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Scientific Data Documentation
National Hospital Discharge Survey, 1984
DSN: CC36.NHDS84 ABSTRACT THIS MATERIAL PROVIDES DOCUMENTATION FOR USERS OF THE DATA TAPES OF THE NHDS CONDUCTED BY THE NATIONAL CENTER FOR HEALTH STATISTICS (NCHS). SECTION I, DESCRIPTION OF THE NATIONAL HOSPITAL DISCHARGE SURVEY, INCLUDES INFORMATION ON THE HISTORY OF THE NHDS, THE SCOPE OF THE SURVEY, THE SAMPLE, DATA COLLECTION PROCEDURES, MEDICAL CODING PROCEDURES, POPULATION ESTIMATES, MEASUREMENT ERRORS AND SAMPLING ERRORS. SECTION II PROVIDES TECHNICAL DETAILS OF THE TAPE (NUMBER OF TRACKS, RECORD LENGTH, ETC.). SECTION III PROVIDES A DETAILED DESCRIPTION OF THE CONTENTS OF EACH DATA RECORD, BY LOCATION. APPENDIX A DEFINES CERTAIN TERMS USED IN THIS DOCUMENT, APPENDIX B PROVIDES POPULATION ESTIMATES TO ALLOW THE USER TO CALCULATE RATES, AND APPENDIX C LISTS THE CLASS 4 PROCEDURES NOT CODED BY THE NHDS.DESCRIPTION OF THE NATIONAL HOSPITAL DISCHARGE SURVEY INTRODUCTION INTRODUCTION.--THIS DOCUMENT AND ITS ATTACHMENTS ALLOW ONE TO USE THE 1984 DATA TAPE WHICH CONTAINS THE DATA COLLECTED BY THE NATIONAL HOSPITAL DISCHARGE SURVEY CONDUCTED BY THE NATIONAL CENTER FOR HEALTH STATISTICS. THE NATIONAL HOSPITAL DISCHARGE SURVEY PROVIDES A CONTINUOUS SAMPLE OF HOSPITAL DISCHARGE RECORDS, COLLECTING MEDICAL AND DEMOGRAPHIC INFORMATION FOR CALCULATING STATISTICS ON HOSPITAL UTILIZATION. THE SURVEY CONSISTS OF DATA ABSTRACTED FROM THE FACE SHEETS OF THE MEDICAL RECORDS FOR SAMPLED INPATIENTS DISCHARGED FROM A NATIONAL SAMPLE OF NON-FEDERAL SHORT-STAY HOSPITALS. FOR A DESCRIPTION OF THE SURVEY DESIGN AND DATA COLLECTION PROCEDURES, SEE BELOW. FOR A MORE DETAILED DESCRIPTION OF THE SURVEY DESIGN, DATA COLLECTION PROCEDURES, AND THE ESTIMATION PROCESS, SEE REFERENCE I. HISTORY HISTORY.--TO PROVIDE MORE COMPLETE AND PRECISE INFORMATION ON THE UTILIZATION OF THE NATION'S HOSPITALS AND ON THE NATURE AND TREATMENT OF ILLNESS AMONG THE HOSPITALIZED POPULATION, THE NCHS IN 1962 BEGAN EXPLORING POSSIBILITIES FOR SURVEYING MORBIDITY IN HOSPITALS. A NATIONAL ADVISORY GROUP WAS ESTABLISHED. THE NCHS CONDUCTED PLANNING DISCUSSIONS WITH OTHER ELEMENTS OF THE PUBLIC HEALTH SERVICE. HOSPITALIZATION MATERIAL FROM THE SURVEY RESEARCH CENTER OF THE UNIVERSITY OF MICHIGAN, THE AMERICAN HOSPITAL ASSOCIATION, AND THE PROFESSIONAL ACTIVITIES STUDY WAS EXAMINED AND EVALUATED. IN 1963, A STUDY BY THE SCHOOL OF PUBLIC HEALTH OF THE UNIVERSITY OF PITTSBURGH UNDER CONTRACT TO THE HCHS DEMONSTRATED THE FEASIBILITY OF AN NHDS TYPE OF PROGRAM. AN ADDITIONAL PILOT STUDY USING ENUMERATORS FROM THE BUREAU OF THE CENSUS WAS CONDUCTED IN LATE 1964 AND CONFIRMED THE UNIVERSITY OF PITTSBURGH'S FINDINGS. FINALLY, WITH ADVICE AND SUPPORT FROM THE AMERICAN HOSPITAL ASSOCIATION, THE AMERICAN MEDICAL ASSOCIATION, INDIVIDUAL EXPERTS, OTHER PROFESSIONAL GROUPS, AND ELEMENTS OF THE U.S. PUBLIC HEALTH SERVICE, THE NCHS INITIATED THE NATIONAL HOSPITAL DISCHARGE SURVEY IN 1964. SCOPE OF THE SURVEY SCOPE OF THE SURVEY.--THE NATIONAL HOSPITAL DISCHARGE SURVEY ENCOMPASSES PATIENTS DISCHARGED FROM NONINSTITUTIONAL HOSPITALS, EXCLUSIVE OF FEDERAL HOSPITALS, LOCATED IN THE SO STATES AND THE DISTRICT OF COLUMBIA. FOR PURPOSES OF THE NHDS, A FACILITY IS CONSIDERED A SHORT-STAY HOSPITAL ONLY IF IT MEETS THE FOLLOWING CRITERIA: I. AT LEAST SIX BEDS ARE MAINTAINED FOR USE BY INPATIENTS. 