SUPPORTING STATEMENT
Part A
Online Application Order Form for Products from the Healthcare Cost and Utilization Project (HCUP)
Version 11/2021
Agency for Healthcare Research and Quality (AHRQ)
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Table of contents
A. Justification 3
1. Circumstances that make the collection of information necessary 3
2. Purpose and use of information 4
3. Use of Improved Information Technology 5
4. Efforts to Identify Duplication 5
5. Involvement of Small Entities 5
6. Consequences if Information Collected Less Frequently 5
7. Special Circumstances 5
8. Consultation outside the Agency 5
9. Payments/Gifts to Respondents 6
10. Assurance of Confidentiality 6
11. Questions of a Sensitive Nature 7
12. Estimates of Annualized Burden Hours and Costs 7
13. Estimates of Annualized Respondent Capital and Maintenance Costs 8
14. Estimates of Annualized Cost to the Government 8
15. Changes in Hour Burden 9
16. Time Schedule, Publication and Analysis Plans 9
17. Exemption for Display of Expiration Date 9
List of Attachments 9
The mission of the Agency for Healthcare Research and Quality (AHRQ) set out in its authorizing legislation, The Healthcare Research and Quality Act of 1999 (see https://www.ahrq.gov/policymakers/hrqa99a.html), is to enhance the quality, appropriateness, and effectiveness of health services, and access to such services, through the establishment of a broad base of scientific research and through the promotion of improvements in clinical and health systems practices, including the prevention of diseases and other health conditions. AHRQ shall promote health care quality improvement by conducting and supporting:
1. Research that develops and presents scientific evidence regarding all aspects of health care; and
2. The synthesis and dissemination of available scientific evidence for use by patients, consumers, practitioners, providers, purchasers, policy makers, and educators; and
3. Initiatives to advance private and public efforts to improve health care quality.
Also, AHRQ shall conduct and support research and evaluations, and support demonstration projects, with respect to (A) the delivery of health care in inner-city areas, and in rural areas; and (B) health care for priority populations, which shall include (1) low-income groups, (2) minority groups, (3) women, (4) children, (5) the elderly, and (6) individuals with special health care needs, including individuals with disabilities and individuals who need chronic care or end-of-life health care.
The Healthcare Cost and Utilization Project is a vital resource helping the Agency achieve its research agenda, thereby furthering its goal of improving the delivery of health care in the United States. HCUP is a family of health care databases developed through a Federal-State-Industry partnership and sponsored by AHRQ. HCUP includes the largest collection of longitudinal hospital care data in the United States, with all-payer, encounter-level information beginning in 1988. The HCUP databases are annual files that contain anonymous information from hospital discharge records for inpatient care and certain components of outpatient care, such as emergency care and ambulatory surgeries.
The project currently creates eight types of restricted access public release databases and related files that are released to authorized users under the terms of the HCUP Data Use Agreement (DUA). These HCUP databases and files are used by researchers for a broad range of health issues, including cost and quality of health services, medical practice patterns, access to health care programs, and outcomes of treatments at the national, State, and local market levels.
HCUP achieves the restricted access public release and tracking of the HCUP databases through the Online Application Form for HCUP Products
(https://www.distributor.hcup-us.ahrq.gov/SpecialPages/Shoppingcart.aspx). To access the eight types of database, HCUP users are required to complete the Online Application Form for HCUP Products which includes three components, the application, HCUP DUA training (https://www.hcup-us.ahrq.gov/DUA/dua/index.html) and signing a HCUP DUA. Users are required to sign one of two DUAs: 1) nationwide or 2) state (hereafter referred to collectively as the HCUP DUA) after they complete the HCUP DUA training.
The HCUP project and the Online Application Form for HCUP Products is being conducted by AHRQ through its contractor pursuant to AHRQ’s statutory authority to conduct and support research on healthcare and on systems for the delivery of such care, including activities with respect to the outcomes, cost, cost-effectiveness, and use of health care services and access to such services. 42 U.S.C. 299a(a)(3).
