Health Care Costs and Utilization

Assessment of the Impact of Two Distinct Survey Design Modifications on Health Care Utilization Estimates in the Medical Expenditure Panel Survey. S. Cohen, T. Ezzati-Rice, M. Zodet, et al., Journal of Economics and Social Measurement, 2011; 36(1):33-69. Examines the impact on national health care utilization estimates of two dominant survey design modifications made in 2007 to AHRQ’s Medical Expenditure Panel Survey. (AHRQ 12-R004)

Changes in Pharmaceutical Treatment of Diabetes and Family Financial Burdens. E. Sarpong, D. Bernard, G. Miller, Medical Care Research and Review, August 2012; 69(4):474-91. Epub April 2012. Examines changes in the prevalence of diabetes and comorbidities, diabetes treatment, financial burdens, and the relationship between financial burdens and patient characteristics among nonelderly adults with diabetes. (AHRQ 12-R079)

Comparing Different Measures of Retention in Outpatient HIV Care. B. Yehia, J. Fleishman, J. Metlay, AIDS, June 2012; 26(9):1131-9. Epub February 2012. Compares different measures of retention in care by using a large geographically diverse sample of patients enrolled in care at 12 HIV clinics between 2001 and 2008. (AHRQ 12-R064)

Concentration of Hospital Care for Acute Sickle Cell Disease-Related Visits. J. Panepinto, P. Owens, A. Mosso, et al., Pediatric Blood Cancer, October 2012; 59(4):685-9. Epub December 2011. Examines the concentration of hospital care for sickle cell disease, including the association between age and expected payer and the concentration of hospital care in patients with multiple sickle cell disease-related acute care visits. (AHRQ 12-R035)

Contemporary Costs of HIV Healthcare in the HAART Era. K. Gebo, J. Fleishman, R. Conviser, et al., AIDS, November 2010, 24(17):2705-2715. Provides updated estimates of expenditures for HIV management. (AHRQ 11-R020)

Determinants of Utilization and Expenditures for the Episodes of Ambulatory Physical Therapy Among Adults. S. Machlin, J. Chevan, W. Yu, M. Zodet, Physical Therapy, July 2011; 91:1018-1029. Presents an analysis of factors associated with the resource intensity of ambulatory physical therapy episodes for U.S. adults as measured by the number of visits and expenses per visit. (AHRQ 11-R074)

Disparities in Antiretroviral Treatment: A Comparison of Behaviorally HIV-Infected Youth and Adults in the HIV Research Network. A. Agwu, J. Fleishman, P. Korthuis, et al., Journal of Acquired Immune Deficiency Syndrome, September 2011; 58(1):100-107. Analyzes and compares highly active antiretroviral treatment (HAART) initiation rates in HAART-naive youth (aged 18 to 24) and adults with HIV infection meeting treatment criteria. (AHRQ 12-R005)

Does Prescription Drug Adherence Reduce Hospitalizations and Costs? The Case of Diabetes. W. Encinosa, D. Bernard, A. Dor, Advances in Health Economics and Health Services Research, 2010; 22:151-173. Estimates the impact of diabetic drug adherence on hospitalizations, emergency room visits, and hospital costs. (AHRQ 11-R008)

Economic Burden of Late Entry into Medical Care for Patients with HIV Infection. J. Fleishman, B. Yehia, R. Moore, et al., Medical Care, December 2010; 48(12):1071-1079. Estimates direct medical care expenditures for HIV patients as a function of disease status at initial presentation to care. (AHRQ 11-R026)

The Effects of Recall Length and Reporting Aids on Household Reporting of Health Care Events in the Medical Expenditure Panel Survey. S. Zuvekas, Journal of Economic and Social Measurement, 2011; 36(4):321-343. Examines the effects of length of recall period and written records on the accuracy of reports of health care use by Medicare beneficiaries in the Medical Expenditure Panel Survey. (AHRQ 12-R075)

Establishment, Retention, and Loss to Follow-Up in Outpatient HIV Care. J.A. Fleishman, B.R. Yehia, R.D. Moore, et al., Journal of Acquired Immune Deficiency Syndromes, July 2012; 60(3):249-59. Epub April 2012. Examines the establishment of outpatient HIV care, its subsequent retention, and loss to followup in a large cohort of HIV-infected patients over a 2-8 year period between 2001 and 2009. (AHRQ 12-R083)

Geographic Variation: A View from the Hospital Sector. R. Henke, W. Marder, B. Friedman, et al., Medical Care Research and Review, 2011; 68(6):699-711. Analyzes national all-payer data for inpatient stays to assess variations in hospitalization by age groups, and consequently, to understand how utilization by the Medicare population may differ from utilization by non-Medicare populations. (AHRQ 12-R020)