2. IT IS LICENSED AS A HOSPITAL IN STATES WITH LICENSURE LAWS. 3. INPATIENT MEDICAL CARE IS PROVIDED UNDER THE SUPERVISION OF A LICENSED DOCTOR OF MEDICINE OR OSTEOPATHY. 4. NURSING SERVICE IS PROVIDED 24 HOURS A DAY UNDER SUPERVISION OF A REGISTERED NURSE. 5. SEPARATE MEDICAL RECORDS ARE MAINTAINED FOR EACH PATIENT ADMITTED. 6. THE AVERAGE LENGTH OF STAY FOR ALL PATIENTS IS LESS THAN 30 DAYS. SAMPLING FRAME AND SIZE OF SAMPLE SAMPLING FRAME AND SIZE OF SAMPLE.--THE NATIONAL MASTER FACILITY INVENTORY OF HOSPITALS AND INSTITUTIONS (NMFI) CONSTITUTES THE SAMPLING FRAME (UNIVERSE) FOR HOSPITAL5 IN THE NHDS. THE NCHS HAS PUBLISHED A DETAILED DESCRIPTION OF THE NHFI, ITS CONTENTS, PLANS FOR MAINTAINING IT, AND PROCEDURES FOR ASSESSING THE COMPLETENESS OF ITS COVERAGE (SEE REFERENCE 2). THE UNIVERSE FOR THE SURVEY CONSISTED ORIGINALLY OF 6,965 SHORT STAY HOSPITALS, EXCLUDING MILITARY AND VA HOSPITALS CONTAINED IN THE NMFI IN 1963. THE SAMPLE OF HOSPITALS FOR 1984 IS SHOWN IN TABLE 1. SOME HOSPITALS REFUSED TO PARTICIPATE AND SOME WERE DEEMED OUT OF SCOPE, EITHER BECAUSE THE HOSPITAL HAD GONE OUT OF BUSINESS OR BECAUSE IT FAILED TO MEET THE NHDS DEFINITION OF A SHORT-STAY HOSPITAL. THE NUMBER OF HOSPITALS WHICH REFUSED TO PARTICIPATE OR WERE OUT OF SCOPE ARE GIVEN IN TABLE I, ALONG WITH THE NUMBER OF PARTICIPATING HOSPITALS. TABLE 1 NUMBER OF HOSPITALS YEAR SAMPLED REFUSED OUT OF SCOPE SURVEYED 1984 553 86 60 407 SAMPLE DESIGN SAMPLE DESIGN. ALL HOSPITAL5 WITH 1,000 BEDS OR MORE IN THE UNIVERSE OF SHORT-STAY HOSPITAL5 WERE SELECTED WITH CERTAINTY IN THE SAMPLE. ALL HOSPITALS WITH FEWER THAN 1,000 BEDS WERE STRATIFIED, THE PRIMARY STRATUM BEING THE 24 SIZE-BY-REGION CLASSES SHOWN IN TABLE 2. WITHIN EACH OF THESE 24 PRIMARY STRATA, THE ALLOCATION OF THE HOSPITAL5 WAS MADE THROUGH A CONTROLLED SELECTION TECHNIQUE SO THAT HOSPITALS IN THE SAMPLE WOULD BE PROPERLY DISTRIBUTED WITH REGARD TO TYPE OF OWNERSHIP AND GEOGRAPHIC DIVISION. SAMPLE HOSPITAL5 WERE DRAWN WITH PROBABILITIES RANGING FROM CERTAINTY FOR THE LARGEST HOSPITALS TO 1 IN 40 FOR THE SMALLEST HOSPITALS. THE WITHIN HOSPITAL SAMPLING RATIO FOR SELECTING SAMPLE DISCHARGES VARIED INVERSELY WITH THE PROBABILITY OF SELECTION OF THE HOSPITAL THE SMALLEST SAMPLING FRACTION OF DISCHARGED PATIENTS WAS TAKEN IN THE LARGEST HOSPITALS, AND THE LARGEST FRACTION WAS TAKEN IN THE SMALLEST HOSPITALS. THIS WAS DONE TO COMPENSATE FOR THE FACT THAT HOSPITALS WERE SELECTED WITH PROBABILITIES PROPORTIONATE TO THEIR SIZE CLASS AND TO ASSURE THAT THE OVERALL PROBABILITY OF SELECTING A DISCHARGE WOULD BE APPROXIMATELY THE SAME IN EACH SIZE CLASS. TABLE 1. DISTRIBUTION OF NON-FEDERAL SHORT-STAY HOSPITALS IN THE UNIVERSE AND NATIONAL HOSPITAL DISCHARGE SURVEY IN-SLOPE SAMPLE BY GEOGRAPHIC REGION AND BED SIZE OF HOSPITAL: UNITED STATES, 1984 BED SIZE OF ALL NORTH HOSPITAL REGIONS NORTHEAST CENTRAL SOUTH WEST ALL SIZES NUMBER OF HOSPITALS UNIVERSE...............6,023 902 1.704 2.291 1.126 SAMPLE...................493 115 140 164 74 6-49 BEDS UNIVERSE...............1,372 78 415 535 344 SAMPLE 39 6 11 13 9 50-99 BEDS UNIVERSE...............1,467 160 427 611 269 SAMPLE 62 10 14 30 8 100-199 BEDS UNIVERSE...............1,398 203 373 571 251 SAMPLE 93 16 22 43 12 