sábado, 18 de julio de 2020

HCUP Quarterly eNews, Summer 2020, Issue 63

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News and Announcements


HCUP Fast Stats Data Updates and Enhancements!

AHRQ has released new information in HCUP Fast Stats, the HCUP tool that provides users with easy access to the latest HCUP-based statistics for healthcare information topics:

The Opioid-Related Hospital Use topic has been updated to include new inpatient and emergency department (ED) data. Since the last update in April 2019, this topic now includes additional 2017 inpatient data (11 States), 2017 ED data (12 States), 2018 inpatient data (36 States), 2018 ED data (27 States), 2019 inpatient data (15 States), and 2019 ED data (4 States).
The National Hospital Utilization and Costs topic has undergone several updates:
A new section, Trends in Emergency Department Visitshas been added and presents national trends in ED visits across a variety of patient characteristics—age, sex, expected payer, community-level income, and location. Statistics are based on the Nationwide Emergency Department Sample (NEDS) and are presented for data years 2008–2017.
Two sections of the topic, Trends in Inpatient Stays and Most Common Diagnoses for Inpatient Stays, have been updated to include national statistics and top diagnoses for 2017. The Trends in Inpatient Stays section presents national trends in inpatient utilization across a variety of patient characteristics. The Most Common Diagnoses for Inpatient Stays section presents the most common conditions listed as the principal diagnosis for hospital inpatient stays by year and across a variety of patient characteristics.  
The Hurricane Impact on Hospital Use topic has been updated to delineate three new medical conditions—circulatory conditions, infections, and respiratory conditions. This topic presents the percent change in population-based inpatient and ED utilization rates post- versus pre-hurricane for 11 U.S. hurricanes between 2005 and 2017. In addition to the three new medical conditions, hospital utilization statistics are provided for all conditions and for injuries by age group and county proximity to the hurricane.

For additional information, please refer to the Fast Stats Frequently Asked Questions page or contact HCUP User Support.

Coming Soon: HCUP Outstanding Article of the Year Award Winners

The recipients of the 11th annual HCUP Outstanding Article of the Year (AOTY) Award will be announced during a special session featuring HCUP during the virtual AcademyHealth Annual Research Meeting (ARM). Each year, AHRQ recognizes researchers who used HCUP databases to explore and address healthcare research topics and issues and published their findings in peer-reviewed journals. Honored work demonstrates how HCUP data have contributed to these investigations. Details about the time and title of the presentation can be found in the HCUP Events section of this newsletter.
Users can find a list of prior recipients on the HCUP Outstanding AOTY Award Archive page and can learn about the selection process by visiting the HCUP Outstanding AOTY Award home page on the HCUP-US website.

New HCUP Nationwide Readmissions Database (NRD) Report Now Available

AHRQ recently released a topical report on the HCUP Nationwide Readmissions Database (NRD) titled Impact of the ICD-10-CM/PCS Transition on Readmission Rates, 2015-2017. The report describes the methodology and findings of an analysis that examined the impact of the transition from the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) to the Tenth Revision, Clinical Modification/Procedure Coding System (ICD-10-CM/PCS) on condition-specific readmission statistics. Conditions are based on two categorizations—diagnosis-related groups (DRGs) and major diagnostic categories (MDCs).
The NRD report can be found on the NRD Related Reports and Data Innovations - ICD-10-CM/PCS Resources pages of the HCUP-US website.

AHRQ Releases New Interactive Data Visualizations Based on HCUP Statistical Briefs

