Part C: Major Data Sources for Healthy People 2010

Data Sources

Number of
Objectives
Tracked

National Health Interview Survey (NHIS)

67

National Health and Nutrition Examination Survey (NHANES)

35

National Vital Statistics System—Mortality (NVSS-M)

32

National Survey of Family Growth (NSFG)

14

National Hospital Discharge Survey (NHDS)

11

Youth Risk Behavior Surveillance System (YRBSS)

11

HIV/AIDS Surveillance System

10

Behavioral Risk Factor Surveillance System (BRFSS)

9

National Household Survey on Drug Abuse (NHSDA)

8

School Health Policies and Programs Study (SHPPS)

8

National Vital Statistics System—Natality (NVSS-N)

8

National Profile of Local Health Departments (NPLHD)

8

National Ambulatory Medical Care Survey (NAMCS)

7

United States Renal Data System (USRDS)

7

STD Surveillance System (STDSS)

7

Medical Expenditure Panel Survey (MEPS)

6

National Hospital Ambulatory Medical Care Survey (NHAMCS)

6

Continuing Survey of Food Intake by Individuals (CSFII)

6

National Crime Victimization Survey (NCVS)

6

1999 National Worksite Health Promotion Survey (NWHPS)

5

State Tobacco Activities Tracking and Evaluation System (STATES)

5

National Notifiable Disease Surveillance System (NNDSS)

5

Monitoring the Future Study (MTF)

5

Sponsor

U.S. Department of Health and Human Services, Centers for Disease Control and Prevention (CDC), National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP).

Mode of Administration

Telephone interview.

Survey Sample Design

Data collection is conducted separately by each State. Sample design uses State-level, random-digit-dialed probability samples of the adult (aged 18 years and over) population. Most States currently use disproportionate random sampling methods. Increasing State participation over time, with 15 States in 1984 and all 50 States and the District of Columbia since 1994. In 1998, State-specific sample sizes ranged from 1,499 to 6,005. The median sample size was 2,648.

Response Rates

State response rates vary from year to year. In 1998, upper-bound response rates ranged from 45 to 95 percent (median response rate: 73 percent).

Primary Survey Content

The survey consists of a core of questions asked in all States, standardized optional questions on selected topics that are administered at the State’s discretion, a rotating core of questions asked every other year in all States, and State-added questions developed to address State-specific needs. Questions cover behavioral risk factors (for example, alcohol and tobacco use), preventive health measures, HIV/AIDS, health status, limitation of activity, and health care access and utilization.

Population Targeted

Civilian, noninstitutionalized population 18 years of age and older who reside in households with telephones.

Demographic Data

Gender, age, educational attainment, race/ethnicity, household income, employment status, and marital status.

Years Collected

Annually since 1984.

Schedule

Annual.

Geographic Estimates

National; State; smaller area estimates possible in some States.

Notes

The BRFSS is a partnership between State Health Departments and CDC; CDC provides about one-half of the financial resources for States to use for data collection efforts. States have substantial input on questions used by all States through the BRFSS. Many Healthy People objectives are tracked with questions that are asked every other year or are optional. Persons who do not have telephones or have telephones but are either in institutional settings or cannot be understood over the telephone are excluded.

Contact Information

Data system homepage: http://www.cdc.gov/nccdphp/brfss

Data system phone: 770-488-2455

Agency homepage: http://www.cdc.gov/nccdphp

Agency phone: 770-488-5401

References

Centers for Disease Control and Prevention. The Behavioral Risk Factor Surveillance System User’s Guide. Atlanta, GA: U.S. Department of Health and Human Services, 1998.

Nelson, D.E.; Holtzman, D.; Waller, M.; et al. Objectives and design of the Behavioral Risk Factor Surveillance System. American Statistical Association 1998 Proceedings of the Section on Survey Research Methods. Alexandria, VA: American Statistical Association (ASA), 1998, 214-218.

Powell-Griner, E. Uses and limitations of the Behavioral Risk Factor Surveillance System data. American Statistical Association 1998 Proceedings of the Section on Survey Research Methods. Alexandria, VA: ASA, 1998, 219-223.

Sponsor

U.S. Department of Agriculture (USDA), Agricultural Research Service (ARS).

