National health statistics reports最新文献

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.

Objective-This report presents demographic characteristics, health service access and use, and timing of key fertility-related milestones among adults aged 18-44 who had ever been in foster care as compared with those who had never been in foster care in the United States. Methods-The National Survey of Family Growth (NSFG) is a nationally representative survey, with data collected through in-person interviews of the household population of the United States. Analyses used 6 years of NSFG interviews spanning September 2011 through September 2017, and included 11,527 male and 14,439 female respondents aged 18-44. Bivariate analyses examined demographic characteristics and health service access and use by having ever been in foster care, as measured by household roster information and childhood background items. Cumulative probabilities of first sexual intercourse, first marriage, and first birth by age were estimated using Kaplan-Meier procedures. All estimates were stratified by sex. Results-Overall, 2.6% of adults aged 18-44 had ever been in foster care, and the percentage was higher for women (3.0%) than for men (2.3%). Lower percentages of men and women who were ever in foster care had a bachelor's degree or higher (4.8% for men and 9.1% for women) compared with those who had never been in foster care (31.1% and 36.2%, respectively). Receipt of public assistance in the past 12 months was more likely among adults who were ever in foster care compared with those who were never in foster care. Adults ever in foster care were less likely than adults never in foster care to be currently covered by private health insurance and were more likely to be covered by Medicaid. Adults ever in foster care also had higher probabilities of first sexual intercourse and first births at younger ages than those never in foster care.

Objective-This report describes characteristics of visits to office-based physicians at which benzodiazepines were prescribed, including visits where opioids were coprescribed. Methods-Data from the 2014-2016 National Ambulatory Medical Care Survey were used. Population-based visit rates were examined by select patient characteristics. Visit characteristics are also presented. Results-During 2014-2016, the rate of visits at which benzodiazepines were prescribed was 27 annual visits per 100 adults. Among visits at which benzodiazepines were prescribed, approximately one-third involved an overlapping opioid prescription for a rate of 10 annual visits per 100 adults. Both visit rates were higher for women than men and increased with age. The percentage of visits with a new prescription for a benzodiazepine or a new prescription for both a benzodiazepine and an opioid was lower than the percentage of visits with continued prescriptions. A problem related to a chronic condition was the most common reason for visits at which benzodiazepines were prescribed, as well as for visits at which benzodiazepines were coprescribed with opioids. Mental disorders were the most frequent primary diagnosis category for visits at which benzodiazepines were prescribed, whereas diseases of the musculoskeletal system and connective tissue was the most frequent primary diagnosis category for visits at which benzodiazepines were coprescribed with opioids.

Objective-This report describes trends in opioid prescribing at emergency department (ED) discharge among adults from 2006-2007 through 2016-2017, by selected patient and hospital characteristics and the type of opioids prescribed. Methods-Data are from the 2006-2017 National Hospital Ambulatory Medical Care Survey. The study population included all ED visits by patients aged 18 and over. The main outcome studied was opioids prescribed at ED discharge, defined using Cerner Multum's third-level therapeutic category codes for narcotic analgesics (Code 60) and narcotic-analgesic combinations (Code 191). Results-The percentage of ED visits by adults with opioids prescribed at discharge increased from 2006-2007 (19.0%) through 2010-2011 (21.5%) and then decreased from 2010-2011 through 2016-2017 (14.6%). The rate of decrease was highest among visits by younger adults aged 18-44 (from 25.5% in 2010-2011 to 15.3% in 2016-2017) and those living in medium or small metropolitan counties (24.3% in 2010-2011 to 14.5% in 2016-2017). The percentage of visits with morphine-equivalent opioids prescribed increased from 2006-2007 (11.3%) through 2010-2011 (12.4%) and decreased from 2010-2011 through 2016-2017 (6.7%). The percentage of visits with stronger than morphine opioids prescribed similarly increased from 2006-2007 (3.8%) through 2010-2011 (5.5%) and decreased to 3.0% in 2016-2017. In contrast, the percentage of visits with weaker than morphine opioids prescribed decreased from 4.0% in 2006-2007 through 3.6% in 2010-2011 and increased to 5.0% in 2016-2017. Among all opioids prescribed at discharge, the percentage with acetaminophen-hydrocodone prescribed decreased from 53.1% in 2012-2013 to 41.5% in 2016-2017, with a corresponding increase for both tramadol and acetaminophen-codeine. Top diagnoses associated with an opioid prescribed at discharge included dental pain, urolithiasis (stones in the kidney, bladder, or urinary tract), fracture injuries, back pain, and extremity pain. For all top diagnoses, the percentage of visits with an opioid prescribed decreased from 2010-2011 through 2016-2017, though the decrease was not statistically significant for urolithiasis.

