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Objectives: This report describes ambulatory care visits to hospital emergency departments in the United States. Statistics are presented on selected patient and visit characteristics.

Methods: The data presented in this report were collected from the 1996 National Hospital Ambulatory Medical Care Survey (NHAMCS). NHAMCS is part of the ambulatory care component of the National Health Care Survey that measures health care utilization across various types of providers. NHAMCS is a national probability survey of visits to hospital emergency and outpatient departments of non-Federal, short-stay, and general hospitals in the United States. Sample data were weighted to produce annual estimates.

Results: During 1996, an estimated 90.3 million visits were made to hospital emergency departments (ED's) in the United States, about 34.2 visits per 100 persons. Persons 75 years and over had the highest rate of emergency department visits. There were an estimated 34.9 million injury-related emergency department visits during 1996, or 13.2 visits per 100 persons. There were 110,000 visits related to injuries caused by firearms, including 73,000 visits for gunshot wounds. Almost one-fifth of the injury visits were work-related for persons 18-64 years of age. Almost four-fifths of the ED visits involved medication therapy. Pain relief drugs accounted for almost 30 percent of the medications mentioned. Acute upper respiratory infection was the leading illness related diagnosis for ED visits.

Objective: This report presents data on annual estimates of the prevalence of use of selected assistive technology devices for vision, hearing, mobility, and orthopedic impairments, including missing limbs. Also presented are statistics on trends in the prevalence of use of selected mobility assistive technology devices for the years 1980, 1990, and 1994.

Methods: The data used for this report are from the 1994 National Health Interview Survey on Disability (NHIS-D), Phase I, which was co-sponsored by a consortium of U.S. Federal agencies and private foundations. All estimates are based on data from the NHIS-D, Phase I, which represent the civilian, noninstitutional population of the United States.

Results: An estimated 7.4 million persons in the U.S. household population used assistive technology devices for mobility impairments, 4.6 million for orthopedic impairments (including missing limbs), 4.5 million for hearing impairments (not including impairments fully compensated by hearing aids), and 0.5 million for vision impairments. Use of any mobility device for all ages had the highest prevalence rate at 28.5 per 1,000 persons. There was a positive correlation between an increase in age and the increase in the prevalence rate of device usage; for example, of persons in the age group 65 years and over, the rate of mobility, hearing, and vision device usage was more than 4 times the rate for the total population.

Conclusion: Assistive technology use has increased because of population size, age composition changes, and a change in the rate of use. Medical and technological advances along with public policy initiatives have also contributed to increased usage.

Objectives: This report presents national estimates of the use of non-Federal short-stay hospitals in the United States during 1995. Numbers and rates of discharges, diagnoses, and procedures are shown by age and sex. Discharges are also shown by geographic region of hospital. Average lengths of stay are presented for discharges and selected diagnostic categories.

Methods: The estimates are based on medical abstract data collected through the National Hospital Discharge Survey for 1995. The survey has been conducted annually by the National Center for Health Statistics since 1965. Diagnoses and procedures presented are coded according to the International Classification of Diseases, 9th Revision, Clinical Modification, or ICD-9-CM.

Objectives: This report describes medications provided or prescribed during ambulatory medical care visits in 1992. Total ambulatory care medication therapy combines data from office-based physicians, hospital outpatient departments (OPD's), and hospital emergency departments (ED's). Drug therapy is described along three dimensions: number of drugs provided or prescribed (drug mention), whether a visit had any drugs mentioned (drug visit), and average number of drugs mentioned per 100 visits (drug mention rate). Utilization in ambulatory care settings is compared in terms of patient, drug, provider, and visit characteristics.

Methods: Annual use of medication therapy was determined using data collected in the 1992 National Ambulatory Medical Care Survey (NAMCS) and the National Hospital Ambulatory Medical Care Survey (NHAMCS). NAMCS includes office visits to nonfederal physicians principally engaged in office practice. The target universe of NHAMCS includes visits to ED's and OPD's of non-Federal, short-stay, or general hospitals. Sample data were weighted to produce annual estimates. Drug mentions are defined as the number of drugs mentioned on the patient record from.

