Association for Public Policy Analysis & Management

Studies using cross-state variation in outcomes often require researchers to expend considerable resources in the collection of information on study states’ relevant statutes and regulations. Moreover, these data collection efforts may be redundant as individual researchers gather similar data for their research projects. This NIH-funded study develops a database – the State Health Practice Database for Research (SHPDR) – to support theoretical and applied research to understand how innovations in treatments, diagnosis, and preventive strategies can be most effectively deployed to improve health and wellbeing of the U.S. population. SHPDR will also facilitate the identification of factors that determine the optimal adoption of effective health technologies, innovations, and discoveries. The need for this resource was established at a 2010 NIH meeting and elaborated in responses from the scientific community to a Request for Information.

Study Design

The development of SHPDR content used an environmental scan and input from a technical expert panel of health economists and health services researchers. This process produced a taxonomy of domains, topics, and subtopics for which state-level data were collected. Data collection required the review and interpretation of statutes and regulations from each state to produce a core data set with numeric and categorical variables. The data collection team also developed concise explanations for each variable value to support health economists’ and health services researchers’ understanding of the statutes and regulations. SHPDR will also include documentation of how variables were constructed, links to the full text of the statutes and regulations, and guidance for researchers on the use of the database.

Population Studied

All participants in the U.S. healthcare system.

Principal Findings

The SHPDR includes binary variables and related documentation reflecting information in state statutes and regulations related to healthcare delivery and financing; quality and safety controls, workforce maintenance and development; provider and facility licensure; health information technology infrastructure; and access to health services. The database is designed to facilitate use with statistical software, and can be linked with existing data resources for hypothesis-driven research. The database will cover all fifty States, and, when completed, will contain data for calendar years 2010, 2012, 2014 and 2016. Data for calendar years 2010 and 2012 are scheduled for release in 2016. The database is designed as a user-friendly Web interface and allows efficient querying and download of selected content and documentation.

Conclusion

The SHPDR will reduce data collection burden by providing researchers with a unified database encompassing longitudinal information from all fifty states. The SHPDR database will meet the need for state-level data for cross-sectional and longitudinal research on a range of issues affecting population health in an environment in which health care technology is changing rapidly.

Implications

The SHPDR addresses an important data gap by providing health services researchers with free access to state statutes and regulations in an organized and user-friendly manner. Identifying the universe of potentially relevant statutes and regulations and assigning variables with contextual justifications to them is a major area where the SHPDR will contribute to and expand research opportunities.