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Health Care Management Resources: Healthcare Cost and Utilization Project

Data and information on issues relevant to the national health care debate, including health care cost, coverage, expenditure, success, delivery, utilization, disparities in quality, and outcomes.

Kids’ Inpatient Database (KID)

Kids’ Inpatient Database (KID)

The Kids' Inpatient Database (KID) is a unique and powerful database of hospital inpatient stays for children. The KID was specifically designed to permit researchers to study a broad range of conditions and procedures related to child health issues. Researchers and policymakers can use the KID to identify, track, and analyze national trends in health care utilization, access, charges, quality, and outcomes.

  • The KID is the only all-payer inpatient care database for children in the United States.
  • The KID contains data from two to three million hospital discharges for children.
  • The 2006 KID contains data drawn from 38 State Inpatient Databases on children 20 years of age and younger.
  • The 2003 KID contains data drawn from 36 State Inpatient Databases on children 20 years of age and younger.
  • The 2000 KID contains data drawn from 27 State Inpatient Databases on children 20 years of age and younger.
  • The 1997 KID contains data drawn from 22 State Inpatient Databases on children 18 years of age and younger.
  • The KID includes a sample of pediatric discharges from over 2,500 to 4,000 U.S. community hospitals (defined as short-term, non-Federal, general and specialty hospitals, excluding hospital units of other institutions).
  • The KID's large sample size enables analyses of both common and rare conditions such as congenital anomalies, uncommon treatments, and organ transplantation.
  • The KID includes charge information on all patients, regardless of payer, including children covered by Medicaid, private insurance, and the uninsured.

The KID contains clinical and resource use information included in a typical discharge abstract, with safeguards to protect the privacy of individual patients, physicians, and hospitals (as required by data sources). The KID can be weighted to produce national estimates.

The KID excludes data elements that could directly or indirectly identify individuals. Purchase of the files is open to all users who sign a Data Use Agreement

(PDF, 54 KB; HTML). Users must agree to use the database for research and statistical purposes only and to make no attempts to identify individuals.

Identities of institutions are available only in States where data sources already make that information public or agree to its release. For these institutions and for research purposes only, linkage is possible to data to the American Hospital Association (AHA) Annual Survey Database (Health Forum, LLC © 2007).

Agency for Healthcare Research and Quality (AHRQ)

Nationwide Inpatient Sample (NIS)

Nationwide Inpatient Sample (NIS)


The Nationwide Inpatient Sample (NIS) is a unique and powerful database of hospital inpatient stays. Researchers and policymakers use the NIS to identify, track, and analyze national trends in health care utilization, access, charges, quality, and outcomes. Key features of this database include the following:
  • The NIS is the largest all-payer inpatient care database in the United States. It contains data from approximately 8 million hospital stays each year.
  • The 2007 NIS contains all discharge data from 1,044 hospitals located in 40 States, approximating a 20-percent stratified sample of U.S. community hospitals.
  • The sampling frame for the 2007 NIS is a sample of hospitals that comprises approximately 90 percent of all hospital discharges in the United States.
  • NIS data are available from 1988 to 2007, allowing analysis of trends over time. The number of States in the NIS has grown from 8 in the first year to 40 at present.
  • The NIS is the only national hospital database containing charge information on all patients, regardless of payer, including persons covered by Medicare, Medicaid, private insurance, and the uninsured.
  • The NIS's large sample size enables analyses of rare conditions, such as congenital anomalies; uncommon treatments, such as organ transplantation; and special patient populations, such as the uninsured.
  • For most States, the NIS includes hospital identifiers that permit linkages to the American Hospital Association (AHA) Annual Survey Database (Health Forum, LLC © 2007) and county identifiers that permit linkages to the Area Resource File.
The NIS contains clinical and resource use information included in a typical discharge abstract, with safeguards to protect the privacy of individual patients, physicians, and hospitals (as required by data sources). The NIS can be weighted to produce national estimates. Beginning with the 2002 NIS, severity adjustment data elements including APR-DRGs, APS-DRGs, Disease Staging, and AHRQ Comorbidity Indicators, are available. Beginning with the 2005 NIS, Diagnosis and Procedure Groups Files containing data elements from AHRQ software tools designed to facilitate the use of the ICD-9-CM diagnostic and procedure information are available. A new feature, beginning with the 2007 NIS, is the addition of data elements describing hospital structural characteristics and provision of outpatient services to the Hospital Weights file.

The NIS excludes data elements that could directly or indirectly identify individuals. Purchase of the files is open to all users who sign a Data Use Agreement (PDF file, 55 KB; HTML). Users must agree to use the database for research and statistical purposes only and to make no attempts to identify individuals.

Identities of institutions are available only in States where data sources already make that information public or agree to its release. For these institutions and for research purposes only, linkage is possible to data from the Annual Survey of the American Hospital Association's Annual Survey Database.

Select for the Introduction to the NIS, 2007 (PDF file, 642 KB<; HTML).

Nationwide Emergency Department Sample (NEDS)

Nationwide Emergency Department Sample (NEDS)

The Nationwide Emergency Department Sample (NEDS) is a unique and powerful database that yields national estimates of emergency department (ED) visits. The NEDS was created to enable analyses of emergency department (ED) utilization patterns and support public health professionals, administrators, policymakers, and clinicians in their decision-making regarding this critical source of care. The ED serves a dual role in the U.S. healthcare system infrastructure as a point of entry for approximately 50% of inpatient hospital admissions and as a setting for treat-and-release outpatient visits.1

  • The NEDS is the largest all-payer ED database in the United States.
  • The NEDS was constructed using records from both the HCUP State Emergency Department Databases (SEDD) and the State Inpatient Databases (SID). The SEDD capture information on ED visits that do not result in an admission (i.e., treat-and-release visits and transfers to another hospital). The SID contain information on patients initially seen in the emergency room and then admitted to the same hospital.
  • The NEDS contains almost 26 million (unweighted) records for ED visits for over 950 hospitals and approximates a 20-percent stratified sample of U.S. hospital-based EDs.
  • The NEDS has many research applications, as it contains information about geographic characteristics, hospital characteristics, patient characteristics, and the nature of visits (e.g., common reasons for ED visits, including injuries).
  • The NEDS includes ED charge information for over 75% of patients, regardless of payer, including patients covered by Medicaid, private insurance, and the uninsured.

The NEDS contains clinical and resource use information included in a typical discharge abstract, with safeguards to protect the privacy of individual patients, physicians, and hospitals (as required by data sources). The NEDS can be weighted to produce national estimates.

The NEDS excludes data elements that could directly or indirectly identify individuals, hospitals, or states. Purchase of the NEDS beginning in 2006 is open to all users who sign a Data Use Agreement (PDF, 54 KB; HTML). Users must agree to use the database for research and statistical purposes only and to make no attempts to identify individuals.

1Owens, P. and Elixhauser, A. Hospital Admissions That Began in the Emergency Department, 2003. Statistical Brief #1. February 2006. Agency for Healthcare Research and Quality, Rockville, Md. http://www.hcup-us.ahrq.gov/reports/statbriefs/sb1.pdf

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