200-299 BEDS UNIVERSE `733 196 177 237 123 SAMPLE 72 18 21 20 13 300-499 BEDS UNIVERSE 715 176 202 224 113 SAMPLE...................119 37 35 25 22 500-999 BEDS UNIVERSE 309 78 101 105 25 SAMPLE 95 23 34 29 9 1,000 BEDS OR MORE UNIVERSE 9 8 1 3 4 1 IN NEARLY ALL HOSPITALS, THE DAILY LISTING SHEET OF DISCHARGES WAS THE FRAME FROM WHICH THE SUBSAMPLES OF DISCHARGES WERE SELECTED WITHIN THE SAMPLE HOSPITALS. THE SAMPLE DISCHARGES WERE SELECTED BY A RANDOM TECHNIQUE, USUALLY ON THE BASIS OF THE TERMINAL DIGIT(S) OF THE PATIENT'S MEDICAL RECORD NUMBERA NUMBER ASSI BED WHEN THE PATIENT WAS ADMITTED TO THE HOSPITAL. IF THE HOSPITAL'S DAILY DISCHARGE LISTING DID NOT SHOW THE MEDICAL RECORD NUMBER, THE SAMPLE WAS SELECTED BY STARTING WITH A RANDOMLY SELECTED DISCHARGE AND TAKING EVERY KTH DISCHARGE THEREAFTER. DATA COLLECTION DATA COLLECTION. DEPENDING ON THE STUDY PROCEDURE AGREED ON WITH THE HOSPITAL ADMINISTRATOR, EITHER HOSPITAL STAFF OR REPRESENTATIVES OF THE NCHS PERFORMED THE SAMPLE SELECTION AND THE TRANSCRIPTION OF INFORMATION FROM THE HOSPITAL RECORDS TO ABSTRACT FORMS. THE ABSTRACT FORM USED FOR 1983 IS SHOWN IN FIGURE 1. IN ABOUT TWO-THIRDS OF THE HOSPITALS THAT PARTICIPATE IN THE NHDS, THE MEDICAL RECORDS DEPARTMENT OF THE HOSPITAL PERFORMED THIS WORK. IN THE REMAINING HOSPITALS, PERSONNEL OF THE U.S. BUREAU OF THE CENSUS ACTING FOR THE NCHS PERFORMED THE WORK. SURVEY HOSPITALS USED AN ABSTRACT FORM TO TRANSCRIBE DATA FROM THE HOSPITAL RECORDS. THE ABSTRACT FORM PROVIDES FOR RECORDING DEMOGRAPHIC DATA, ADMIS- SION AND DISCHARGE DATES, DISCHARGE STATUS, AND INFORMATION ON DISCHARGE DIAGNOSES AND SURGICAL OPERATIONS OR PROCEDURES. ALL DISCHARGE DIAGNOSES WERE LISTED ON THE ABSTRACT FORM IN THE ORDER OF PRINCIPAL DIAGNOSIS, OR FIRST LISTED DIAGNOSIS IF THE PRINCIPAL DIAGNOSIS WAS NOT IDENTIFIED, FOLLOWED BY THE ORDER IN WHICH ALL OTHER DIAGNOSES WERE ENTERED ON THE FACE SHEET OF THE MEDICAL RECORD. ALL OPERATIONS WERE LISTED IN THE ORDER IN WHICH THEY WERE RECORDED ON THE FACE SHEET. SHIPMENTS OF COMPLETED ABSTRACT FORMS FOR EACH SAMPLE HOSPITAL WERE TRANSMITTED, ALONG WITH SAMPLE SELECTION CONTROL SHEETS, TO A CENSUS REGIONAL OFFICE. EVERY SHIPMENT OF ABSTRACTS WAS REVIEWED AND EACH ABSTRACT FORM WAS CHECKED FOR COMPLETENES5 ABSTRACTS WERE THEN SENT TO THE NCHS FOR PROCESSING. MEIDCAL CODING AND EDIT MEDICAL CODING AND EDIT. THE MEDICAL INFORMATION RECORDED ON THE SAMPLE PATIENT ABSTRACTS WAS CODED CENTRALLY BY THE NCHS STAFF. A MAXIMUM OF SEVEN DIAGNOSTIC CODES WAS ASSIGNED FOR EACH SAMPLE ABSTRACT; IN ADDITION, IF THE MEDICAL INFORMATION INCLUDED SURGERY, A MAXIMUM OF FOUR CODES FOR SURGICAL OPERATIONS AND PROCEDURES WAS ASSIGNED. FOLLOWING THE CONVERSION OF THE DATA ON THE MEDICAL ABSTRACT TO COMPUTER TAPE, A FINAL MEDICAL EDIT WAS ACCOMPLISHED BY COMPUTER INSPECTION RUNS AND A REVIEW OF REJECTED ABSTRACTS. IF SEX OR AGE OF PATIENT WAS INCOMPATIBLE WITH THE RECORDED MEDICAL INFORMATION, PRIORITY WAS GIVEN TO THE MEDICAL INFORMATION IN THE EDITING DECISION. NHHDS MEDICAL CODERS CODE FROM ABSTRACTS OF MEDICAL RECORDS IN THE ORDER THE DIAGNOSES AND PROCEDURES ARE ENTERED. FOR MOST ABSTRACTS, THIS CODING PROCEDURE IS RELATIVELY FREE OF PROBLEMS. IT WAS NOTED, HOWEVER, THAT ACUTE CARDIAL INFARCTION FREQUENTLY WAS NOT THE LEAD ENTRY IN A GROUP OF CIRCULATORY