Crosswalk files
Our ZIP code to HSA to HRR crosswalk files allow you to aggregate data you may have at the ZIP code level to the hospital service area (HSA) or hospital referral region (HRR) level. NOTE: These files were revised February 2007.

• 2005 ZIP code crosswalk
• 2004 ZIP code crosswalk
• 2003 ZIP code crosswalk
• 2002 ZIP code crosswalk
• 2001 ZIP code crosswalk
• Hospital to HSA/HRR crosswalk
• HSA to HRR crosswalk

Geographic boundary files
Our HSA and HRR boundary files allow you to create your own maps using ESRI® ArcGIS® software.

• HRR boundaries
• HSA boundaries

Hospital performance reports by state
These reports allow you to compare the relative efficiency of health care providers in managing patients with severe chronic illness. We identified a group of patients who died between 2001 and 2005, each of whom was diagnosed with at least one of nine chronic illnesses. These patients were assigned to the hospital to which they were admitted most often during the last two years of their lives, and hospital-specific utilization and Medicare spending rates for that period were computed. Each table is organized by hospital referral region and sorted in descending order of Medicare inpatient & Part B spending. More information about the data can be found in our recent report, Tracking the Care of Patients With Severe Chronic Illness: The Dartmouth Atlas of Health Care 2008.

Most state reports include hospitals and referral regions located in other states. Hospitals in different states were included if they are located in a hospital referral region in the chosen report's state. Hospital referral regions in other states were included if they contain hospitals from the chosen report's state.

Hospital performance reports by system
These reports are similar to the performance reports by state, except that hospitals are organized by system. System membership was determined using the AHA Annual Survey 2005. If a hospital's system membership changed during the study period 2001-2005, it is included based on the 2005 membership information. Reports are available for systems comprising at least ten hospitals, five of which have sufficient deaths to include Part B data.

Regional performance reports
These reports compare the relative efficiency of states and hospital referral regions in managing patients with severe chronic illness. These patients died between 2001 and 2005, and each was diagnosed with at least one of nine chronic illnesses. Patients were included regardless of whether they were hospitalized for chronic illness during the last two years of their lives.

• HRR performance report
• State performance report

Excel versions of performance reports
This workbook contains three worksheets: a hospital-specific worksheet, an HRR-level worksheet, and a state-level worksheet. The format is similar to the above formatted PDF reports, with data for patients who died between 2001 and 2005 and were diagnosed with at least one of nine chronic illnesses. The hospital-specific worksheet uses Excel's AutoFilter function to allow you to select groups of hospitals of interest to you by clicking on the arrow at the top of each column and highlighting the selected criterion. The HRR and state tables are sorted by overall Medicare spending; the hospital-specific tables are sorted by HRR, then by Medicare spending within HRR.

NOTE: the rates and populations in the HRR and state tables are lower than those in the hospital tables. The regional study includes chronically ill patients who were not hospitalized during the last two years of life, which has the effect of reducing the per capita rates (since these patients were never hospitalized, they had no hospital utilization and lower physician utilization). The populations are lower because the regional study used a 20% sample of patients; the 20% Part B database was required to identify chronically ill patients who were not hospitalized.