California Licensed Hospital or Local Health Department Requests (AB 2876)
The California Office of Statewide Health Planning and Development (OSHPD) provides confidential patient-level data sets to eligible hospitals and health departments. California Licensed Hospitals and Local Health Departments are eligible to request HIPAA-limited data set versions of OSHPD's patient level data. The 2004 law that allows for the release of these data was Assembly Bill 2876 (AB 2876), Health and Safety Code Section 128766.
The contents of these AB 2876 files, including descriptions of the variables that they contain, are described in the nonpublic data documentation. A cross-referenced list variables across multiple years is contained in the Master Variable Grid. Details about the current data submission guidelines are available in the MIRCal online reporting system manuals.
- 1. Confirm your eligibility for confidential data.
Before you start the application process, please confirm your eligibility. OSHPD is authorized to disclose HIPAA-limited data set (FAQ #8) versions of its patient level data to:
- California-licensed hospitals
- Local Health Officers and Local Health Departments
- The following federal public health agencies for their statutorily authorized activities:
- Agency for Healthcare Research and Quality and Centers for Disease Control and Prevention
A request for a limited data set pursuant to §128766 is a request for confidential data. The standard confidential data request rules apply, except that Committee for the Protection of Human Subjectsreview is only required if the data are requested for research purposes. Requests that are exclusively for purposes of public health or healthcare operations do not require institutional review board approval. AB 2876 requests require a Data Use Agreement (DUA), signed by the responsible hospital or local health department officer.
Contact HIRC by telephone at (916) 326-3802 or by e-mail for more information on AB 2876 eligibility.
- 2. Does the data set meet your analytical needs?
AB 2876 Model Data Sets containing predetermined sets of variables are available for PDD, ED, and AS. AB 2876 custom data sets are also available. Review the Variable Availability Table (PDD or ED/AS) for a quick comparison of the two types of AB2873 request. Review the nonpublic documentation for more detail on the data sets.
- 3. Review the Data Request Checklist(AB 2876) for California Licensed Hospitals or Local Public Health Department to begin the request process.
New File Format available
To make the data sets easier to use, a “Label” formatted file was created. The AB 2876 data sets are offered in two formats: SAS (.sas7bdat) or comma-delimited (.txt). The SAS data sets were created using SAS version 9.3. To make the data sets easier to use, a “Label” formatted file was created for both file types. In the “Label” versions, alphanumeric values have been replaced by more descriptive “English” values. For example, for the variable “sev_code”, the descriptive label “MS-DRG assignment is based on the presence of MCC” replaced the code values of “1”. For three variables (oshpd_id, MDC, MSDRG), new descriptive label variables were added (oshpd_name, mdc_name, msdrg_name) and the original variables were retained. The variable attributes, including code values are provided in the AB 2876 online documentation. Note that the variable length may differ across the Code/Label version of the file. To assist SAS users, a PROC Format file will be provided to associate labels with variables. Note that facility and MS-DRG codes and their associated labels potentially change across years and year-specific code-label crosswalk lists must be used.
AB 2876 AHRQ Prevention Quality Indicator ProductsTwo AHRQ Prevention Quality Indicator (PQI) products are available to AB 2876-eligible requesters.
These products provide indicators for preventable hospitalizations or ambulatory care-sensitive conditions, which can be used to assess healthcare quality and access. These indicators often reveal striking variations in healthcare for conditions that are potentially preventable through treatment in non-hospital settings and/or proper medication and management. The indicators are based on OSHPD’s hospital patient discharge data and include conditions such as hypertension, diabetes, and asthma in the adult population. PQI reports for the general public are also available.
The PQI Summary Table and Record-Level File can be used for community health assessments, county and ZIP Code-level “hot-spotting,” and quality improvement monitoring and evaluation. These products can help answer questions about a community’s healthcare delivery system, such as:
- What counties and ZIP Codes have the highest preventable hospitalization rates?
- What are the most common preventable hospitalizations in California?
- What is the distribution of the preventable hospitalizations by age/race/ethnicity, gender, and payer?
AB 2876 Patient Origin/Market Share Report
Hospitals and communities face tremendous budgetary pressures, making the need to understand key operating performance issues critical.
The Patient Origin and Market Share (PO/MS) Report available to AB 2876-eligible requesters includes facility, patient ZIP Code and county, age group, payer, and MS-DRG information. Data is available for 2008-2012; data can be requested for one or more years. PO/MS Reports for the general public are also available.
The PO/MS Reports support ZIP Code-based analyses, such as:
- How big is the market?
- Which hospital(s) control the market? (Top 5 by volume?)
- What is the market share by service line?
- Where do the residents of my county go for care?
- 1. What years of confidential data are available?
An AB 2876 file is available for each year the inpatient discharge (PDD), emergency department (ED) or ambulatory surgery (AS) patient data was collected.
- 2. How much do the confidential data sets cost?
