Advance data最新文献

Objective: This report presents Healthy Eating Index (HEI) scores for adults, 60 years of age and over, from the National Health and Nutrition Examination Survey (NHANES), 1999-2002, and examines the association between the HEI scores and sex, age, race and ethnicity, education, smoking status, tooth retention, self-reported health, and body mass index (BMI).

Methods: The percentage of older adults meeting the recommendations for the HEI components and dietary quality based on the overall score were estimated. Means and standard errors were calculated for selected sociodemographic and health characteristics for the total population and stratified by sex. A two-tailed t-test or analysis of variance was used to test the effects of the sociodemographic and health characteristics on the HEI scores. When a characteristic consisted of three levels, the Bonferroni method of adjustment was used to assess significant differences in the mean scores.

Results: Seventy-two percent of older adults met the guidelines for cholesterol intake and 56% met the recommendation for diet variety, but less than one-third met the recommendations for HEI's five food groups. Only 17% of older adults consumed a "good" quality diet. Males had higher scores for some components, but females had higher scores for others. Age significantly influenced several HEI components, but not in a consistent fashion. Non-Hispanic white persons usually had the highest scores and non-Hispanic black persons had the lowest scores. Adults with more years of education usually had higher scores but smokers usually had lower scores. Edentulous persons and those who rated their health as fair or poor generally ate fewer servings of fruits and vegetables, ate a less varied diet, and had a poorer quality diet than persons with teeth or who rated their health higher. Females with a BMI of 30 or higher ate fewer servings of dairy products, consumed a higher percentage of calories from total and saturated fat, and had a lower quality diet than those whose BMI was less than 30.

Conclusions: This research demonstrates that many older adults' diets need improvement, and that many sociodemographic and health characteristics were associated with their intake of food and nutrient groups and overall dietary quality.

Objective: This report compares national estimates for selected health status indicators, health behaviors, health care utilization, health conditions, immunizations, and human immunodeficiency virus (HIV) testing status among selected non-Hispanic Asian adult subgroups. Comparison estimates for the non-Hispanic white, non-Hispanic black, non-Hispanic American Indian or Alaska Native (AIAN), and Hispanic adult populations are also presented.

Methods: The estimates in this report were derived from the Family Core and the Sample Adult Core components of the 2004-2006 National Health Interview Surveys (NHIS), conducted by the Centers for Disease Control and Prevention's National Center for Health Statistics (NCHS). Estimates were generated and comparisons conducted using the SUDAAN statistical package to account for the complex sample design.

Results: In general, non-Hispanic Asian adults were least likely to be current smokers, be obese, have hypertension, delay or not receive medical care because of cost, be tested for HIV, or be in fair or poor health compared with non-Hispanic white, non-Hispanic black, non-Hispanic AIAN, or Hispanic adults. Across non-Hispanic Asian subgroups, Vietnamese adults were least likely to have a bachelor's degree or higher and most likely to be poor, be in fair or poor health, and abstain from alcohol use. Korean adults were most likely to be uninsured, be current smokers, and be without a usual place for health care. Japanese adults were most likely to be current moderate or heavier drinkers, and Filipino adults were most likely to be obese.

Objectives: This report presents the latest information on the use of electronic medical records in physician offices. Percentages of medical practices and physicians within the practices using electronic medical records (EMR) are presented for 2006 by selected physician and practice characteristics.

Methods: Data from the physician induction interviews of the 2006 National Ambulatory Medical Care Survey (NAMCS) are presented. NAMCS includes a national probability sample of nonfederal office-based physicians who saw patients in an office setting. Sample data were weighted to produce national estimates of physicians. Estimates of medical practices were derived from NAMCS physician data by adjusting the weighting scheme using a multiplicity estimator.

