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New facts and figures are now available
Maybe your benchmarking efforts require you to put together some comparative data on the costs of treating various maladies in a hospital setting. Maybe you need to get a handle on recent trends in the nursing home industry. You may be heading up your organization’s marketing effort to penetrate the over-65 segment of the population and need to know more about the characteristics of Medicare beneficiaries. Or, you may need some MSA-level (Metropolitan Statistical Area) data on HMO penetration.
If you fall into any of the above categories, you’re in luck. There is a source of new and/or recently updated data (or maybe one you’ve just missed) out there that can help fill at least some of your information needs. Check below for details on a number of data products now available, including content, contacts, and pricing information:
The Medicare beneficiary population is often described in homogenous terms, yet those covered by the program vary significantly in terms of their health, income, supplemental insurance status, and medical service use. Produced by the Henry J. Kaiser Family Foundation, The Faces of Medicare is a new publication that profiles the groups within the Medicare population, providing basic information, trends, and data on six sets of beneficiaries that include:
1.healthy retirees, who represent less than 10% of the total Medicare population, but sometimes are portrayed as typical of all seniors;
2. under-65 disabled beneficiaries, whose disproportionately high rates of health and cognitive problems are compounded by low incomes;
3. racial and ethnic minority beneficiaries, who by 2025 will account for one in three Medicare beneficiaries;
4. beneficiaries with cognitive impairments, now nearly one in four Medicare beneficiaries, who face unique challenges navigating the health care system;
5. low-income elderly and disabled, who remain among the most vulnerable;
6. women, who constitute more than 56% of Medicare beneficiaries but nearly 70% of Medicare’s poor.
Health care professionals designing service delivery systems targeted at Medicare beneficiaries will want to be familiar with the data Faces provides on each of these groups, which includes information on general demographic characteristics, health service use, insurance coverage rates, long-term care needs, and special issues.
The beneficiary-level profiles provided by Faces are complemented by state and regional data offered in a companion Kaiser Foundation publication, Medicare State Profiles: State and Regional Data on Medicare and the Population It Serves. Although Medicare is a national program, there are substantial variations across states and regions in terms of beneficiary characteristics, health needs, and utilization of Medicare-covered services, according to this report. Likewise, there are also considerable differences in Medicare spending and the emergence of Medicare managed care. In a single resource document, Medicare State Profiles presents state by state demographic data on the Medicare population, along with information on health service utilization, spending, and Medicare HMO penetration. It also provides regional data on the distribution of beneficiaries by poverty level, self-reported health status, and insurance coverage.
The Faces of Medicare (www2.kff.org/content/ 1999/1481/) and Medicare State Profiles: State and Regional Data on Medicare and the Population it Serves (www2.kff.org/content/1999/1474/) are both available at no cost on the Kaiser Family Foundation Web site (www.kff.org). You’ll need Adobe Acrobat Reader to access the documents. Other publications on Medicare are available on the Foundation’s Medicare Policy Project Web site (www2.kff. org/sections.cgi?section= medicare).
AHCPR hospitalization, nursing home data
Hospital Inpatient Statistics, 1996 is the latest in a series of statistical publications from the U.S. Agency for Health Care Policy and Research (AHCPR) showing why Americans are hospitalized, how long they stay in the hospital, the procedures they undergo, and the charges for their stays. In short, "This in-depth profile of inpatient care answers many key questions about how specific conditions are treated in hospitals and the resulting outcomes," says AHCPR administrator John M. Eisenberg, MD. "It contributes to the evidence base needed to develop effective strategies for improving the quality and value of health care."
The most common reasons for hospital admission in the United States, based on 1996 data, are births (3.8 million admissions), followed by coronary atherosclerosis (1.4 million), pneumonia (1.2 million), congestive heart failure (990,000), and heart attack (774,000), according to Inpatient Statistics. Meanwhile, the most expensive conditions, or diagnoses, among those treated in U.S. hospitals in 1996, were spinal cord injury ($56,800), infant respiratory distress syndrome ($56,600), low birth weight ($50,300), leukemia ($46,700), and heart valve disorders ($45,300). These figures are expressed as average charges for the entire stay.
In the length of stay arena, patients stayed in the hospital an average of five days overall. But stays involving premature birth, with problems such as low birth weight and slow growth of the fetus, averaged 23 days. Stays because of infant respiratory distress syndrome averaged 22 days, and patients with spinal cord injuries remained hospitalized an average of 16 days.
Inpatient Statistics estimates are based on all-payer data from AHCPR’s Nationwide Inpatient Sample (see NIS database update section, below), which approximates a 20% sample of U.S. community hospitals. The database is part of the Healthcare Cost and Utilization Project (HCUP), a federal-state-industry partnership to make high-quality hospital data available for research purposes.
