Health Services Research & Development

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2007 HSR&D National Meeting Abstract

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National Meeting 2007

1038 — How Decision Support System National Data Extracts Can be Linked with Veterans Health Administration Hospital Discharge and Outpatient Data Sets

King SS (HERC) , Phibbs CS (HERC), Yu W (HERC), Barnett PB (HERC)

Objectives:
To provide researchers with information about how fiscal year (FY) 2004 Decision Support System (DSS) National Data Extracts (NDE) can be linked with the FY2004 Veterans Health Administration (VHA) hospital discharge and outpatient data sets. This information will assist researchers (1) to combine DSS records with clinical characteristics of care, (2) to make the best use of the DSS cost estimates in their research projects, and (3) to explore the value of DSS national cost data extracts to VHA health-care studies.

Methods:
The following data sets were compared using the scrambled social security number and other key variables: (1) The DSS discharge database and the Patient Treatment File (PTF), (2) the DSS NDE treating specialty file and the PTF bedsection file, (3) the outpatient National Patient Care Database (NPCD) and the DSS outpatient visits extract.

Results:
All but 0.02 percent of the records between the DSS discharge database and the PTF could be matched. The DSS treating specialty file included 99.7% of the stays recorded in the acute care (PB) PTF bedsection file and 97.4% of the stays in the extended care (XB) PTF bedsection file. The PTF files included 97.8% of the stays in the DSS treating specialty file. Over 32,000 patients in the NPCD did not have any care in the DSS outpatient visits extract. But by expanding our analysis by using a new file that contains outpatient encounters that were assigned low cost by DSS, there were just 6,728 patients who had visits in the NPCD and not in the DSS outpatient data (only 0.14% of all patients in NPCD).

Implications:
By including low cost DSS encounters in the comparison between the DSS and NPCD databases, outpatient utilization thought to be missing from DSS was found. With adjustments for database design, inpatient stays in the DSS NDEs can be matched almost perfectly with corresponding records in the PTF.

Impacts:
Our research suggests that the DSS national cost data extracts have a great value to VHA health-care studies. Researchers are encouraged to consult the Health Economics Resource Center web site at http://www.herc.research.med.va.gov/home/default.asp for further information about DSS data.