National health statistics reports最新文献

Objectives: This report presents national estimates of difficulties in functioning for children ages 2-17.

Methods: 2021-2023 National Health Interview Survey (NHIS) data were used to assess difficulties in functioning among children. NHIS has included the Child Functioning Module, developed jointly by UNICEF and the Washington Group on Disability Statistics, since 2019. The module's questions ask about difficulties in the following functional domains: seeing, hearing, walking, communication, behavior, and learning (for all children ages 2-17); fine motor and playing (for children ages 2-4); and self-care, remembering, concentrating, coping with change, relationships, and affect (anxiety and depression) (for children ages 5-17). Prevalence estimates were calculated for different levels of difficulty (a lot of difficulty, some difficulty, or no difficulty) and are presented for overall functioning, by individual functional domain, and by number of functional domains where difficulties were reported. Differences in functioning by age, sex, race and Hispanic origin, urbanization level, and family income are also presented.

Results: In 2021-2023, about one-quarter (24.9%) of children ages 2-4 experienced difficulties in functioning (4.1% experienced a lot of difficulty in one or more domains and 20.8% experienced some difficulty). Among children ages 5-17, just over one-half (50.8%) experienced functioning difficulties (13.0% experienced a lot of difficulty and 37.8% experienced some difficulty). The prevalence of functioning difficulties varied by sex, with boys being more likely than girls to experience a lot of difficulty in at least one domain, but differences across other characteristics varied. Functioning difficulties were most prevalent in the domains of communication, learning, behavior, and playing among children ages 2-4. For those ages 5-17, the most prevalent domains were anxiety, accepting change, behavior, depression, and making friends. Among children who experienced functioning difficulties, most had difficulty in only one functional domain.

Introduction: Personal care aides (aides) are a key part of the long-term care infrastructure and provide hands-on care and support with essential activities of daily living to older and disabled Americans. This report presents the number of aides employed in adult day services centers (ADSC) and residential care communities (RCC), the hours they spend with their service users, and their training and benefits.

Methods: Data are from the ADSC and RCC provider components of the 2022 National Post-acute and Long-term Care Study, conducted biennially by the National Center for Health Statistics. The study includes several questions on staffing, including about the number of registered nurses (RNs), licensed practical nurses (LPNs) or licensed vocational nurses (LVNs), and aides employed directly by ADSCs and RCCs. Full-time equivalent (FTE) staff is based on the number of full-time and part-time employees. A measure of hours per user (participant or resident) per day was used to compare staffing levels in the two settings relative to the number of users. Responses to questions on number of hours of training required and types of training and benefits offered to aides were used to compare in and across ADSC and RCC settings.

Results: Of the 15,600 nursing (RN, LPN or LVN, and aide) FTEs employed in ADSCs and 452,000 employed in RCCs, the majority were aides (63.2% and 76.0%, respectively). Both settings often employed at least one aide (56.2% and 75.6%). The average total of all nursing staffing hours per participant or resident per day was 1 hour and 34 minutes for ADSCs and 4 hours and 25 minutes for RCCs. A lower percentage of ADSCs than RCCs offered training in dementia care (50.8% and 72.3%) and end-of-life issues (19.7% and 58.4%).

Objective: This report provides a comprehensive look at enrollment in high-deductible health plans (HDHP), including consumer-directed health plans (CDHP) among privately insured people younger than age 65.

Methods: Data from the 2019 through 2023 National Health Interview Survey were used to examine enrollment in HDHPs and CDHPs among people younger than age 65 with private health insurance. CDHPs are HDHPs with an associated health savings account or health reimbursement account. All estimates are presented by sex, age group, race and Hispanic origin, family income, family educational attainment, level of urbanization, and source of private coverage.

Results: In 2023, among privately insured people younger than age 65, 41.7% were enrolled in an HDHP. Enrollment increased from 40.3% in 2019 to 43.3% in 2021, followed by a decrease to 41.7% in 2023. Among people with employment-based coverage, enrollment in an HDHP increased from 40.2% in 2019 to 43.4% in 2021, followed by a decrease to 41.9% in 2023. For people with directly purchased coverage, enrollment in an HDHP increased from 44.3% in 2019 to 47.0% in 2020, followed by a decrease to 43.1% in 2023. Generally, White non-Hispanic people were the most likely to be enrolled in an HDHP. Black non-Hispanic and Hispanic people were the least likely to be enrolled in an HDHP. Enrollment in an HDHP increased with family income and family educational attainment. In 2023, 19.5% of people younger than age 65 with private health insurance were enrolled in a CDHP. Enrollment characteristics of people with CDHPs mirrored those of people with HDHPs overall. However, children were more likely to be enrolled in an CDHP plan than adults ages 18-64. People with employment-based coverage were nearly four times more likely to be enrolled in a CDHP than their counterparts with directly purchased coverage.

Objective: This report presents national estimates of the percentage of adults age 65 and older who met the federal physical activity guidelines for both aerobic and muscle-strengthening activities during leisure time by sociodemographic and health-related characteristics.

