Blog & News
New Brief: Using HCUP Data for State Health Policy AnalysisMay 12, 2017:
The SHARE grant program has released a new brief examining the use of administrative data for the purpose of state health policy analysis. In particular, the brief highlights the hospital administrative data available from the Healthcare Cost and Utilization Project (HCUP) and presents a case study of a SHARE-funded project that uses HCUP data to evaluate the impacts of California’s early ACA Medicaid expansion on inpatient hospital utilization.
What is the HCUP?
The HCUP is a collection of six different databases sponsored by the federal Agency for Healthcare Research and Quality (AHRQ) that can be purchased through the HCUP Central Distributor. These databases consist of longitudinal hospital data—with a primary focus on community hospitals--based on de-identified discharge records for individual patients. The six different HCUP databases are:
- • National Inpatient Sample (NIS)
- • Kids’ Inpatient Database (KID)
- • Nationwide Emergency Department Sample (NEDS)
- • Nationwide Readmissions Database (NRD)
- • State Inpatient Databases (SID)
- • State Emergency Department Databases (SEDD)
Using HCUP Data to Examine State-Level Utilization
For state-focused health policy research, the State Inpatient Databases (SID), which consist of hospital inpatient discharge data on approximately 90 percent of all U.S. hospital discharges, are especially useful for understanding patient utilization. The SID not only allow researchers to examine hospital-level differences within states but also foster multi-state comparisons and analyses because of their uniformity.
Case Study: Early Medicaid Expansion in California
Researchers at Virginia Commonwealth University (VCU), led by Dr. Peter Cunningham, used the SID to examine the utilization impact of California’s early Medicaid expansion. Specifically, the research team compared
- Utilization at hospitals in California from 2010 to 2013 with utilization at hospitals in neighboring states without an early Medicaid expansion, and
- Utilization over the same time period at safety net and non-safety net hospitals within California.
Preliminary Findings: Highlights
Preliminary findings from the VCU study include (among others):
- • Inpatient volumes increased at California hospitals relative to the comparison states following California’s Medicaid expansion, when controlling for national trends.
- • Medicaid admissions as a percent of total admissions increased after California’s Medicaid expansion, while uninsured admissions declined when compared to non-expansion states (again, controlling for national trends).
- • Overall inpatient volumes at safety net hospitals within California increased to a greater extent than at the state’s non-safety net hospitals following the early Medicaid expansion.
- • Both safety net and non-safety net hospitals within California observed similar patterns in payer mix after the Medicaid expansion, with an increase in Medicaid admissions as a percent of total admissions and a decrease in uninsured admissions as a percent of total admissions.
For more information on the HCUP, the SID, and preliminary findings from the VCU study, view the full issue brief: “Using HCUP Data for State Health Policy Analysis: A Case Study Examining the Impacts of an Early Medicaid Expansion.”