Healthcare Cost and Utilization Project

The Healthcare Cost and Utilization Project (HCUP, pronounced "H-Cup") is a family of health care databases and related software tools and products from the United States that is developed through a Federal-State-Industry partnership and sponsored by the Agency for Healthcare Research and Quality (AHRQ).^[1]

General Information

HCUP provides access to health care databases for research and policy analysis, as well as tools and products to enhance the capabilities of the data.^[2]

HCUP databases combine the data collection efforts of State data organizations, hospital associations, private data organizations, and the Federal government to create a national information resource of patient-level health care data. State organizations that provide data to HCUP are called Partners.

HCUP includes the largest collection of multi-year hospital care (inpatient, outpatient, and emergency department) data in the United States, with all-payer, encounter-level information beginning in 1988. These databases enable research on a broad range of health research and policy issues at the national, state, and local market levels, including cost and quality of health services, medical practice patterns, access to health care, and outcomes of treatments. Additionally, AHRQ has developed a comprehensive set of software tools to be used when evaluating hospital data. AHRQ's free software tools can be used not only with the HCUP databases, but also with other administrative databases. HCUP's Supplemental Files are only for use with HCUP databases.

HCUP User Support Web site (HCUP-US)

The HCUP User Support Web site is the main repository of information for HCUP. It is designed to answer HCUP-related questions; provide detailed information on HCUP databases, tools, and products; and offer technical assistance to HCUP users. HCUP’s tools, publications, documentation, news, services, HCUP Fast Stats, and HCUPnet (the free online data query system) may all be accessed through HCUP-US. The Web site also provides information on how to obtain HCUP databases through the HCUP Central Distributor. HCUP-US is located at https://www.hcup-us.ahrq.gov.

HCUP Overview Course

To help researchers and policymakers discover and use HCUP’s data, tools, and products to their fullest potential, HCUP developed a free, interactive online course that provides an overview of the features, capabilities, and potential uses of HCUP. The course is modular, so users can either move through the entire course or access exactly the resources in which they are most interested. The On-line HCUP Overview Course can work both as an introduction to HCUP data and tools and a refresher for established users.

HCUP Online Tutorial Series

The HCUP Online Tutorial Series is a set of free, interactive training courses that provide HCUP data users with information about HCUP data and tools, and training on technical methods for conducting research with HCUP data. The online courses are modular, so users can move through an entire course or access the sections in which they are most interested. Available tutorials feature topics such as loading and checking HCUP data, HCUP’s sampling design, calculating standard errors, producing national estimates, conducting multi-year analysis, and how to use the nationwide readmissions database.

HCUP Databases

Overview of HCUP Databases

HCUP databases bring together the data collection efforts of State data organizations, hospital associations, private data organizations, and the Federal government to create an information resource of patient-level health care data.

HCUP’s databases date back to 1988 data files. The databases contain encounter-level information for all payers compiled in a uniform format with privacy protections in place. Researchers and policymakers can use its records to identify, track, and analyze national trends in health care use, access, charges, quality, and outcomes. The databases are suited for a broad range of analyses—including rare conditions and special patient populations.

HCUP databases are released approximately 6–18 months after the end of a given calendar year, with State databases available earlier than the national dataset. For example, 2016 State data was available beginning in 2017, and nationwide data was available beginning in July 2018.

Currently there are seven types of HCUP databases: four with national- and regional-level data and three with State- and local-level data.

National Databases—for national and regional analyses

National Inpatient Sample (NIS) (formerly the Nationwide Inpatient Sample): Annual inpatient data from a stratified systematic sample of discharges from all hospitals in HCUP, equal to approximately 20 percent of all discharges in U.S. community hospitals, excluding rehabilitation and long-term acute-care hospitals. Data are available from 1988 forward, and a new database is released annually, approximately 18 months after the end of a calendar year. The NIS Overview and the NIS Database Documentation pages of the HCUP-US Web site contain additional information. Data are available from 1988 forward, and a new database is released annually, approximately 18 months after the end of a calendar year.
Kids' Inpatient Database (KID): A nationwide sample of pediatric inpatient discharges designed specifically for users to study a broad range of conditions and procedures related to child health issues. The KID was released every three years, from 1997 to 2012 and resumed release again in 2016.
Nationwide Emergency Department Sample (NEDS): A database of approximately 31 million records that yields national estimates of 143 million emergency department (ED) visits. The NEDS captures encounters where the patient is admitted for inpatient treatment, as well as those in which the patient is treated and released. The NEDS is released annually and is available from 2006 forward.
Nationwide Readmissions Database (NRD): The NRD is a unique and powerful database designed to support various types of analyses of national readmission rates for all payers and the uninsured. This database addresses a large gap in health care data - the lack of nationally representative information on hospital readmissions for all ages. The NRD is released every year from 2010 forward.

State Databases—for State and local analyses

The State Inpatient Databases (SID): Databases from the universe of inpatient discharge abstracts from participating States, released annually. Data are available from 1995 forward. The SID are released on a rolling basis, as early as six months following the end of a calendar year.
The State Ambulatory Surgery and Services Databases (SASD): Ambulatory surgery encounter abstracts from hospital-affiliated and sometimes freestanding ambulatory surgery sites in participating States. Data are available from 1997 forward. The SASD are released on a rolling basis, as early as six months following the end of a calendar year.
The State Emergency Department Databases (SEDD): Hospital-affiliated emergency department data for visits in participating States that do not result in hospitalizations. Data are available from 1999 forward. The SID are released on a rolling basis, as early as six months following the end of a calendar year.

Obtaining HCUP databases through the Central Distributor

A number of HCUP State Partners make their data available for purchase through the HCUP Central Distributor. Applications for the databases are available on its Web site. Starting March 1, 2016, the Nationwide Databases are delivered via secure digital download. Please note, prospective purchasers and all persons with access to the databases are required to take the Data Use Agreement Training Course and sign the Data Use Agreement before using the data.

The price of the data varies by the database and year. Recent years of the NIS are $625 per data-year, with a special rate for students of $125. The KID is $500 per data-year, with a special rate for students of $100. The NEDS is $750 per data-year, and $150 for students. The NRD is $1,000 per data-year, and $200 for students. The cost of the State databases is set by the individual State Partner supplying the data to HCUP. Pricing varies by State and database, and certain Partners may have different prices for the type of organization requesting the data (non-profit, government, academic, etcetera). Purchasing and pricing information can be found in the Database Catalog and on the HCUP User Support Web site.

HCUP Tools and Software

To enhance the capabilities of the HCUP databases, HCUP provides a number of tools and software programs that can be applied to HCUP and other similar administrative databases.

HCUP Fast Stats will continue to be updated regularly (quarterly or annually, as newer data become available) for timely, topic-specific national and State-level statistics.

References

[1] What is HCUP?

[2] Fact Sheet: Databases and Related Tools from the Healthcare Cost and Utilization Project (HCUP)

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