Results: In 2006, 29.2 percent of office-based physicians reported using full or partial EMR systems, which represented a 22% increase since 2005 and a 60% increase since 2001, when the NAMCS began monitoring this technology. Starting in 2005, the NAMCS included questions about EMR system features that health information technology experts consider minimal for a comprehensive EMR, namely computerized orders for prescriptions, computerized orders for tests, reporting of test results (lab or imaging), and clinical notes. Based on these requirements, 12.4 percent of physicians surveyed used comprehensive EMR systems in 2006, a figure not significantly different from the 9.3 percent reported for 2005. From 2005 to 2006, the percentage of medical practices using full or partial EMR systems increased by 42% (from 18.3 to 25.9 percent), but the percentage of medical practices using a comprehensive EMR system did not change.

Objective: This report presents national estimates of fall injury episodes for noninstitutionalized U.S. adults aged 65 years and over, by selected characteristics. Circumstances surrounding the fall injury and activity limitations and utilization of health care resulting from the fall injury are also presented.

Methods: Combined data from the 2001-2003 National Health Interview Surveys (NHIS), conducted by the Centers for Disease Control and Prevention's National Center for Health Statistics (NCHS), were analyzed to produce estimates for the U.S. civilian noninstitutionalized population. Data on nonfatal medically attended fall injuries occurring within the 3 months preceding the interview were obtained from an adult family member.

Results: The annualized rate of fall injury episodes for noninstitutionalized adults aged 65 years and over in 2001-2003 was 51 episodes per 1,000 population. Rates of fall injuries increased with age, and were higher for women compared with men. Non-Hispanic white older adults had higher rates of fall injuries compared with non-Hispanic black older adults. Older adults with certain chronic conditions and activity limitations had higher rates of fall injuries compared with older adults without these conditions. The most common cause of fall injuries among older adults was slipping, tripping, or stumbling, and most fall injuries occurred inside or around the outside of the home. Nearly 60 percent of older adults who experienced a fall injury visited an emergency room for treatment or advice. Nearly one-third of older adults experiencing a fall injury needed help with activities of daily living as a result, and over one-half of these persons expected to need this help for at least 6 months. A similar percentage experienced limitation in instrumental activities of daily living as a result of fall injuries.

Conclusion: Fall injuries remain very prevalent among older adults and result in high health care utilization and activity limitations. Rates of fall injuries vary by demographic and health characteristics of older noninstitutionalized adults.

Objective: This study presents baseline data to determine which hospital characteristics are associated with preparedness for terrorism and natural disaster in the areas of emergency response planning and availability of equipment and specialized care units.

Methods: Information from the Bioterrorism and Mass Casualty Preparedness Supplements to the 2003 and 2004 National Hospital Ambulatory Medical Care Surveys was used to provide national estimates of variations in hospital emergency response plans and resources by residency and medical school affiliation, hospital size, ownership, metropolitan statistical area status, and Joint Commission accreditation. Of 874 sampled hospitals with emergency or outpatient departments, 739 responded for an 84.6 percent response rate. Estimates are presented with 95 percent confidence intervals.

Results: About 92 percent of hospitals had revised their emergency response plans since September 11, 2001, but only about 63 percent had addressed natural disasters and biological, chemical, radiological, and explosive terrorism in those plans. Only about 9 percent of hospitals had provided for all 10 of the response plan components studied. Hospitals had a mean of about 14 personal protective suits, 21 critical care beds, 12 mechanical ventilators, 7 negative pressure isolation rooms, and 2 decontamination showers each. Hospital bed capacity was the factor most consistently associated with emergency response planning and availability of resources.

Objectives: This investigation describes terrorism preparedness among U.S. office-based physicians and their staffs in identification and diagnosis of terrorism-related conditions, training methods and sources, and assistance with diagnosis and reporting.

Methods: The National Ambulatory Medical Care Survey (NAMCS) is an annual national probability survey of approximately 3,000 U.S. nonfederal, office-based physicians. Terrorism preparedness items were added in 2003 and 2004.