Objective-This report examines select measures of health care access, utilization, and financial burden by metropolitan statistical area (MSA) status among adults aged 18-64. Methods-Data from the 2017 National Health Interview Survey were used to examine how a usual place to go for care, visits to a doctor or emergency room in the past year, unmet medical need due to cost, inability to afford prescription medications, and problems paying medical bills differed by MSA status among adults aged 18-64. Estimates are presented for adults living in a large MSA (population of 1 million or more), living in a small MSA (less than 1 million in population), and not living in an MSA. Results-In 2017, adults not living in an MSA generally had reduced access to or use of health care, and a higher financial burden associated with their care, compared with those in more populous areas. However, after controlling for selected sociodemographic and health characteristics, it was found that for the measures examined, adults not living in MSAs were more likely to have a usual place to go for care but less likely to have financial burden associated with their care compared with those in small or large MSAs. Conclusion-The unadjusted results show that adults not living in an MSA are more likely to have financial burden associated with their health care and reduced access to or use of health care services compared with those in large MSAs. However, the differences in the measures examined may be due to differential distributions of poverty levels, insurance coverage status, or other sociodemographic or health characteristics between the MSA status categories rather than MSA status itself.

Background-External cause-of-injury frameworks, or matrices, based on the International Classification of Diseases (ICD) provide standardized categories for reporting injuries by mechanism and intent of injury. In 2014, the National Center for Health Statistics (NCHS) and the National Center for Injury Prevention and Control (NCIPC) published a proposed external cause-of-injury 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. When data became available, NCHS and NCIPC collaborated with the Council of State and Territorial Epidemiologists and state and local health departments to evaluate the proposed matrix to identify any changes needed before finalization. This report describes the results of that evaluation. Methods-With guidance from NCHS and NCIPC, state and local injury epidemiologists from five jurisdictions analyzed their hospital discharge and emergency department administrative claims data. The epidemiologists applied the ICD-9-CM matrix to ICD-9-CM coded data and the 2014 proposed ICD-10-CM matrix to ICD-10-CM coded data for similar time periods (e.g., January through December). The numbers for each mechanism and intent category in each of the two matrices were calculated and compared, and major differences were explored. Results-Based on the findings, several adjustments were made to the original placement of codes in the 2014 proposed ICD-10-CM external cause-of-injury matrix. These changes involved codes related to Drowning/submersion, Firearm, Motor vehicle-Traffic, Overexertion, and Unspecified mechanisms. In addition, new external cause codes not available at the time the 2014 proposed matrix was developed were added to create the 2019 final matrix. Conclusions-The 2019 final ICD-10-CM external cause-of-injury matrix provides standard categories for reporting injuries by mechanism and intent of injury. Use of this tool promotes consistency for comparisons across populations and over time.

Linking nationally representative population health survey data with Social Security Administration (SSA) disability program data provides a rich source of information on program recipients. Survey participant data from the 1998-2005 National Health Interview Survey (NHIS) were linked to SSA administrative records from 1997 through 2005. The goal of this study was to assess agreement between the actual benefit receipt based on the SSA administrative records and the survey report of benefit receipt in the linked NHIS and SSA file for the U.S. civilian noninstitutionalized population. This evaluation provides information on the expected accuracy of survey report of Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI) benefit receipt, including how participant characteristics may be associated with reporting misclassification. The results indicate that there is some underreporting of SSA disability benefit receipt based on the NHIS responses compared with the SSA administrative records. The analysis identified some differences between the concordant and discordant groups for selected characteristics, but there were no clear patterns among the different survey questions or the different survey participant characteristics.