[Federal Register Volume 84, Number 42 (Monday, March 4, 2019)]
[Notices]
[Pages 7370-7372]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2019-03734]


=======================================================================
-----------------------------------------------------------------------

DEPARTMENT OF HEALTH AND HUMAN SERVICES

Agency for Healthcare Research and Quality


Agency Information Collection Activities: Proposed Collection; 
Comment Request

AGENCY: Agency for Healthcare Research and Quality, HHS.

ACTION: Notice.

-----------------------------------------------------------------------

SUMMARY: This notice announces the intention of the Agency for 
Healthcare Research and Quality (AHRQ) to request that the Office of 
Management and Budget (OMB) approve the proposed information collection 
project: ``Online Application Order Form for Products from the 
Healthcare Cost and Utilization Project (HCUP).''
    This proposed information collection was previously published in 
the Federal Register on December 18, 2018 and allowed 60 days for 
public comment. AHRQ received no substantive comments from members of 
the public. The purpose of this notice is to allow an additional 30 
days for public comment.

DATES: Comments on this notice must be received by April 3, 2019.

ADDRESSES: Written comments should be submitted to: AHRQ's OMB Desk 
Officer by fax at (202) 395-6974 (attention: AHRQ's desk officer) or by 
email at [email protected] (attention: AHRQ's desk officer).

FOR FURTHER INFORMATION CONTACT: Doris Lefkowitz, AHRQ Reports 
Clearance Officer, (301) 427-1477, or by email at 
[email protected].

SUPPLEMENTARY INFORMATION: 

Proposed Project

Online Application Order Form for Products From the Healthcare Cost and 
Utilization Project (HCUP)

    In accordance with the Paperwork Reduction Act, 44 U.S.C. 3501-
3521, AHRQ invites the public to comment on this proposed information 
collection. The Healthcare Cost and Utilization Project (HCUP, 
pronounced ``H-Cup'') is a vital resource helping the Agency achieve 
its research agenda, thereby furthering its goal of improving the 
delivery of health care in the United States. HCUP is a family of 
health care databases and related software tools and products developed 
through a Federal-State-Industry partnership and sponsored by AHRQ. 
HCUP includes the largest collection of longitudinal hospital care data 
in the United States, with all-payer, encounter-level information 
beginning in 1988. The HCUP databases are annual files that contain 
anonymous information from hospital discharge records for inpatient 
care and certain components of outpatient care, such as emergency care 
and ambulatory surgeries. The project currently releases seven types of 
databases created for research use on a broad range of health issues, 
including cost and quality of health services, medical practice 
patterns, access to health care programs, and outcomes of treatments at 
the national, State, and local market levels. HCUP also produces a 
large number of software tools to enhance the use of administrative 
health care data for research and public health use. Software tools use 
information available from a variety of sources to create new data 
elements, often through sophisticated algorithms, for use with the HCUP 
databases.
    HCUP's objectives are to:
     Create and enhance a powerful source of national, state, 
and all-payer health care data.
     Produce a broad set of software tools and products to 
facilitate the use of HCUP and other administrative data.
     Enrich a collaborative partnership with statewide data 
organizations (that voluntarily participate in the project) aimed at 
increasing the quality and use of health care data.
     Conduct and translate research to inform decision making 
and improve health care delivery.
    This project is being conducted by AHRQ through its primary 
contractor and subcontractor, IBM Watson Health and Social & Scientific 
Systems, Inc., pursuant to AHRQ's statutory authority to conduct and 
support research on health care and on systems for the delivery of such 
care, including activities with respect to the outcomes, cost, cost-
effectiveness, and use of health care services and access to such 
services. 42 U.S.C. 299a(a)(3).

