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Linda McCaig and David Woodwell Ambulatory Care Statistics Branch Division of Health Care Statistics National Center for Health Statistics/CDC Using NAMCS and  NHAMCS Data
Overview ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
 
National probability sample surveys ,[object Object],[object Object],[object Object],[object Object]
Original NAMCS survey goals ,[object Object],[object Object],[object Object],[object Object],[object Object]
NAMCS history ,[object Object],[object Object],[object Object],[object Object]
NHAMCS history ,[object Object],[object Object]
How are NAMCS and NHAMCS data used?
Data uses ,[object Object],[object Object],[object Object],[object Object],[object Object]
Data users ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Setting government policy ,[object Object],[object Object]
 
Antibiotic prescribing rates at physician office visits for children  Rate per 1000 population Rate per 1000 visits
 
Prescribing rates at physician office visits by specialty Psychiatry Ophthalmology Otolaryngology Orthopedic surgery
Female ambulatory care visit rates for selected diagnoses by race
Annual rate of illness and injury ED visits for seniors by race Illness, black   1 Illness, white  1 Injury, black  1 NOTE:  1  p < .01. Injury, white
Diabetes visit rates per 10,000 persons by setting 49 147 1289 1998-99 38 157 1118 1996-97 36 117 865 1994-95 33 84 962 1992-93 ED OPD Office Year
NAMCS and NHAMCS Methodology
NAMCS Scope ,[object Object],[object Object]
In-Scope NAMCS locations  ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Out-of-Scope NAMCS locations ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
NAMCS Sample design ,[object Object],[object Object],[object Object],[object Object]
NHAMCS Scope  ,[object Object],[object Object],[object Object]
NHAMCS Sample design ,[object Object],[object Object],[object Object],[object Object],[object Object]
Gaining cooperation ,[object Object],[object Object],[object Object],[object Object]
Data collection procedures ,[object Object],[object Object],[object Object],[object Object],[object Object]
Items collected ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Repeating fields ,[object Object],[object Object],[object Object],[object Object],[object Object]
Data processing ,[object Object],[object Object],[object Object]
Coding systems used ,[object Object],[object Object],[object Object],[object Object]
NAMCS and NHAMCS 1999-2000 PRFs
Patient record form  - common items ,[object Object],[object Object],[object Object],[object Object],[object Object]
Patient record form - common items ,[object Object],[object Object],[object Object],[object Object]
Patient record form – common items ,[object Object],[object Object],[object Object],[object Object],[object Object]
Injury items ,[object Object],[object Object],[object Object],[object Object]
Office and OPD PRF - unique items ,[object Object],[object Object],[object Object],[object Object]
Office and OPD PRF - unique items ,[object Object],[object Object],[object Object]
ED Patient record form - unique items ,[object Object],[object Object],[object Object],[object Object],[object Object]
NAMCS and NHAMCS PRF revisions 2001-02 – emphasis on the continuity of care
Office and OPD PRF  - new items for 2001-02   ,[object Object],[object Object],[object Object],[object Object]
ED PRF - new items for 2001-02 ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
NAMCS and NHAMCS PRF revisions 2003-04
ED PRF- revisions for 2003-04 ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
2001-02 Induction Interview revisions ,[object Object],[object Object]
2003-04 Induction Interview revisions ,[object Object],[object Object]
ED Overcrowding ,[object Object],[object Object]
Analysis of Facility Level Data
Percent of physicians who do not accept new patients by payment type
Distribution of hospital EDs on average waiting time
Overview ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Encounter vs. person data ,[object Object],[object Object],[object Object],[object Object]
Sample weight ,[object Object],[object Object],[object Object],[object Object]
Sampling error ,[object Object],[object Object],[object Object]
Reliability criteria ,[object Object],[object Object],[object Object]
Ways to improve reliability of estimates ,[object Object],[object Object]
Nonsampling error ,[object Object],[object Object],[object Object],[object Object]
Minimizing nonsampling error ,[object Object],[object Object],[object Object],[object Object],[object Object]
NAMCS Response rates
NHAMCS Response rates ED OPD
Attempts to improve response rate  ,[object Object],[object Object],[object Object]
Methodological studies ,[object Object],[object Object],[object Object],[object Object],[object Object]
Initial results of incentives test ,[object Object],[object Object],[object Object]
Data dissemination
 
Outside research ,[object Object],[object Object],[object Object],[object Object],[object Object]
Microdata files ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Enhanced public-use files ,[object Object],[object Object],[object Object],[object Object],[object Object]
Comparison of RSEs Physician assistant Seen by Cardiac monitor IV fluids Admitted to hosp 0 5 10 15 20 RSE In-house Masked GVC
Comparison of RSEs for ED visits by age Patient age in years In-house Public-use 1-stage gvc <15 15-24 25-44 45-64 65-74 75+ 0 5 10 15 RSE
Future release ,[object Object],[object Object],[object Object]
Where to get more information ,[object Object],[object Object],[object Object],[object Object]
http://www.cdc.gov/nchs/about/major/ahcd/ahcd1.htm
NCHS Research Data Center
Why the Research Data Center? ,[object Object],[object Object],[object Object],[object Object]
Data Center- cont. ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Data Center rules ,[object Object],[object Object],[object Object],[object Object]
I need more information ! ,[object Object],[object Object],[object Object],[object Object]
Thank You ,[object Object],[object Object],[object Object],[object Object]
 

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