The Healthcare Cost and Utilization Project (HCUP) National Inpatient Sample (NIS) is the largest publicly available all-payer inpatient care database in the United States. The NIS is designed to produce U.S. regional and national estimates of inpatient utilization, access, cost, quality, and outcomes. Unweighted, it contains data from more than 7 million hospital stays each year. Weighted, it estimates more than 35 million hospitalizations nationally. Developed through a Federal-State-Industry partnership sponsored by the Agency for Healthcare Research and Quality (AHRQ), HCUP data inform decision making at the national, State, and community levels. Starting with the 2012 data year, the NIS is a sample of discharges from all hospitals participating in HCUP, covering more than 97 percent of the U.S. population. For prior years, the NIS was a sample of hospitals. The NIS allows for weighted national estimates to identify, track, and analyze national trends in health care utilization, access, charges, quality, and outcomes. The NIS's large sample size enables analyses of rare conditions, such as congenital anomalies; uncommon treatments, such as organ transplantation; and special patient populations, such as the uninsured. NIS data are available since 1988, allowing analysis of trends over time. The NIS inpatient data include clinical and resource use information typically available from discharge abstracts with safeguards to protect the privacy of individual patients, physicians, and hospitals (as required by data sources). Data elements include but are not limited to: diagnoses, procedures, discharge status, patient demographics (e.g., sex, age), total charges, length of stay, and expected payment source, including but not limited to Medicare, Medicaid, private insurance, self-pay, or those billed as ‘no charge’. The NIS excludes data elements that could directly or indirectly identify individuals. Restricted access data files are available with a data use agreement and brief online security training.

Usage

The National (Nationwide) Inpatient Sample (NIS) is part of a family of databases and software tools developed for the Healthcare Cost and Utilization Project (HCUP). The NIS is the largest publicly available all-payer inpatient healthcare database designed to produce U.S. regional and national estimates of inpatient utilization, access, cost, quality, and outcomes. Unweighted, it contains data from around 7 million hospital stays each year. Weighted, it estimates around 35 million hospitalizations nationally. Developed through a Federal-State-Industry partnership sponsored by the Agency for Healthcare Research and Quality (AHRQ), HCUP data inform decision making at the national, State, and community levels.

Abstract

The NIS is the largest publicly available all-payer inpatient healthcare database designed to produce U.S. regional and national estimates of inpatient utilization, access, cost, quality, and outcomes. Unweighted, it contains data from around 7 million hospital stays each year. Weighted, it estimates around 35 million hospitalizations nationally. Developed through a Federal-State-Industry partnership sponsored by the Agency for Healthcare Research and Quality (AHRQ), HCUP data inform decision making at the national, State, and community levels.

Its large sample size is ideal for developing national and regional estimates and enables analyses of rare conditions, uncommon treatments, and special populations.

Usage

The 2017 & 2018 Severity records that were missing from the previous version of this dataset have been recovered and are now included in the dataset, meaning no records are missing.

Also %3Cu%3EDO NOT%3C/u%3E

use this data without referring to the NIS Database Documentation, which includes:

• Description of NIS Database
• Restrictions on Use

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• Data Elements
• Additional Resources for Data Elements
• ICD-10-CM/PCS Data Included in the NIS Starting with 2015 (More details about this transition available here.)
• Known Data Issues
• NIS Supplemental Files
• HCUP Tools: Labels and Formats
• Obtaining HCUP Data

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Before Manuscript Submission

%3Cu%3E%3Cstrong%3EAll manuscripts%3C/strong%3E%3C/u%3E

(and other items you'd like to publish) %3Cu%3E%3Cstrong%3Emust be submitted to%3C/strong%3E%3C/u%3E

%3Cu%3E%3Cstrong%3Ephsdatacore@stanford.edu%3C/strong%3E%3C/u%3E

for approval prior to journal submission.

We will check your cell sizes and citations.