Method of Collection

    The HCUP releases seven types of databases for public research use:

[[Page 7371]]

    (1) The National Inpatient Sample (NIS) is the largest all-payer 
inpatient care database in the United States, yielding national 
estimates of hospital inpatient stays. The NIS approximates 20 percent 
of the discharges from all U.S. community hospitals and contains data 
from approximately 7 million hospital stays each year. NIS data 
releases are available for purchase from the HCUP Central Distributor 
for data years beginning in 1988.
    (2) The Kids' Inpatient Database (KID) is the only all-payer 
inpatient care database for children in the United States. The KID was 
specifically designed to permit researchers to study a broad range of 
conditions and procedures related to child health issues. The KID 
contains a sample of 2 to 3 million discharges for children age 20 and 
younger from more than 4,200 U.S. community hospitals. KID data 
releases are available every third year starting in 1997.
    (3) The Nationwide Emergency Department Sample (NEDS) is the 
largest all-payer ED database in the United States. It is constructed 
to capture information both on ED visits that do not result in an 
admission and on ED visits that result in an admission to the same 
hospital. The NEDS contains more than 31 million unweighted records for 
ED visits at about 950 U.S. community hospitals and approximates a 20-
percent stratified sample of U.S. hospital-based EDs. NEDS data 
releases are available beginning with data year 2006.
    (4) The State Inpatient Databases (SID) contain the universe of 
inpatient discharge abstracts from data organizations in 48 States and 
the District of Columbia that currently participate in the SID. 
Together, the SID encompass approximately 97 percent of all U.S. 
community hospital discharges. Most States that participate in the SID 
make their data available for purchase through the HCUP Central 
Distributor. Files are available beginning with data year 1990.
    (5) The State Ambulatory Surgery and Services Databases (SASD) 
contain encounter-level data from ambulatory surgery and other 
outpatient services from hospital-owned facilities. In addition, some 
States provide data for ambulatory surgery and outpatient services from 
nonhospital-owned facilities. Currently, 35 States participate in the 
SASD. Files are available beginning with data year 1997.
    (6) The State Emergency Department Databases (SEDD) contain data 
from hospital-owned emergency departments (ED) for visits that do not 
result in a hospitalization. Currently, 38 States participate in the 
SEDD. Files are available beginning with data year 1999.
    (7) The Nationwide Readmissions Database (NRD) is designed to 
support various types of analyses of national readmission rates. This 
database addresses a large gap in health care data--the lack of 
nationally representative information on hospital readmissions. The NRD 
is a calendar-year, discharge-level database constructed from the HCUP 
State Inpatient Databases (SID).
    To support AHRQ's mission to improve health care through scientific 
research, HCUP databases and software tools are disseminated to users 
outside of the Agency through a mechanism known as the HCUP Central 
Distributor at https://www.hcup-us.ahrq.gov/tech_assist/centdist.jsp. 
The HCUP Central Distributor assists qualified researchers to access 
uniform research data across multiple states with the use of one 
application process. The HCUP databases disseminated through the 
Central Distributor are referred to as ``restricted access public 
release files''; that is, they are publicly available, but only under 
restricted conditions.
    This information collection request is for the activities 
associated with the HCUP database application process, not the 
collection of health care data for HCUP databases.
    The activities associated with this application include:
    (1) HCUP Application. All persons requesting access to the HCUP 
databases must complete an application at https://distributor.hcup-us.ahrq.gov/. Applications for HCUP State databases require a brief 
description of the planned research use to ensure that the intended use 
is consistent with HCUP policies and with the HCUP Data Use Agreement 
(DUA). Paper versions of all application packages are also available 
for downloading at http://www.hcup-us.ahrq.gov/tech_assist/centdist.jsp.
    (2) HCUP DUA Training. All persons wanting access to the HCUP 
databases must complete an online training course. The purpose of the 
training is to emphasize the importance of data protection, reduce the 
risk of inadvertent violations, and describe the individual's 
responsibility when using HCUP data. The training course can be 
accessed and completed online at http://www.hcup-us.ahrq.gov/techassist/dua.jsp.
    (3) HCUP DUA. All persons wanting access to the HCUP databases must 
sign a data use agreement. An example DUA for the Nationwide databases 
is available at http://www.hcup-us.ahrq.gov/team/NationwideDUA.jsp.
    HCUP databases are released to researchers outside of AHRQ after 
the completion of required training and submission of an application 
that includes a signed HCUP DUA. In addition, before restricted access 
public release state-level databases are released, AHRQ must review and 
approve the applicant's statement of intended use to ensure that the 
planned use is consistent with HCUP policies and with the HCUP DUA. 
Fees are set for databases released through the HCUP Central 
Distributor depending on the type of database. The fee for sale of 
state-level data is determined by each participating Statewide Data 
Organization and reimbursed to those organizations. Information 
collected in the HCUP Application process will be used for two purposes 
only:
    1. Business Transaction: In order to deliver the HCUP databases and 
software, contact information is necessary for shipping some types of 
HCUP data on disk (or any other media used in the future).
    2. Enforcement of the HCUP DUA: The HCUP DUA contains several 
restrictions on use of the data. Most of these restrictions have been 
put in place to safeguard the privacy of individuals and establishments 
represented in the data. For example, data users can only use the data 
for research, analysis, and aggregate statistical reporting and are 
prohibited from attempting to identify any persons in the data. Contact 
information on HCUP DUAs is retained in the event that a violation of 
the DUA takes place.

