database is self-explanatory, as it provides information on all hospital inpatient stays nationally. For example, if a patient visits the ER and the physician deems that the patient needs further evaluation or treatment, the physician will admit the patient to the hospital facility, thus the patient now becomes an inpatient. Therefore, this patient’s data will be entered into this database. The NIS currently contains more than 7 million unweighted hospital stays a year, and more than 35 million weighted hospitalizations nationally. Due to changes within the NIS, beginning of 2012, the NIS data sample consists of patient’s discharge records from all hospitals that participate in HCUP, rather than a sample of hospitals from which all discharges were retained. The more recent changes in 2015 consists of
The NIS is drawn from all States participating in HCUP, representing more than 97 percent of the U.S. population.
The NIS approximates a 20-percent stratified sample of discharges from U.S. community hospitals, excluding rehabilitation and long-term acute care hospitals.
The self-weighting design of the new NIS reduces the margin of error for estimates and delivers more stable and precise estimates than previous versions of the NIS.
The NIS protects patient confidentiality because State and hospital identifiers are no longer provided.
The new NIS retains a large sample size, which enables analyses of rare conditions, uncommon treatments, and special patient populations. (The Healthcare Cost and Utilization Project, 2018).
The NIS includes clinical and resource-use information on discharges that contain clinical and non-clinical data for each and every hospital stay, while at the same time safeguarding patients, physicians, and hospitals privacy. The NIS also supports multiple health care policy research topics to aid in comparative studies. The topics include, utilization of health services by special populations, hospital stays for rare conditions, variations in medical practice, healthcare cost inflation, regional and national analyses, quality of care and patient safety, impact of health policy changes, and access to care (The Healthcare Cost and Utilization Project, 2018).
The Kids’ Inpatient Database (KID) is in part, the same as the NIS, but exclusively for pediatric patients. It includes data from 3 million unweighted pediatric discharges a year, and 7 million weighted pediatric hospitalizations. Data collected are national estimates of inpatient stays younger than 21 years of age, and aids in national and regional studies of common and rare pediatric conditions. The data is used to track and analyze national trends in healthcare utilizations, access, charges, quality and outcomes, and this data is only available every three years since 1997 to enable researchers to analyze trends over time. There are 44 states participating in the KID as of 2012 (The Healthcare Cost and Utilization Project, 2018).
The Nationwide Readmission Database (NRD) is a database that focuses on the large gap of health care data to include the lack of nationally representative information on hospital readmissions for all ages. It contains data from about 36 million discharges and is drawn from The State Inpatient Databases (SID), which is also a database that participates in HCUP. In 2015, the NRD was made up from 27 states with reliable and verified patient linkage numbers from SID that are used to track patients across hospitals within a certain state. The key features of the NRD include, data for analysis across hospital types and the study of readmissions for uncommon disorders and procedures, discharge data from 27 states, that accounts for 57.8% of the total U.S. resident population and 56.6% of all U.S. hospitalizations, criteria to determine the relationship between multiple hospital admissions, and the outcomes of readmissions (The Healthcare Cost and Utilization Project, 2018).
The State Ambulatory Surgery and Services Databases (SASD) is encounter-level data for ambulatory surgeries and can include various types of outpatient services to include observation stays, lithotripsy, radiation therapy, imaging, chemotherapy, and labor and delivery. All of the data included in each vary by the type of surgery, by state and data year, and include data from hospital-owned ambulatory surgery facilities with only some states that include nonhospital-owned facilities. Currently, there are 35 states that participate in the SASD. This database includes a core set of clinical and nonclinical information on all patients no matter the payer to include Medicare, Medicaid, private insurance, and the uninsured. The data includes, all-listed diagnoses and procedures, patient demographics, payment sources, total charges, and hospital identifiers that allow linkage to inpatient hospital databases (The Healthcare Cost and Utilization Project, 2018).
References
The Healthcare Cost and Utilization Project. (2018). Overview of HCUP. Retrieved from https://www.hcup-us.ahrq.gov/overview.jsp
The Healthcare Cost and Utilization Project. (2018). NIS Overview. Retrieved from https://www.hcup-us.ahrq.gov/nisoverview.jsp
The Healthcare Cost and Utilization Project. (2018). KID Overview. Retrieved from https://www.hcup-us.ahrq.gov/kidoverview.jsp
The Healthcare Cost and Utilization Project. (2018). NRD Overview. Retrieved from https://www.hcup-us.ahrq.gov/nrdoverview.jsp
The Healthcare Cost and Utilization Project. (2018). SASD Overview. Retrieved from https://www.hcup-us.ahrq.gov/sasdoverview.jsp
Texas Department of State Health Services. (2018). Texas Health Care Information Collection (THCIC). Retrieved from http://www.dshs.texas.gov/thcic/