DIAGNOSES FOR EXAMPLE, THE PATIENT'S RECORD MAY HAVE ARTERIOSCLEROSOS LISTED FIRST AND ARTERIOSCLEROTIC HEART DISEASE LISTED SECOND WITH ACUTE MYOCARDIAL LNFARCTLON LISTED THIRD. A DECISION WAS MADE TO REORDER SOME ACUTE MYOCARDIAL INFARCTION DIAGNOSES. THE NEW PROCEDURE, BASED ON ACCEPTED MEDICAL CODING PRACTICE, STATES THAT WHENEVER AN ACUTE MYOCARDIAL INFARCTION IN ENCOUNTERED WITH OTHER CIRCULATORY DIAGNOSES AND IS OTHER THAN THE FIRST ENTRY, IT SHOULD BE REORDERED TO FIRST POSITION. THE BASIC SYSTEM FOR CODING THE DIAGNOSES ON THE NHDS SAMPLE PATIENT ABSTRACTS IS THE INTERNATIONAL CLASSIFICATION OF DISEASES, 9TH REVISION, CLINICAL MODIFICATION (ICD-9-CM) (SEE REFERENCE 3). THE ICD-9-CM SECTION FOR SURGICAL OPERATIONS, DIAGNOSTIC AND OTHER THERAPEUTIC PROCEDURES IS THE CODING SYSTEM USED FOR SURGICAL PROCEDURES AND OPERATIONS. THE UNIFORM HOSPITAL DISCHARGE DATA SET (UHDDS) CLASSIFIES ICD-9-CM PROCEDURES INTO FOUR CLASSES. CLASSES 1.3 CONSIST OF "SIGNIFICANT PROCEDURES" - THAT IS, PROCEDURES WHICH CARRY AN OPERATIVE OR ANESTHETIC RISK OR REQUIRE HIGHLY TRAINED PERSONNEL, SPECIAL FACILITIES, OR SPECIAL EQUIPMENT. CLASS 4 PROCEDURES ARE NOT CONSIDERED SIGNIFICANT; THEREFORE, REPORTING THEM IS CONSIDERED OPTIONAL. THE CLASS 4 PROCEDURES NOT CODED BY THE NHDS ARE LISTED IN APPENDIX C. POPULATION ESTIMATES POPULATION ESTIMATES.--APPENDIX B CONTAINS POPULATION ESTIMATES PROVIDED BY THE U.S. BUREAU OF THE CENSUS. THE ESTIMATES COVER THE U.S. CIVILIAN RESIDENT POPULATION ON JULY I OF THE DATA YEAR. THESE POPULATION ESTIMATES ARE CONSISTENT WITH THOSE PUBLISHED IN CURRENT POPULATION REPORTS, SERIES P-25; HOWEVER, THESE TABLES ARE NOT OFFICIAL POPULATION ESTIMATES OF THE BUREAU OF THE CENSUS. MEASUREMENT ERRORS MEASUREMENT ERRORS.--AS IN ANY SURVEY, RESULTS ARE SUBJECT TO NONSAMPLING OR MEASUREMENT ERRORS, WHICH INCLUDE ERRORS DUE TO HOSPITAL NONRESPONSE, MISSING ABSTRACTS, INFORMATION INCOMPLETELY OR INACCURATELY RECORDED ON ABSTRACT FORMS, AND PROCESSING ERRORS. LESS THAN I PERCENT OF THE DIS- CHARGE RECORDS FAILED TO INCLUDE AGE OR SEX OF PATIENT OR DATE OF ADMISSION OR DISCHARGE. IF THE HOSPITAL RECORD DID NOT STATE AGE OR SEX OF PATIENT, IT WAS IMPUTED BY ASSIGNING THE PATIENT AN AGE OR SEX CONSISTENT WITH THE AGE OR SEX OF OTHER PATIENTS WITH THE SAME DIAGNOSTIC CODES. IF THE DATES OF ADMISSION OR DISCHARGE WERE NOT GIVEN, AND IF THEY COULD NOT BE OBTAINED FROM THE MONTHLY SAMPLE LISTING SHEET TRANSMITTED BY THE SAMPLE HOSPITAL, A LENGTH OF STAY WAS IMPUTED BY ASSIGNING THE PATIENT A STAY CHARACTERISTIC OF THE STAYS OF OTHER PATIENTS OF THE SAME AGE. IN ADDITION, NONRESPONSE (ABOUT 6 PERCENT) FOR PRINCIPAL EXPECTED SOURCE OF PAYMENT WAS IMPUTED TO REFLECT SIMILARITIES IN SEX AND AGE. SAMPLING ERRORS SAMPLING ERRORS.--PROCEDURES FOR CALCULATING SAMPLING ERRORS ARE DESCRIBED IN DETAIL IN REFERENCE I. ESTIMATES OF STANDARD ERRORS FOR A PARTICULAR YEAR CALCULATED FROM NHDS DATA ARE AVAILABLE IN THE APPENDIX OF THE NHDS PUBLICATIONS FOR THAT YEAR. HOW TO USE THE DATA TAPE HOW TO USE THE DATA TAPE.