Estimated Annual Respondent Burden

    Exhibit 1 shows the estimated annualized burden associated with the 
applicants' time to order any of the HCUP databases. An estimated 1,500 
persons will order HCUP data annually. Each of these persons will 
complete an application (10 minutes), the DUA training (15 minutes) and 
a DUA (5 minutes). The total burden is estimated to be 750 hours 
annually.
    Exhibit 2 shows the estimated annualized cost burden associated 
with the applicants' time to order HCUP data. The total cost burden is 
estimated to be $29,662 annually.

[[Page 7372]]



                                  Exhibit 1--Estimated Annualized Burden Hours
----------------------------------------------------------------------------------------------------------------
                                                                     Number of
                    Form name                        Number of     responses per     Hours per     Total burden
                                                    respondents     respondent       response          hours
----------------------------------------------------------------------------------------------------------------
HCUP Application Form...........................           1,500               1           10/60             250
HCUP DUA Training...............................           1,500               1           15/60             375
HCUP DUA........................................           1,500               1            5/60             125
                                                 ---------------------------------------------------------------
    Total.......................................           4,500              na              na             750
----------------------------------------------------------------------------------------------------------------


                                   Exhibit 2--Estimated Annualized Cost Burden
----------------------------------------------------------------------------------------------------------------
                                                     Number of     Total burden   Average hourly    Total cost
                    Form name                       respondents        hours        wage rate *       burden
----------------------------------------------------------------------------------------------------------------
HCUP Application Form...........................           1,500             250          $39.55          $9,887
HCUP DUA Training...............................           1,500             375           39.55          14,831
HCUP DUA........................................           1,500             125           39.55           4,944
                                                 ---------------------------------------------------------------
    Total.......................................           4,500             750              na          29,662
----------------------------------------------------------------------------------------------------------------
* Based upon the mean of the average wages for Life Scientists, All Other (19-1099), National Compensation
  Survey: Occupational Employment Statistics, May 2017 National Occupational Employment and Wage Estimates
  United States, U.S. Department of Labor, Bureau of Labor Statistics. http://www.bls.gov/oes/current/oes_nat.htm#b29-0000.

Request for Comments

    In accordance with the Paperwork Reduction Act, comments on AHRQ's 
information collection are requested with regard to any of the 
following: (a) Whether the proposed collection of information is 
necessary for the proper performance of AHRQ health care research and 
health care information dissemination functions, including whether the 
information will have practical utility; (b) the accuracy of AHRQ's 
estimate of burden (including hours and costs) of the proposed 
collection(s) of information; (c) ways to enhance the quality, utility, 
and clarity of the information to be collected; and (d) ways to 
minimize the burden of the collection of information upon the 
respondents, including the use of automated collection techniques or 
other forms of information technology.
    Comments submitted in response to this notice will be summarized 
and included in the Agency's subsequent request for OMB approval of the 
proposed information collection. All comments will become a matter of 
public record.

Francis D. Chesley, Jr.,
Acting Deputy Director.
[FR Doc. 2019-03734 Filed 3-1-19; 8:45 am]
 BILLING CODE 4160-90-P