Information collected in the HCUP Online Application Form process will be used for two purposes only:
1. Business Transaction: In order to deliver the HCUP databases to the applicants, contact information is necessary for shipping the data on disk (or any other media used in the future) and payment collection.
2. Enforcement of the HCUP Data Use Agreement (DUA): The HCUP DUA contains several restrictions on use of the data. Most of these restrictions have been put in place to safeguard the privacy of individuals and establishments represented in the data. For example, data users can only use the data for research, analysis, and aggregate statistical reporting and are prohibited from attempting to identify any persons in the data. Contact information on HCUP DUAs is retained in the event that a violation of the HCUP DUA takes place requiring legal remedy.
No other source of data is available to allow AHRQ to deliver data to purchasers or allow follow up in the event of a HCUP DUA violation. This information collection does not duplicate any other effort and the information cannot be obtained from any other source.
This request is consistent with the general information collection guidelines of 5 CFR 1320.5(d)(2). No special circumstances apply.
8.a. Federal Register Notice
As required by 5 CFR 1320.8(d), the notice was published in the Federal Register on January 3rd, 2022, Volume 87, on page 87 for 60 days (see Attachment B).
AHRQ did not consult with any outside individual or agency with respect to this information collection. The information collection required as a part of the online application process is an absolute minimum for conducting the transaction and is modeled on a process already established by the National Technical Information Service (NTIS) at https://www.ntis.gov/about/about-us.xhtml. AHRQ is unable to utilize NTIS for dissemination of HCUP databases because of special circumstances required for release of the data; 1) the need to review applications for state-level data to ensure that the planned use is consistent with HCUP policies and with the HCUP data use requirements, and 2) the need to retain copies of signed HCUP DUAs.
No payment, gift or remuneration will be provided to respondents.
The confidentiality of information about individuals and organizations is protected under Section 934(c) of the Public Health Service Act, 42 USC 299c-3(c). The public is informed of the purposes for which the information is collected and that, in accordance with this statute, any identifiable information about them will not be used or disclosed for any other purpose.
Information that can directly identify respondents is collected. Information collected includes name, organization, street address, phone number, and e-mail address. All information collected is necessary for the commercial transaction including shipment of the data requested and for follow up in the event of a potential violation of the HCUP DUA.
The identifiable information collected is transmitted to the hosting server via an encrypted Secure Socket Layer (SSL) connection. Access to the database housing the identifiable information is accomplished through individual authorized administrative accounts. The server housing the identifiable information is located in secure data center that is protected via card controlled entry points, video monitoring systems, biometric readers, cage locks, and system firewalls.
The information stored is captured and transmitted over an SSL connection for secure encrypted transmission.
Access to the database is only permissible at the administrator level and is done so for either a) in order to fulfill the applicants request, b) for system maintenance, or c) in the event of a HCUP DUA violation.
The server housing the system is located in a secure facility with card controlled entry points, and video surveillance at key points for physical access to protected areas that contain information and information processing facilities, camera monitoring systems, biometric readers, and cage locks.
The information system has been categorized as a FISMA LOW per the FIPS 199 system categorization form. The controls required for a low system provide adequate assurance that the confidentiality, integrity and availability of the information system are met as required by FISMA.
The information collected by the electronic form are stored in a secure database. Data stored in the database will remain there indefinitely until requested by AHRQ. At the conclusion of the contract, the information system as well as a current copy of the database can be provided to AHRQ by request.
The information system uses a defense-in-depth strategy for user access. Users are assigned individual credentials along with role based least-privileged user account (LUA). The LUA approach ensures that users follow the principle of least privilege and always log on with limited user accounts. This strategy also aims to limit the use of administrative credentials to administrators, and then only for administrative tasks.
