National health statistics reports最新文献

Objectives-This report describes the prevalence of multiple (two or more) chronic conditions (MCC) among veterans and nonveterans and examines whether differences by veteran status may be explained by differences in sociodemographic composition, smoking behavior, and weight status based on body mass index. Methods-Data from the 2015-2018 National Health Interview Survey were used to estimate the prevalence of MCC among adults aged 25 and over by veteran status and sex. Estimates (age-stratified and age-adjusted) were also presented by race and Hispanic origin, educational attainment, poverty status, smoking status, and weight status. Multivariate logistic regression models examined the odds of MCC by veteran status after age stratification (65 and over or under 65) and further adjustment for age and other covariates. Results-Among adults aged 25 and over, age-adjusted prevalence of MCC was higher among veterans compared with nonveterans for both men and women (22.2% compared with 17.0% for men aged 25-64, 66.9% compared with 61.9% for men aged 65 and over, 25.4% compared with 19.6% among women aged 25-64, and 74.1% compared with 61.8% among women aged 65 and over). Following stratification by age and adjustment for selected sociodemographic characteristics, the prevalence of MCC remained higher among veterans compared with nonveterans for both men and women. After further adjustment for smoking status and weight status, differences in the prevalence of MCC by veteran status were reduced but remained statistically significant, with the exception of men aged 65 and over.

Objective-To measure health care utilization among adults with inflammatory bowel disease (IBD) and compare with adults without IBD. Methods-Adults aged 18 and over with IBD (1.2%) and without IBD were identified from the 2015 and 2016 National Health Interview Survey (n = 66,610). This study presents age-adjusted percentages and model-adjusted prevalence ratios (APRs) of selected health service use to identify differences by IBD status. IBD status and use of health care services are based on self-reports. Results-Compared with adults without IBD, adults with IBD were more likely to have visited any doctor or mental health provider in the past 12 months. IBD was also associated with higher prevalence of being prescribed medication, and having received acute care services, such as emergency room visits, overnight hospitalizations, or surgeries. Differences by IBD status were greatest for visiting a specialist (APR: 1.98; 95% confidence interval [CI]: 1.82-2.14) and home visits (APR: 1.80; 95% CI: 1.25-2.59) in the past 12 months. Conclusions-Adults with IBD had higher health service use than adults without IBD. Future studies may assess patient characteristics and outcomes associated with increased utilization among IBD patients.

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.