Mode of Administration

Two nonconsecutive days of food intake data collected 3-10 days apart during in-person interviews using the 24-hour dietary recall method. About 2 weeks later, one adult from each household was asked to answer a series of questions about knowledge and attitudes toward dietary guidance, health, and use of food labels.

Survey Sample Design

Nationally representative stratified multistage area probability sample of U.S. noninstitutionalized civilian population, all ages. Subsampling of individuals in households. Oversampling of low-income households with incomes at or below 130 percent of the poverty threshold. For 1994–96, sample size for 1-day dietary data was 16,103; for 2-day dietary data, it was 15,303.

Response Rates

One-day response rate: 80 percent; and 2-day response rate: 76 percent.

Primary Survey Content

Kinds and amounts of foods consumed on each of 2 nonconsecutive days, sources of foods, time, name of each eating occasion. Also collected are food expenditures, shopping practices, pregnancy, lactation, nursing status, and height and weight.

Population Targeted

The civilian, noninstitutionalized population residing in all 50 States and the District of Columbia, all ages.

Demographic Data

Household: Income, poverty status, household size, region, urbanization, tenancy, participation in Food Stamp and WIC programs.

Individual: Gender, age, education, race, ethnicity (Hispanic or non-Hispanic), employment status of persons 15 years of age and older.

Years Collected

1994–96.

Schedule

Periodic.

Geographic Estimates

National; four U.S. Census Bureau regions; Standard Metropolitan Statistical Areas.

Notes

Additional outcome variables: For each of 2 days of intake and 2-day averages, food intakes in grams of 71 USDA-defined food groups and subgroups, nutrient intakes of 28 nutrients and food components, nutrient intakes expressed as percentages of the 1989 Recommended Dietary Allowances, and Pyramid servings from 30 food groups. Various components of the dietary collection methodology will change from the 1994–96 survey to the next survey planned for the year 2000. Two 24-hour recalls will be collected by telephone instead of by in-person interview. Further research will assess the impact of the changes in dietary data collection methods on the comparability of the 1994–96 and the 2000 survey estimates.

Contact Information

Data system homepage:

http://www.barc.usda.gov/bhnrc/foodsurvey/home.htm

Data system phone: 301-504-0170

Agency homepage: http://www.usda.gov

Agency phone: 202-720-2791

Sponsor

U.S. Department of Health and Human Services, Centers for Disease Control and Prevention (CDC), National Center for HIV, STD, and TB Prevention (NCHSTP).

Mode of Administration

Reports from health care providers are sent to the local, State, or territorial health departments. States and territories share, on a voluntary basis, de-identified data with CDC.

Survey Sample Design

All 50 States, the District of Columbia, Puerto Rico, the U.S. Virgin Islands, and other U.S. territories report AIDS cases.

Response Rates

Response rates vary by geographic region and patient population. In most areas, reporting of AIDS cases is at least 85 percent complete. Reporting of deaths is about 90 percent complete.

Primary Survey Content

The AIDS case definition was modified in 1985, 1987, 1993 (for adults and adolescents), and 1994 (for pediatric cases). Data include mode of exposure to HIV, case definition category, and other clinical and demographic information.

Population Targeted

Entire population of all 50 States, the District of Columbia, Puerto Rico, the U.S. Virgin Islands, and other U.S. territories. AIDS data are nationally representative.

Demographic Data

Age, gender, race, ethnicity, State and county of residence, country of birth, and living status.

Years Collected

CDC first received reports of persons with AIDS in 1981.

Schedule

Biannual. HIV/AIDS Surveillance Report is published twice a year. Supplemental reports are published on an ad hoc basis and available on the Web at http://www.cdc.gov/nchstp/hiv_aids/stats/hasrlink.HTM and at http://www.cdc.gov/nchstp/hiv_aids/pubs/mmwr.htm.

Geographic Estimates

National, State, and Metropolitan Statistical Area. Data release policies dictate that no data that could be used to identify a person reported to the system may be released, thus, release of data in cell sizes less than or equal to three in a given category are prohibited.

Notes

HIV/AIDS case surveillance is a population-based system.