For more information about how to cite PHS and PHS datasets, please visit:

https:/phsdocs.developerhub.io/need-help/citing-phs-data-core

You must also %3Cu%3E%3Cstrong%3Emake sure that your work meets all of the AHRQ (data owner) requirements for publishing%3C/strong%3E%3C/u%3E

with HCUP data--listed at https://hcup-us.ahrq.gov/db/nation/nis/nischecklist.jsp

HCUP Online Tutorials

For additional assistance, AHRQ has created the HCUP Online Tutorial Series, a series of free, interactive courses which provide training on technical methods for conducting research with HCUP data. Topics include an HCUP Overview Course and these tutorials:

• The HCUP Sampling Design tutorial is designed to help users learn how to account for sample design in their work with HCUP national (nationwide) databases. • The Producing National HCUP Estimates tutorial is designed to help users understand how the three national (nationwide) databases – the NIS, Nationwide Emergency Department Sample (NEDS), and Kids' Inpatient Database (KID) – can be used to produce national and regional estimates. HCUP 2020 NIS (8/22/22) 14 Introduction • The Calculating Standard Errors tutorial shows how to accurately determine the precision of the estimates produced from the HCUP nationwide databases. Users will learn two methods for calculating standard errors for estimates produced from the HCUP national (nationwide) databases. • The HCUP Multi-year Analysis tutorial presents solutions that may be necessary when conducting analyses that span multiple years of HCUP data. • The HCUP Software Tools Tutorial provides instructions on how to apply the AHRQ software tools to HCUP or other administrative databases.

New tutorials are added periodically, and existing tutorials are updated when necessary. The Online Tutorial Series is located on the HCUP-US website at www.hcupus.ahrq.gov/tech_assist/tutorials.jsp.

Important notes about the 2015 data

In 2015, AHRQ restructured the data as described here:

https://hcup-us.ahrq.gov/db/nation/nis/2015HCUPNationalInpatientSample.pdf

Some key points:

• For the 2015 data, all diagnosis and procedure data elements, including any data elements derived from diagnoses and procedures, were moved out of the Core File and into the Diagnosis and Procedure Groups Files.
• Prior to 2015, and for Q1-3 of 2015, the DX1-30 and PR1-15 variables (which use ICD-9 codes) variables were used, but starting in Q4 of 2015, the I10_DX1-30 and I10_PR1-I10-15 (which use ICD-10 codes) were used. The best way to identify discharges for quarter 1-3 or quarter 4 is based on the value of the diagnosis version (DXVER); For quarters 1-3, DXVER has a value of 9; while for quarter 4, DXVER has a value of 10.
• Some other variables al

The Nationwide Inpatient Sample (NIS) is a database focused on hospital stay information. Users are able to use the NIS to identify, track, and analyze national trends in health care utilization, access, charges, quality, and outcomes. Background The Nationwide Inpatient Sample (NIS) is maintained by the Healthcare Cost and Utilization Project. The NIS is the largest all-payer inpatient care database in the United States. It contains data from approximately 8 million hospital stays each year. The 2009 NIS contains all discharge data from 1,050 hospitals located in 44 States, approximating a 20-percent stratified sample of U.S. community hospitals. The sampling frame for the 2009 NIS is a sample of hospitals that comprises approximately 95 percent of all hospital discharges in the United States. The NIS is the only national hospital database containing charge information on all patients, regardless of payer, including persons covered by Medicare, Medicaid, private insurance, and the uninsured. User functionality Users must pay to access the database. NIS releases for data years 1988-2009 are available from the HCUP Central Distributor. The 2009 NIS may be purchased for $50 for students and $350 for all others on a single DVD-ROM with accompanying documentation. . Data Notes NIS data are available from 1988 to 2009. The number of states in the NIS has grown from 8 in the first year to 44 at present. Beginning with the 2002 NIS, severity adjustment data elements including APR-DRGs, APS-DRGs, Disease Staging, and AHRQ Comorbidity Indicators, are available. Begi nning with the 2005 NIS, Diagnosis and Procedure Groups Files containing data elements from AHRQ software tools designed to facilitate the use of the ICD-9-CM diagnostic and procedure information are available. Beginning with the 2007 NIS, data elements describing hospital structural characteristics and provision of outpatient services are available in the Hospital Weights file. NIS Release 1 includes data from 8-11 States and spans the years 1988 to 1992. NIS Releases 2 and 3 contain data from 17 States for 1993 and 1994, respectively. NIS Releases 4 and 5 contain data from 19 States for 1995 and 1996. NIS Release 6 contains data from 22 States for 1997. NIS 1998 contains data from 22 States. NIS 1999 contains data from 24 States. NIS 2000 contains data from 28 States. NIS 2001 contains data from 33 States. NIS 2002 contains data from 35 States. NIS 2003 contains data from 37 States. NIS 2004 contains data from 37 States. NIS 2005 contains data from 37 States. NIS 2006 contains data from 38 States. NIS 2007 contains data from 40 States. NIS 2008 contains data from 42 States.

