Cost-to-Charge Ratios for Emergency Department Files

The HCUP Cost-to-Charge Ratios for Emergency Department Files (CCR for ED Files) are hospital-level files designed to supplement the data elements in the State Emergency Department Databases (SEDD) and Nationwide Emergency Department Sample (NEDS), beginning with data year 2012. HCUP Cost-to-Charge Ratios for Inpatient Files are also available. The CCR Files are part of a family of databases and software tools developed as part of the Healthcare Cost and Utilization Project (HCUP), a Federal-State-Industry partnership sponsored by the Agency for Healthcare Research and Quality. HCUP databases, tools, and software inform decision making at the national, State, and community levels.

Contents:

Overview of the CCR for ED Files
Description of the CCR for ED Files
File Information
Hardware and Software Requirements
User Documentation
How Can Users Obtain the CCR for ED Files?

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Overview of the CCR for ED Files

The HCUP Emergency Department databases contain data on total charges for each hospital emergency department (ED) visit in the databases. The charge information for ED visits represents the amount that hospitals billed for services, but does not reflect how much hospital services cost or the specific amounts that hospitals received in payment. For some analyses, users may be interested in estimating how hospital charges translate into actual costs.

The HCUP CCR for ED Files enable this conversion. Each file contains hospital-specific cost-to-charge ratios based on all-payer ED costs for nearly every hospital in the corresponding SEDD and NEDS. Cost information was obtained from the hospital accounting reports collected by the Centers for Medicare & Medicaid Services. Some imputations for missing values were necessary.

Users can merge the data elements on the appropriate file to the corresponding SEDD or NEDS by the HCUP hospital identification number (HOSPID for the SEDD and HOSP_NEDS for the NEDS). Using the merged data elements from the cost-to-charge ratio files and the total charges reported in the SEDD or NEDS, users may convert the hospital total charge data to cost estimates by simply multiplying the HCUP total charges element (TOTCHG) by the appropriate cost-to-charge ratio.

HCUP CCR for ED Files are designed to be used exclusively with the HCUP SEDD or NEDS. The CCR Files are unique by year and database.

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Description of the CCR for ED Files

The HCUP CCR for ED Files are used to estimate the cost of resource use for ED visits based on the reported total charge and the cost-to-charge ratios provided in the supplemental files. Costs reflect the actual expenses incurred in the production of hospital services, such as wages, supplies, and utility costs; charges represent the amount a hospital billed for the case. Hospital charges reflect the amount the hospital billed for the entire ED visit and do not include professional (physician) fees.

The CCR for ED Files allow researchers to obtain costs using hospital-specific ratios, where provided, or by weighted average ratios for hospitals in peer groups defined by hospital characteristics and State.

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File Information

Data Year	SAS File Name	Observations	Data Elements	Data Type	Summary Statistics	Password
2021	edcc2021CD.csv	2152	8	SEDD	X	N/A
2021	cc2021NEDS.csv	993	4	NEDS	X	N/A
2020	edcc2020CD.csv	2201	8	SEDD	X	N/A
2020	cc2020NEDS.csv	995	4	NEDS	X	N/A
2019	edcc2019NEDS.csv	989	4	NEDS	X	N/A
2019	edcc2019CD.csv	2185	8	SEDD	X	N/A
2018	edcc2018NEDS.csv	990	4	NEDS	X	N/A
2018	edcc2018CD_v2	2191	8	SEDD	X	N/A
2018	edcc2018CD.csv	1718	8	SEDD	X	N/A
2017	edcc2017NEDS.csv	984	4	NEDS	N/A	N/A
2017	edcc2017CD_v2.csv	1458	8	SEDD	N/A	N/A
2016	edcc2016NEDS.csv	953	4	NEDS	N/A	N/A
2016	edcc2016CD.csv	1442	8	SEDD	N/A	N/A
2015	edcc2015NEDS.csv	953	4	NEDS	N/A	N/A
2015	edcc2015CD.csv	1441	8	SEDD	N/A	N/A
2014	edcc2014NEDS.csv	945	4	NEDS	N/A	N/A
2014	edcc2014CD.csv	1387	8	SEDD	N/A	N/A
2013	edcc2013NEDS.csv	947	4	NEDS	N/A	N/A
2013	edcc2013CD.csv	1394	8	SEDD	N/A	N/A
2012	edcc2012NEDS.csv	950	4	NEDS	N/A	N/A
2012	edcc2012CD.csv	1331	8	SEDD	N/A	N/A

Revision History

The 2017-2018 CCR-SEDD were revised in October 2021.

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Hardware and Software Requirements

The HCUP CCR for ED Files are available in comma-separated values (CSV) format. The SEDD and NEDS files require a statistical software package such as SAS, SPSS, or Stata to use for analytic purposes.

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