--THE NHDS RECORDS ARE WEIGHTED TO ALLOW INFLATION TO NATIONAL OR REGIONAL ESTIMATES. THE WEIGHT APPLIED TO EACH RECORD IS FOUND IN TAPE LOCATION ILL-I IS. TO PRODUCE AN ESTIMATE OF THE NUMBER OF DISCHARGES, THE WEIGHTS FOR THE DESIRED RECORDS MUST BE SUMMED. TO PRODUCE AN ESTIMATE FOR NUMBER OF DAYS OF CARE, THE WEIGHT MUST BE MULTIPLIED BY THE LENGTH OF STAY (TAPE LOCATION 101-104) AND THESE PRODUCTS ARE SUMMED. LENGTH OF STAY DATA CAN BE OBTAINED BY USING RECODES ALREADY ON THE TAPE (SEE ITEMS 19 AND 23 IN THE TAPE LAYOUT), OR BY DIVIDING DAYS OF CARE BY NUMBER OF DISCHARGES AS CALCULATED ABOVE. DIAGNOSIS-RELATED GROUPS DIAGNOSIS-RELATED GROUPS (DRGS)..-MANY USERS OF THE NHDS DATA TAPES HAVE EXPRESSED AN INTEREST IN CONVERTING THESE DATA TO DRGS. THIS HAS BEEN DONE USING THE DRG GROUPER PROGRAM OBTAINED FROM THE HEALTH CARE FINANCING ADMINISTRATION IN AUGUST 1983. THE DRGS AND THE DRG GROUPER PROGRAM WERE DEVELOPED OUTSIDE OF THE NATIONAL CENTER FOR HEALTH STATISTICS; ANY QUESTIONS ABOUT DRGS, OTHER THAN SPECIFIC QUESTIONS ABOUT HOW THEY RELATE TO NHDS DATA, SHOULD BE ADDRESSED ELSEWHERE. QUESTIONS QUESTIONS.--QUESTIONS CONCERNING DATA ON THE TAPE SHOULD BE DIRECTED TO THE HOSPITAL CARE STATISTICS BRANCH, DIVISION OF HEALTH CARE STATISTICS, NATIONAL CENTER FOR HEALTH STATISTICS, CENTER BUILDING, ROOM 2-43, 3700 EAST-WEST HIGHWAY, HYATTSVILLE, MARYLAND 20782. REFERENCES NATIONAL CENTER FOR HEALTH STATISTICS: DEVELOPMENT OF THE DESIGN OF THE NCHS HOSPITAL DISCHARGE SURVEY, BY W. R. SIMMONS. VITAL AND HEALTH STATISTICS. PHS PUB. NO. 1000, SERIES 2-NO. 39. PUBLIC HEALTH SERVICE. WASHINGTON. U.S. GOVERNMENT PRINTING OFFICE, SEPT. 1970. NATIONAL CENTER FOR HEALTH STATISTICS: DEVELOPMENT AND MAINTENANCE OF A NATIONAL INVENTORY OF HOSPITALS AND INSTITUTIONS. VITAL AND HEALTH STATISTICS. PHS PUB. NO. 1000, SERIES 1-NO. 3. PUBLIC HEALTH SERVICE. WASHINGTON. U.S. GOVERNMENT PRINTING OFFICE, FEB. 1965. NATIONAL CENTER FOR HEALTH STATISTICS: INTERNATIONAL CLASSIFICATION OF DISEASES, 9TH REVISION, CLINICAL MODIFICATION. DHHS PUB. NO. (PHS) 80-1260. PUBLIC HEALTH SERVICE. WASHINGTON. U.S. GOVERNMENT PRINTING OFFICE, SEPT. 1980.RECORD LAYOUT NATIONAL HOSPITAL DISCHARGE SURVEY - 1984 OUTLINE OF ITEMS AND CODES ARRANGED BY LOCATION IN THE FINAL MEDICAL TAPE RECORD ITEM TAPE NUMBER OF NUMBER LOCATION POSITIONS ITEM DESCRIPTION AND CODES 1 1 1 SAMPLE FRAME 1: ADNISSION LIST 2: DISCHARGE LIST 2 1 BLANK 2 3 1 DISCHARGE STATUS RECODE 1: ALIVE 2:DEAD 3:NOT STATED 4 1 BLANK 3 5-7 3 DIAGNOSIS-RELATED GROUP CODE* 8 1 BLANK 4 9-10 2 CONTROL MONTH THIS CODE IS EITHER THE MONTH OF ADMISSION OR DISCHARGE DEPENDING UPON THE SAMPLE FRAME USED IN A HOSPITAL AS CODED IN LOCATION 1. 01: JANUARY THROUGH 12: DECEMBER 11-12 2 BLANK 5 13-14 2 CENTURY OF BIRTH (18 OR 10) 15-24 10 BLANK 6 25-30 6 DATE OF BIRTH THIS ITEM IS USED TO CALCULATE AGE AT DATE OF ADMISSION, IF IT PASSES THE EDIT. (THIS ITEM APPEARS IN THE OUTPUT RECORD AS IT WAS IN THE INPUT RECORD EXCEPT IN THE CASE OF MONTH IMPUTED AS 06 AND/OR DAY IMPUTED AS 15.) *SEE TEXT SECTION, "DIAGNOSIS-RELATED GROUPS." 6.1 25-26 2 MONTH OF BIRTH 6.2 27-28 2 DAY OF BIRTH 6.3 29-30 2 YEAR OF BIRTH 03-84: 1900-1984 85-99: 1885-1899 7 31-33 3 AGE UNITS NUMBER (LOCATION 33) (LOCATION 31-32) 1: YEARS 01-99 2: MONTHS 01-11 3: DAYS 00-28 8 34 1 SEX 1: MALE 2: FEMALE 35 1 BLANK 9 36 1 MARITAL STATUS 1: MARRIED 2: SINGLE 3: WIDOWED 4: DIVORCED 5: SEPARATED 6: NOT STATED 7: UNKNOWN 10 37-41 5 DATE OF ADMISSION (IMPUTED ACCORDING TO AGE IF INVALID OR BLANK.) 