title: Statewide Hospital Discharge Data: Collection, Use, Limitations, and Improvements.
abstract: OBJECTIVE
  To provide an overview of statewide hospital discharge databases (HDD), including their uses in health services research and limitations, and to describe Agency for Healthcare Research and Quality (AHRQ) Enhanced State Data grants to address clinical and race-ethnicity data limitations.
  
  
  RESULTS
  Almost all states have statewide HDD collected by public or private data organizations. Statewide HDD, based on the hospital claim with state variations, contain useful core variables and require minimal collection burden. AHRQ's Healthcare Cost and Utilization Project builds uniform state and national research files using statewide HDD. States, hospitals, and researchers use statewide HDD for many purposes. Illustrating researchers' use, during 2012-2014, HSR published 26 HDD-based articles on health policy, access, quality, clinical aspects of care, race-ethnicity and insurance impacts, economics, financing, and research methods. HDD have limitations affecting their use. Five AHRQ grants focused on enhancing clinical data and three grants aimed at improving race-ethnicity data.
  
  
  CONCLUSIONS
  ICD-10 implementation will significantly affect the HDD. The AHRQ grants, information technology advances, payment policy changes, and the need for outpatient information may stimulate other statewide HDD changes. To remain a mainstay of health services research, statewide HDD need to keep pace with changing user needs while minimizing collection burdens.
authors.affiliation: Center for Delivery, Organization, and Markets, Agency for Healthcare Research and Quality, Rockville, MD.
authors.forename: Roxanne M
authors.initials: RM
authors.lastname: Andrews
mesh_terms: D003625:Data Collection / Q000379:methods*; D016208:Databases, Factual; D005006:Ethnicity / Q000706:statistics & numerical data*; D006302:Health Services Research; D006801:Humans; D038801:International Classification of Diseases; D010351:Patient Discharge; D058996:Quality Improvement; D044469:Racial Groups / Q000706:statistics & numerical data*; D012109:Research Support as Topic; D014481:United States; D016270:United States Agency for Healthcare Research and Quality
keywords: Administrative data; clinical data; ethnicity; hospital; race