New Summary Data from the National Nursing Home Survey
The National Center for Health Statistics (NCHS) released 2004 National Nursing Home Survey (NNHS) Data Tables. The NNHS is a periodic survey providing data on nursing homes, nursing home residents, and their care. These new tables summarize characteristics of nursing homes and current nursing home residents.
In 2004, there were 16,100 nursing homes in the United States providing care to almost 1.5 million nursing home residents. More than 40 percent of nursing residents were 85 years or older at the time of interview. The most common primary diagnoses at admission included diseases of the circulatory system (24 percent), mental disorders (16 percent), and diseases of the nervous system and sense organs (14 percent).
The 2004 NNHS data tables include a variety of new items. New facility content includes preparation and experience of top management, wages and benefits for nursing staff, end-of-life practices, special care programs (e.g., wound care, dementia care), arrangements for providing medical services, accreditation, staff and resident immunization practices, and use of electronic information systems.
The facility tables are located at:
http://www.cdc.gov/nchs/about/major/nnhsd/Facilitytables.htm.
New items collected about current residents include medications, emergency department (ED) visits, hospitalizations, advance directives, physical restraints, pain assessment and management, pressure ulcers, falls, and weight management. At the time of interview, almost two-thirds of current residents had an advance directive, about 10 percent had at least one pressure ulcer, and about 7 percent had at least one hospitalization in the past 90 days.
The current resident estimate and standard error tables are located at:
http://www.cdc.gov/nchs/about/major/nnhsd/ResidentTables.htm.
Release of the 2006 Nationwide Inpatient Sample and Kids’ Inpatient Database
The Agency for Healthcare Research and Quality (AHRQ) released the Healthcare Cost and Utilization Project (HCUP) Nationwide Inpatient Sample (NIS) featuring 2006 data. The NIS is the largest all-payer inpatient care database in the United States and is updated annually. It is composed of data from 1988 to 2006, allowing analysis of trends over time.
The NIS is nationally representative of all short-term, non-federal, community hospitals in the United States. It is based on a 20 percent stratified sample of hospitals from the HCUP State Inpatient Databases (SID) and comprises 90 percent of all discharges in the United States. The data include all patients, regardless of payer, including persons covered by Medicare, Medicaid, and private insurance, and the uninsured. The data can be weighted to produce national estimates, allowing researchers and policymakers to use the NIS to identify, track, and analyze national trends in health care utilization, access, charges, quality, and outcomes. The vast size of the NIS enables analyses of rare conditions, such as congenital anomalies; uncommon treatments, such as organ transplantation; and special patient populations, like the uninsured. Its size also allows the study of topics at both the national and regional levels. In addition, NIS data are standardized across years to facilitate ease of use.
The 2006 NIS contains data from more than 8 million hospital stays. It encompasses all discharge data from 1,045 hospitals in 38 states. For most states, the NIS includes hospital identifiers that allow linkages to the American Hospital Association's database and county identifiers that permit linkages to the Area Resource File (ARF) from the Health Resources and Services Administration (HRSA). The NIS contains clinical and resource use information included in a typical discharge abstract, with safeguards to protect the privacy of individual patients, physicians, and hospitals (as required by data sources).
In addition, AHRQ released the HCUP Kids’ Inpatient Database (KID) featuring 2006 data. Released every three years since the 1997 data year, the KID is the only dataset in the U.S. designed specifically to study hospital use, outcomes, and charges in the pediatric (under 21 years) population. The KID’s large sample size enables studies of rare and common health care conditions, procedures, and subpopulations that may be difficult to study with other databases because children account for a relatively small proportion of hospital stays.
The KID includes a sample of pediatric discharges from the HCUP SID. These discharges are stratified by three strata: uncomplicated in-hospital birth, complicated in-hospital birth, and all other pediatric cases. Systematic random sampling is used to select 10 percent of uncomplicated in-hospital births, 80 percent of complicated in-hospital births, and 80 percent of all other pediatric discharges included in the SID. Complicated births and other non-birth pediatric cases are over-sampled to ensure that rare pediatric conditions are captured in the KID.
The 2006 KID contains data from 3,739 hospitals in 38 states, and includes children covered by Medicare, Medicaid, private insurance, and the uninsured. The data can be weighted to produce national estimates, allowing researchers and policymakers to use the KID to identify, track, and analyze national trends in health care utilization, access, charges, quality, and outcomes. Using the KID, it is possible to study varied topics, including the incidence of uncommon conditions, the economic burden associated with specific procedures or conditions, and the pediatric conditions most often associated with particular outcomes.
