Estimating state-specific population-based hospitalization rates from in-state hospital discharge data.

Objective: To develop weights to estimate state population-based hospitalization rates for all residents of a state using only data from in-state hospitals which exclude residents treated in other states.

Data Sources And Study Setting: Agency for Healthcare Research and Quality, Healthcare Cost and Utilization Project (HCUP), State Inpatient Databases (SID), 2018-2019, 47 states+DC.

Study Design: We identified characteristics for patients hospitalized in each state differentiating movers (discharges for patients hospitalized outside state of residence) from stayers (discharges for patients hospitalized in state of residence) and created weights based on 2018 data informed by these characteristics.

Trends in treatment costs of U.S. emergency department visits.

Background: Spending on emergency department (ED) services in recent years has increased faster than spending in any other area of healthcare. Analyzing growth rates of ED treatment costs by patient and hospital attributes may illuminate ways to reduce overall hospital cost growth. Prior studies have examined changes in ED visit charges and expenditures over time, but little research has focused on changes in ED treatment costs.

Methods for estimating the cost of treat-and-release emergency department visits.

Objective: To evaluate and compare approaches to estimating the service delivery cost of emergency department (ED) visits from total charge data only.

Data Sources: The 2013-2017 Healthcare Cost and Utilization Project's (HCUP) State Emergency Department Databases (SEDD) and the Centers for Medicare and Medicaid Services Healthcare Cost Report Information System (HCRIS) public use files.

Study Design: Compare a baseline approach (requiring cost-center-level charge detail) and four alternative methods (relying on total charges only) for estimating ED visit costs.

Effects of Hurricanes on Emergency Department Utilization: An Analysis Across 7 US Storms.

Objective: Emergency departments (EDs) are critical sources of care after natural disasters such as hurricanes. Understanding the impact on ED utilization by subpopulation and proximity to the hurricane's path can inform emergency preparedness planning. This study examines changes in ED utilization for residents of 344 counties after the occurrence of 7 US hurricanes between 2005 and 2016.

Changes in hospital service demand, cost, and patient illness severity following health reform.

Objective: To estimate the effects of the health insurance exchange and Medicaid coverage expansions on hospital inpatient and emergency department (ED) utilization rates, cost, and patient illness severity, and also to test the association between changes in outcomes and the size of the uninsured population eligible for coverage in states.

Data Sources: Healthcare Cost and Utilization Project State Inpatient and Emergency Department Databases, 2011-2015, Nielsen Demographic Data, and the American Community Survey.

Study Design: Retrospective study using fixed-effects regression to estimate the effects in expansion and nonexpansion states by age/sex demographic groups.

Early Impact of the Affordable Care Act Coverage Expansion on Safety-Net Hospital Inpatient Payer Mix and Market Shares.

Objective: To examine the impact of the Affordable Care Act's coverage expansion on safety-net hospitals (SNHs).

Study Setting: Nine Medicaid expansion states.

Study Design: Differences-in-differences (DID) models compare payer-specific pre-post changes in inpatient stays of adults aged 19-64 years at SNHs and non-SNHs.

Changes in Hospital Inpatient Utilization Following Health Care Reform.

Objective: To estimate the effects of 2014 Medicaid expansions on inpatient outcomes.

Data Sources: Health Care Cost and Utilization Project State Inpatient Databases, 2011-2014; population and unemployment estimates.

Study Design: Retrospective study estimating effects of Medicaid expansions using difference-in-differences regression.

The Workforce wellness index: a method for valuing US workers' health.

Objective: To devise a methodology to create a single health risk-cost score that can be applied to health risk assessment survey data and account for the medical costs associated with modifiable risks.

Methods: We linked person-level health risk assessment data with medical benefit eligibility and claims data for 341,650 workers for the period 2005 to 2010 and performed multivariate analyses to estimate costs associated with high risks. We used the estimated costs and risk prevalence rates to create a composite Workforce Wellness Index (WWI) score.

Association of a clinical knowledge support system with improved patient safety, reduced complications and shorter length of stay among Medicare beneficiaries in acute care hospitals in the United States.

Background: Electronic clinical knowledge support systems have decreased barriers to answering clinical questions but there is little evidence as to whether they have an impact on health outcomes.

Methods: We compared hospitals with online access to UpToDate with other acute care hospitals included in the Thomson 100 Top Hospitals Database (Thomson database). Metrics used in the Thomson database differentiate hospitals on a variety of performance dimensions such as quality and efficiency.

Recent trends in hospital utilization for acute myocardial infarction and coronary revascularization in the United States.

Medical advances may be shifting patients with coronary artery disease away from the hospital setting despite an aging United States population. We explored this possibility using national inpatient data to estimate the number and population-based rates of hospitalization for acute myocardial infarction (AMI) and coronary revascularization from 2002 to 2005. Our primary data source was the Acute Care Tracker database, a proprietary administrative database that contains data on approximately 6 million discharges per year from 458 hospitals across the United States.