高血压英文ppt精品课件healthcare cost and utilization

Healthcare Cost and Utilization Project (HCUP) Background Family of health care databases and related software tools Developed through a Federal-State- Industry partnership Family of databases State Inpatient Databases (SID) State Ambulatory Surgery Databases (SASD) State Emergency Department Databases (SEDD) Nationwide Inpatient Sample (NIS) Nationwide Emergency Department Sample (NEDS) Kids Inpatient Sample (KID) HCUP databases Contain a core set of clinical and non- clinical information found in a typical discharge abstract lPatient demographics lDiagnosis codes lProcedure codes lDischarge status lCharges for ALL PAYERS lMedicare, Medicaid, private insurance, the uninsured HCUP databases, contd Information from discharge abstracts are translated into a uniform format l facilitate multi-State and national-State comparisons and analyses State Inpatient Databases (SID) Files are available beginning with data year 1990 Contains the universe of inpatient discharge abstracts (100%) 44 states participate in the SID, lencompassing 95% of all U.S. community hospital discharges Variations across the SIDs /db/state/siddist/siddistvarnote2009.jsp National Inpatient Sample (NIS) Files date back to 1988. The largest ALL PAYER inpatient care database in the U.S. l8 million hospital stays l1,000 hospitals l20% stratified sample of U.S. community hospitals Kids Inpatient Sample (KID) Data years: 1997, 2000, 2003, 2006 The number of participating states varies by year The only ALL PAYER inpatient care database for children in the U.S. (age 20 years) The 2006 KID contains a sample of l3 million hospital stays l3,500 U.S. community hospitals State Emergency Department Databases (SEDD) Files are available beginning with data year 1999. The SEDD contains data from hospital- affiliated emergency department (ED) abstracts for visits that do not result in hospitalization. Currently, 29 states participate in the SEDD National Emergency Department Sample (NEDS) Files are available beginning with data year 2006. Larges ALL PAYER ED database in the U.S. Constructed from both the SEDD and the SID to capture data both on ED visits that result in an admission, and ED visits that do not result in an admission. National Emergency Department Sample (NEDS), contd The NEDS contains more than 25 million unweighted records for ED visits 1,000 U.S. Community Hospitals 20% stratified sample of U.S. hospital- based EDs. State Ambulatory Surgery Databases (SASD) Files are available beginning with data year 1997. The SASD contain data from ambulatory care encounters in hospital- affiliated (and sometimes freestanding) ambulatory surgery sites . Currently, 29 states participate in the SEDD HCUP also includes: Research reports and statistics (HCUPnet, fact books, published reports) /data/hcup/ / REF: AHRQ Pub No. 10-P009-EF, Revised March 2011 Tools for use with administrative data l Clinical classification system (CCS) for each of ICD-9 and ICD-10 l Method to classify diagnosis or procedures from International Classification of Diseases ICD-9 or ICD-10 into clinically meaningful categories l /toolssoftware/ccs/ccs.jsp#download l Clinical Classifications Software (CCS) for Services and Procedures l Method for classifying Current Procedural Terminology Codes and Healthcare Common Procedure Coding System (HCPCS) codes into clinically meaningful procedure categories l Mental Health and Substance Abuse Clinical Classifications Software (CCS-MHSA) - now integrated into the CCS (no longer a stand-alone software l Defines variables that identify general categories for mental health and substance abuse ICD-9 diagnosis in hospital discharge records. Examples of single-level CCS diagnosis categories 98. Essential hypertension 99. Hypertension with complications and secondary hypertension 100. Acute myocardial infarction 101. Coronary atherosclerosis and other heart disease Examples of multi-level CCS diagnosis categories 7. Diseases of the circulatory system 7.1. Hypertension 7.1.1. Essential hypertension 98 7.1.2. Hypertension with complications and secondary hypertension 99 . Hypertensive heart and/or renal disease . Other hypertensive complications 7.2. Diseases of the heart Examples of single-level CCS procedure categories 43. Heart valve procedures 44. Coronary artery bypass graft (CABG) 45. Percutaneous transluminal coronary angioplasty (PTCA) 46. Coronary thrombolysis Examples of multi-level CCS procedure categories 7. Operations on the cardiovascular system 7.1. Heart valve procedures 43 7.2. Coronary artery bypass graft 44 7.2.1. Bypass of one coronary artery 7.2.2. Bypass of two coronary arteries 7.2.3. Bypass of three coronary arteries 7.2.4. Bypass of four coronary arteries Tools for use with administrative data Comorbidity software l Assigns variables that identify coexisting conditions on hospital discharge records using ICD-9 diagnosis codes. Quality indicators l Measures of health care quality that utilize readily available hospital inpatient administrative data l PREVENTION QUALITY INDICATORS identify hospital admissions that evidence suggests that could have been prevented through high- quality outpatient care l INPATIENT QUALITY INDICATORS quality of care inside hospitals (such as inpatient mortality for medical conditions and surgical procedures) l PATIENT SAFETY INDICATORS quality of care inside hospitals but with a focus on potentially avoidable complications and iatrogenic events. l PEDIATRIC QUALITY INDICATORS for children age 18 and for newborns receiving care in hospitals, identify potentially avoidable hospitalizations among children Tools for use with administrative data Procedure classes l Permit categorizing ICD-9 procedure codes into one of 4 categories: minor diagnostic, minor therapeutic, major diagnostic, and major therapeutic. Chronic condition indicator l Chronic or not chronic Utilization Flags l Use of procedure and services such as admission to ICU, CCU, NICU and specific diagnostic tests and therapies. l /tools_software.jsp Supplemental files Cost-to-charge ratio files Hospital market structure files Definition of Community hospitals* (AHA) /resource/newpage.asp#registered *Community hospitals are defined as all nonfederal, short-term general, and other special hospitals. Other special hospitals include obstetrics and gynecology; eye, ear, nose, and throat; rehab