Results: An estimated 1.1 billion medications were provided or prescribed at ambulatory care visits in 1992. The setting with the greatest percent of visits with medication therapy was the ED; OPD's had the lowest percent with medications. Patients at the ED were provided more pain relief type drugs. The rate of drug mentions and percent of visits with medications were significantly higher in OPD clinics of general medicine and pediatrics compared with other types of OPD clinics. In office-based settings, physicians specializing in cardiovascular diseases were most likely to prescribe medications. Also, cardiovascular-renal type drugs accounted for the largest percent of office-based drug mentions. Visits with illness diagnoses are most likely to receive medication therapy. Trend data comparing 1980 to 1992 office-based mentions showed significant changes on several characteristics: single-ingredient drug status, physician specialty, and patient age.

Conclusions: The profile of patients using office- and hospital-based ambulatory care settings are quite different as is the case-mix of conditions. These differences play an important role in medications utilized. The aging of the U.S. population from 1980 to 1992 appeared to have significant effects on several drug mention characteristics.

Objective: This report presents a comprehensive review of data on the smoking behaviors of women with a recent birth from the 1990 National Health Interview Survey. Data on current and lifetime smoking status and smoking behaviors before and after learning of pregnancy are presented. Selected demographic characteristics of women--including age, race, education, and family income--are also presented.

Methods: Data presented in this report are from the 1990 National Health Interview Survey on Health Promotion and Disease Prevention (NHIS-HPDP). Questions on pregnancy and smoking were administered as part of this supplement to women 18-44 years of age who either had a live birth in the 5 years preceding the interview, or who were pregnant at the time of the interview. These analyses were limited to women with a live birth in the 5 years preceding the 1990 NHIS who were not currently pregnant.

Results: Of 13,674,000 women with a recent live birth, about 39 percent had ever smoked, 25 percent smoked in the year before they became pregnant, and 15 percent smoked during their most recent pregnancy. Women who smoked prior to learning of their pregnancy were most likely to be moderate smokers, white women, never married, and of lower income. Women who smoked after learning of their pregnancy were most likely to be light smokers, representing a shift in smoking behaviors after learning of pregnancy. Nearly 23 percent of women reported that they stopped smoking altogether after learning of their pregnancy.

Conclusions: These findings are consistent with data from other sources and provide support for recently observed trends in smoking and pregnancy. A majority of women who had ever smoked continued to smoke throughout pregnancy. Although many women altered their smoking behaviors, only about one quarter of women reported that they stopped smoking entirely. Public health service messages must continue to encourage women to stop smoking entirely during pregnancy to maximize the health benefits to their infants.

Objective: This report presents the sociodemographic characteristics, functional dependencies in the activities of daily living (ADL) and instrumental activities of daily living (IADL), dental status, primary admission diagnosis, types of services used, and source of payment of elderly nursing home residents.

Methods: The data used for this report are from the National Center for Health Statistics' 1995 National Nursing Home Survey's (NNHS) sample of current residents age 65 years and above. The 1995 NNHS is the fourth annual survey of nursing homes. The first survey was conducted from August 1973 through April 1974, the second was conducted from May through December 1977, and the third was conducted from August 1985 through January 1986. The 1995 NNHS was conducted from July 1995 through December 1995.

Results: The overall results of the survey indicate that elderly nursing home residents were predominantly women, 75 years old and over, white, non-Hispanic, and widowed. A large portion of residents needed assistance in their ADL's and IADL's. A shifting of the primary source of payment to Medicaid occurred among residents who used Medicare as their source of payment at the time of admission.

Objective: This report describes ambulatory care visits made to physician offices within the United States. Statistics are presented on selected physician patient, and visit characteristics for aggregated ambulatory care visits.

Methods: The data presented in this report were collected from the 1995 National Ambulatory Medical Care Survey (NAMCS). NAMCS is part of the ambulatory care component of the National Health Care Survey, which measures health care utilization across various types of providers. NAMCS is a national probability survey of visits to office-based physicians in the United States. Sample data were weighted to produce annual estimates.

