Federal Data Sources for Federal Data Sources for Child Health Services ResearchChild Health Services Research

Overview Overview

Pamela Owens, PhDPamela Owens, PhDJane Sisk, PhDJane Sisk, PhD

Jessica Banthin, PhDJessica Banthin, PhDJune 2006 June 2006

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Advancing Advancing Excellence in Excellence in Health CareHealth Care ObjectivesObjectives

To become familiar with Federal databases To become familiar with Federal databases available to answer research and policy available to answer research and policy questions related to children’s health carequestions related to children’s health care

To be able to identify the most appropriate To be able to identify the most appropriate database to answer your specific research or database to answer your specific research or policy questionpolicy question

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Advancing Advancing Excellence in Excellence in Health CareHealth Care Overview of PanelOverview of Panel

Choosing the most appropriate databaseChoosing the most appropriate database– Factor to consider when choosing a databaseFactor to consider when choosing a database– ExamplesExamples

Data from the National Center for Health Statistics (NCHS)Data from the National Center for Health Statistics (NCHS)– Jane Sisk, PhDJane Sisk, PhD

Medical Expenditure Panel Survey (MEPS)Medical Expenditure Panel Survey (MEPS)– Jessica Banthin, PhDJessica Banthin, PhD

Healthcare Cost and Utilization Project (HCUP)Healthcare Cost and Utilization Project (HCUP)– Pamela Owens, PhDPamela Owens, PhD

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Advancing Advancing Excellence in Excellence in Health CareHealth Care

Choosing a Database Choosing a Database Consider …. Consider ….

What is your research or policy question?What is your research or policy question?

Can the question be addressed with survey data? Can the question be addressed with survey data? With administrative data?With administrative data?

What perspective are you interested in (e.g., patient, What perspective are you interested in (e.g., patient, provider, facility, setting, visit)?provider, facility, setting, visit)?– Unit of analysisUnit of analysis

What population are you interested in (e.g., national, What population are you interested in (e.g., national, regional, state, local)?regional, state, local)?– Population, sampling framePopulation, sampling frame

What sample size do you need to answer your What sample size do you need to answer your question?question?– Total NTotal N– Pooling yearsPooling years

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Advancing Advancing Excellence in Excellence in Health CareHealth Care

Choosing a Database Choosing a Database Consider …. Consider ….

What time frame are you interested in (e.g., specific What time frame are you interested in (e.g., specific year, cross-sectional, trends)?year, cross-sectional, trends)?– Year(s) of dataYear(s) of data

What information do you need to answer your What information do you need to answer your question?question?– Data elementsData elements

Do you need to bring together several types of data?Do you need to bring together several types of data?– LinkagesLinkages

How much money and time do you have to answer How much money and time do you have to answer the question?the question?– CostCost– Availability/AccessibilityAvailability/Accessibility

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Advancing Advancing Excellence in Excellence in Health CareHealth Care Children’s Use of AntibioticsChildren’s Use of Antibiotics

What are the research questions?What are the research questions?– Has there been a change in children’s use of antibiotics Has there been a change in children’s use of antibiotics

across a 5-year time period?across a 5-year time period?

– What factors are associated with children’s use of What factors are associated with children’s use of antibiotics? antibiotics?

What perspective?What perspective? – Children as the unit of analysisChildren as the unit of analysis

What population?What population?– Children across the US (national)Children across the US (national)

Time:Time: – Trends - 5 consecutive years of dataTrends - 5 consecutive years of data

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Advancing Advancing Excellence in Excellence in Health CareHealth Care Children’s Use of AntibioticsChildren’s Use of Antibiotics

What information is needed to answer the question?What information is needed to answer the question? – Antibiotic use (medication use)Antibiotic use (medication use)

– Respiratory conditions (disease)Respiratory conditions (disease)

– Outpatient visit utilizationOutpatient visit utilization

– InsurerInsurer

– Demographics – income, race/ethnicityDemographics – income, race/ethnicity

How much money and time should be allocated to the How much money and time should be allocated to the project?project?

What database should you choose?What database should you choose?

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Advancing Advancing Excellence in Excellence in Health CareHealth Care Quality of Health CareQuality of Health Care

What are the research questions?What are the research questions?– Does quality of outpatient and inpatient care vary by Does quality of outpatient and inpatient care vary by

insurance?insurance?– How does the answer to this question vary by specific How does the answer to this question vary by specific

conditions or sub-populations (e.g., SCHCN)? conditions or sub-populations (e.g., SCHCN)?

What perspective?What perspective? – Children as the unit of analysisChildren as the unit of analysis– Hospitalizations as the unit of analysisHospitalizations as the unit of analysis

What population?What population?– Children who use health care across the US, Children who use health care across the US,

across a state, across a countyacross a state, across a county

Time:Time: – Cross-sectional (one year)Cross-sectional (one year)– Trends (multi-year)Trends (multi-year)

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Advancing Advancing Excellence in Excellence in Health CareHealth Care Quality of CareQuality of Care

What information is needed to answer the question?What information is needed to answer the question? – Quality of careQuality of care

• How is it going to be measured?How is it going to be measured?• What measures are available? What measures are available?

– Insurance/payerInsurance/payer– Demographic information on the patient (age, race, income, Demographic information on the patient (age, race, income,

residence)residence)– Specific conditionsSpecific conditions– Procedures performed during the visit/hospitalizationProcedures performed during the visit/hospitalization– Insurer/Payer of the visit/hospitalizationInsurer/Payer of the visit/hospitalization– Outcome of the visit/hospitalizationOutcome of the visit/hospitalization

How much money and time should be allocated to the How much money and time should be allocated to the project?project?

What database should you choose?What database should you choose?

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Advancing Advancing Excellence in Excellence in Health CareHealth Care

IOM Releases Report on IOM Releases Report on Emergency Care for Children: Growing PainsEmergency Care for Children: Growing Pains

What are the general research questions?What are the general research questions?– How safe is pediatric emergency care?How safe is pediatric emergency care?– How equitable is pediatric emergency care? How equitable is pediatric emergency care? – How much does pediatric emergency care cost?How much does pediatric emergency care cost?

What perspective?What perspective? – Emergency department (ED) visits as the unit of analysisEmergency department (ED) visits as the unit of analysis– [Children as the unit of analysis][Children as the unit of analysis]

What population?What population?– Children who use the EDs across the US, across a state, Children who use the EDs across the US, across a state,

across a countyacross a county

Time:Time: – Cross-sectional (one year)Cross-sectional (one year)– Trends (multi-year)Trends (multi-year)

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Advancing Advancing Excellence in Excellence in Health CareHealth Care

IOM Releases Report on IOM Releases Report on Emergency Care for Children: Growing PainsEmergency Care for Children: Growing Pains

What information is needed to answer the question?What information is needed to answer the question?

– Emergency department useEmergency department use

– Demographic information on the patient (age, race, income, Demographic information on the patient (age, race, income, geographic location)geographic location)

– Reason for ED visitReason for ED visit

– Procedures performed during the ED visitProcedures performed during the ED visit

– Insurer/Payer of the ED visitInsurer/Payer of the ED visit

– Cost, charges, expenditures associated with the ED visitCost, charges, expenditures associated with the ED visit

– Outcome of the ED visit (e.g., hospitalized, discharged home)Outcome of the ED visit (e.g., hospitalized, discharged home)

How much money and time should be allocated to the project?How much money and time should be allocated to the project?

What database should you choose?What database should you choose?