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Survey of Resources for Health Care Analysts. Veronika Badurova Kennell & Associates, Inc. Context . The purpose of this session is to provide a toolkit of available resources, such as reference information, data, or grouping software, that can be helpful to healthcare analysts.
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Survey of Resources for Health Care Analysts Veronika Badurova Kennell & Associates, Inc.
Context • The purpose of this session is to provide a toolkit of available resources, such as reference information, data, or grouping software, that can be helpful to healthcare analysts. FOR OFFICIAL USE ONLY
Objectives • After completing this session, the attendee will be able to: • List key resources that are readily available and helpful to healthcare analysts • Describe the Navy Analytics Newsletter • Locate the Agency for Healthcare Research and Quality Website • Describe the AHRQ Clinical Classification Software and identify at least one functional use of the CCS • Describe the HCUP database • Locate the Centers for Disease Control (CDC) Website and identify databases that may be helpful • Locate the RESDAC website and identify helpful resources • Locate the CMS website and identify helpful resources • Locate the BEA OCFO website and identify ICDs and Functional Specifications for M2 and MDR • Locate the DMISID table and MEPRS Info Portal websites FOR OFFICIAL USE ONLY
Navy Analytics Newsletter • Published in M2 • Public Folders → M2 → Navy → Analytics Newsletter • Outline: • Broad Issue Article • Skills & Methods • Data & Information Systems • New Knowledge • Tips and Tricks • Knowledge Sources FOR OFFICIAL USE ONLY
Navy Analytics Newsletter • Wide audience – sections pertain to every analyst level • Variety of Topics • Financial Management • Populations • Data Quality • Mental Health • Medical Home Port • Obstetric Services FOR OFFICIAL USE ONLY
Who is the Agency for Healthcare Research and Quality (AHRQ)? • AHRQ is an agency within DHHS. • AHRQ’s mission is “to improve the quality, safety, efficiency, and effectiveness of health care for all Americans.” • AHRQ has funded the creation of tools and resources that will help meet the needs of health care researchers/analysts and decision-makers. FOR OFFICIAL USE ONLY
AHRQ • AHRQ – Agency for Healthcare Research and Quality • Healthcare Cost and Utilization Project (HCUP, pronounced “H-Cup”) - is a family of health care databases and related software tools and products developed through a Federal-State-Industry partnership, which brings together data collection efforts to create a national information resource patient-level health care data. http://www.hcup-us.ahrq.gov/overview.jsp • Databases- Largest collection of longitudinal hospital care data in the U.S. • AHRQ Quality Indicators (QIs) – measures of health care quality, which consist of 3 modules, that make use of readily available hospital inpatient administrative data. • Clinical Classification Software (CCS) – developed with HCUP data, CCS is a grouping software that provides a method for classifying ICD-9-CM diagnoses or procedures into clinically meaningful categories. Great for aggregate statistical reporting. http://www.hcup-us.ahrq.gov/toolssoftware/ccs/ccs.jsp • Note: now also includes categories from the Clinical Classifications Software for Mental Health and Substance Abuse (CCS –MHSA) FOR OFFICIAL USE ONLY
AHRQ • Databases • Largest collection of longitudinal hospital care data in the U.S. • Can be utilized for research on a broad range of health policy issues: cost and quality of health services, medical practice patterns, access to health care programs, and outcomes of treatments at the national, state, and local market levels. http://www.hcup-us.ahrq.gov/databases.jsp • Databases Include: • The National Inpatient Sample (starting in 1988) • The Kid’s Inpatient Database (starting in 1997) • The Nationwide Emergency Department Sample (starting in 2006) • The State Inpatient Databases (starting in 1995) • The State Ambulatory Surgery Databases (starting in 1997) • The State Emergency Department Databases (starting in 1999) FOR OFFICIAL USE ONLY
HCUP Research Publications HCUP Databases Software Tools Research Publications User Support FOR OFFICIAL USE ONLY
HCUP Research Products • Products include: • Research studies • Statistical Briefs • Fact Books HCUP Provides Many Research Products
Statistical Brief Topics • More than 100 briefs posted – a new brief posted every two weeks: • Pregnancy/Childbirth • Traumatic Brain Injury • Readmissions and Re-visits • Ambulatory Surgeries • Potentially Preventable Hospitalizations • Injuries • Pediatric Hospitalizations • Emergency Room Utilization • Most Expensive Hospital Conditions
Clinical Classification Software • How does CCS work? • CCS consists of two related classification systems – single & multi-level. • Single-level (of 231 mutually exclusive categories) is most useful for ranking diagnosis/procedures and for direct integration into risk adjustment and other software while multi-level CCS is most useful when evaluating larger aggregations of conditions/procedures or exploring them in greater detail. FOR OFFICIAL USE ONLY