Results: During 1995, an estimated 697.1 million visits were made to physician offices in the United States, an overall rate of 2.7 visits per person. One quarter of the NAMCS visits were made to general and family physicians, which was significantly higher than the other 13 specialties. Persons 75 years of age and over had the highest rate of physician office visits 5.9 visits per person. Females had a significantly higher rate of visits to physician offices than males did overall, as did white persons compared with black persons. Of all visits made to these offices in 1995, 86% were covered by some form of insurance, and 11 percent were paid "out-of-pocket." There were an estimated 81.6 million injury-related visits during 1995, or 31.2 visits per 100 persons. A significantly higher proportion of injury visits were made by white persons compared with black persons. Over two-thirds of all injury visits were for unintentional injuries.

Objective: This report describes outpatient department visits in the United States in 1995. Statistics are presented on selected patient and visit characteristics.

Methods: The data presented in this report were collected from the 1995 National Hospital Ambulatory Medical Care Survey (NHAMCS). NHAMCS is part of the ambulatory care component of the National Health Care Survey, which measures health care utilization across various types of providers. NHAMCS is a national probability survey of visits to outpatient departments and emergency departments of non-Federal, short-stay and general hospitals in the United States. Sample data were weighted to produce annual estimates.

Results: During 1995, an estimated 67.2 million visits were made to hospital outpatient departments in the United States, an overall rate of 25.7 visits per 100 persons. Overall, visit rates did not vary by age. Females and black persons had higher rates of visits than males and whites, respectively. There were an estimated 7.3 million injury-related outpatient department visits in 1995.

Objective: This report presents data on hospice care discharges. Numbers and percents of discharges are shown by selected characteristics of the agencies from which the patients were discharged, by selected patient characteristics, by services provided, by types of personnel that provided the services, and by diagnoses of these discharged patients.

Methods: The data used for this report are from the National Center for Health Statistics' 1994 National Home and Hospice Care Survey. This is an annual survey through which data are collected on the use of hospices and home health care agencies in the United States.

Results: There were an estimated 328,000 discharges from hospice care from 1,300 hospices and home health agencies in 1993-94. Death was the reason for discharge for 88 percent of the discharges. Fifty-two percent of the discharges were for men, 73 percent were for patients 65 years of age and over, 79 percent were white, 49 percent were married, and 30 percent were widowed. Eighty-three percent of the discharged patients were living in a private or semiprivate residence during their care and 95 percent had a primary caregiver. During the last time service was provided prior to discharge, 67 percent received help from the agency with at least one activity of daily living (ADL), 53 percent with at least one instrumental activity of daily living (IADL), and 30 percent with walking. These discharges had an average of 2.2 diagnoses at admission; 69 percent had a primary diagnosis of a malignant neoplasm; and 8 percent had a primary diagnosis of heart disease.

Objective: This report describes ambulatory care visits to hospital emergency departments in the United States. Statistics are presented on selected patient and visit characteristics.

Methods: The data presented in this report were collected from the 1995 National Hospital Ambulatory Medical Care Survey (NHAMCS). NHAMCS is part of the ambulatory care component of the National Health Care Survey, which measures health care utilization across various types of providers. NHAMCS is a national probability survey of visits to hospital emergency and outpatient departments of non-Federal, short-stay, and general hospitals in the United States. Sample data were weighted to produce annual estimates.

Results: During 1995, an estimated 96.5 million visits were made to hospital emergency departments (ED's) in the United States, about 36.9 visits per 100 persons. Persons 75 years and over the highest rate of emergency department visits. There were an estimated 37.2 million injury-related emergency department visits during 1995, or 14.2 visits per 100 persons. There were 225 thousand visits related to injuries caused by firearms, including 144 thousand visits for gunshot wounds. One-fifth of the injury visits were work-related for persons 18-64 years of age. Four-fifths of the ED visits involved medication therapy with pain relief drugs accounting for 30 percent of the medications mentioned. Acute upper respiratory infection was the leading illness-related diagnosis for ED visits.