Results: About 40 percent of physicians or their staffs received training for anthrax or smallpox, but less than one-third received training for any of the other exposures. About 42.2 percent of physicians, 13.5 percent of nurses, and 9.4 percent of physician assistants and nurse practitioners received training in at least one exposure. Approximately 56.2 percent of physicians indicated that they would contact state or local public health officials for diagnostic assistance more frequently than federal agencies and other sources. About 67.1 percent of physicians indicated that they would report a suspected terrorism-related condition to the state or local health department, 50.9 percent to the Centers for Disease Control and Prevention (CDC), 27.5 percent to the local hospital, and 1.8 percent to a local elected official's office. Approximately 78.8 percent of physicians had contact information for the local health department readily available. About 53.7 percent had reviewed the diseases reportable to health departments since September 2001, 11.3 percent had reviewed them before that month, and 35 percent had never reviewed them.

Objectives: This report presents national estimates of the use of nonfederal short-stay hospitals in the United States during 2005 and selected trend data. Numbers and rates of discharges, diagnoses, and procedures are shown by age and sex. Average lengths of stay are presented for all discharges and for selected diagnostic categories by age and by sex.

Methods: The estimates are based on data collected through the 2005 National Hospital Discharge Survey (NHDS). The survey has been conducted annually by NCHS since 1965. Diagnoses and procedures presented are coded using the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM).

Results: Trends in the utilization of nonfederal short-stay hospitals show that the overall average length of a hospital stay has declined significantly. In 2005, the average length of stay for all inpatients was 4.8 days compared with 7.8 days in 1970. Stays for discharges aged 15-44, 45-64 and 65 years and over also declined, but the average lengths of stay for those under 15 years of age were the same in 1970 and 2005. In 2005, there were an estimated 34.7 million hospital discharges, excluding newborn infants. Persons aged 65 years and over comprised 38 percent of all inpatients. One notable trend for elderly people is that their rate of hospitalization for septicemia increased 47 percent from 2000 to 2005. There were 45 million procedures performed on inpatients during 2005. Obstetrical procedures (6.9 million) comprised 25 percent of all procedures performed on females. Cesarean section (18 percent), repair of current obstetric laceration (18 percent), and artificial rupture of membranes (14 percent) accounted for one-half of all obstetrical procedures. Males had more cardiovascular procedures than females (4.1 million compared with 2.9 million), whereas females had more operations on the digestive system than males (3.2 million compared with 2.4 million).

Objectives: This report describes ambulatory care visits to hospital outpatient departments (OPDs) in the United States. Statistics are presented on selected hospital, patient, and visit characteristics. Selected trends in OPD utilization from 1995 to 2005 are also presented.

Methods: The data presented in this report were collected in the 2005 National Hospital Ambulatory Medical Care Survey (NHAMCS), a national probability sample survey of visits to emergency and OPDs of nonfederal, short-stay, and general hospitals in the United States. Sample data are weighted to produce annual national estimates.

Results: During 2005, an estimated 90.4 million visits were made to hospital OPDs in the United States, about 31.0 visits per 100 persons. Females (37.2 per 100 persons) had higher OPD visit rates than males (24.7 visits per 100 persons), and black or African-American persons (56.8 visits per 100 persons) had higher OPD visit rates than white persons (28.3 visits per 100 persons). Visit rates to OPD clinics for preventive care were highest for children under 1 year of age (43.1 per 100 persons). Almost one-half of OPD visits (46.1 percent) were made by patients with one or more chronic conditions. Hypertension was the most frequent chronic condition listed (19.7 percent). Visits with asthma declined with increasing age. From 1995 to 2005, the following visit characteristics changed: The visit rate for children under 15 years of age increased by 38%, the percentage of visits made by adults 18 years and over with depression indicated on the medical record increased by 48%; visits by adults with obesity, diabetes, and hypertension increased by 24%, 34%, and 43%, respectively; visits with counseling for tobacco use increased from 2.7 to 3.8 percent; visits with counseling for diet and nutrition increased from 9.4 to 15.7 percent; and visits with 6 or more medications prescribed or provided more than doubled, from 4.9 to 11.2 percent.