10.1 37-38 2' MONTH OF ADMISSION 01: JANUARY THROUGH 12: DECEMBER 10.2 39-40 2 DAY OF ADMISSION 01-31 10.3 41 1 YEAR OF ADMISSION 1983 1984 11 42-46 5 DATE OF DISCHARGE (IMPUTED ACCORDING TO AGE IF INVALID OR BLANK.) 11.1 42-43 2 MONTH OF DISCHARGE 01: JANUARY THROUGH 12: DECEMBER 11.2 44-45 2 DAY OF DISCHARGE 01-31 11.3 46 1 YEAR OF DISCHARGE 1984 1985 12 47 1 DISCHARGE STATUS 1: ROUTINE DISCHARGE/DISCHARGED HOME 2: LEFT AGAINST MEDICAL ADVICE 3: DISCHARGED/TRANSFERRED TO ANOTHER SHORT-TERM HOSPITAL 4: DISCHARGED/TRANSFERRED TO LONG- TERM CARE INSTITUTION 5: ALIVE, DISPOSITION NOT STATED 6: DEAD 7: STATUS NOT STATED 48 1 BLANK 13 49 1 AGE RECODE 1: LESS THAN 15 YEARS 2: 15-44 YEARS 3: 45-64 YEARS 4: 65 YEARS AND OVER 14 50 1 NUMBER OF DIAGNOSTIC CODES RECORDED 1 - MINIMUM 7 - MAXIMUM 15 51 1 NUMBER OF SURGICAL CODES RECORDED 0 - MINIMUM 4 - MAXIMUM 16 52-56 5 DATE OF SURGERY #3 16.1 52-53 2 MONTH OF SURGERY 01-12 16.2 54-55 2 DAY OF SURGERY 01-31 16.3. 56 1 YEAR OF SURGERY 2: 1983 3: 1984 4: 1985 17 57-61 5 DATE OF SURGERY #4 SAME FORMAT AS ABOVE (52-56) 62-77 16 BLANK 18 78-81 4. LENGTH OF STAY IN DAYS THIS ITEM WAS GENERATED IN THE COMPUTER ON THE BASIS OF DATE OF ADMISSION AND DATE OF DISCHARGE. IN CASE OF BLANK OR INVALID DATE OF ADMISSION AND/OR DATE OF DISCHARGE, THIS ITEM WAS IMPUTED ACCORDING TO AGE. CODES RANGE FROM 0000 TO 0730. 19 82-83 2 LENGTH OF STAY RECODE -1 (COMPUTER GENERATED) 00: 00 DAYS 01: 01 DAYS . . . . . . 31: 31 DAYS AND OVER 20 84-85 2 AGE RECODE (COMPUTER GENERATED) 00: NEWBORN 01: UNDER 1 YEAR 02: 01-04 YEARS 03: 05-14 YEARS 04: 15-24 YEARS 05: 25-34 YEARS 06: 35-44 YEARS 07: 45.54 YEARS 08: 55-64 YEARS 09: 65-74 YEARS 10: 75 YEARS AND OVER 21 86 1 RACE RECODE (COMPUTER GENERATED) 1: WHITE 2: OTHER 3: NOT STATED 22 87 1 MARITAL STATUS RECODE (COMPUTER GENERATED) 1: MARRIED 2: NOT MARRIED 3: NOT STATED 23 88 1. LENGTH OF STAY RECODE #2 (COMPUTER GENERATED) 1: 00-07 DAYS 2: 08-14 DAYS 3: 15-21 DAYS 4: 22.28 DAYS 5: 29 DAYS AND OVER 89-90 2 BLANK 24 91 1 GEOGRAPHIC REGION (NMFI) 1: NORTHEAST 2: NORTH CENTRAL 3: SOUTH 4: WEST 92 1 BLANK 25 93 1 GEOGRAPHIC DIVISION NORTHEAST REGION 1: NEW ENGLAND 2: MIDDLE ATLANTIC NORTH CENTRAL REGION 3: EAST NORTH CENTRAL 4: WEST NORTH CENTRAL SOUTH REGION 5: SOUTH ATLANTIC 6: EAST SOUTH CENTRAL 7: WEST SOUTH CENTRAL WEST REGION 8: MOUNTAIN 9: PACIFIC 94-98 5 BLANK 26 99 1 NUMBER OF BEDS RECODE (INTERVIEW) 1: 6-49 BEDS 2: 50-99 BEDS 3: 100-199 BEDS 4: 200-299 BEDS 5: 300-499 BEDS 6: 500-999 BEDS 7: 1,000 BEDS OR MORE 27 100 1 HOSPITAL OWNERSHIP (INTERVIEW) 1: PROPRIETARY 2: CHURCH 3: GOVERNMENT 4: NONPROFIT, EXCLUDING CHURCH 28 101-104 4 LENGTH OF STAY IN DAYS DATA IN 78-81 HAS BEEN TRANSFERRED TO THIS DATA FIELD WITH 0000 DAYS RECODED TO 0001. 105-110 6 BLANK 29 111-115 5 WEIGHT FINAL ADJUSTED WEIGHT (WHOLE NUMBER--USED IN TABLE PREPARATION) 116-130 IS BLANK 30 131-136 6 EXPECTED SOURCE(S) OF PAYMENT 30.1 131 1 PRINCIPAL NO. 1 30.2 132 1 PRINCIPAL NO. 2 30.3 133 1 OTHER NO. 1 30.4 134 1 OTHER NO. 2 30.5 135 1 OTHER NO. 3 30.6 136 1 OTHER NO. 4 CODE SOURCE OF PAYMENT I: WORKMEN'S COMPENSATION 2: MEDICARE 3: MEDICAID 4: TITLE V 5: OTHER GOVERNMENT PAYMENT 6: BLUE CROSS 7: OTHER PRIVATE OR COMMERCIAL INSURANCE 8: SELF-PAY 9: NO CHARGE 0: OTHER 31 137-141 5 DATE OF SURGERY #1 31.1 137-138 2 MONTH OF SURGERY 01-12 31.2 139-140 2 DAY OF SURGERY 01-31 31.3 141 1 YEAR OF SURGERY 2: 1983 3: 1984 4: 1985 32 142-146 5 DATE OF SURGERY #2 SAME FORMAT AS ABOVE (137-141) 147-148 2 BLANK 33 149-183 35 DIAGNOSTIC CODES** (FIVE-DIGIT CODES) 33.1 149-153 5 DIAGNOSIS NO. 1 33.2 154-158 5 DIAGNOSIS NO. 2 33.3 159-163 5 DIAGNOSIS NO. 3 33.4 164-168 5 DIAGNOSIS NO. 4 33.5 169-173 5 DIAGNOSIS NO. 5 33.6 174-178 5 DIAGNOSIS NO. 6 33.7. 