Meanwhile, for professionals and practitioners active in the development and/or operations of nursing homes, AHCPR’s Nursing Home Trends, 1987 and 1996, provides comparative information about nursing homes and their residents for these two points in time. It features findings from AHCPR’s 1996 Medical Expenditure Panel Survey (MEPS) and the 1987 National MEPS Institutional Population Component. Highlights include:
• From 1987 to 1996, the proportion of nursing home residents 85 and older rose from 49% to 56% for women, and from 29% to 33% for men.
• The numbers of nursing homes and nursing home beds both increased by almost 20% from 1987 to 1996, from 14,050 homes/1.48 million beds in 1987 to 16,840 homes/1.76 million beds in 1996.
• The number of nursing home residents needing help with three or more activities of daily living such as bathing, dressing, transferring, feeding, and toileting, increased from 72% in 1987 to 83% in 1996.
• In 1996, the most common type of special care unit was for treatment of Alzheimer’s and related dementias.
• Between 1987 and 1996, there was a trend toward incorporating assisted and/or independent living beds within traditional nursing home facilities. The proportion of these beds rose from 6.9% in 1987 to 11.3% in 1996.
Both Inpatient Statistics (AHCPR Publication no. 99-0034) and Nursing Home Trends (AHCPR 99-0032) are available at no charge. Contact AHCPR by mail at the AHCPR Publications Clearinghouse, P.O. Box 8547, Silver Spring, MD 20907-8547; or, by phone at (800) 358-9295. The agency’s Web site is http://www.ahcpr.gov.
NIS database update
Also from AHCPR, the Nationwide Inpatient Sample (NIS) Release 5, featuring data on hospital inpatient care, conditions, services, and costs, is available on CD-ROM. One of several data-bases and software tools developed as part of the AHCPR-sponsored HCUP, NIS is the largest all-payer inpatient care database available in the United States and is used by a variety of researchers and policymakers to identify, track, and analyze trends in health care utilization, access, charges, quality, and outcomes.
The latest block in a historical database that stretches back to 1988, NIS Release 5 was initially released this past spring. It contains 1996 data covering approximately 6.5 million hospital stays at some 900 community hospitals in 19 states, approximating a 20% stratified sample of U.S. community hospitals. By integrating data from statewide health data organizations, the NIS is a uniform, multistate database that promotes comparative studies of health care services. It will support health care policy research on a variety of topics including:
• use and cost of hospital services;
• medical practice variation;
• health care cost inflation;
• analyses of states and communities;
• medical treatment effectiveness;
• quality of care;
• impact of health policy changes;
• access to care;
• diffusion of medical technology;
• utilization of health services by special populations.
Additionally, NIS includes hospital identifiers that allow linkages to the American Hospital Association’s Survey of Hospitals database, as well as county identifiers that permit linkages to county-level information in the Health Resources and Services Administration’s Area Resource File.
For more information about the NIS database or other HCUP products, visit the AHCPR’s Web site (http://www.ahcpr.gov/data/hcup/) or contact the agency by e-mail at firstname.lastname@example.org. To order the NIS Release 5 (as a set of six CD-ROMs with accompanying documentation) for $160, contact the National Technical Information Service (NTIS), U.S. Department of Commerce, 5285 Port Royal Road, Springfield, VA 22161. Telephone (800) 553-6847 or (703) 605-6000. Or, you may order on-line at http://www.ntis.gov/fcpc. When ordering, refer to PB number 99-500480. Previous releases featuring 1993, 1994, and 1995 data are also available for $160; Release 1, a 26-CD set featuring data from 1988 through 1992, is available for $322.
A new database combining comprehensive hospital data with the latest managed care information is now available from the American Hospital Association’s (AHA) Health Forum and InterStudy, a supplier of managed care data.
The Duet Database provides health care decision makers and researchers with a wide variety of information about hospitals and managed care at the MSA level. It contains hospital data from the AHA’s annual survey, along with Inter-Study’s MSA level data on the HMO industry from its semi-annual National HMO Census.
According to its developers, the database is designed for penetration research, competitive analysis, and utilization studies in the managed care arena; hospitals can use the database to research similar or benchmark markets to understand how managed care will affect utilization and revenue.
The Duet Database is available on CD-ROM in both Microsoft Access and ASCII formats. Buyers can choose to purchase hospital data or managed care data only for $1,800. The total database sells for $3,000. The database is slated to be released twice annually. Managed care inquires should be directed to InterStudy Publications at (800) 844-3351; hospital inquires to the Health Forum at(800) 821-2039. To order, call (800) AHA-2626.