Methods: Data from the 2022 National Health Interview Survey were used to estimate the percentage of adults age 65 and older who met the U.S. Department of Health and Human Services 2018 Federal Physical Activity Guidelines for Americans for both aerobic and muscle-strengthening activities during leisure time. Adults were considered to have met the guidelines if they met both aerobic and muscle-strengthening recommendations. Estimates are presented by age group, sex, race and Hispanic origin, education, family income, urbanization level, respondent-assessed health status, chronic conditions, disability status, severity of depression symptoms, severity of anxiety symptoms, and body mass index.

Results: Overall, 13.9% (age adjusted) of adults age 65 and older met federal physical activity guidelines for both aerobic and muscle-strengthening activities in 2022. Differences were seen by several sociodemographic characteristics. Men (16.9%), White non-Hispanic adults (15.2%), and those living in metropolitan areas (14.7%) were more likely to meet the guidelines. The percentage meeting the federal physical activity guidelines increased with increasing education level and family income and decreased with number of chronic conditions. Older adults who reported poor health status had the lowest percentage meeting the guidelines compared with those reporting good, very good, or excellent health. Older adults without disabilities were three times more likely to meet the federal physical activity guidelines than adults with disabilities (15.9% compared with 5.0%, respectively). Older adults with no depression or anxiety symptoms were more likely to meet the guidelines than those with mild symptoms or moderate or severe symptoms.

Objective: This report examines the prevalence of symptoms of anxiety and depression among adults by sociodemographic and geographic characteristics, and how those may have changed between 2019 and 2022.

Methods: Data from the 2022 National Health Interview Survey were used to examine the prevalence of symptoms of anxiety, using the Generalized Anxiety Disorder scale (GAD-7), and symptoms of depression, using the Patient Health Questionnaire depression scale (PHQ-8).

Results: During 2022, about one in five adults age 18 and older experienced any symptoms of anxiety (18.2%) or symptoms of depression (21.4%) in the past 2 weeks. The severity of symptoms differed by sociodemographic and geographic characteristics. The percentages of adults with mild, moderate, or severe symptoms of both anxiety and depression were highest among adults ages 18-29 and decreased with age and were higher among women than men. Asian non-Hispanic adults were least likely to experience moderate and severe symptoms of anxiety and depression compared with the other race and Hispanic-origin groups examined. In addition, the percentage of adults with any symptoms of anxiety and depression was highest among those with less than a high school education and with family incomes less than 100% of the federal poverty level and was higher among those living in rural areas. A significant increase was seen in the percentage of adults with anxiety symptoms (from 15.6% to 18.2%, respectively) and depression symptoms (from 18.5% to 21.4%, respectively) between 2019 and 2022. Increases in symptoms of anxiety and depression were seen throughout the subgroups examined, including adults ages 18-44, Black non-Hispanic and White non-Hispanic adults, adults with a high school education or more, and adults with family incomes of 100% of the federal poverty level or higher, as well as adults from all regions and urbanization levels.

Objective: This report describes care received at health centers in the United States in 2022. Estimates are presented for selected characteristics.

Methods: The data presented in this report are from the 2022 National Ambulatory Medical Care Survey Health Center Component. Data were collected from federally qualified health centers and federally qualified health center look-alikes and weighted to produce nationally representative estimates of visits to health centers from all 50 U.S. states and the District of Columbia.

Results: During 2022, an estimated 89.5 million visits were made by adults to health centers in the United States, an overall rate of 349.4 visits per 1,000 adults. The visit rate among women was higher than for men. Differences in visit rates by age were not significant. Adults who were not married accounted for 48.2% of visits, and adults who were married accounted for 37.6% of visits. More than one-half of health center visits were disease-related (61.4%). Symptoms-related diagnoses accounted for 22.0% of visits. Screenings (12.6%) and examinations (10.2%) were also frequent reasons for health center visits. Social determinants of health were listed as a reason for the visit at 2.0% of health center visits. Endocrine diseases represented the most frequently mentioned disease category (29.1%), overall and among adults age 45 and older. Mental disorders represented the most common disease category among adults ages 18-44.

Conclusions: Women visited health centers at a higher rate than men. In addition, patient and visit characteristics, including marital status and diagnoses, differed by age.

Objective: This report describes differences in the experience of family food insecurity in the past 30 days among working adults ages 18-64 by selected work conditions.

Methods: Using data from the 2021 National Health Interview Survey on working adults ages 18-64, family food insecurity in the past 30 days was examined by selected work conditions, including type of work shift, work schedule inflexibilities, advance notice of work schedule, and monthly change in earnings. Bivariate associations between family food insecurity and each type of work condition were examined, and logistic regression models were used to estimate associations adjusting for age, sex, race and Hispanic origin, nativity status, marital status, presence of children in family, educational attainment, family income as a percentage of the federal poverty level, employed full time, occupation, health status, disability status, rural residence, and region. Model-adjusted prevalence of family food insecurity among working adults by type of work conditions is reported.

