National health statistics reports最新文献

Purpose-This report compares emergency department (ED) visits for respiratory illness between the 2014 National Hospital Care Survey (NHCS) and the 2014 National Hospital Ambulatory Medical Care Survey (NHAMCS) to determine the potential of researching respiratory illness in EDs with non-nationally representative NHCS data. The 2014 NHCS data linked to records in the 2014-2015 National Death Index (NDI) are also described to provide results on mortality after ED visits for respiratory illness. Methods-For both surveys, encounters with respiratory illness were identified using diagnosis codes from the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM). Weighted NHAMCS percentage estimates and their 95% confidence intervals (CIs) are shown for all demographic characteristics. Unweighted NHCS percentages are presented for all demographic and health care characteristics and are compared with weighted NHAMCS percentage estimates and used to report NHCS-only results. Standard errors and CIs are also presented for the NHCS unweighted percentages as a measure of variability. Results-The percentage of NHCS ED visits for respiratory illness fell within NHAMCS measures of statistical variation for overall and specific respiratory illnesses. Additionally, respiratory illness by sex, older age groups, older men, and female patients of all ages fell within these measures. Compared with NHAMCS, NHCS had a higher percentage of ED visits for respiratory illness for both infants (under 1 year) and children (1-17 years) but a lower percentage for adults aged 18-44. NHCS data show that 15.2% of patients with ED visits for respiratory illness were hospitalized and of those hospitalized, 6.6% died within 90 days post-discharge. However, 11.1% of patients admitted to the intensive care unit died within 90 days. Conclusion-Although the 2014 NHCS data are not nationally representative, the data may be used for exploratory analyses and have analytical capabilities that are not available in other hospital surveys.

Background-Injury diagnosis frameworks, or matrices, based on the International Classification of Diseases (ICD) provide standardized categories for reporting injuries by body region and nature of injury. In 2016, the National Center for Health Statistics (NCHS) and the National Center for Injury Prevention and Control (NCIPC) published a proposed injury diagnosis matrix for use with data coded using the ICD, 10th Revision, Clinical Modification (ICD-10-CM). At the time the proposed matrix was developed, ICD-10-CM coded data were not available to evaluate the performance of the proposed matrix. As data became available, NCHS and NCIPC received recommendations from clinicians and researchers to improve the consistency and clinical applicability of categorization of codes within the matrix. This report describes the modifications made to the 2016 proposed ICD-10-CM injury diagnosis matrix and presents the final 2020 ICD-10-CM injury diagnosis matrix. Methods-Comments on the 2016 proposed matrix were received from several federal agencies, military health centers, state health departments, researchers, and others. Additionally, subject matter experts from NCHS, NCIPC, the Council of State and Territorial Epidemiologists, and others reviewed code descriptions, coding guidelines, updates to the ICD-10-CM code set, and other materials to identify possible needed changes to the 2016 proposed ICD-10-CM injury diagnosis matrix. Results-Consideration of issues raised by clinicians and researchers and from the internal review resulted in relocation of approximately 3% of the 9,000 codes in the 2016 proposed ICD-10-CM injury diagnosis matrix. These relocations generally involved changes to the assigned nature-of-injury category. Additionally, approximately 200 new injury diagnosis codes not available at the time the 2016 proposed matrix was developed were added to create the final 2020 matrix. Conclusions-The 2020 final ICD-10-CM injury diagnosis matrix provides standard categories for reporting injuries by body region and nature of injury. Use of this tool promotes consistency for comparisons across populations and over time.

Introduction-Increasingly, residential care communities (RCCs) are becoming a source of care for older adults with Alzheimer's disease and other dementias. Nationally in 2016, 41.9% of RCC residents were diagnosed with dementia. This report examines selected characteristics of RCCs and characteristics of their residents by the prevalence of Alzheimer's disease and other dementias. Methods-Data in this report are from the RCC survey component of the 2016 wave of the biennial National Study of Long-Term Care Providers (NSLTCP), conducted by the National Center for Health Statistics. RCCs were grouped into three categories indicating prevalence of Alzheimer's disease and other dementias in their communities: RCCs with less than 25% of their residents diagnosed with dementia, RCCs with 25%-75% of their residents diagnosed with dementia, and RCCs with more than 75% of their residents diagnosed with dementia. RCC characteristics included bed size, metropolitan statistical area location, provision of mental health services, and staff hours per resident day. Resident characteristics included selected conditions and need for assistance with activities of daily living. Results-Approximately one-quarter of RCCs (25.3%) had more than 75% of their residents diagnosed with Alzheimer's disease and other dementias. More RCCs with over 75% of their residents diagnosed with dementia were in metropolitan statistical areas (90.5%) compared with RCCs with 25%-75% (81.4%) and less than 25% of their residents diagnosed with dementia (76.4%). Aide and activities staff hours per resident day were higher in RCCs with more than 75% of their residents diagnosed with dementia compared with the other dementia prevalence categories. The prevalence of depression and the need for assistance with activities of daily living were higher in RCCs with more than 75% of the residents diagnosed with dementia compared with the other dementia prevalence categories.