Public users of the information system establish their credentials upon entry to the system by using their e-mail address as the user ID and specifying their own password. That password is securely stored in the system’s database. The credentials are needed so that a public user can reference their order history. If a user forgets his/her password, the system will reset it and convey that information via e-mail. The public user will have to change that default password upon reentry to the system. Administrative users of the information system have credentials assigned to them by the system administrator. Various role levels are defined, each allowing the administrative user permissions to perform specific functions.
The information system allows applicants to specify a payment option of credit card, check, or purchase order. Information to complete credit card transactions is collected by the information system and transmitted securely to a PCI-compliant payment gateway for approval. The payment gateway product processes the transaction and the funds are transferred when the transaction is captured at the time of the order is fulfilled and the data is shipped. Credit card information is not captured or retained by the information system’s database.
No questions of a sensitive nature will be asked.
Exhibit 1 shows the estimated annualized burden associated with the applicants’ time to order any of the HCUP databases. An estimated 1,800 persons will order HCUP data annually. Each of these persons will complete Online Application Order Form for HCUP products (30 minutes). The total burden for the Online Application Order Form is estimated to be 900 hours annually.
Exhibit 2 shows the estimated annualized cost burden associated with the applicants’ time to order HCUP data. The total cost burden is estimated to be $39,879 annually.
Exhibit 1. Estimated annualized burden hours
Form Name |
Number of respondents |
Number of responses per respondent |
Hours per response |
Total burden hours |
Total for the HCUP Data Purchase Ordering Form |
1,800 |
1 |
30/60 |
900 |
Exhibit 2. Estimated annualized cost burden
|
Number of respondents |
Total burden hours |
Average hourly wage rate* |
Total cost burden |
Total |
1,800 |
900 |
$44.31 |
$39,879 |
*Based upon the mean of the average wages for Life Scientists, All Other (19-1099), National Compensation Survey:
Occupational Employment Statistics, May 2020 National Occupational Employment and Wage Estimates United States, U.S. Department of Labor, Bureau of Labor Statistics. https://www.bls.gov/oes/current/oes_nat.htm#19-0000
There are no direct costs to respondents other than their time to submit the online application order form.
Exhibit 3 shows the estimated total and annualized cost to process HCUP database applications and maintain the ordering system over the 3 years covered by this information collection request. It is estimated to cost $22,913 annually to operate and maintain the ordering system.
Exhibit 3. Estimated Total and Annualized Cost
Cost Component |
Total Cost |
Annualized Cost |
Application Review |
$24,300 |
$8,100 |
Maintenance/Troubleshooting |
$19,698 |
$6,566 |
Customer Inquiries |
$24,741 |
$8,247 |
Total |
$68,739 |
$22,913 |
Exhibit 4. Federal Government Personnel Annual Cost
Activity |
Federal Personnel |
Hourly Rate* |
Estimated Hours |
Cost |
Data Collection Oversight |
1 (GS-13 Step 9) |
$63.14 |
440 |
$27,689 |
Total |
$27,689 |
|||
* Based on annual salaries from the 2021 OPM Pay Schedule for Washington/DC area: https://www.opm.gov/policy-data-oversight/pay-leave/salaries-wages/salary-tables/21Tables/html/DCB_h.aspx
An increase in public use of the system has taken place because public interest in the data has increased; however, there has been no change in the estimated hour burden per person.
The Online Application Form for HCUP Products and the related order tracking system was implemented in the fall of 2012 and is on-going.
AHRQ does not seek this exemption.
List of Attachments:
Attachment A -- Online Application Order Form for HCUP products (the Questionnaire/Instrument):
The data collection instrument is available at https://www.distributor.hcup-us.ahrq.gov/SpecialPages/Shoppingcart.aspx
Screen shots of the online application process is attached.
HCUP Training URL: https://www.hcup-us.ahrq.gov/DUA/dua/index.html
HCUP Data Use Agreement
Nationwide databases
State databases
Attachment B: Federal Register Notice
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
| File Title | OMB Clearance Application |
| Author | hamlin-ben |
| File Modified | 0000-00-00 |
| File Created | 2022-03-14 |