Contact Information

Data system homepage: http://www.cdc.gov/nchstp/hiv_aids/surveillance.htm

Data system phone: 404-639-2057

Agency homepage: http://www.cdc.gov/nchstp/od/nchstp.html

Agency phone: 770-488-5401

References

Centers for Disease Control and Prevention (CDC). Guidelines for national human immunodeficiency virus case surveillance, including monitoring for human immunodeficiency virus infection and acquired immunodeficiency syndrome. Morbidity and Mortality Weekly Report 48(RR13), 1999.

CDC. HIV/AIDS Surveillance Report. Year-end 1998. Vol. 10, No. 2, 1999.

Sponsor

U.S. Department of Health and Human Services: Agency for Healthcare Research and Quality (AHRQ) and Centers for Disease Control and Prevention (CDC), National Center for Health Statistics (NCHS).

Mode of Administration

The MEPS comprises four linked, integrated surveys, three of which are of interest here:

Household Component (HC): Computer-assisted, in-person interviews;

Medical Provider Component (MPC): Telephone interviews and mailed surveys; and,

Insurance Component (IC): Telephone interviews and mailed surveys.

Survey Sample Design

Each year, the MEPS HC sample is a nationally representative subsample of the National Health Interview Survey (NHIS), which uses a stratified multistage probability design that permits a continuous sampling of 358 primary sampling units. The 1996 HC collected data on 10,500 families and 24,000 individuals who participated in the 1995 NHIS. The MPC bases its sample on the HC. The IC partially bases its sample on the HC. Data are obtained through employers, unions, or other private health insurance sources identified by the HC respondents.

Response Rates

HC: Rate varies by round, so effective response rate varies by reference period of analysis; however, for estimates of calendar year 1996, MEPS has a response rate of 70 percent, including the NHIS and three rounds of data collection. MPC: Rate is over 90 percent. IC: Rate varies by type of establishment; it is over 90 percent for governments and less for employers.

Primary Survey Content

HC: Health conditions, health status, use of medical care services, charges and payments, access to care, satisfaction with care, health insurance coverage, income, and employment. MPC: Information on medical care events from medical providers identified by HC respondents, including expense information for events covered under various managed care plans. IC: Data on types of health insurance plans, associated premiums, and numbers of plans offered.

Population Targeted

HC:  Civilian noninstitutionalized families and individuals, all ages. MPC: Medical providers identified by HC respondents. IC: Health insurance companies.

Demographic Data

Age, race, ethnicity, region, occupation, employment status, and household composition.

Years Collected

1977, 1987, and 1996 to present.

Schedule

Annual.

Geographic Estimates

National. The HC data also can be shown for the four Census regions (Northeast, Midwest, South, and West). Some State information can be provided for the IC.

Notes

AHRQ fields a new MEPS panel each year. In this design, two calendar years of information are collected from each household in a series of five rounds of data collection over a 2 1/2-year period. These data are then linked with additional information collected from the respondents’ medical providers, employers, and insurance providers. This series of data collection activities is repeated each year on a new sample of households, resulting in overlapping panels of survey data.

Contact Information

Data system homepage: http://www.meps.ahrq.gov/survey.htm#target2

Data system phone: 301-594-1406

Agency homepage: http://www.meps.ahrq.gov

Agency phone: 301-594-1406

References

Agency for Health Care Policy and Research (AHCPR). Construction of Weights for the 1996 Medical Expenditure Panel Survey Insurance Component List Sample. MEPS Methodology Report No. 8. AHRQ Pub. No. 00-0005. Rockville, MD: AHCPR, 1999.

Sommers, J.P. List Sample Design of the 1996 Medical Expenditure Panel Survey Insurance Component. MEPS Methodology Report No. 6 AHRQ Pub. No. 99-0037. Rockville, MD: AHCPR, 1999.

Sommers, J.P.; Bethel, J.; and Broene, P. Construction of Weights for the 1996 Medical Expenditure Panel Survey Nursing Home Component. MEPS Methodology Report No. 7. AHRQ Pub. No. 99-0045. Rockville, MD: AHCPR, 1999.

Cohen, S.B.; DiGaetano, R.; and Goksel, H. Estimation Procedures in the 1996 Medical Expenditure Panel Survey Household Component. MEPS Methodology Report No. 5. AHRQ Pub. No. 99-0027. Rockville, MD: AHCPR, 1999.

