Texas HCUP Program Mailout HI300-01 ✓ Solved

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TEXAS: HCUP PROGRAM Texas: HCUP Program Maile Laysa HI300-01

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.

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, including patient and facility characteristics, diagnoses and procedures, and charges.

The Healthcare Cost and Utilization Project (HCUP) is a group of health care databases and related software tools and products developed through a Federal-State-Industry partnership sponsored by the Agency for Healthcare Research and Quality (AHRQ). These databases collectively gather information from state data, hospital associations, private data organizations, and the Federal government 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, gathering information since 1988. The databases aid in researching health policy issues such as 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 group of databases includes 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).

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 at the beginning of 2012, the NIS data sample now consists of patient discharge records from all hospitals that participate in HCUP, instead of a sample of hospitals from which all discharges were retained. The changes in 2015 altered the NIS to draw 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, enabling analyses of rare conditions, uncommon treatments, and special patient populations. The NIS includes clinical and resource-use information on discharges containing clinical and non-clinical data for each hospital stay while safeguarding patients, physicians, and hospitals' privacy. It also supports multiple health care policy research topics to aid in comparative studies, including utilization of health services by special populations, hospital stays for rare conditions, variations in medical practice, health care cost inflation, regional and national analyses, quality of care and patient safety, impact of health policy changes, and access to care.

The Kids’ Inpatient Database (KID) is similar to 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 for individuals younger than 21 years and aid in national and regional studies of common and rare pediatric conditions. The data helps track and analyze national trends in healthcare utilization, 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 Nationwide Readmission Database (NRD) addresses the gap in health care data regarding 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). In 2015, the NRD comprised data from 27 states with reliable and verified patient linkage numbers from SID that are used to track patients across hospitals within a certain state. 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 states that account for 57.8% of the total U.S. resident population, criteria to determine the relationship between multiple hospital admissions, and the outcomes of readmissions.

The State Ambulatory Surgery and Services Databases (SASD) provide encounter-level data for ambulatory surgeries and can include various outpatient services such as observation stays, lithotripsy, radiation therapy, imaging, chemotherapy, and labor and delivery. The data collected vary based on the type of surgery, state, and data year, and include information from hospital-owned ambulatory surgery facilities, with some states including nonhospital-owned facilities. Currently, there are 35 states participating in the SASD, which includes a core set of clinical and non-clinical information on all patients regardless of payer, including 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.

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The Healthcare Cost and Utilization Project (HCUP) is an essential national resource that collates health care data across various states, providing full insights into patient encounters and hospital utilization trends. In Texas, HCUP data is primarily gathered through the Texas Health Care Information Collection (THCIC), which plays a significant role in informing health policy and improving care delivery at multiple levels.

The THCIC, established in 1995, is operated by the Texas Department of State Health Services, which systematically collects health care activity associated with hospitals and health maintenance organizations throughout Texas. The range of data collected includes inpatient and outpatient discharges, capturing vital information on patient demographics, diagnoses, procedures, and service charges (Texas Department of State Health Services, 2018). This data is crucial for understanding how health care services are utilized and the quality of care provided.

One of the primary databases within HCUP is the National Inpatient Sample (NIS). This dataset is instrumental for researchers looking into various health policy issues, as it provides comprehensive information on all inpatient hospital stays in the United States. With over 7 million unweighted hospital stays reported annually, the NIS facilitates the analysis of rare conditions and treatment approaches while simultaneously maintaining the confidentiality of patient information (The Healthcare Cost and Utilization Project, 2018).

Research utilizing the NIS can explore trends in patient care, such as variations in practice patterns, healthcare access disparities, and the impact of health policy changes (The Healthcare Cost and Utilization Project, 2018). The self-weighting design of the NIS ensures its estimates are stable and reliable, which is essential for accurately assessing hospital performance and patient outcomes.

In addition to the NIS, the Kids' Inpatient Database (KID) offers invaluable insights specifically regarding pediatric hospitalizations. This dataset allows for the analysis of healthcare trends concerning children, providing critical data that informs policies aimed at improving pediatric healthcare quality and safety (The Healthcare Cost and Utilization Project, 2018). By analyzing KID's trends, researchers can better advocate for necessary changes in pediatric care to address health disparities observed in youth populations.

The Nationwide Readmission Database (NRD) fills another significant gap in health care data by supplying comprehensive insights into hospital readmissions across various demographics. Understanding readmission rates is imperative for identifying potential areas of healthcare improvement while also formulating policies aimed at reducing unnecessary readmissions and enhancing patient care outcomes. The NRD utilizes data from multiple states, providing a robust overview of readmission patterns nationwide (The Healthcare Cost and Utilization Project, 2018).

Moreover, databases such as the State Ambulatory Surgery and Services Databases (SASD) play an essential role in documenting outpatient surgeries. As outpatient care becomes increasingly prevalent, analytics drawn from SASD data provide necessary information on the scope, quality, and cost of outpatient services offered across Texas (The Healthcare Cost and Utilization Project, 2018). Such data is pivotal for adjusting healthcare policies to ensure that both inpatient and outpatient services meet community health needs effectively.

In conclusion, Texas's participation in HCUP greatly enhances the state’s ability to leverage health care data for informed decision-making regarding policy and service delivery. The databases within HCUP, such as NIS, KID, NRD, and SASD, collectively provide a treasure trove of information that supports research activities necessary for enhancing health care quality, reducing costs, and improving patient outcomes across the continuum of care. As Texas continues to evolve in its health care provisions, HCUP data will remain vital for promoting evidence-based practices and ensuring that health care delivery aligns with community needs.

References

  • The Healthcare Cost and Utilization Project. (2018). Overview of HCUP. Retrieved from HCUP Overview
  • The Healthcare Cost and Utilization Project. (2018). NIS Overview. Retrieved from NIS Overview
  • The Healthcare Cost and Utilization Project. (2018). KID Overview. Retrieved from KID Overview
  • The Healthcare Cost and Utilization Project. (2018). NRD Overview. Retrieved from NRD Overview
  • The Healthcare Cost and Utilization Project. (2018). SASD Overview. Retrieved from SASD Overview
  • Texas Department of State Health Services. (2018). Texas Health Care Information Collection (THCIC). Retrieved from THCIC Overview

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