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Objective: This report investigates international differences in injury mortality rates among 11 of the countries participating in the International Collaborative Effort on Injury Statistics.

Methods: The cause, intent, and age-specific injury mortality rates are calculated and presented from Australia, Canada, Denmark, England & Wales, France, Israel, New Zealand, The Netherlands, Norway, Scotland, and the United States. Data are presented by cause (or mechanism) and intent (or manner of death) according to the matrix framework for presenting injury mortality statistics published in August 1997. The benefits of this matrix approach to investigating injury mortality are explained with numerous examples.

Results: Injury death rates are higher in France and Denmark and lower in England & Wales, Israel, and The Netherlands than elsewhere. New Zealand, the United States, and Norway had similar average annual injury death rates of 56-57 per 100,000 population. As an example of the benefit of presenting data in the matrix framework, the total poisoning death rate in Denmark for all categories of intent (13 per 100,000) is about twice the rate in the United States. Unintentional poisoning death rates, however, are similar in the United States and Denmark (about 4 per 100,000) and are higher than elsewhere. However, the suicide poisoning death rate in Denmark is 3 times the rate in the United States.

Conclusion: Using these results, the ICE on Injury will be investigating death registration practices in each of the countries to better understand international variation in injury mortality due to reporting or registration procedures.

Objectives: This report describes the utilization of ambulatory medical care services as provided by nonfederally employed, office-based orthopedic surgeons during the period 1995-96. Statistics are presented on selected physician, patient, and visit characteristics.

Methods: The data presented in this report were collected from the 1995 and 1996 National Ambulatory Medical Care Surveys (NAMCS). NAMCS is a national probability sample survey of visits to nonfederally employed, office-based physicians. Sample data are weighted to produce annual estimates. The survey is a component of the National Health Care Survey, which measures health care utilization across a variety of providers. Data are presented in this report as annual averages, unless otherwise noted.

Results: During 1995-96, an estimated 76.5 million office visits were made to orthopedic surgeons, an average of 38.3 million visits per year. The annual average visit rate was 14.5 visits per 100 persons. This represents an increase over the 1975-76 estimate of 11.3 visits per 100 persons. Visits to orthopedic surgeons accounted for 5.3 percent of all office-based ambulatory care visits during 1995-96, but this specialty received 28.3 percent of all injury-related office visits. The most frequent reasons given by patients for visiting orthopedic surgeons were knee symptoms, postoperative visits, back symptoms, and shoulder symptoms.

Objectives: This report presents national estimates of the use of non-Federal short-stay hospitals in the United States during 1996. 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 1996. 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.

Results: In 1996, there were an estimated 30.5 million discharges of inpatients, excluding newborn infants, from non-Federal, short-stay hospitals in the United States. The discharge rate was 116 per 1,000 population and the average length of stay was 5.2 days. Five diagnostic categories accounted for more than a million discharges. These were heart disease, delivery, malignant neoplasms, pneumonia, and psychoses. There were 40.4 million procedures performed on hospital inpatients during the same year. About three-fourths of all procedures were in four ICD-9-CM chapters: miscellaneous diagnostic and therapeutic procedures, obstetrical procedures, operations on the cardiovascular system, and operations on the digestive system.

Objective: This report presents numbers and percents of hospice care current patients and discharges by characteristics of the agencies from which the care was received, patient and discharge characteristics, services provided, types of personnel that provided the services, admission diagnoses, and procedures.

Methods: The data used for this report are from the National Center for Health Statistics' 1996 National Home and Hospice Care Survey. This is a sample survey through which data are collected on the use of hospices and home health care agencies in the United States.

Results: During 1996, there were an estimated 59,400 patients receiving hospice care services from 1,800 hospices and home health care agencies in the United States. These agencies had 393,200 discharges from hospice care during the year prior to the survey. The agencies tended to be voluntary nonprofit, certified by Medicare and Medicaid, and located in a metropolitan statistical area. About a third were part of a chain or group of agencies and 40 percent were operated by a hospital. Fifty-five percent of the current patients and 50 percent of the discharges were women. Both current patients and discharges tended to be 65 years of age and over, white, married or widowed, lived in a private or semiprivate residence, and had a primary caregiver. The most common diagnoses at admission were malignant neoplasms and heart disease. About a fifth of the patients and discharges had a surgical or diagnostic procedure related to their admission for care. The most common ones were miscellaneous diagnostic and therapeutic procedures.

Objectives: This report presents estimates of surgical and nonsurgical procedures performed on an ambulatory basis in hospitals and freestanding ambulatory surgery centers in the United States during 1996. Data are presented by types of facilities, age and sex of the patient, and geographic region. Major categories of procedures and diagnoses are shown by age, sex, and region.

Methods: The estimates are based on data collected by the 1996 National Survey of Ambulatory Surgery conducted by the National Center for Health Statistics. The 1996 data were abstracted from 125,000 medical records in 488 hospitals and freestanding ambulatory surgery centers.

