Centers for Medicare & Medicaid Services - Hospital Compare

General description

1. Database primary purpose - To better inform healthcare consumers about a hospital’s quality of care. Hospital Compare provides information on the quality-of-care hospitals are providing to their patients.
2. Overall data type - Health facilities
3. Dataset type - Longitudinal
4. Data source - Claims, surveys
5. Data level - Hospital level
6. Geographic location of the data collection sites - United States
7. Sponsor, manager, or home institution - Centers for Medicare & Medicaid Services
8. Date range - 2005 - 2020. Also, CMS started publishing star ratings in 2015.
9. Geolocation data - Address, city, county, state, zip code
10. Dates - Start and end quarters (quarter/year), start and end dates (mm/dd/yyyy)
11. Hospital identifiers - Facility ID, Facility name, Facility Medicare Provider ID
12. NPI - Yes, for the Ambulatory Surgical Center Quality Reporting Program (ASCQR)
13. Longitudinal tracking - Track hospitals
14. Financial variables - Payment measure ID and name, payment category, value of care, Medicare spending per beneficiary (MSPB)
15. Clinical areas of interest - all
16. Number of records - over 4,000 Medicare-certified hospitals, including acute care hospitals, critical access hospitals (CAHs), children’s hospitals, Veterans Health Administration (VHA) Medical Centers, and hospital outpatient departments
17. Variables that are uniquely present in this dataset - Quality measure information on (1) care measures (percentages and/or rates of performance), (2) outcome measures, and (3) patient experience of care; all available at hospital -, state-, and national-level
18. Database caveats and limitations -
    • Data is collected for the purpose of making healthcare payments and reporting hospital quality performance information, and not for research; there are limitations to the data that you should consider when analyzing;
    • Only includes a diagnosis documented via the International Classification of Diseases, Ninth Revision (ICD-9) or ICD-10codes, and its difficult to assess surgical complications;
    • There is no physiological or biochemical patient information, such as vital signs, laboratory test results, and pathology results;
    • There are no timestamps during a hospital stay. This can limit the study of how care progresses or when events and complications occur during hospitalization;
    • Lack of data on uncovered services or benefits and managed care enrollee information. This limits the evaluation of outpatient utilization patterns;
    • The data are derived from billing data, allowing inconsistent documentation for comorbidity and severity;
    • Researchers using the Home Health Agency (HHA) data need to be aware of changes in how CMS codes HHA services over time.

Applicable methods

1. Time to Event Models (1, 2)
2. Exploratory Analyses (3)
3. Propensity score (3, 4)
4. Time Series (5)
5. Time to event (4)
6. Sensitivity Analysis (4)
7. Cost-effectiveness (6, 7, 8, 9)
8. Survival analysis (10)
9. Models with grouped outcomes (11)
10. Implementation Science (12, 13, 14, 15, 16, 17)

High-impact designs

• Enrichment of the CMS Hospital Compare dataset through linkage to other datasets, such as Robert Wood Johnson Foundation Health Insurance Exchange (HIX) Compare, Vericred, and the American Hospital Association (AHA) survey 18, and CMS Inpatient Prospective Payment System and U.S. Census 19.

• Use of state-level difference-in-differences approach to identify the impact of Medicaid expansion on ED wait times20

Data dictionary

To access the CMS Hospital Compare dictionary, click here

Variable categories

1. General information - overall hospital rating, structural measures, and health information technology (HIT)
2. Survey of patients’ experiences – Hospital Consumer Assessment of Healthcare Providers and Systems survey (HCAHPS)
3. Timely and effective care - cataract care, colonoscopy follow-up, heart attack care, Emergency Department (ED) care, preventive care, cancer care, blood clot prevention, pregnancy & delivery care, and outpatient imaging efficiency
4. Complications & deaths - surgical complications, CMS Patient Safety Indicators (PSIs), healthcare-associated infections (HAIs), and 30-day death (mortality rates)
5. Unplanned hospital visits - 30-day rates of readmission and Excess Days in Acute Care (EDAC)
6. Use of medical imaging
7. Payment & value of care - MSPB, payment for heart attack, heart failure, hip/knee replacement, and pneumonia patients, and value of care for heart attack, heart failure, hip/knee replacement, and pneumonia patients
8. Veterans Health Administration Hospital Data
9. Psychiatric Unit Services - Inpatient Psychiatric Facility Quality Reporting (IPFQR) Program

Linkage to other datasets

• CMS Hospital Compare can theoretically be linked to any dataset where the hospital name and location (i.e., city, zip code) are mentioned, although that linkage might require the use of NLP and manual checking.