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Health Care Database Key Attributes Questionnaire
HEALTH CARE DATABASE INFORMATION
1. Database description (Summary of the database, strengths, limitations):
2. Geographic area represented:
--Please select the country--
Afghanistan
Albania
Algeria
Andorra
Angola
Argentina
Armenia
Australia
Austria
Azerbaijan
Bahamas, The
Bahrain
Bangladesh
Barbados
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Central African Republic
Chad
Chile
China
Colombia
Comoros
Congo
Costa Rica
Croatia
Cyprus
Czech Republic
Denmark
Djibouti
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands (Islas Malvinas)
Faroe Islands
Fiji
Finland
France
French Guiana
Gabon
Georgia
Germany
Ghana
Greece
Greenland
Guatemala
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Ireland
Israel
Italy
Jamaica
Japan
Jordan
Kazakhstan
Kenya
Korea (North)
Korea (South)
Kuwait
Kyrgyzstan
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Mali
Malta
Mauritania
Mauritius
Mexico
Moldova
Monaco
Mongolia
Montenegro
Morocco
Mozambique
Namibia
Nepal
Netherlands
New Zealand
Nicaragua
Niger
Nigeria
Northern Mariana Islands
Norway
Oman
Pakistan
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Poland
Portugal
Puerto Rico
Qatar
Reunion
Romania
Russia
Rwanda
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
Spain
Sri Lanka
Suriname
Svalbard and Jan Mayen
Swaziland
Sweden
Switzerland
Taiwan
Tajikistan
Tanzania, United Republic of
Thailand
Togo
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Venezuela
Vietnam
Western Sahara
Yemen
Zambia
Zimbabwe
3. Name of the database:
4. Database Technical Details
File Structure (i.e. cd rom, pdf, Microsoft word or excel)
Database overview web URL (required format: http://www.ispor.org)
Contact person name
Contact person address
Contact person email
Contact person telephone number
Access database web URL (required format: http://www.ispor.org)
Email of the person responsible for updating this record (this email will be used to update or revise database record)
5. Database information:
How many years are covered by the database?
When did the database begin?
When did the database end?
How many unique patients in the last 12 months?
6. Are diagnostic or procedure codes included?
yes
no
Are ICD-9 (International Classification of Diseases) codes included?
yes
no
Are ICD-10 codes included?
yes
no
Are ICD-12 codes included?
yes
no
Are Current Procedural Terminology (CPT) codes included?
yes
no
Are diagnosis-related group (DRG) codes included for hospital data?
yes
no
Are HCPCS (Healthcare Common Procedure Coding System) included?
yes
no
7. Do you have In-Hospital patient information?
yes
no
Hospital in-patient records
yes
no
Hospital admission and discharge dates
yes
no
Hospital procedure codes
yes
no
Length of stay?
yes
no
Intensive care unit versus general ward days?
yes
no
Dates of procedures within an admission?
yes
no
8. Do you have out-of-Hospital patient information?
yes
no
Non-hospital (office visit, other) patient records
yes
no
Date of service
yes
no
Non-hospital procedure codes
yes
no
9. Are all diseases included in the database?
yes
no
Is there data on specific diseases? If yes, please check all that apply from list below
Alcoholism / Drug Abuse
Hypertension
Allergy
Immune Disorder
Alzheimer's Disease
Infection-all
Angina
Influenza
Angioplasty
Ischemia
Anxiety
Left Ventricular Disease
Arrhythmia
Medical Device
Arthritis
Men's Health - All
Asthma
Mental Health
Atrial Fibrillation
Metabolic Disorders
Attention Deficit Disorder
Migraine
Auto-immune Disorders
Multiple Sclerosis
Bipolar Disorder
Muscular-skeletal Disorders (including Tunnel Syndrome)
Cancer
Myocardial Infarction
Cardiovascular Diseases-all
Neurological Disorders-all
Cerebral Palsy
No specific or Multiple Diseases
Children's Health
Obesity
Chronic Obstructive Pulmonary Disease
Obsessive Compulsive Disorder
Congestive Heart Failure
Osteoarthritis
Coronary Artery Disease
Osteoporosis
Coronary Heart Disease
Pain
Coronary Syndrome
Parkinson's disease
Cystic Fibrosis
Peripheral Arterial Disease
Dementia
Psychosis
Dental Disorders
Rare Diseases
Depression
Respiratory Disorders
Diabetes
Restless Leg Syndrome
Ear Disorders
Rheumatoid Arthritis
Elderly Health
Schizophrenia
Endocrine Disorders (Pituitary/Thyroid)
Skin Disorders (Including Hair Loss)
Epilepsy
Sleep Disorders
Eye Disorders
Smoking
Fabry Disease
Stents
Fibromyalgia
Stroke
GI Disorders
Surgery
Hematologic Disorders
Thrombosis
HIV
Urinary / Kidney
Hunter's Syndrome
Vaccine
Hypercholesterolemia
Veterinary Medicine
Hyperlipidemia
Women's Health
Other (Please Specify)
10. Do you have financial information?
yes
no
Medical service “true” costs?
yes
no
Medical service charges to insurance?
yes
no
Medical service payments by insurance?
yes
no
Medical service charges to the patient?
yes
no
Is the amount the patient pays for the medical services as a co-payment available?
yes
no
Is the amount the patient must pay first before coverage of medical services (a deductible) available?
yes
no
Is prior authorization information included? (i.e. medical service requires authorization by health management organization before the service is rendered)
yes
no
Drug use?
yes
no
Drug “true” costs?
yes
no
Drug cost charged to insurance?
yes
no
Drug payments by insurance?
yes
no
Is the amount the patient pays for the drug as a co-payment available?
yes
no
Is the amount the patient must pay first before coverage of drug costs (a deductible) available?
yes
no
11. Do you have drug information available?
yes
no
Is drug information available for all patients?
yes
no
Are drug name, dose and strength included?
yes
no
Are days supply and quantity dispensed included?
yes
no
Is the date and time a prescription was filled or made available to the patient included?
yes
no
Is drug formulary information included? (i.e. drug on or not on formulary)
yes
no
Is drug prior authorization information included? (i.e. drug requires authorization by drug management organization before the prescription is filled)
yes
no
Does the database include (or is an additional database available for) patient/member eligibility or enrollment files?
yes
no
12. Do you provide research services to analyze the data?
yes
no
13. Is the data publicly available?
yes
no
Other:
Contact ISPOR @
info@ispor.org
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