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Rehabilitation Dataset Directory: Dataset Profile

Dataset: Hospital Service Area (HSA) and Hospital Referral Regions (HRR) (HSA & HRR )

Basic Information
Dataset full name: Hospital Service Area (HSA) and Hospital Referral Regions (HRR)
Dataset acronym HSA & HRR
Summary “Hospital service areas (HSA) are collection of ZIP codes whose residents receive most of their institutional care from the hospitals in that area. The HSA were defined by assigning ZIP codes to the hospital area where the greatest proportion of their Medicare residents were hospitalized. Hospital referral regions (HRR) represent regional health care markets for tertiary medical care. Each HRR contains at least one hospital that performs major cardiovascular procedures and neurosurgery. HRR were defined by assigning HSA to the region where the greatest proportion of major cardiovascular procedures were performed, with minor modifications to achieve geographic contiguity, a minimum population size of 120,000, and a high localization index” (Source: Dartmouth Atlas Project). The following data sources are used for computing HAS/HRR: the Centers for Medicare and Medicaid Services (CMS), U.S. Census, American Hospital Association, American Medical Association, and the National Center for Health Statistics.
Key Terms Geographical and Regional Variation, Quality of Care, Centers for Medicare and Medicaid Services, Medicare Spending, Racial Disparities
Study Design Longitudinal
Data Type(s) Administrative
Sponsoring Agency/Entity Dartmouth Institute for Health Policy and Clinical Practice
Health conditions/Disability measures
Health condition(s) NA
Disability Measures NA
Measures/outcomes of interest
Topics Geographical and regional variation, Quality of care, Centers for Medicare and Medicaid Services, Medicare spending, Racial disparities
Sample Population Hospital Service Area (HSA) and Hospital Referral Regions (HRR)
Sample Size/Notes HSA: 3,436 HRR:306
Unit of Observation Hospital Service Area (HSA) and Hospital Referral Regions (HRR): State and Region
Geographic Coverage National
Geographic specificity Zip Code
Data Collection
Data Collection Mode Administrative
Years Collected 1995-2007
Data Collection Frequency Annual (Note: No update after 2007)
Strengths and limitations
Strengths Data ideal for doing health-policy research, on regional variation, and services utilization. Data can be linked with other CMS/non-CMS datasets
Limitations Data files have limited or no usability as stand alone files (Must be linked with other survey or administrative data)
Data details
Primary Website
Data Access
Data Access Requirements Public Use Dataset
Summary Tables/reports
Dataset components (where applicable) NA
Selected papers
Technical The Dartmouth Atlas of Health Care in the United States
Other Papers

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The Rehabilitation Research Cross-dataset Variable Catalog has been developed through the Center for Large Data Research & Data Sharing in Rehabilitation (CLDR). The Center for Large Data Research and Data Sharing in Rehabilitation involves a consortium of investigators from the University of Texas Medical Branch, Cornell University's Yang Tan Institute (YTI), and the University of Michigan. The CLDR is funded by NIH - National Institute of Child Health and Human Development, through the National Center for Medical Rehabilitation Research, the National Institute for Neurological Disorders and Stroke, and the National Institute of Biomedical Imaging and Bioengineering. (P2CHD065702).

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