179-183 5 DIAGNOSIS NO. 7 34 184-199 16 SURGICAL CODES * (FOUR-DIGIT CODES) 34.1 184-187 4 SURGERY NO. 1 34.2 188-191 4 SURGERY NO. 2 34.3 192-195 4 SURGERY NO. 3 34.4 196-199 4 SURGERY NO. 4 200 I BLANK CODES ARE IN COMPLIANCE WITH THE ICD-9-CM. THERE IS AN IMPLIED DECIMAL BETWEEN POSITIONS 3 AND 4 FOR EACH DIAGNOSTIC CODE AND BETWEEN POSITIONS 2 AND 3 FOR EACH SURGICAL CODE.APPENDICES APPENDIX A DEFINITIONS OF CERTAIN TERMS USED IN THIS DOCUMENT HOSPITALS.--SHORT-STAY SPECIAL AND GENERAL HOSPITALS HAVING SIX BEDS OR MORE FOR INPATIENT USE AND AN AVERAGE LENGTH OF STAY OF LESS THAN 30 DAYS. FEDERAL HOSPITALS AND HOSPITAL UNITS OF INSTITUTIONS ARE NOT INCLUDED. BED SIZE OF HOSPITAL.--MEASURED BY THE NUMBER OF BEDS, CRIBS, AND PEDIATRIC BASSINETS REGULARLY MAINTAINED (SET UP AND STAFFED FOR USE) FOR PATIENTS; BASSINETS FOR NEWBORN INFANTS ARE NOT INCLUDED. TYPE OF OWNERSHIP OF HOSPITAL.--THE TYPE OF ORGANIZATION THAT CONTROLS AND OPERATES THE HOSPITAL. HOSPITALS ARE GROUPED AS FOLLOWS: VOLUNTARY NONPROFIT.--HOSPITALS OPERATED BY A CHURCH OR ANOTHER NONPROFIT ORGANIZATION. GOVERNMENT.--HOSPITALS OPERATED BY STATE OR LOCAL GOVERNMENTS. PROPRIETARY.--HOSPITALS OPERATED BY INDIVIDUALS, PARTNERSHIPS, OR CORPORATIONS FOR PROFIT. PATIENT.--A PERSON WHO IS FORMALLY ADMITTED TO THE INPATIENT SERVICE OF A SHORT-STAY HOSPITAL FOR OBSERVATION, CARE, DIAGNOSIS, OR TREATMENT. DISCHARGE.--THE FORMAL RELEASE OF A PATIENT BY A HOSPITAL, THAT IS, THE TERMINATION OF A PERIOD OF HOSPITALIZATION BY DEATH OR BY DISPOSITION TO PLACE OF RESIDENCE, NURSING HOME, OR ANOTHER HOSPITAL. DISCHARGE DIAGNOSIS.--ONE OR MORE DISEASES OR INJURIES (OR SPECIAL CONDITIONS AND EXAMINATIONS WITHOUT SICKNESS OR TESTS WITH NEGATIVE FINDINGS) THAT THE ATTENDING PHYSICIAN ASSIGNS' TO THE MEDICAL RECORD OF PATIENTS. (SEE "MEDICAL CODING AND EDIT," PAGE 5.) OPERATION.--ONE OR MORE SURGICAL OPERATIONS, PROCEDURES, OR SPECIAL TREATMENTS THAT ARE ASSIGNED BY THE PHYSICIAN TO THE MEDICAL RECORD OF PATIENTS DISCHARGED FROM THE INPATIENT SERVICE OF SHORT-STAY HOSPITALS. (SEE "MEDICAL CODING AND EDIT," PAGE 5.) AGE.--PATIENT'S AGE REFERS TO AGE AT BIRTHDAY PRIOR TO ADMISSION TO THE HOSPITA INPATIENT SERVICE. RACE.--PATIENTS ARE CLASSIFIED INTO THE THREE GROUPS LISTED IN THE TAPE RECORD FORMAT UNDER RACE (ITEM 21). GEOGRAPHIC REGION AND DIVISION.--HOSPITALS ARE CLASSIFIED BY LOCATION INTO ONE OF THE FOUR GEOGRAPHIC REGIONS AND NINE GEOGRAPHIC DIVISIONS OF THE UNITED STATES (ITEMS 24 AND 25 IN THE TAPE RECORD FORMAT), WHICH CORRESPOND TO THOSE USED BY THE U.S. BUREAU OF THE CENSUS.APPENDIX B CIVILIAN POPULATION* BY SEX, AGE, GEOGRAPHIC RAGION, AND RACE: UNITED STATES, JULY 1, 1984 (POPULATION ESTIMATES CONSISTENT WITH SERIES P-25, CURRENT POPULATION REPORTS, U.S. BUREAU OF THE CENSUS) AGE, GEOGRAPHIC REGION, AND RACE BOTH SEXES MALE FEMALE POPULATION IN THOUSANDS ALL AGES................... 234,443 113,199 121,244 NORTHEAST.................. 49,617 23,646 25,971 NORTH CENTRAL.............. 