OSHPD charges $200 for one year of PDD data or one-half year of ED or AS data, and $50 for Patient Origin and Market Share (PO/MS) or Prevention Quality Indicator (PQI) data products. The most current three years of data are complimentary to nonprofit California hospitals and local health departments. See the OSHPD Pricing Policy.
- 3. How long does it take to receive data after I submit a request?
It depends on the complexity of the request and the completeness of it. Generally from the time your request is received until the data is shipped or transmitted, an AB 2876 request takes about one month. It may be longer or shorter depending on the request.
- 4. Can a private consultant order the AB 2876 data?
No. However, a licensed California hospital can request the data and submit a signed Business Associate Agreement with a contractor. The contractor would then be able to analyze the data for the hospital.
- 5. Is there a template "Business Associate Agreement" available?
OSHPD does not have a template Business Associate Agreement.
- 6. What purpose does the Data Use Agreement serve?
HIPAA specifically requires that the data use agreement must:
- Establish the permitted uses and disclosures of the health information; these must be consistent with the stated purpose. The agreement may not authorize the recipient to use or further disclose the data in a manner that would violate the HIPAA regulations if done by the covered entity;
- Establish who is permitted to use or receive the limited data set (including any agents and subcontractors)
- Provide that the data recipient will:
- Not use or further disclose the information other than as permitted by the agreement or as otherwise required by law.
- Use appropriate safeguards to prevent use or disclosure of the information other than as provided for in the agreement (i.e., provide appropriate data security).
- Report to the entity providing the information any use or disclosure that is not provided for in the agreement of which it becomes aware.
- Ensure that any agents who have access to the information agree to the same restrictions and conditions that apply to the limited data set recipient with respect to such information.
- Not identify the information or contact the individuals.
- 7. What is a "Model Data Set"?
The "model data sets" were developed by OSHPD to streamline the §128766 data request process for many hospitals and public health entities. The concept behind the model data sets is that public health officials and hospitals could explain or justify in advance their need for certain data elements for certain common purposes, so that each requester would not need to do so each time they requested non-public data under §128766.
Before the first model data sets were designed, there was a series of meetings with interested parties who explained their most common anticipated uses for the data and the data elements that were the minimum necessary for those uses.
Each data set contains a set of the least sensitive data elements that will meet the most common needs cited by these data requesters. The Model Data Set Documentation provides the justification for the inclusion of each data element for data sets designed for certain purposes. When the data sets are requested for such purposes, the specific justification normally required for each individual data element can be waived.
If a hospital or public health entity wants to request a set of data elements different from those included in the "model data sets" or a public file, they must justify the need for each data element individually, using the Forms for requesting a Custom Data Set.
- 8. What is a "HIPAA Limited Data Set"?
Under HIPAA, a limited data set is a set of individually identifiable health information. The term “limited data set” refers to a specific subset of data created for a specific purpose.
A limited data set may be created and disclosed if a set of requirements are met:
- The data set does not contain any direct identifiers
- Direct identifiers include name, address, Social Security Number, Medical Record Number, and many other items not included in OSHPD's data set.
- Dates, ages, ZIP Codes, and Record, Linkage, Numbers (RLNs) are not considered "direct" identifiers.
- The data will only be used for certain permitted purposes
- Research the definition is the same as the definition used by CPHS (requests for research use must be reviewed by the CPHS)
- Public health
- Health care operations for hospitals, this includes business planning and development
- The data set is created for a specific purpose, which must be clearly described
- A detailed data use agreement must be in place
- The data set must contain only the minimum necessary information the disclosure must be limited to the information reasonably necessary to accomplish the intended purpose. The request must explain how the data are necessary for the specific purpose.
As this requirement is applied to the OSHPD data, it means the request must identify:
- The set of records requested
- Data type
- Time periods
- Subset of records (for example, a specific age group)
- The data elements needed on the records
OSHPD's HIPAA-limited data sets are required to be consistent with the requirements of 45 CFR Section 164.514. The statutes that govern OSHPD's release of patient record-level data specify that only the minimum necessary data for the approved purpose may be released. In consultation with hospitals and local health officers OSHPD has developed Model Data Sets for inpatient discharge (PDD), emergency department (ED), and ambulatory surgery (AS) data. These data sets contain the data elements typically required for the functions of healthcare operations and public health activities; a standard justification for these data elements has been pre-approved. Additional data elements may be requested based on specific justification of need for these elements. Note that the direct identifiers collected in the OSHPD data are not available for release under H&S Code 128766. The term "limited data set" refers to a specific subset of data created for a specific purpose.
- The data set does not contain any direct identifiers
This page was last updated on Friday, September 30, 2016.
Type of Request
Data Years Available
Healthcare Information Resource Center
400 R Street, Suite 250
Sacramento, CA 95811-6213
Tel: (916) 326-3802
Fax: (916) 324-9242
Hours: Monday-Friday 8 a.m. to 5 p.m. (PST)