Objectives: This report compares the health status of selected Asian national origin groups.

Methods: 1992-94 National Health Interview Survey (NHIS) data were analyzed for six Asian national origin groups (Chinese, Filipino, Asian Indian, Japanese, Vietnamese, and Korean), the Asian and Pacific Islander (API) population as a whole, and the non-Hispanic white population. Unadjusted and age-adjusted estimates and standard errors of health indicators and sociodemographic characteristics were generated. A broad range of health issues was studied including respondent-assessed health status, activity limitation, physician contacts, restricted activity days, hospital episodes, smoking status, and knowledge of acquired immunodeficiency syndrome (AIDS).

Results: A greater age-adjusted percent of Vietnamese (17.2 percent) and Korean (12.8 percent) persons had fair or poor respondent-assessed health status than persons of Chinese, Filipino, and Japanese descent (6.1-7.4 percent). A lower age-adjusted percent of Chinese persons (6.5 percent) experienced activity limitation compared with Filipino, Japanese, and Vietnamese persons (9.4-13.2 percent). Japanese persons (4.9 contacts) had a greater average annual number of physician contacts than Chinese persons (3.1 contacts) after age adjusting the data. When the data were age adjusted, a higher percent of Korean adults (22.5 percent) were current smokers than Chinese (10.0 percent) and Asian Indian adults (8.7 percent). A higher age-adjusted percent of Vietnamese (21.2 percent) and Asian Indian (18.0 percent) adults reported knowing nothing about AIDS compared with Japanese adults (5.1 percent). A greater proportion of Vietnamese adults (91.6 percent) had not been tested for the AIDS virus infection compared with Chinese, Filipino, Asian Indian, and Japanese adults (72.6-78.5 percent) after age adjusting the data.

Conclusions: Differences in health emerge when data on the API population are analyzed by national origin group. Estimates of health presented for the API population as a whole mask differences among subgroups.

Objective: This report presents numbers and percents of home health and hospice care agencies, their current patients, and their discharges. Agency characteristics include type of ownership, region, certification, location, and affiliation. Patient and discharge characteristics include age, sex, race, marital status admission diagnoses, and procedures.

Methods: The data used for this report are from the National Center for Health Statistics' 1996 National Home and Hospice Care Survey. This is a sample survey through which data are collected on the use of home health and hospice care agencies in the United States.

Results: During 1996, there were an estimated 2.5 million current patients and 8.2 million discharges from 13,500 home health and hospice care agencies in the United States. The agencies tended to be proprietary, certified by Medicare and Medicaid as a home health agency, and located in a metropolitan statistical area. Almost half were part of a chain or group of agencies. The home health and hospice care patients and discharges tended to be 65 years of age and over, female, white, and married or widowed. The most common diagnoses for home health care patients were diseases of the circulatory system, and the most common diagnoses for hospice care patients were malignant neoplasms. About a third of the home health care patients and about a fifth of the hospice care patients had a surgical or diagnostic procedure related to their admission for care. The most common procedures for home health care patients were operations on the musculoskeletal system, and for hospice care patients they were miscellaneous diagnostic and therapeutic procedures.

Objectives: This report presents estimates of surgical and nonsurgical procedures performed on an ambulatory basis in hospitals and freestanding ambulatory surgery centers in the United States during 1995. Data are presented by types of facilities, age, sex, and geographic region. Major categories of procedures and diagnoses are shown by age, sex, and region.

Methods: The estimates are based on data collected from the 1995 National Survey of Ambulatory Surgery conducted by the National Center for Health Statistics. The 1995 data were abstracted from 122,000 medical records in 489 hospitals and freestanding ambulatory surgery centers.

Objective: This report describes ambulatory care visits to hospital outpatient 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 outpatient 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 1996, an estimated 67.2 million visits were made to hospital outpatient departments in the United States, about 25.4 visits per 100 persons. Overall, visits rates did not vary by age. Females and black persons had higher rates of visits than males and white persons, respectively. There were an estimated 6.8 million injury--related outpatient department visits during 1996.

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

Methods: The data presented in this report were collected from the 1996 National Ambulatory Medical Care Survey (NAMCS). The NAMCS is part of the ambulatory care component of the National Health Care Survey, which measures health care utilization across various types of providers. The NAMCS is a national probability sample survey of visits to office-based physicians in the United States. Sample data are weighted to produce annual estimates.

Results: During 1996, an estimated 734.5 million visits were made to physician offices in the United States, an overall rate of 2.8 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 and over had the highest rate of physician office visits, 6.3 visits per person. Females had a significantly higher rate of visits to physicians offices than males did overall, as did white persons compared with black persons. Of all visits made to these offices in 1996, 87 percent were covered by some form of insurance, and 8.7 percent were paid "out-of-pocket." There were an estimated 87.6 million injury-related visits during 1996, or 33.1 visits per 100 persons. Three-quarters of these visits were for unintentional injuries.