2001 forward. The National (Nationwide) Inpatient Sample (NIS) is part of a family of databases and software tools developed for the Healthcare Cost and Utilization Project (HCUP). The NIS is the largest publicly available all-payer inpatient health care database in the United States, yielding national estimates of hospital inpatient stays. Unweighted, it contains data from more than 7 million hospital stays each year. Weighted, it estimates more than 35 million hospitalizations nationally. Indicators from this data source have been computed by personnel in CDC's Division for Heart Disease and Stroke Prevention (DHDSP). This is one of the datasets provided by the National Cardiovascular Disease Surveillance System. The system is designed to integrate multiple indicators from many data sources to provide a comprehensive picture of the public health burden of CVDs and associated risk factors in the United States. The data are organized by indicator, and they include CVDs (e.g., heart failure). The data can be plotted as trends and stratified by age group, sex, and race/ethnicity.

Abstract

The National (Nationwide) Kids' Inpatient Database (KID) is part of a family of databases and software tools developed for the Healthcare Cost and Utilization Project (HCUP). Only years 2003, 2006, 2009, 2012 are available on the PHS Data Portal.

The Kids' Inpatient Database (KID) is the largest publicly available all-payer pediatric inpatient care database in the United States, containing data from two to three million hospital stays. 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. KID releases for data years 1997, 2000, 2003, 2006, 2009, 2012, 2016, and 2019 are available for purchase online through the Online HCUP Central Distributor. The KID was not produced for 2015 because of the transition from ICD-9-CM to ICD-10-CM/PCS coding.

Usage

KID Database Documentation includes:

• Description of KID Database
• Restrictions on Use
• Files Specifications and Load Programs
• Data Elements
• Additional Resources for Data Elements
• ICD-10-CM/PCS Included in 2016 KID
• Information on Change to KID Design in 2000
• Known Data Issues
• KID Supplemental Files
• HCUP Tools: Labels and Formats
• Obtaining HCUP Data

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Documentation

Please visit the HCUP National KID page for more information.

There are several Microsoft Word documents here detailing data creation methods and with various dictionaries describing the included and derived variables.The Database Creation Description is meant to walk a user through some of the steps detailed in the SAS code with this project.The alphabetical list of variables is intended for users as sometimes this makes some coding steps easier to copy and paste from this list instead of retyping.The NIS Data Dictionary contains some general dataset description as well as each variable's responses.

Users can use the online interactive tool (HCUP-net) to gather national, state and all-payer patient health care data or users can purchase the data from the HCUP databases. Background HCUP is sponsored by the Agency for Healthcare Research and Quality. It is a collection of databases that provide information on patient health care data, including information typically found on a hospital discharge form. Topics include: cost of care, access to care, and treatment outcomes. The HCUP databases include: The National Inpatient Sample, The Kids' Inpatient Database, The State Ambulatory Surgery Database, and The State Emergency Department Databases. Many of these are available for purchase. User Functionality Users can purchase any of the aforementioned databases from the HCUP Central Administrator. Directions and contact information are readily available from the HCUP website. Users can also access the HCUP interactive tool, HCUP-net. Please click the appropriate link in the keywords to access this tool. Data Notes HCUP began collecting health care data in 1988. Specific information about a particular database can be found on the website.