58,965 28,950 30,375 SOUTH...................... 79,678 38,310 41,368 WEST....................... 46,182 22,653 23,529 WHITE...................... 199,641 96,775 102,867 ALL OTHER.................. 34,801 16,424 18,377 0-14 YEARS................. 51,733 26,475 25,259 UNDER 1 YEAR............... 3,637 1,861 1,755 1-4 YEARS.................. 14,179 7,254 6,927 5-14 YEARS................. 33,917 17,360 16,557 NORTHEAST.................. 9,850 5,041 4,809 NORTH CENTRAL.............. 13,188 6,757 6,431 SOUTH...................... 18,055 9,234 8,822 WEST....................... 10,640 5,444 5,196 WHITE...................... 42,045 21,572 20,473 ALL OTHER.................. 9,689 4,904 4,786 15-44 YEARS................ 109,958 54,096 55,862 15-24 YEARS................ 39,230 19,471 19,759 25-34 YEARS................ 40,328 19,803 20,523 35-44 YEARS................ 30,401 14,821 15,580 NORTHEAST.................. 23,047 11,248 11,798 NORTH CENTRAL.............. 27,511 13,625 13,885 SOUTH...................... 37,140 18,136 19,005 WEST....................... 22,262 11,087 11,175 WHITE...................... 92,995 46,132 46,863 ALL OTHER.................. 16,963 7,963 8,999 45-64 YEARS................ 44,712 21,329 23,382 45-54 YEARS................ 22,397 10,856 11,540 55-64 YEARS................ 22,315 10,473 11,842 NORTHEAST.................. 10,205 4,818 5,388 NORTH CENTRAL.............. 11,044 5,314 5,730 SOUTH...................... 15,069 7,118 7,951 WEST....................... 8,392 4,081 4,313 WHITE...................... 39,280 18,880 20,403 ALL OTHER.................. 5,430 2,450 2,979 65 YEARS AND OVER.......... 28,040 11,299 16,741 65-74 YEARS................ 16,746 7,318 9,429 75 YEARS AND OVER.......... 11,294 3,981 7,313 NORTHEAST.................. 6,515 2,539 3,976 NORTH CENTRAL.............. 7,223 2,895 4,327 SOUTH...................... 9,414 3,823 5,591 WEST....................... 4,888 2,041 2,846 WHITE...................... 25,321 10,193 15,129 ALL OTHER.................. 2,719 1,107 1,612 *THE NHDS USED THE CIVIALIAN NONINSTITUTIONALIZED POPULATION TO CALCULATE HOSPITAL UTILIZATION RATES FROM 1965 THROUGH 1980. BEGINING IN 1981, THE CIVIALIAN RESIDENT POPULATION IS BEING USED TO CALCULATE RATES. IF YOU HAVE PURCHASED NHDS TAPES BEFORE YEARS 1981 AND CALCULATED RATES USING THE CIVILIAN NONINSTITUTIONALIZED POPULATION PROVIDED IN THE DOCU- MENTATION, THESE RATES WILL HAVE TO BE ADJUSTED TO BE COMPRABLE TO 1984 RATES USING THE CIVILIAN RESIDENT POPULATION.APPENDIX C UHDDS CLASS 4 PROCEDURES NOT CODED BY THE NHDS 08.19 87.43-87.49 16.21 87.69 18.01 87.79 18.11 87.85-87.89 18.19 87.92 21.21 87.95-87.99 21.29 88.09 22.19 88.16-88.31 24.19 88.33 25.09 88.35 25.91 88.37 26.19 88.39 27.29 89.01-89.13 27.91 89.15-89.16 28.19 89.26-89.31 29.19 89.33-89.39 31.48-31.49 89.45-89.53 41.38-41.39 89.55-89.59 42.29 89.66 44.19 89.7 45.19 90.01-91.99 45.28-45.29 93.01-93.25 48.23 93.27-93.28 48.29 93.31-93.39 49.21 93.42-93.44 49.29 93.61-93.91 49.41 93.94 58.29 93.96 61.19 93.99-94.23 64.19 94.25 64.91 94.29-95.03 64.94 95.05-95.11 69.92 95.14-95.15 70.21 95.31-95.49 73.91-73.92 96.'09-96.19 75.35 96.26-96.28 85.19 96.34-97.04 86.19 97.14-97.69 86.92 97.72-97.89 87.09-87.12 99.02-99.24 87.16-87.17 99.26-99.59 87.22-87.29 99.71-99.79 87.36-87.37 99.82-99.99 87.39
