National health statistics reports最新文献

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.

Linking national survey data with administrative data sources enables researchers to conduct analyses that would not be possible with each data source alone. Recently, the Data Linkage Program at the National Center for Health Statistics (NCHS) released updated linked mortality files, including the National Health Interview Survey data linked to the National Death Index mortality files. Two versions of the files were released: restricted-use files available through NCHS and Federal Statistical Research Data Centers and public-use files. To reduce the reidentification risk, statistical disclosure limitation methods were applied to the public-use files before they were released. This included limiting the amount of mortality information available and perturbing cause of death and follow-up time for select records. To assess the comparability of the restricted-use and public-use files, relative hazard ratios for all-cause and cause-specific mortality using Cox proportional hazards models were estimated and compared. The comparative analysis found that the two data files yielded very similar descriptive and model results.

Introduction-This report presents a trend analysis of electronic health record (EHR) use and health information exchange capability among residential care communities. EHR systems and health information exchange have the potential to improve communication and facilitate care coordination, especially during care transitions. Methods-Data in this report are from the residential care community survey component of the 2012, 2014, and 2016 waves of the biennial National Study of Long-Term Care Providers (NSLTCP), which is conducted by the National Center for Health Statistics. For the EHR use measure, respondents were asked if, for other than accounting or billing purposes, they used EHRs. Among those who indicated they did use EHRs, health information exchange capability was also measured using items that asked residential care communities if their computerized system supported electronic health information exchange with physicians or pharmacies. A weighted least-squares regression was used to test the significance of trends across the 2012, 2014, and 2016 NSLTCP waves by several residential care community characteristics, including bed size, ownership status, chain affiliation, U.S. Census division, and metropolitan statistical area (MSA) status. Results-The percentage of residential care communities that used EHRs increased between 2012 and 2016 overall (20% to 26%), for all bed size categories, profit and nonprofit ownership, chain and nonchain affiliation, six out of nine census divisions, and MSA and non-MSA status. Among residential care communities reporting EHR use, computerized support for health information exchange with physicians or pharmacies also increased between 2012 and 2016 overall (47.2% to 55.0%) and among communities that had more than 100 beds, were for profit, chain affiliated, located in the East North and East South Central census divisions, and in both MSAs and non-MSAs.

Objective-This report examines the prevalence of developmental disabilities among children in both rural and urban areas as well as service utilization among children with developmental issues in both areas. Methods-Data from the 2015-2018 National Health Interview Survey (NHIS) were used to examine the prevalence of 10 parent- or guardian-reported developmental disability diagnoses (attention-deficit/hyperactivity disorder [ADHD], autism spectrum disorder, blindness, cerebral palsy, moderate to profound hearing loss, learning disability, intellectual disability, seizures, stuttering or stammering, and other developmental delays) and service utilization for their child. Prevalence estimates are presented by urbanicity of residence (urban or rural). Bivariate logistic regressions were used to test for differences by urbanicity. Results-Children living in rural areas were more likely to be diagnosed with a developmental disability than children living in urban areas (19.8% compared with 17.4%). Specifically, children living in rural areas were more likely than those in urban areas to be diagnosed with ADHD (11.4% compared with 9.2%) and cerebral palsy (0.5% compared with 0.2%). However, among children with a developmental disability, children living in rural areas were significantly less likely to have seen a mental health professional, therapist, or had a well-child checkup visit in the past year, compared with children living in urban areas. Children with a developmental disability living in rural areas were also significantly less likely to receive Special Educational or Early Intervention Services compared with those living in urban areas. Conclusion-Findings from this study highlight differences in the prevalence of developmental disabilities and use of services related to developmental disabilities by rural and urban residence.