AHCPR. Design and Methods of the 1996 Medical Expenditure Panel Survey Nursing Home Component. MEPS Methodology Report 3. AHCPR Pub. No. 98-0041. Rockville, MD: AHCPR, 1998.

AHCPR. Sample Design of the 1996 Medical Expenditure Panel Survey Nursing Home Component. MEPS Methodology Report 4. AHCPR Pub. No. 98-0042. Rockville, MD: AHCPR, 1998.

Cohen, J. Design and Methods of the Medical Expenditure Panel Survey Household Component. MEPS Methodology Report No. 1. AHCPR Pub. No. 97-0026. Rockville, MD: AHCPR, 1997.

Cohen, S. Sample Design of the 1996 Medical Expenditure Panel Survey Household Component. MEPS Methodology Report No. 2. AHCPR Pub. No. 97-0027. Rockville, MD: AHCPR, 1997.

Cohen, J.W.; Monheit, A.C.; Beauregard, K.M.; et al. The Medical Expenditure Panel Survey: A National Health Information Resource. Inquiry 33:373-389, 1996/1997. Also available as AHCPR Pub. No. 97-R043. Washington, DC: AHCPR, 1997.

Sponsor

U.S. Department of Health and Human Services, National Institutes of Health (NIH), National Institute on Drug Abuse (NIDA).

Mode of Administration

Self-administered paper and pencil questionnaire completed by a random sample of 8th, 10th, and 12th graders.

Survey Sample Design

The Monitoring the Future Study utilizes a three-stage probability design that includes primary sampling units (PSUs), schools within PSUs, and students within schools. Up to 350 students per school are selected, either by randomly sampling classrooms or by some other random method that is convenient for the school and judged to be unbiased. Beginning in 1991, national samples of 8th and 10th graders were included. Approximately 50,000 responses are collected annually from all three grades combined.

Response Rates

The 1998 response rate for 8th, 10th, and 12th graders was 88, 87, and 82 percent, respectively.

Primary Survey Content

Cigarette, alcohol, and illicit drug use; attitudes and beliefs regarding drug use; attitudes of significant others regarding drug use; drug exposure and availability; lifestyle values, attitudes, and behaviors; participation in organized activities, leisure time activities, and religion; deviant behavior and victimization; health; college plans; and demographic data. Drug use and related attitudes are the key variables.

Population Targeted

Students in 8th, 10th, and 12th grades from public and private schools in the coterminous United States.

Demographic Data

Gender, race/ethnicity, parental education (used as a proxy for socioeconomic status). Data on sexual orientation are not collected.

Years Collected

1975 through present.

Schedule

Annual.

Geographic Estimates

National, census region, and population density (Large Metropolitan Statistical Areas [MSAs], other MSA, non-MSA).

Notes

To obtain estimates, numerator and denominator data are weighted to reflect differential probabilities of selection at three stages of selection: primary areas (counties or groups of counties) within stratum, schools within primary areas, and students within schools. Final weights are normalized to average unity, thus the numerator and denominator estimates reflect the sample design but not population totals. This weighting scheme allows the estimates to be representative of the population of students in public and private schools in the continental United States.

Contact Information

Data system homepage: http://www.isr.umich.edu/src/mtf/index.html

Data system phone: Not available

Agency homepage: http://www.nida.nih.gov

Agency phone: 301-443-6637

References

Johnston, L.D.; Bachman, J.G.; and O'Malley, P.M. Monitoring the Future: Questionnaire Responses From the Nation's High School Seniors. Ann Arbor, MI: Institute for Social Research, 1995.

O'Malley, P.M. The Monitoring the Future Study. In: Jaffe, J.H., et al., eds. Encyclopedia of Drugs and Alcohol. New York, NY: Macmillan, 1995.

Wallace, J.M., Jr., and Bachman, J.G. Validity of self-reports in student-based studies on minority populations: Issues and concerns. In: De La Rosa, M., and Andrados, J.L., eds. Drug Abuse Among Minority Youth: Advances in Research and Methodology. NIDA Research Monograph No. 130:167-200. Rockville, MD: National Institute on Drug Abuse, 1993.