The Healthcare Cost and Utilization Project (HCUP) Kids' Inpatient Database (KID) is the largest publicly available all-payer pediatric inpatient care database in the United States, containing data from two to three million hospital stays each year. 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. Developed through a Federal-State-Industry partnership sponsored by the Agency for Healthcare Research and Quality, HCUP data inform decision making at the national, State, and community levels. The KID is a sample of pediatric discharges from 4,000 U.S. hospitals in the HCUP State Inpatient Databases yielding approximately two to three million unweighted hospital discharges for newborns, children, and adolescents per year. About 10 percent of normal newborns and 80 percent of other neonatal and pediatric stays are selected from each hospital that is sampled for patients younger than 21 years of age. The KID contains clinical and resource use information included in a typical discharge abstract, with safeguards to protect the privacy of individual patients, physicians, and hospitals (as required by data sources). It includes discharge status, diagnoses, procedures, patient demographics (e.g., sex, age), expected source of primary payment (e.g., Medicare, Medicaid, private insurance, self-pay, and other insurance types), and hospital charges and cost. Restricted access data files are available with a data use agreement and brief online security training.

Summary Trend TablesThe HCUP Summary Trend Tables include information on hospital utilization derived from the HCUP State Inpatient Databases (SID), State Emergency Department Databases (SEDD), National Inpatient Sample (NIS), and Nationwide Emergency Department Sample (NEDS). State statistics are displayed by discharge month and national and regional statistics are displayed by discharge quarter. Information on emergency department (ED) utilization is dependent on availability of HCUP data; not all HCUP Partners participate in the SEDD.The HCUP Summary Trend Tables include downloadable Microsoft® Excel tables with information on the following topics:Overview of trends in inpatient and emergency department utilizationAll inpatient encounter typesInpatient encounter typeNormal newbornsDeliveriesNon-elective inpatient stays, admitted through the EDNon-elective inpatient stays, not admitted through the EDElective inpatient staysInpatient service lineMaternal and neonatal conditionsMental health and substance use disordersInjuriesSurgeriesOther medical conditionsED treat-and-release visitsDescription of the data source, methodology, and clinical criteria (Excel file, 43 KB)Change log (Excel file, 65 KB)For each type of inpatient stay, there is an Excel file for the number of discharges, the percent of discharges, the average length of stay, the in-hospital mortality rate per 100 discharges,1 and the population-based rate per 100,000 population.2 Each Excel file contains State-specific, region-specific, and national statistics. For most files, trends begin in January 2017. Also included in each Excel file is a description of the HCUP databases and methodology.

Usage

The National (Nationwide) Inpatient Sample (NIS) is part of a family of databases and software tools developed for the Healthcare Cost and Utilization Project (HCUP). The NIS is the largest publicly available all-payer inpatient healthcare database designed to produce U.S. regional and national estimates of inpatient utilization, access, cost, quality, and outcomes. Unweighted, it contains data from around 7 million hospital stays each year. Weighted, it estimates around 35 million hospitalizations nationally. Developed through a Federal-State-Industry partnership sponsored by the Agency for Healthcare Research and Quality (AHRQ), HCUP data inform decision making at the national, State, and community levels.

The Healthcare Cost and Utilization Project (HCUP) Nationwide Emergency Department Sample (NEDS) is the largest all-payer emergency department (ED) database in the United States. yielding national estimates of hospital-owned ED visits. Unweighted, it contains data from over 30 million ED visits each year. Weighted, it estimates roughly 145 million ED visits nationally. Developed through a Federal-State-Industry partnership sponsored by the Agency for Healthcare Research and Quality, HCUP data inform decision making at the national, State, and community levels. Sampled from the HCUP State Inpatient Databases (SID) and State Emergency Department Databases (SEDD), the HCUP NEDS can be used to create national and regional estimates of ED care. The SID contain information on patients initially seen in the ED and subsequently admitted to the same hospital. The SEDD capture information on ED visits that do not result in an admission (i.e., treat-and-release visits and transfers to another hospital). Developed through a Federal-State-Industry partnership sponsored by the Agency for Healthcare Research and Quality, HCUP data inform decision making at the national, State, and community levels. The NEDS contain information about geographic characteristics, hospital characteristics, patient characteristics, and the nature of visits (e.g., common reasons for ED visits, including injuries). The NEDS contains clinical and resource use information included in a typical discharge abstract, with safeguards to protect the privacy of individual patients, physicians, and hospitals (as required by data sources). It includes ED charge information for over 85% of patients, regardless of expected payer, including but not limited to Medicare, Medicaid, private insurance, self-pay, or those billed as ‘no charge’. The NEDS excludes data elements that could directly or indirectly identify individuals, hospitals, or states.Restricted access data files are available with a data use agreement and brief online security training.