HCUPnet. This interactive online service from the Healthcare Cost and Utilization Project (HCUP) gives users easy access to national statistics as well as to selected State statistics about hospital stays. HCUPnet guides users step-by-step to obtain these statistics by using data from HCUP's Nationwide Inpatient Sample, Kids' Inpatient Database, and State Inpatient Databases for States that participate. Web-based HCUPnet is a user-friendly source for information on various aspects of care in U.S. hospitals, such as: the "National Bill" for total hospital charges for the most expensive conditions; "Instant Tables" that give statistics on the most common conditions and procedures; and trends (beginning 1993) in length of hospital stays, in-hospital deaths, charges, and other outcomes for all conditions and procedures. HCUPnet is free and publicly available at: http://hcupnet.ahrq.gov.

HIV-Related Medical Service Use by Rural/Urban Residents: A Multistate Perspective. L. Wilson, T. Korthuis, J. Fleishman, et al., AIDS Care, August 2011; 23(3):971-979. Examines how receipt of high-quality HIV services varies according to patients’ geographic location. (AHRQ 12-R006)

Impact of the 2009 Influenza Pandemic on Pneumococcal Pneumonia Hospitalizations in the United States. D. Weinberger, L Simonsen, R. Jordan, et al., Journal of Infectious Diseases, February 2012; 205(3):458-465. Quantifies the population-wide impact of the 2009 influenza pandemic on the age-specific incidence of pneumococcal disease hospitalizations across the United States. (AHRQ 12-R051)

Inefficiency Differences Between Critical Access Hospitals and Prospectively Paid Rural Hospitals. M. Rosko, R. Mutter, Journal of Health Politics, Policy and Law, February 2010; 35(1):95-126. Compares the cost efficiency of critical access hospitals with that of rural hospitals to contrast the performance of hospitals operating under different payment systems. (AHRQ 10-R056).

Inpatient Health Services Utilization Among HIV-Infected Adult Patients in Care 2002-2007. B. Yehia, J. Fleishman, P. Hicks, et al., Journal of Acquired Immune Deficiency Syndrome, March 2010; 53(3):397-404. Examines the frequency of inpatient hospitalization, the number of inpatient days, and factors associated with use of inpatient resources in a multistate cohort of HIV-infected adults between 2002 and 2007. (AHRQ 10-R046)

Investing in Preventive Dental Care for the Medicare Population: A Preliminary Analysis. J. Moeller, H. Chen, R. Manski, American Journal of Public Health, November 2010;100(11):2262-2269. Estimates the use of preventive dental care services by the U.S. Medicare population and assesses whether money spent on preventive dental care results in less money being spent on expensive nonpreventive procedures. (AHRQ 11-R012)

Kids' Inpatient Database (KID). Agency for Healthcare Research and Quality, May 2007, two-fold brochure. Provides information about the Kids' Inpatient Database, a hospital administrative dataset that is designed specifically to assess hospital care among newborns, children, and adolescents. Part of the Healthcare Cost and Utilization Project (HCUP), the KID is an affordable database for studying hospital use among children. (AHRQ 06(07)-0016-2)

Let the Data Be Our Guide: Trends and Tools for Research on Health Care Utilization. C. Clancy, Health Economics, January 2012; 21(1):19-23. Discusses various tools that can be used by researchers to study trends in practice patterns and expenditures, including tools available from AHRQ. (AHRQ 12-R036)

Mental Health and Family Out-of-Pocket Expenditure Burdens. S. Zuvekas, T. Selden, Medical Care Research and Review, April 2010; 67(2):194-212. Uses data from the Medical Expenditure Panel Survey (MEPS) to determine the annual and within-year concentration of medical spending and the extent to which mental health treatment contributes to high out-of-pocket burdens among families with and without mental health problems. (AHRQ 10-R069)

National Estimates of Out-of-Pocket Health Care Expenditure Burdens Among Nonelderly Adults with Cancer: 2001 to 2008. D. Bernard, S. Farr, Z. Fang, Journal of Clinical Oncology, June 2011; 29:e-pub. Compares the prevalence of high out-of-pocket cost burdens among patients who have cancer with other chronically ill and well patients and examines the sociodemographic characteristics associated with high burdens among patients with cancer. (AHRQ 11-R058)

Nationwide Emergency Department Sample (NEDS) Brochure. Agency for Healthcare Research and Quality, November 2011. Six-panel brochure provides information about the Nationwide Emergency Department Sample (NEDS), the largest all-payer emergency department database in the United States, which can be used to create national and regional estimates of ED care, both treat-and-release visits and inpatient stays. (AHRQ 12-M006-2).

