Evidence map›Paper›PMID 37602919›Full record

ArticleHealth services research2023

Estimating state-specific population-based hospitalization rates from in-state hospital discharge data.

Marc Roemer, Mary Beth Schaefer, Gary T Pickens, Marguerite L Barrett

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Article in Health services research, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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1citing papers in PubMed
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1 · What the graph read from it

What it found

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2 · The registry

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3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

4 authors.

Marc RoemerAgency for Healthcare Research and Quality, Rockville, Maryland, USA.ORCID 0000-0001-6547-6913
Mary Beth SchaeferAffiliation at time of study: IBM, Santa Barbara, California, USA.
Gary T PickensIndependent Consultant, Chicago, Illinois, USA.
Marguerite L BarrettML Barrett, Inc., Del Mar, California, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo develop weights to estimate state population-based hospitalization rates for all residents of a state using only data from in-state hospitals which exclude residents treated in other states. DATA SOURCES AND STUDY

settingAgency for Healthcare Research and Quality, Healthcare Cost and Utilization Project (HCUP), State Inpatient Databases (SID), 2018-2019, 47 states+DC. STUDY

designWe identified characteristics for patients hospitalized in each state differentiating movers (discharges for patients hospitalized outside state of residence) from stayers (discharges for patients hospitalized in state of residence) and created weights based on 2018 data informed by these characteristics. We calculated standard errors using a sampling framework and compared weight-based estimates against complete observed values for 2019. DATA COLLECTION/EXTRACTION

methodsSID are based on administrative billing records collected by hospitals, shared with statewide data organizations, and provided to HCUP. PRINCIPAL

findingsOf 34,186,766 discharged patients in 2018, 4.2% were movers. A higher share of movers (vs. stayers) lived in state border and rural counties; a lower share had discharges billed to Medicaid or were hospitalized for maternal/neonatal services. The difference between 2019 observed and estimated total discharges for all included states and DC was 9402 (mean absolute percentage error = 0.2%). We overestimated discharges with an expected payer of Medicaid, from the lowest income communities, and for maternal/neonatal care. We underestimated discharges with an expected payer of private insurance, from the highest income communities, and with injury diagnoses and surgical services. Estimates for most subsets were not within a 95% confidence interval, likely due to factors impossible to account for (e.g., hospital closures/openings, shifting consumer preferences).

conclusionsThe weights offer a practical solution for researchers with access to only a single state's data to account for movers when calculating population-based hospitalization rates.

Indexed as

HospitalizationHospitals, StateDelivery of Health CareHumansInfant, NewbornMedicaidPatient Acceptance of Health CareUnited Stateshealth care-seeking behaviorinpatient dataout-of-state hospitalizationspopulation-based ratesweighting methods

Identifiers

PMID37602919
PMCPMC10622291

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.