Two interactive data visualizations based on HCUP Statistical Briefs were recently released on the AHRQ website. These tools allow users to generate desired statistics used in HCUP Statistical Briefs.
The data visualization for Statistical Brief #255Inpatient Stays and Emergency Department Visits Involving Traumatic Brain Injury, 2017 is available for users interested in traumatic brain injury (TBI)—the sudden damage to the brain cause by a bump, blow, jolt, or penetrating injury to the head. Hospitalization rates, ED visits, and causes for TBIs can be easily produced by selecting various age group buttons (< 5, 5–17, 18–34, 35–64, and 65+ years). Major findings of the report and visualization conclude that compared with inpatient stays without a TBI diagnosis, those stays principally for TBIs were longer, were costlier, and had an in-hospital mortality rate that was four times higher.
The data visualization for Statistical Brief #259Characteristics and Costs of Potentially Preventable Inpatient Stays, 2017 was also recently added to the AHRQ website. Potentially preventable hospitalizations are inpatients stays for treating ambulatory care-sensitive conditions, such as complications of diabetes and asthma, that evidence suggests may be avoidable, in part, through timely and quality primary and preventive care. This data visualization allows users to choose one of seven options to categorize the data by age, community-level income, hospital region, location of patient residence, race/ethnicity, sex, or overall. One illustration of the data shows the drastic effects of community-level income on rates of preventable inpatient stays in adult populations. Another shows the magnitude of asthma-related complications as the cause of inpatient stays for pediatric patients.
Users can access the Traumatic Brain Injury Impacts and Causes and Characteristics and Costs of Potentially Preventable Inpatient Stays, 2017 data visualizations on the Data Visualizations home page of the AHRQ website.

Access HCUP Sessions During AcademyHealth’s Virtual Annual Research Meeting

HCUP will be taking part in AcademyHealth’s ARM, which will be held through an online platform this year in response to COVID-19. The virtual ARM will be taking place July 28–August 6, 2020. HCUP activities will include poster presentations and a special session that will provide attendees with an overview of the HCUP databases, products, and tools as well as an announcement of the HCUP Outstanding AOTY Award recipients.
A complete list of upcoming HCUP-related activities is available in the HCUP Events section of this newsletter. Additional information is available on the HCUP Calendar of Events home page of the HCUP-US website.

Learn About HCUP at the September 16 and 23 User Webinars

Save the date for HCUP’s 2020 Fall Webinar Series. There will be two online sessions that will introduce and explain HCUP to users interested in learning more about the HCUP databases, products, and tools to enhance their health services and policy research.
On September 16, a webinar titled Overview of the HCUP Databases will provide an introduction to the HCUP family of databases. On September 23, a second webinar, Overview of HCUP Products and Tools, will cover the use of HCUP software tools and supplemental files to facilitate and augment research. The webinars will be open to the public at no charge. Each will require separate advance registration. Registration information and webinar descriptions will be available in early September on the HCUP Workshops and Webinars page.

Data and Products

Recently Released: 2018 State Databases and Additional 2014–2017 Databases

Since April 2020, the following State databases have been released:
2018: Alaska, Colorado, Delaware, Florida, Kansas, Maryland, Nebraska, New Jersey, New Mexico, North Carolina, Rhode Island, Vermont, and Washington
2017: Vermont
2018: Florida, Kansas, Maryland, Nebraska, New Jersey, North Carolina, and Vermont
2017: Vermont
2016: Hawaii
2015: Hawaii
2014: Hawaii
2018: Florida, Kansas, Maryland, Nebraska, New Jersey, North Carolina, Rhode Island, and Vermont
2017: Colorado, Vermont
Complete listings of available databases by year can be found in the Database Catalog on the HCUP-US website. Databases can be purchased online through the HCUP Central Distributor, and aggregated national and selected State statistics can be accessed via HCUPnet.
***Please note, some HCUP Central Distributor operations have been affected by the current national emergency related to COVID-19. Please refer to the notice posted on the online HCUP Central Distributor for current status information.

Publications Spotlights

New HCUP Statistical Briefs Posted on HCUP-US

Since April 2020, the following HCUP Statistical Briefs have been released:
#261: National Inpatient Hospital Costs: The Most Expensive Conditions by Payer, 2017
#260Social Determinants of Health and County Population Rates of Opioid-Related Inpatient Stays and Emergency Department Visits, 2016
#259Characteristics and Costs of Potentially Preventable Inpatient Stays, 2017
#258Hospital Burden of Opioid-Related Inpatient Stays: Metropolitan and Rural Hospitals, 2016
#257Costs of Emergency Department Visits for Mental and Substance Use Disorders in the United States, 2017
To access these and other Statistical Briefs, please visit the HCUP Statistical Briefs page on the HCUP-US website.