Nationwide Inpatient Sample (NIS) Brochure. Agency for Healthcare Research and Quality, March 2006. Provides information about the Nationwide Inpatient Sample (NIS), a nationally representative sample of all short-term, non-Federal hospitals. Part of the Healthcare Cost and Utilization Project, the NIS is a reliable and affordable database for studying hospital data on important health care topics. (AHRQ 06-0016-1)

Patient-Centered Care Categorization of U.S. Health Care Expenditures. P. Conway, K. Goodrich, S. Machlin, et al., Health Services Research, April 2011; 46(2):479-490. Uses 2007 data from the Medical Expenditure Panel Survey (MEPS) to categorize medical expenditure data into seven patient-centered care categories: chronic conditions, acute illness, trauma/injury or poisoning, dental, pregnancy/birth-related, routine preventive health care, and other. (AHRQ 11-R029)

Paying Physicians by Capitation: Is the Past Now Prologue? S. Zuvekas, J. Cohen, Health Affairs, September 2010; 29(9):1661-1666. Analyzes trends in physician capitation over the period 1996-2007 for all types of physician care, with a focus on how individual physicians or physician practices are paid. (AHRQ 11-R003)

Profile of Inpatient Operating Room Procedures in U.S. Hospitals in 2007. A. Elixhauser, R. Andrews, Archives of Surgery, December 2010; 145(12):1201-1208. Uses 2007 discharge data from the Healthcare Cost and Utilization Project to provide an overview of inpatient operating room procedures in the United States. (AHRQ 11-R023)

State Ambulatory Surgery Databases (SASD) Brochure. Agency for Healthcare Research and Quality, September 2007. Provides information about the State Ambulatory Surgery Databases (SASD), which capture ambulatory surgery encounters at hospital facilities (and some free-standing facilities) within each participating State. The SASD have been available since 1997 and are an integral component of the Healthcare Cost and Utilization Project (HCUP) family of databases. (AHRQ 06(07)-0016-4)

State- and Payer-Specific Estimates of Annual Medical Expenditures Attributable to Obesity. J. Trogdon, E. Finkelstein, C. Feagan, et al., Obesity, January 2012; 20(1):214-220. Presents current State-level estimates of the costs attributable to obesity in total and separately for Medicare and Medicaid populations. (AHRQ 11-R063)

State Emergency Department Databases (SEDD) Brochure. Agency for Healthcare Research and Quality, September 2007. Provides information about the State Emergency Department Databases (SEDD), available annually since 1999. The SEDD capture emergency visits at hospital-affiliated emergency departments that do not result in hospital admission. To facilitate multi-State comparisons and analyses, data are translated into a uniform, user-friendly format. The SEDD are an integral component of the Healthcare Cost and Utilization Project (HCUP) family of databases. (AHRQ 06(07)-0016-5)

State Inpatient Databases (SID) Brochure. Agency for Healthcare Research and Quality, September 2007. Provides information about the State Inpatient Databases (SID), an integral component of the Healthcare Cost and Utilization Project (HCUP) family of databases. Each participating State's SID includes patient discharge records from that State. The SID have been available annually since 1990 and are ideal for studying State-level inpatient health care issues. (AHRQ 06(07)-0016-3)

A Survey of Health Care Use and Spending. Agency for Healthcare Research and Quality, October 2011, 9 pp. Brochure describes AHRQ’s Medical Expenditure Panel Survey (MEPS), the individual surveys that make up MEPS, and the availability of MEPS data. (AHRQ 11(12)-0092)

Trends and Burden of Bronchiectasis-Associated Hospitalizations in the United States, 1993-2006. A. Seitz, K. Olivier, C. Steiner, et al., Chest, October 2010; 138(4):944-949. Provides insights into the overall trends and burdens of bronchiectasis-associated hospitalizations in the United States. (AHRQ 12-R017)

Users of Medicaid Home and Community-Based Services Are Especially Vulnerable to Costly Avoidable Hospital Admissions. R. Konetzka, S. Karon, D. Potter, Health Affairs, June 2012; 31(6):1167-1175. Examines the incidence of potentially avoidable hospital admissions by users of Medicaid home and community-based services. (AHRQ 12-R077)

Using Information on Clinical Conditions to Predict High-Cost Patients. J. Fleishman, J. Cohen, Health Services Research, April 2010; 45(2):532-552. Compares the ability of different research models to predict prospectively whether someone will incur high medical expenditures. (AHRQ 10-R052)

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