Healthcare Cost and Utilization Project


The Healthcare Cost and Utilization Project is a family of healthcare databases and related software tools and products from the United States that is developed through a Federal-State-Industry partnership and sponsored by the Agency for Healthcare Research and Quality.

General Information

HCUP provides access to healthcare databases for research and policy analysis, as well as tools and products to enhance the capabilities of the data. HCUP databases combine the data collection efforts of State data organizations, hospital associations, private data organizations, and the Federal Government to create a national information resource of patient-level healthcare data. State organizations that provide data to HCUP are called Partners.
HCUP includes multiyear hospital administrative data in the United States, with all-payer, encounter-level information beginning in 1988. These databases enable research on health and policy issues at the national, State, and local levels, including cost and quality of health services, medical practice patterns, access to healthcare, and outcomes of treatments.
AHRQ has also developed a set of software tools to be used when evaluating hospital data. These software tools can be used with the HCUP databases and with other administrative databases. HCUP’s Supplemental Files are only for use with HCUP databases.
HCUP databases have been used in various studies on a number of topics, such as breast cancer, depression, and multimorbidity, incidence and cost of injuries, role of socioeconomic status in patients leaving against medical advice, multiple chronic conditions and disparities in readmissions, and hospitalization costs for cystic fibrosis.

HCUP User Support Website (HCUP-US)

The HCUP User Support website is the main repository of information for HCUP. It is designed to answer HCUP-related questions; provide detailed information on HCUP databases, tools, and products; and offer technical assistance to HCUP users. HCUP’s tools, publications, documentation, news, services, HCUP Fast Stats, and HCUPnet may all be accessed through HCUP-US. HCUP-US is located at https://www.hcup-us.ahrq.gov.

HCUP Overview Course

HCUP has developed an interactive online course that provides an overview of the features, capabilities, and potential uses of HCUP. The course is modular, so users can either move through the entire course or access the resources in which they are most interested. The On-line HCUP Overview Course ] can work both as an introduction to HCUP data and tools and a refresher for established users.

HCUP Online Tutorial Series

The HCUP Online Tutorial Series is a set of interactive training courses that provide HCUP data users with information about HCUP data and tools, and training on technical methods for conducting research with HCUP data. The online courses are modular, so users can move through an entire course or access the sections in which they are most interested. Topics include loading and checking HCUP data, understanding HCUP’s sampling design, calculating standard errors, producing national estimates, conducting multiyear analysis, and using the Nationwide Readmissions Database.

HCUP Databases

HCUP databases bring together data from State data organizations, hospital associations, private data organizations, and the Federal Government to create an information resource of patient-level healthcare data.
HCUP’s databases date back to 1988 data files. The databases contain encounter-level information for all payers compiled in a uniform format with privacy protections in place. Researchers and policymakers can use the records to identify, track, and analyze national trends in healthcare use, access, charges, quality, and outcomes.
HCUP databases are released approximately 6 to 18 months after the end of a given calendar year, with State databases available earlier than the national or nationwide datasets.
Currently, there are eight types of HCUP databases: four with national- and regional-level data and three with State- and local-level data.

National Databases

  • : A 20 percent stratified sample of all-payer, inpatient discharges from U.S. community hospitals. The NIS is available from 1988 forward, and a new database is released annually, approximately 18 months after the end of a calendar year.
  • : A nationwide sample of all-payer pediatric inpatient care discharges. Its large sample size is ideal for developing national and regional estimates and enables analyses of rare conditions, such as congenital anomalies, as well as uncommon treatments, such as organ transplantation. The KID was released every 3 years, from 1997 to 2012 and resumed release again in 2016.
  • : An all-payer emergency department database of approximately 30 million records that yields national estimates of 145 million ED visits. The NEDS captures encounters where the patient is admitted for inpatient treatment, as well as those in which the patient is treated and released. The NEDS is released annually and is available from 2006 forward.
  • : The NRD is designed to support various types of analyses of national readmission rates for all patients, regardless of expected payer for the hospital stay. The NRD is released annually and is available from 2010 forward.
  • : The NASS is the largest all-payer ambulatory surgery database that has been constructed in the United States, yielding national estimates of major ambulatory surgery encounters performed in hospital-owned facilities. The NASS is released annually and is available starting with the 2016 data year.

    State Databases

  • : The SID are databases from the universe of inpatient discharge abstracts from participating States, released annually. Data are available from 1995 forward. The SID are released on a rolling basis, as early as 6 months following the end of a calendar year.
  • : The SASD are ambulatory surgery and other outpatient service abstracts from hospital-owned and sometimes freestanding ambulatory surgery sites in participating States. Data are available from 1997 forward. The SASD are released on a rolling basis, as early as 6 months following the end of a calendar year.
  • : The SEDD are hospital-affiliated emergency department data for visits in participating States that do not result in hospitalizations. Data are available from 1999 forward. The SEDD are released on a rolling basis, as early as 6 months following the end of a calendar year.

    HCUP Tools and Software

HCUP provides a number of tools and software programs that can be applied to HCUP and other similar administrative databases.

Readily Available HCUP Statistics

HCUPnet

HCUPnet is an online query system that provides healthcare statistics and information from the HCUP national and State databases for those States that have agreed to participate.
HCUPnet can be used for identifying, tracking, analyzing, and comparing statistics on hospital inpatient stays, emergency care, and ambulatory surgery, as well as obtaining measures of quality-based information from the AHRQ Quality Indicators. Select statistics are available at a national- and county-level. HCUPnet can also be used for trend analysis with healthcare data available from 1993 forward.
HCUPnet also includes a feature called hospital readmissions that provides users with some statistics on hospital readmissions within 7 and 30 days of hospital discharge.

HCUP Fast Stats

HCUP Fast Stats is a web-based tool that provides easy access to the latest HCUP-based statistics for healthcare information topics. HCUP Fast Stats uses visual statistical displays in standalone graphs, trend figures, or simple tables to convey complex information at a glance. Fast Stats topics are updated regularly for timely, topic-specific national and State-level statistics.
The following topics are available:
  • State Trends in Hospital Use by Payer. This topic includes statistics from up to 44 States on the number of hospital discharges by payer group.
  • National Hospital Utilization and Costs. This topic focuses on national statistics on inpatient stays: Trends, Most Common Diagnoses, and Most Common Operations.
  • State Trends in Emergency Department Visits by Payer. These ED statistics are a supplement to the existing State-level inpatient stay trends by expected payer.
  • Opioid-Related Hospital Use, National and State. This topic reports population-based rates of opioid-related hospital use by discharge quarter. Trends are available for inpatient stays and emergency department visits by expected payer.
  • Neonatal Abstinence Syndrome, National and State. This new topic provides trends in NAS-related newborn hospitalizations at the national and State level. Rates of NAS per 1,000 newborn hospitalizations are presented overall as well as by sex, expected payer, community-level income, and patient location.
  • Hurricane Impact on Hospital Use. This new topic provides historical inpatient and treat-and-release emergency department utilization information from 11 U.S. hurricanes between 2005 and 2017. Supported by the Patient-Centered Outcomes Research Trust Fund and created in collaboration with the Office of the Assistant Secretary for Planning and Evaluation and the Office of the Assistant Secretary for Preparedness and Response, this topic is designed to help HCUP users understand medical care utilization during and after past hurricanes to assist in the preparation for and deployment of medical services in future disasters.

    HCUP Software

The HCUP software can be applied to HCUP databases, to systematically create new data elements from existing data, thereby enhancing a researcher's ability to conduct analyses. While designed to be used with HCUP databases, the analytic tools may be applied to other administrative databases.