HCUP Q&A

Question: am starting a new research project specifically aimed at studying patients in the ED setting across the country. I came across the Nationwide Emergency Department Sample (NEDS) and think it may be helpful for my research. Before I purchase the database, I have some questions on what is included.
Is the NEDS limited to patients admitted to and discharged from the ED?
How do I differentiate between the SEDD and SID records in the NEDS?
Is it appropriate to link the NEDS with the National (Nationwide) Inpatient Sample (NIS)?
What is the order of diagnosis or procedure codes on a given record? Are they in chronological order? For instance, can I say that the second diagnosis or procedure code listed likely occurred prior to the seventh diagnosis or procedure code listed during the patient's visit?
Are admission date and admission hour available?
 Answers:
Is the NEDS limited to patients admitted to and discharged from the ED?
No. The NEDS is constructed using records from (1) the HCUP SEDD (www.hcup-us.ahrq.gov/seddoverview.jsp), 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 HCUP SID (www.hcup-us.ahrq.gov/sidoverview.jsp), which contain information on patients initially seen in the ED and then admitted to the same hospital. The NEDS approximates a 20 percent stratified sample of U.S. hospital-owned EDs.
How do I differentiate between the SEDD and SID records in the NEDS?
The NEDS contains the data element HCUPFILE, which identifies the source of the ED record and indicates whether it was from the SEDD or the SID.
Further, the NEDS provides a Core file, which includes common data elements that appear on both the inpatient and ED records (e.g., age, admission month, diagnosis codes, sex, length of stay). It also contains a supplemental inpatient file, which includes data elements for inpatient records only (e.g., disposition of the patient from the inpatient stay, ICD-10-PCS procedure codes, diagnosis-related groups), and a supplemental ED file, which includes data elements for treat-and-release records only (e.g., disposition of the patient from the ED, Healthcare Common Procedure Coding System/Current Procedural Terminology® procedure codes).
Is it appropriate to link the NEDS with the National (Nationwide) Inpatient Sample (NIS)?
The NIS and the NEDS should not be linked together. Because the NEDS already contains inpatient records where patients were initially seen in the ED, linking to the NIS would cause duplication of records. The NEDS unique record identifier, KEY_ED, does not link to other HCUP databases. However, you could use the NIS to make comparisons to the NEDS if desired.
What is the order of diagnosis or procedure codes on a given record? Are they in chronological order? For instance, can I say that the second diagnosis or procedure code listed likely occurred prior to the seventh diagnosis or procedure code listed during the patient's visit?
The original value of the first-listed diagnosis or procedure code, whether blank or coded, is retained in the first position of the diagnosis or procedure vector.
The order of the secondary diagnosis or procedure codes is determined by general coding practices or by each facility or hospital. HCUP does not have any specific information about these practices. In general, diagnosis or procedure codes are assigned by professional coders using information abstracted from the medical record after the patient is discharged. Previous reviews of documentation by professional medical record coders have resulted in no indication of a sequencing rule that secondary diagnoses or procedures must be coded in order (by date/time) or by severity.
Are admission date and admission hour available on the NEDS?
Admission date and admission time (hour) are not available on the NEDS. The HCUP databases were designed to be consistent with the definition of “limited data sets” under the Health Insurance Portability and Accountability Act. For this reason, AHRQ's policy is to exclude full dates (e.g., date of admission and discharge, date of birth, date of procedure) from the databases. HCUP provides partial dates (month, year) in place of full dates.
Variables available include both admission month (AMONTH) and admission day is on a weekend (AWEEKEND). The full list of variables available on the NEDS can be found on the NEDS Description of Data Elements page on the HCUP-US website.

HCUP Events

For a complete list of HCUP presentations and events, visit the HCUP Events Calendar.
HCUP Session
On August 5, at 3:30 p.m., AHRQ staff will present a special virtual session titled AHRQ-AcademyHealth HCUP Outstanding Article of the Year Award and AHRQ Databases for Research.
Poster Presentations
For the duration of the conference, the following HCUP posters will be available for virtual access to attendees:
Rates and Reasons for Revisits After Deliveries With and Without Severe Maternal Morbidity
Utilization of Robotic Technology for Ambulatory Surgery
September 16, 2020: Overview of the HCUP Databases Webinar
September 23, 2020: Overview of HCUP Products and Tools Webinar

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