Results: In 2021, 4.4% of working adults ages 18-64 lived in families experiencing food insecurity. Differences in family food insecurity by work conditions persisted even after adjusting for potential confounders. After adjustment, those working rotating or other types of shifts were more likely to report family food insecurity (5.7%) compared with day shift workers (4.0%). Workers who reported that it was very difficult or somewhat difficult to change their work schedule were more likely to experience family food insecurity (6.3%) than workers who reported it was very easy or somewhat easy to change their work schedule (3.8%). Food insecurity also varied by monthly change in earnings, from 3.9% among workers whose earnings did not change to 5.5% among workers whose earnings changed at least a moderate amount from month to month.

Objective: This report examines telemedicine use by office-based physicians and long-term care providers in the United States, stratified by electronic health record use and by provider or practice size. Further, it examines differences in telemedicine use before and after the COVID-19 pandemic onset among office-based physicians and assesses telemedicine use during the first year of the COVID-19 pandemic for long-term care providers.

Methods: Nationally representative estimates in this report are derived from data collected in the 2019 and 2021 National Electronic Health Records Survey, which assesses characteristics of office-based physicians, and the 2020 National Post-acute and Long-term Care Study, which assesses characteristics of adult day services centers and residential care communities. Measures include telemedicine using audio with video or web videoconference for patient care, electronic health record use for more than accounting or billing purposes, and size of physician practices and long-term care providers.

Results: In 2021, 80.5% of physicians in office-based settings used telemedicine for patient care, up from 16.0% in 2019. In 2020, 20.5% of adult day services centers and 44.5% of residential care communities used telemedicine to care for users with COVID-19. Office-based physicians, adult day services centers, and residential care communities that used electronic health record systems were more likely to also use telemedicine compared with those not using electronic health records. Large practices and providers were more likely to use telemedicine compared with small practices and providers.

Conclusion: Findings from this report describe telemedicine use among office-based physicians and long-term care providers. Practices and providers that used electronic health records and were larger were more likely to also use telemedicine for patient care during the COVID-19 pandemic.

Objectives: This report provides a comprehensive look at prescription medication use, prescription drug coverage, and cost-related nonadherence among adults age 65 and older (older adults).

Methods: Data from the 2021-2022 National Health Interview Survey were used to report prescription medication use in the past 12 months, prescription drug coverage at the time of interview, and cost-related nonadherence in the past 12 months among older adults. Two types of cost-related nonadherence are reported: 1) not getting needed prescription medication due to cost; and 2) not taking medication as prescribed due to cost (skipping doses, delaying filling a prescription, and taking less medication than prescribed) in the past 12 months. All estimates are presented by sex, age group, race and Hispanic origin, family income, food insecurity, urbanization, education, marital status, health insurance coverage, health status, disability status, and number of chronic conditions.

Results: In 2021-2022, 88.6% of older adults took prescription medication, 82.7% had prescription drug coverage, 3.6% did not get needed prescription medication due to cost, and 3.4% did not take medication as prescribed due to cost. Older adults with no prescription drug coverage were more likely to not get prescription medication and to not take needed medication as prescribed than older adults with private or public prescription drug coverage. For both measures, cost-related nonadherence was six times higher among older adults who were food insecure compared with those who were food secure, and more than twice as likely among older adults reporting fair or poor health or with disabilities compared with those in excellent, very good, or good health, or without disabilities.

Objective: This report presents national results from the National Post-acute and Long-term Care Study to describe providers and services users in seven major settings of paid, regulated post-acute and long-term care services in the United States.

Methods: Data are from the 2020 National Post-acute and Long-term Care Study, which includes surveys of adult day services centers and residential care communities and administrative data from the Centers for Medicare and Medicaid Services on home health agencies, hospices, inpatient rehabilitation facilities, long-term care hospitals, and nursing homes.

Results: The findings show variation in characteristics of the seven post-acute and long-term care settings. About 68,150 providers served roughly 7.3 million people in the United States; about one-half of these providers were residential care communities, and about one-quarter were nursing homes. The Northeast had a higher percentage of adult day services centers than other settings, the Midwest had a higher percentage of nursing homes, the South had a higher percentage of long-term care hospitals, and the West had a higher percentage of residential care communities. Among the settings, more registered nurses were employed in inpatient rehabilitation facilities and long-term care hospitals, and more licensed practical nurses in home health agencies and long-term care hospitals. The most common services were skilled nursing and therapeutic services. Adult day services centers had the highest percentage of users younger than age 65, while nearly one-half of hospice and nursing home users were age 85 and older. Adult day services centers had the highest percentage of other non-Hispanic and Hispanic users among the settings. The percentage of users with selected diagnoses and activities of daily living difficulties varied by setting.

Conclusion: The providers described in this report comprise a large share of the U.S. post-acute and long-term care industry. This report provides the most recent nationally representative information on these providers and services users and updates findings from previous National Center for Health Statistics reports.