Sponsor

U.S. Department of Health and Human Services, Centers for Disease Control and Prevention (CDC), National Center for Health Statistics (NCHS).

Mode of Administration

Field personnel meet with participating physicians and instruct them in survey data collection methods. Physicians are asked to complete 1-page questionnaires on a sample of their office visits during an assigned reporting period.

Survey Sample Design

The NAMCS utilizes a three-stage survey design that involves probability samples of primary sampling units (PSUs), physician practices within PSUs, and patient visits within physician practices. Participating physicians are randomly assigned to a 1-week reporting period during the survey year, and a systematic random sample of patient visits during that period is selected by the physician, using a visit sampling rate that varies by the size of the practice. Sample data are weighted to produce national estimates of office visits. About 2,500 physicians were sampled in 1998 and more than 23,000 survey encounter forms were completed.

Response Rates

The survey response rate has averaged around 70 percent.

Primary Survey Content

Information is obtained on various aspects of office visits, including physician practice characteristics, patient characteristics, and other visit characteristics. The survey form is redesigned every 2 years to address changing health data needs. Among the items collected are patient’s age, gender, race, and ethnicity; patient’s expressed reason for visiting the physician; place, cause, and intentionality of injury, if any; physician’s diagnoses; diagnostic services ordered or provided; therapeutic services; ambulatory surgical procedures performed; medications; providers seen; visit disposition; time spent with physician; and expected source of payment.

Population Targeted

The basic sampling unit is the physician-patient encounter or visit. Visits made to the offices of nonfederally employed, office-based physicians who are classified by the American Medical Association or the American Osteopathic Association as being primarily engaged in direct patient care. The specialties of anesthesiology, pathology, or radiology are not included. Not included are contacts by telephone, visits made outside the physician’s office, visits in hospitals or institutional settings, and visits made for administrative purposes only.

Demographic Data

Patient’s age, gender, race, and ethnicity.

Years Collected

Annual from 1973–81; again in 1985; resumed an annual schedule in 1989.

Schedule

Annual.

Geographic Estimates

National; four regions.

Notes

The NAMCS is a visit-based survey rather than a population-based survey. Therefore, estimates of incidence and prevalence of disease cannot be computed. The survey is cross-sectional in nature. Multiple visits may be made by the same person within the sample.

Contact Information

Data system homepage:

http://www.cdc.gov/nchs/about/major/ahcd/ahcd1.htm

Data system phone: 301-458-4600

Agency homepage: http://www.cdc.gov/nchs

Agency phone: 301-458-INFO (4636)

References

Woodwell, D.A. National Ambulatory Medical Care Survey: 1997 Summary. Advance data from Vital and Health Statistics, No. 305. Hyattsville, MD: National Center for Health Statistics, 1999.

Sponsor

U.S. Department of Justice, Bureau of Justice Statistics, Office of Justice Programs.

Mode of Administration

Interview: With the exception of the first and the fifth of a total of seven interviews, all interviews are done by phone using computer-assisted telephone interviewing (CATI). The first and fifth interviews are personal interviews using computer-assisted personal interviewing (CAPI).

Survey Sample Design

The NCVS uses a stratified, multistage cluster sample. Primary sampling units (PSUs) consist of counties, groups of counties, or large metropolitan areas. The 1994 survey sample households were drawn from the 1980-based sample design. Data are collected every year from a sample of approximately 50,000 households that includes about 100,000 people aged 12 years and older. PSUs remain in the sample for a total of 3 years. A total of seven interviews are conducted at 6-month intervals during the 3-year process.

Response Rates

Response rates have consistently remained around 95 percent (96 percent of eligible housing units and 92 percent of individuals in interviewed households).

Primary Survey Content

The NCVS counts incidents not reported to police and is one of two U.S. Department of Justice measures of crime in the United States. The survey contains a screening section with detailed questions and cues on victimizations and situations within which crimes may take place. Interviewers follow up positive responses and collect details about victimizations in incident reports.

Population Targeted

Noninstitutionalized population aged 12 years and older residing in the United States.

Demographic Data

Age, gender, race, ethnicity, and income. Property crimes include data on age, race, ethnicity, and household size.