Clinical Classification Software • Example 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 • Example 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 & secondary hypertension[99] 7.1.2.1. Hypertensive heart and/or renal disease 7.1.2.2. Other hypertensive complications 7.2. Diseases of the heart • CCS documentation: http://www.hcup-us.ahrq.gov/toolssoftware/ccs/ccs.jsp#download FOR OFFICIAL USE ONLY
Example of single-level CCS diagnosis codes FOR OFFICIAL USE ONLY
Example of multi-level CCS diagnosis codes FOR OFFICIAL USE ONLY
Clinical Classification Software • How/For what can CCS be used? • CCS can be used as “crutch” for analysts who don’t know as much about coding as they would like. • Serves as a way to crosswalk ICD-9 and CPT Procedure codes especially useful for those procedures which can be done inpatient and outpatient. • Managed care plans can use CCS to rank hospitalizations by type of condition (i.e.) specifically examine numbers of cases, length of stay, and total costs to better understand which conditions/procedures were associated with the highest resource use. • Researchers can use CCS to explore conditions/procedures that are most frequent in their study populations or to compare alternative treatments for similar conditions or to develop risk adjustment models/as a way to predict future health resource utilization. FOR OFFICIAL USE ONLY
HCUP User Support Resources • Download tools and products: • www.hcup-us@ahrq.gov • Active technical assistance: • E-mail: hcup@ahrq.gov • Phone: (866) 290-HCUP
CMS Website • Regulation and Guidance • Research, Statistics, Data and Systems • CMS Information Technology • Computer Data & Systems • Provider Type • Statistics, Trends & Reports • Medicare Program Rates & Statistics • Medicare & Medicaid Trends in Health Care Sectors • Research • Monitoring Programs • Payment Error Rate Measurement (PERM) • http://www.cms.gov/Research-Statistics-Data-and-Systems/Research-Statistics-Data-and-Systems.html FOR OFFICIAL USE ONLY
RESDAC • The Research Data Assistance Center (ResDAC) is a CMS contractor that provides free assistance to academic, government and non-profit researchers interested in using Medicare and/or Medicaid data for their research. • ResDAC is staffed by a consortium of epidemiologists, public health specialists, health services researchers, biostatisticians, and health informatics specialists from the University of Minnesota. • http://www.resdac.org/ FOR OFFICIAL USE ONLY
Center for Disease Control (CDC) • Data & Statistics by Topic • http://www.cdc.gov/DataStatistics/ • Health Care Data Interactive • Healthy People 2010 Data • http://www.cdc.gov/nchs/healthy_people/hp2010/DATA2010.htm • Available Surveys and Data Collection Systems • National Health and Nutrition Examination Survey (NHANES) • National Health Interview Survey (NHIS) • National Immunization Survey (NIS) FOR OFFICIAL USE ONLY
MDR & M2 Functional Specifications • MDR & M2 Functional Specifications – OCFO BEA • Useful for: all MDR & M2 users • Contains: • Functional specification of the MHS Data Repository and MHS Mart (M2), • Data dictionaries for each file/database (MRD & M2) • Interface Control Documents (MDR & M2) • MDR Users Guide • Includes sample code, background information on available databases, and UNIX commands. FOR OFFICIAL USE ONLY
DMIS ID Table • DMISID table (www.dmisid.com) • Definition: The Defense Medical Information System Identifier • Useful for: all MDR & M2 users • Contains: A complete and up-to-date list DMIS IDs, which are the controlling standard for both medical and military facility identification and cost/workload classification. • Addition elements: zip codes, catchment areas, prisms, MSMAs, parent and child DMIS IDs, military service, etc. • Downloadable as a dataset • Note: MDR User Guide includes a section on format files (and code) as there are annual DMIS ID reference tables in the MDR. FOR OFFICIAL USE ONLY
MEPRS Info Portal • MEPRS Info Portal (www.meprs.info ) • Definition: Medical Expense & Performance Reporting System • Useful for : all MDR & M2 users (esp. finance, budget) • Contains: Feeds from EAS IV. MEPRS is the standard cost accounting system for the MHS containing Tri-Service financial, personnel, and workload data from reporting MTFs/DTFs worldwide. • Consolidated Cost Report (CCR) • EAS IV Functional Data Dictionary • Six Sigma MEPRS Management Metrics • MEPRS Newsletter and Questions FOR OFFICIAL USE ONLY
LOINC Codes • LOINC (Logical Observation Identifiers Names and Codes) • Definition: A universal code system for identifying laboratory and clinical observations. Much more detailed than normal CPT codes. • Useful for: all MDR users (esp. clinicians) • Structure: • Website: http://loinc.org/ FOR OFFICIAL USE ONLY
ISO 3166 Code Lists • The government is switching to two character ISO 3166 state and country codes. • http://www.iso.org/iso/country_codes/iso_3166_code_lists.htm FOR OFFICIAL USE ONLY