Purpose-This report compares 2014 National Hospital Care Survey (NHCS) emergency department (ED) data with national estimates of ED visits due to opioid use (i.e., "opioid-involved visits") from the 2013-2015 National Hospital Ambulatory Medical Care Survey (NHAMCS) to determine the potential of researching the impact and outcomes of opioid use on hospital EDs with non-nationally representative NHCS data. The 2014 NHCS data are also linked to records in the 2014 and 2015 National Death Index (NDI) to examine mortality after the opioid-involved ED visit. Methods-A previously published algorithm, which uses a list of International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) diagnosis codes and external-cause-of-injury codes denoting opioid use, was used to identify opioid-involved visits in NHCS and NHAMCS, which are compared by sex and age. Weighted percentage estimates and their 95% confidence intervals (CIs) are shown for all demographic characteristics using NHAMCS data. Unweighted percentages are presented for all demographic and health care characteristics using NHCS data. Standard errors and CIs are also presented for the NHCS unweighted percentages as a measure of variability. Results-The percentage of opioid-involved ED visits from NHCS fell within measures of statistical variation from NHAMCS by sex and several age groups. Less consistency of NHCS results compared with NHAMCS was seen for sex-specific age groups. NHCS has a higher percentage of opioid-involved ED visits and a higher percentage of opioid-involved ED visits for those aged 25-34, but a lower percentage for those aged 25 and under. NHCS data show that 19.2% of patients with any opioid-involved ED visit made two or more such visits, and 1.2% died within 30 days post-discharge.

made by adults aged 18 and over with documented hypertension by age, sex, and race and ethnicity during 2014-2016. Methods-Data are from the 2014-2016 National Ambulatory Medical Care Survey (NAMCS), a nationally representative survey of visits to nonfederal, officebased physicians. The study population includes all office-based physician visits made by nonpregnant adults aged 18 and over with complete data on patient residence. Patient residence is based on the county of patient residence. The primary outcome is the percentage of visits with diagnosed hypertension, as defined by documentation of hypertension in their medical record. Variation in visits with documented hypertension was assessed by patient residence, sex, age, and race and ethnicity. Results-During 2014-2016, the percentage of visits by adults aged 18 and over with diagnosed hypertension who lived in large metro suburban areas (34.2%) was lower than visits by adults who lived in small-medium metro areas (37.9%) and rural areas (40.1%). The percentage of visits by men with hypertension (41.0%) was higher than women (33.5%) overall and in large metro suburban areas (38.7% for men and 31.0% for women), small-medium metro areas (43.5% for men and 33.8% for women), and rural areas (44.9% for men and 36.5% for women). The percentage of visits by adults with hypertension increased with age, from 10.3% for adults aged 18-44 to 58.6% for adults aged 75 and over. This same pattern was observed in all patient residence areas. The percentage of visits by non-Hispanic black adults with hypertension (47.3%) was higher than for non-Hispanic white adults (35.7%) and for Hispanic adults (34.6%). This same pattern was observed in large metro urban and large metro suburban areas.

Objective-This report presents national estimates of age at first menstrual period for women aged 15-44 in the United States in 2013-2017 based on data from the National Survey of Family Growth (NSFG). Estimates for 2013-2017 are compared with those from previous NSFG survey periods (1995, 2002, and 2006-2010). Methods-Data for all survey periods analyzed are based on in-person interviews with nationally representative samples of women in the household population aged 15-44 in the United States. For the 2013-2017 survey period, interviews were conducted with 10,590 female respondents aged 15-44. In 2015-2017, the age range of the NSFG included women aged 15-49, but only those aged 15-44 were included in this analysis. The response rate for the 2013-2017 NSFG was 67.4% for women. Measures of menarche in this report include average age at first menstrual period, probability of first menstrual period at each age, and the relationship between age at menarche and age at first sexual intercourse. Results-The median age at menarche decreased from 1995 (12.1) to 2013-2017 (11.9). The cumulative probability of menarche at young ages was higher in 2013-2017 compared with 1995. Differences in age at menarche exist by Hispanic origin and race, mother's education, and living arrangement at age 14. A decreasing linear trend in the probability of age at first sexual intercourse by age at menarche was seen.

Objective-This report describes select measures of health among former cigarette smokers aged 65 and over. Methods-Data from the 2018 National Health Interview Survey were used to describe the health of former cigarette smokers aged 65 and over by estimating the percentage with fair or poor health, chronic obstructive pulmonary disease (COPD), four or more chronic conditions, and limitations in social participation. The health measures were adjusted for age, sex, race and Hispanic origin, and education and presented by the number of years that the former smoker smoked. The number of years smoked was estimated from responses to questions on the age the former smoker started to smoke regularly and how long ago they quit smoking cigarettes. Results-Among adults aged 65 and over, 49.4% of men and 30.6% of women were former cigarette smokers. Almost one-fourth of former smokers smoked for 40 years or more. Controlling for sociodemographic characteristics, former smokers reported higher levels of fair or poor health, COPD, and four or more chronic conditions compared with never smokers and similar levels of fair or poor health, four or more chronic conditions, and limitations in social participation compared with current smokers. Former smokers had higher levels of fair or poor health, COPD, four or more chronic conditions, and social participation limitations as their years of smoking increased. Conclusions-Smoking cessation has been shown to be beneficial at any age. However, even after quitting smoking, the length of time a person smoked is reflected in current health measures among people aged 65 and over.