Years Collected

1974 to present.

Schedule

Annual.

Geographic Estimates

National.

Contact Information

Data system homepage: http://www.oip.usdoj.gov/bjs/cvict.htm#ncvs

Data system phone: 202-616-3494

Agency homepage: http://www.oip.usdoj.gov/bjs

Agency phone: 202-307-0770

References

Kinderman, C.; Lynch, J.; and Cantor, D. Effects of the Redesign on Victimization Estimates. Washington, DC: Bureau of Justice Statistics, 1997.

Hubble, D. The National Crime Victimization Survey Redesign: New Questionnaire and Procedures Development and Phase-In Methodology. Orlando, FL: Annual meetings of the American Statistical Association, 1995.

Persley, C. The National Crime Victimization Survey Redesign: Measuring the Impact of New Methods. Orlando, FL: Annual meetings of the American Statistical Association, 1995.

Biderman, A.D.; Cantor, D.; Lynch, J.P.; et al. Final Report
of Research and Development for the Redesign of the National Crime Victimization Survey. Washington, DC: Bureau of Social Sciences Research, Inc., 1986.

Hubble, D. The National Crime Survey’s New Questionnaire Phase-in: Preliminary Results. Tucson, AZ: International Conference on Measurement Errors in Surveys, 1990.

Hubble, D., and Wilder, B.E. Preliminary Results from the National Crime Survey CATI Experience. New Orleans, LA: Proceedings of the American Statistical Association: Survey Methods Section, 1988.

Sponsor

U.S. Department of Health and Human Services, Centers for Disease Control and Prevention (CDC), National Center for Health Statistics (NCHS).

Mode of Administration

Personal interview in households using computer-assisted personal interviewing (CAPI), administered by professional interviewers, and conducted in English and Spanish (for CAPI, Spanish version was initiated in mid-1998).

Survey Sample Design

The NHIS uses a stratified multistage probability design that permits a continuous sampling of 358 primary sampling units (PSUs), with over-sampling of African Americans and Hispanics. A typical NHIS sample for the data collection years 1995–2004 consists of approximately 7,000 second-stage units (segments) within a PSU. The expected sample of 43,000 occupied respondent households yields a probability sample of about 111,000 persons. The survey is designed so that the sample scheduled for each week is representative of the target population and the weekly samples are additive over time.

Response Rates

Response rates for the basic NHIS core questionnaire have ranged from 91 to 96 percent over the years, with rates of sample person components generally ranging from 85 to 90 percent of eligible respondents. Response rates for special health topics (supplements) have generally also been in this lower range. The effect, if any, of the new CAPI technology is not yet known. 

Primary Survey Content

Information is obtained on demographic characteristics, illnesses, injuries, impairments, chronic conditions, utilization of health resources, health insurance, and other health topics. The core household interview asks about everyone in the household. Additional questions are asked of one sample adult and one sample child (under 18 years) per family in the household. The sample adult questionnaire includes chronic health conditions and limitations in activity, health behaviors, health care access, health care provider contacts, immunizations, and AIDS knowledge and attitudes. The sample child questionnaire includes questions about chronic health conditions, limitation of activities, health status, behavior problems, health care access and utilization, and immunizations. Child data are proxy-reported by a parent or other knowledgeable adult respondent. Adult sample person data are all self-reported. Special modules are fielded periodically, and cover areas such as cancer, prevention, and disability.

Population Targeted

Civilian noninstitutionalized population residing in the United States, all ages.

Demographic Data

Gender, age, race/Hispanic ethnicity, education, income, marital status, place of birth, industry, and occupation.

Years Collected

Continuously since 1957. Current sample design began in 1995; current questionnaire design began in 1997.

Schedule

Annual.

Geographic Estimates

National; four U.S. Census Bureau regions; some of the 10 HHS regions, some States; metropolitan and nonmetropolitan areas.

Contact Information

Data system homepage:  http://www.cdc.gov/nchs/nhis.htm

Data system phone: 301-458-4001

Agency homepage: http://www.cdc.gov/nchs

Agency phone: 301-458-INFO (4636)

References

Hendershot, G.; Adams, P.; Marano, M.; et al. Current estimates from the National Health Interview Survey, 1996. National Center for Health Statistics (NCHS).
Vital and Health Statistics 10(200), 1999.