The Nationwide Emergency Department Sample (NEDS) was created to enable analyses of emergency department (ED) utilization patterns and support public health professionals, administrators, policymakers, and clinicians in their decision-making regarding this critical source of care. The NEDS can be weighted to produce national estimates. The NEDS is the largest all-payer ED database in the United States. It was constructed using records from both the HCUP State Emergency Department Databases (SEDD) and the State Inpatient Databases (SID), both also described in healthdata.gov. The SEDD capture information on ED visits that do not result in an admission (i.e., treat-and-release visits and transfers to another hospital). The SID contain information on patients initially seen in the emergency room and then admitted to the same hospital. The NEDS contains 25-30 million (unweighted) records for ED visits for over 950 hospitals and approximates a 20-percent stratified sample of U.S. hospital-based EDs. The NEDS contains information about geographic characteristics, hospital characteristics, patient characteristics, and the nature of visits (e.g., common reasons for ED visits, including injuries). The NEDS contains clinical and resource use information included in a typical discharge abstract, with safeguards to protect the privacy of individual patients, physicians, and hospitals (as required by data sources). It includes ED charge information for over 75% of patients, regardless of payer, including patients covered by Medicaid, private insurance, and the uninsured. The NEDS excludes data elements that could directly or indirectly identify individuals, hospitals, or states.

Demographics of patients seen at the ED with football injuries by admission to hospital 2010 to 2013 ((N = 819,000).

The annual incidence is presented by events per 100,000 hospitalizations.

Characteristics of study cohort, stratified by three periods between 2006 and 2014.

Users are able to access information related to inpatient care for children under 20 years old. Researchers, students, and policymakers can use the KID to identify, track, and analyze national trends in health care utilization, access, charges, quality, and outcomes. Background The Kids' Inpatient Database (KID) is one in a family of databases and software tools developed as part of the Healthcare Cost and Utilization Project (HCUP). A Federal-State-Industry partnership sponsored by the Agency for Healthcare Research and Quality, HCUP data inform decisionmaking at the national, State, and community levels. The KID is nationally representative sample. The Kids' Inpatient Database (KID) for 2009 includes 4,121 hospitals from 44 states. The KID fo r 2006 includes 3,739 hospitals from 38 states. The KID for 2003 includes 3,438 hospitals from 36 states. The KID for 2000 includes 2,784 hospitals from 27 States. The KID for 1997 includes 2,521 hospitals from 22 States. User functionality Users must pay to access the KID database. KID files for 2009, 2006, 2003, 2000, and 1997 are available through the HCUP Central Distributor. The 2009 KID may be purchased for $50 for students and $350 for all others on a single DVD-ROM with accompanying documentation. C The KID is distributed as fixed-width ASCII formatted data files compressed with WinZip®. Previously it was distributed on two CD ROMs, but beginning with the 2009 KID, it is distributed on a si ngle DVD. In order to load and analyze the KID data on a computer, you will need a DVD drive, a hard drive with 10 gigabytes of space available, and SAS, SPSS, Stata or similar analysis software Data Notes KID data is available for 1997, 2000, 2003, 2006, and 2009. Surveys are completed every three years.

In-hospital mortality rate and annual change in rate for specific infection site among patients with sepsis.

Supplementary Material 1

Demographics and hospital outcomes comparing White and Black patients hospitalized with diabetic foot complications, National Inpatient Sample (2003–2014).