Objective-This report describes how problems paying medical bills and forgone medical care vary by family composition among families with at least one older adult (aged 65 and over). Methods-Data from families in the 2017-2018 National Health Interview Survey that included at least one older adult were analyzed (n = 19,471). Bivariate and multivariate analyses, adjusted for selected family characteristics that may put families at financial risk, were conducted for both outcome measures and shown by family composition. The family compositions examined were one older adult living alone, two older adults, one younger (aged 18-64) and one older adult, three or more adults (where at least one was an older adult), and two or more adults (where at least one was an older adult) and at least one child (under age 18 years). Results-About 8.6% of families with older adults experienced problems paying medical bills, and 8.9% had forgone medical care. The most common composition for older-adult families was one older adult living alone (39.7%). Older-adult families consisting of only two older adults were the least likely to have experienced problems paying medical bills (4.0%) and to have forgone medical care (3.8%) compared with other family compositions. Older-adult families with at least one child were the most likely to experience problems paying medical bills (21.3%) and to have forgone medical care (18.4%). After adjusting for selected family characteristics in multivariate analyses, the odds of experiencing problems paying medical bills and forgone medical care weakened for all family compositions but remained significantly lower for families with two older adults. Conclusion-Among families with older adults, financial burdens of medical care vary based on family composition.

Objective-This report demonstrates the utility of linking the restricted-use 2014 National Hospital Care Survey (NHCS), 2014-2015 National Death Index (NDI), and 2014-2015 Drug-Involved Mortality (DIM) data to study opioid-involved emergency department (ED) visits, hospitalizations, and mortality within 1 year post-discharge. Example research questions and unweighted results are presented. Results are not nationally representative. Methods-Patient records from the 2014 NHCS with sufficient identifying information were linked to the 2014-2015 NDI and DIM data. Visits were considered opioid-involved if they had International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) diagnosis codes 304.00-304.02, 304.70-304.72, 305.50-305.52, 760.72, 965.00-965.02, 965.09, 970.1, or E850.0-E850.2 in any diagnosis or external cause of injury code field. Opioid-involved drug overdose deaths were deaths with an International Classification of Diseases, 10th Revision (ICD-10) underlying cause-of-death code of X40-44, X60-64, X85, or Y10-Y14 and a multiple cause code of T40.0-T40.4 or T40.6. Results-In the 2014 NHCS, there were 15,495 patients with an opioid-involved ED-only visit and 24,059 patients with an opioid-involved hospitalization. Of the 20,962 patients with an opioid-involved hospitalization eligible to be linked to NDI, 1,805 died (9%) within 1 year of discharge. Of these deaths, 341 (19%) resulted from a drug overdose. Of drug overdose deaths, 243 (71%) involved an opioid, where 12% died within 30 days post-discharge, 19% within 31-90 days, and 69% within 91-365 days. Opioids most frequently mentioned included heroin (46%), fentanyl (20%), oxycodone (13%), methadone (12%), and morphine (12%). These categories are not mutually exclusive because a death may involve more than one drug. For approximately 22% of patients who died of an opioid-involved drug overdose in 2014, their last ED-only visit or hospitalization was opioid-involved. Conclusion-While the NHCS data are not nationally representative, these unlinked and linked National Center for Health Statistics data allow for exploratory analyses of ED visits, hospitalizations, and associated mortality outcomes.

Objective-This report describes hearing difficulty, vision trouble, dual sensory impairment (hearing and vision loss), and balance problems among male veterans and nonveterans. Methods-Sample adult data from the 2016 National Health Interview Survey (NHIS) were used to assess degree of hearing difficulty, vision trouble, and dual sensory impairment in men aged 18 and over by veteran status. Data from the 2016 NHIS Sample Adult Balance Supplement were also used to create estimates of balance or dizziness problems for men by veteran status. Results-Male veterans were significantly less likely to have excellent or good hearing than nonveterans (72.9% compared with 84.1%), and significantly more likely to have a little or moderate trouble hearing (23.2% compared with 13.6%), as well as more likely to have a lot of hearing difficulty or to be deaf (3.9% compared with 2.4%). Male veterans were also more likely to have dual sensory impairment and balance problems than nonveterans (5.0% compared with 2.5% and 24.3% compared with 18.7%, respectively). When data were stratified by age, male veterans aged 18-44 were over three times more likely to have a little or moderate trouble hearing compared with nonveteran men in the same age group (18.0% compared with 5.3%). Male veterans in age groups 45-64 and 65-74 were also more likely to have a little or moderate trouble hearing compared with nonveteran men in the same age groups. When the data were stratified by age, male veterans and nonveterans had similar percentages of dual sensory impairment. Lastly, male veterans in age groups 45-64 and 65-74 were more likely to have balance problems than nonveteran men in the same age groups.