The HCUP Cost-to-Charge Ratio for Inpatient Files (CCR for Inpatient Files) are hospital-level files designed to supplement the data elements in the SID, NIS, KID, and NRD. HCUP Cost-to-Charge Ratio for Emergency Department Files (CCR for ED 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 CCR for Inpatient Files
• Description of the CCR for Inpatient Files
• File Information
• Hardware and Software Requirements
• User Documentation
• How Can Users Obtain HCUP CCR for Inpatient Files?

The HCUP Inpatient databases - the SID, NIS, KID, and NRD - contain data on total charges for each hospital discharge in the databases. Charges represents the amount that hospitals billed for services; this differs from costs, or the actual expenses incurred in the production of hospital services, such as wages, supplies, and utility. HCUP total charges exclude professional (physician) fees.

The HCUP CCR for Inpatient Files provide users with ratios that will allow the conversion of the HCUP charges into cost estimates. Each file contains hospital-specific cost-to-charge ratios based on all-payer inpatient cost for nearly every hospital in the corresponding SID, NIS, KID, and NRD. Cost information was obtained from the hospital accounting reports collected by the Centers for Medicare & Medicaid Services (CMS). Some imputations for missing values were necessary.

Users can merge the data elements from the appropriate CCR File onto the corresponding NIS, KID, NRD, or SID by the HCUP hospital identification number (HOSPID, and beginning with the 2012 databases, HOSP_NIS, HOSP_KID, or HOSP_NRD). The cost of inpatient care for a discharge can be estimated by multiplying the HCUP total charges data element (TOTCHG) by the appropriate cost-to-charge ratio.

HCUP CCR for Inpatient Files are designed to be used exclusively with the HCUP NIS, KID, NRD, or SID. The CCR files are unique by year and database.

The HCUP CCR for Inpatient Files are used to estimate the cost of resource use for inpatient hospital stays and its variation across hospitals and conditions based on the reported total charge and the cost 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.

The CCR for Inpatient 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.

Revision History

The 2010-2018 CCR-SID were revised in October 2021.
The 2018 CCR-SID was revised in December 2020.
The 2010 CCR-NIS and CCR-SID were revised in August 2013.

The HCUP CCR for Inpatient Files are available in ASCII comma-separated values (CSV) format. The NIS, KID, NRD, and SID files require a statistical software package such as SAS, SPSS, or Stata to use for analytic purposes.

User documentation for the HCUP CCR for Inpatient Files includes a user guide and a methodologies document.

The user guide contains:

• A more detailed description of the file's purpose, usage, and format
• Instructions for linking the files to the NIS, KID, NRD, or SID
• A summary of State participation
• Descriptions of key data elements

The methodologies document contains:

• An overview of the CCR method
• A detailed description of the development process for the CCR files
• A summary of the CCR imputation model
• Guidance for using the CCRs with HCUP databases

User Documentation for CCR for Inpatient Files

• User Guide: Cost-to-Charge Ratio for Inpatient Files, 2001-2022 (PDF file, 452 KB)
• HCUP Cost-to-Charge Ratio Methodologies (HCUP Methods Series Report) (PDF file, 680 KB)
• Prior versions

HCUP CCR for Inpatient Files are provided as separate files available with the HCUP Central Distributor SID, NIS, KID, and NRD. These supplemental files are available free of charge from the HCUP Central Distributor.

The CCR for Inpatient Files are provided as complimentary files that are automatically included with download orders for the NIS, KID, and NRD databases. The CCR files for the SID can be added to an order for the accompanying SID - they are not automatically included with the order.