Questionnaires from the National Health Interview Survey, 1985–89. NCHS. Vital and Health Statistics 1(31), 1993.

Massey, J.T.; Moore, T.F.; Parsons, V.L.; et al. Design and estimation for the National Health Interview Survey, 1985–94. NCHS. Vital and Health Statistics 2(110), 1989.

Sponsor

U.S. Department of Health and Human Services, Centers for Disease Control and Prevention (CDC), National Center for Health Statistics (NCHS).

Mode of Administration

Hospital staff are asked to complete one-page questionnaires (Patient Record forms) on a sample of their patient visits during an assigned reporting period.

Survey Sample Design

The NHAMCS utilizes a four-stage probability design that involves samples of primary sampling units (PSUs), hospitals within PSUs, clinics within hospitals, and patient visits within clinics. Hospital staff were asked to complete Patient Record forms for a systematic random sample of patient visits occurring during a randomly assigned 4-week reporting period during the survey year. Sample data are weighted to produce national estimates of patient visits. About 400 emergency departments participated in 1998 and more than 24,000 Patient Record forms were completed. About 230 outpatient departments (OPD) participated in 1998 and about 30,000 Patient Record forms were completed.

Response Rates

The response rates are about 95 percent.

Primary Survey Content

NHAMCS includes two files: ED visits and OPD visits. Information is obtained on various aspects of patient visits, including patient characteristics, physician characteristics, and other visit characteristics. The survey form is redesigned every 2 years to address changing health data needs. Among the items collected are: patient’s age, gender, race, and ethnicity; patient’s expressed reason for visit; place, cause, work-relatedness, and intentionality of injury, if any; physician’s diagnoses; diagnostic services ordered or provided; procedures provided; medications ordered, supplied, administered or continued; providers seen; visit disposition; immediacy with which patient should be seen; time spent with physician; and, expected source of payment.

Population Targeted

The basic sampling unit is the patient visit. Included in the survey are in-person visits by patients to EDs and OPDs of noninstitutional general and short-stay hospitals, exclusive of Federal, military, and Veterans Administration hospitals, located in the 50 States and the District of Columbia. Telephone contacts are excluded.

Demographic Data

Patient’s age, gender, race, and ethnicity.

Years Collected

Annual since 1992.

Schedule

Annual.

Geographic Estimates

National, four U.S. Census Bureau regions.

Notes

The NHAMCS is a visit-based survey rather than a population-based survey. Estimates of visits per person per year can be produced using U.S. Census Bureau civilian noninstitutionalized population estimates. The survey is cross-sectional in nature. Multiple visits may be made by the same person within the sample.

Contact Information

Data system homepage: http://www.cdc.gov/nchs/about/major/ahcd/ahcd1.htm

Data system phone: 301-458-4600

Agency homepage: http://www.cdc.gov/nchs

Agency phone: 301-458-INFO (4636)

References

McCaig, L.F.; and McLemore, T. Plan and operation of the National Hospital Ambulatory Medical Care Survey. National Center for Health Statistics. Vital and Health Statistics 1(34), 1994.

Sponsor

U.S. Department of Health and Human Services, Centers for Disease Control and Prevention (CDC), National Center for Health Statistics (NCHS).

Mode of Administration

Manual sample selection and abstraction of inpatient medical records by field personnel or automated data collection through the purchase of electronic files from commercial abstracting sources, States, or hospitals.

Survey Sample Design

The NHDS utilizes a three-stage probability design that includes primary sampling units (PSUs) used for the 1985–94 NHIS, hospitals within PSUs, and discharges within hospitals. The largest hospitals were selected with certainty. The annual number of records included in the survey is approximately 300,000.

Response Rates

The survey response rate averages between 92 and 95 percent annually.

Primary Survey Content

Variables collected include: age; gender; race; ethnicity; admission and discharge dates (length of stay); discharge status; source of payment; hospital size, ownership, and region; from 1-7 diagnoses coded using the ICD-9-CM; and, from 0-4 procedures using the ICD-9-CM.

Population Targeted</