The HCUP Hospital Market Structure Files are hospital-level files designed to supplement the data elements in the NIS, KID, and SID databases. They 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
• How Are the Hospital Market Structure Files Used?
• What Files Are Available?
• Hardware and Software Requirements
• User Guides
• How Can Users Obtain the HCUP Hospital Market Structure Files?

The Hospital Market Structure File contains various measures of hospital market competition. These measures are aggregate and are meant to broadly characterize the intensity of competition that hospitals may be facing under various definitions of market area.

AHRQ?s Hospital Market Structure Measures Project began as an intramural study in 2000, spurred by a need for better and more readily available measures of hospital markets. For more information about the design of the measures, please see the published article by Wong HS, Zhan C, and Mutter R. ("Do Different Measures of Hospital Competition Matter in Empirical Investigations of Hospital Behavior?" Review of Industrial Organization 26: 61-87, 2005.)

Hospital market definitions were based on hospital locations, and in some cases, patient ZIP Codes. Hospital locations were obtained from the American Hospital Association (AHA) Annual Survey Database, Area Resource File (ARF), HCUP Historical Urban/Rural ? County (HURC) file, and ArcView GIS. Patient ZIP Codes were obtained from the SID.

The HCUP Hospital Market Structure Files replicate the earlier study measures but use more recent data. In building the files, AHRQ introduced some modest refinements to the methods described in the published paper. To create the competition measures, SID and publicly available data are utilized in sophisticated algorithms based on the four most common ways of defining hospital market areas (i.e., geopolitical boundaries, fixed radius, variable radius, and patient flow) and the two most frequently used methods of capturing the intensity of competition within a market area (i.e., the number of hospitals and the Herfindahl-Hirschman Index (HHI)). Depending on the algorithm employed, the measures take the form of an integer (e.g., ranging from 1 to about 100), an integer plus a fraction (for weighted values), or a value between 0 and 1 (e.g., 0.25).

Users can merge the data elements on the Hospital Market Structure File to the corresponding NIS, KID, or SID hospitals by the hospital identification number (HOSPID). Using the merged data elements, hospital market structure measures can then be included in analyses using the NIS, KID, or SID.

HCUP Hospital Market Structure Files are designed to be used exclusively with the HCUP NIS, KID, or SID. These files are unique each year.

The HCUP Hospital Market Structure Files broadly characterize the intensity of competition that an individual hospital may be facing under various market definitions.

Hospital market structure measures are generally useful for performing empirical analyses that examine the effects of hospital competition on the cost, access, and quality of hospital services. They are most useful to analysts as a secondary control variable (e.g., for assessing whether a statistical relationship exists between two variables when hospital market structure is controlled).

The HCUP Hospital Market Structure Files are created every three years. The following files are currently available:

• 2009
• 2006
• 2003
• 2000
• 1997

These files link to the NIS, KID, and SID for most States available through the HCUP Central Distributor.

The HCUP Hospital Market Structure Files can be run on desktop computers with a CD-ROM reader, and are available in ASCII format. The files on the CD require a statistical software package such as SAS or SPSS to use for analytic purposes.

The User Guides for the HCUP Hospital Market Structure Files contain:

• A more detailed description
• Instructions for linking the files to the NIS, KID, or SID
• State participation
• A description of internal validation methods
• Descriptions of key variables.

Downloading Information

• Hospital Market Structure Files: 2009 User Guide (PDF file, 31 KB)
• Hospital Market Structure Files: 2006 User Guide (PDF file, 31 KB)
• Hospital Market Structure Files: 2003 User Guide (PDF file, 18 KB)
• Hospital Market Structure Files: 2000 User Guide (PDF file, 18 KB)
• Hospital Market Structure Files: 1997 User Guide (PDF file, 18 KB)

HCUP Hospital Market Structure Files are available from the HCUP Central Distributor. These files are free of charge. Contact the HCUP Central Distributor to obtain your own copy of these files.