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Scientific Data Documentation
National Survey of Ambulatory Surgery, 1994
National Survey of Ambulatory SurgeryAbstractThis material provides documentation for users of the 1994 NSAS Public Use Data Tape. The NSAS was implemented by the National Center for Health Statistics (NCHS)in 1994. It covers ambulatory surgery procedures performed in hospitals and free-standing ambulatory surgery centers in the United States.Section I describes the survey and includes information on the history and scope of the NSAS; the survey methodology, data collection and medical coding procedures; population estimates, measurement errors, and sampling errors. Section II provides technical details of the tape.Section III provides a detailed description of the contents of each data record.Appendix A defines certain terms used in this document; Appendix B contains the ICD-9-CM Addenda; Appendix C provides population estimates to allow the user to calculate rates; and Appendix D provides unweighted and weighted frequencies for selected descriptive variables.TABLE OF CONTENTSSection I. Description of the National Survey of Ambulatory SurgerySection II. Technical Description of TapeSection III. Record Format: Location and Coding of Data ElementsAppendix A: Definitions of Certain Terms Used in This DocumentAppendix B: ICD-9-CM AddendaAppendix C: Population EstimatesAppendix D: Unweighted & Weighted Frequencies of Selected NSAS VariablesI. Description of the National Survey of Ambulatory SurgeryIntroduction This document describes the 1994 National Survey of Ambulatory Surgery (NSAS) and provides information for users of the 1994 NSAS public use data file. This survey, conducted by the National Center for Health Statistics (NCHS) and implemented in 1994, covers ambulatory surgery procedures performed in hospitals and free-standing ambulatory surgery centers in the United States. A brief description of the survey design and data collection procedures is given below. A more detailed description of the survey design, data collection procedures, and the estimation process will be published in a forthcoming report from the NCHS.History The National Survey of Ambulatory Surgery was undertaken to obtain information about the use of ambulatory surgery. Ambulatory, or outpatient, surgery has increased in the United States since the early 1980's. Two major reasons for this increase were advances in medical technology and cost containment initiatives.On the medical side, many surgeries performed for hospital inpatients have moved to outpatient settings, in part because improvements in anesthesia and better analgesics for relief of pain have made surgery less complex and risky (1). Also, minimally invasive and non-invasive procedures, such as laser surgery, laparoscopy, and endoscopy, have been developed and are being performed with increasing frequency.On the cost side, concern about rising health care costs led to changes in the Medicare program that encouraged the use of ambulatory surgery (2). In 1982 the Medicare program was expanded to cover care in ambulatory surgery centers. In 1983, a prospective payment system based on diagnosis-related groups (DRG's) was adopted for hospital inpatient care. This system created strong financial incentives for hospitals to perform less complex surgery in an ambulatory setting. In the mid-1980's, the peer review organizations for Medicare established outpatient settings as the norm for certain surgeries and denied Medicare payment for hospital admissions deemed inappropriate or medically unnecessary. Many State Medicaid plans and private insurers followed the lead of the Medicare program and adopted similar policies.As these changes went into effect, freestanding ambulatory surgery centers increased in number, from 239 centers that performed 380,000 procedures in 1983, to over 1,800 centers performing more than 3.2 million procedures ten years later (3). The number of ambulatory surgery procedures done in hospitals and freestanding settings combined rose from 5.4 million in 1983 to 16.2 million in 1993 (4).The National Hospital Discharge Survey (NHDS), which has been conducted by the National Center for Health Statistics every year since 1965, includes information on procedures performed on inpatients (5). The NHDS remains a good source of data for surgical procedures, such as open-heart surgery or cesarean sections, that must be done on an inpatient basis. But for surgeries that can be performed on an ambulatory basis, NHDS estimates are incomplete. Thus the National Survey of Ambulatory Surgery was undertaken to provide data on the increasing use of this type of health care.SURVEY METHODOLOGYSource of the Data The NSAS covers ambulatory surgery procedures performed in hospitals and free- standing ambulatory surgery centers (FSASC). The hospital universe includes noninstitutional hospitals exclusive of Federal, military, and Department of Veterans Affairs hospitals, located in the 50 States and the District of Columbia. Only short-stay hospitals (hospitals with an average length of stay for all patients of less than 30 days) or those whose specialty is general (medical or surgical) or children's general are included in the survey. These hospitals must also have six beds or more staffed for patient use. The universe definition is the same as that used for the National Hospital Discharge Survey. The sampling frame for the hospital universe consisted of eligible hospitals listed in the 1993 SMG Hospital Market Database (6).The universe of freestanding facilities includes FSASCs that are regulated by the States or certified by HCFA, the Health Care Financing Administration, for Medicare participation. The sampling frame consisted of facilities listed in the 1993 Freestanding Outpatient Surgery Center Database (7) and Medicare-certified facilities included in the HCFA Provider-of-Services (POS) file (8). Facilities specializing in dentistry, podiatry, abortion, family planning, or birthing are excluded. However, these procedures are not excluded from in-scope locations. A detailed description of the development and operation of the NSAS will be provided in a forthcoming report.Sample design and data collection--The NSAS samples facilities using a multi-stage probability design with some facilities selected with certainty and others sampled with varying selection probabilities. Independent samples of hospitals and free-standing ambulatory surgery centers were drawn. The sample includes with certainty facilities which perform a high volume of ambulatory surgeries annually. Non-certainty facilities are selected using a stratified, cluster design, where the clusters are 198 primary sampling units (PSUs) that comprise the sample of PSUs used in the 1985-1994 National Health Interview Survey (NHIS). PSUs are counties or groups of counties, or county equivalents, or towns and townships (the latter in New England and Hawaii).Noncertainty facilities were stratified by facility type (hospital versus freestanding), ambulatory surgery status of hospitals (i.e. whether or not the hospital performed such surgery), facility specialty, and geographic region. From each stratum containing fewer than six facilities, up to three facilities were selected by means of systematic random sampling, with selection probabilities proportional to size, where size is the number of ambulatory surgeries performed annually. For strata containing six or more facilities, first stage sampling involved selection of 112 PSUs, which are a probability subsample of the 198 PSUs in the 1985-94 NHIS sample. Some of these PSUs were sampled with certainty. Selection of noncertainty PSUs was performed within PSU strata defined within the four geographic regions by the number of people in the 1980 Census of Population and NHIS stratification variables. From each PSU stratum, the PSUs were selected with probability proportional to the projected 1985 population. The hospital sample is clustered within a probability subsample of 112 of those PSUs.The second stage of the cluster design consisted of selection of non-certainty facilities from the sampled PSUs, using systematic random sampling with probabilities propor tional to the annual number of ambulatory surgeries performed. For both hospitals and FSASCs, up to three facilities of each type and specialty were selected from each non- certainty PSU and up to 15 facilities were selected across the combined certainty PSUs in each region. For the stratum of hospitals which, according to the sampling frame data, did not have ambulatory surgery, a national sample of 50 hospitals was selected to permit estimates of surgery in hospitals that either change their status or differ from frame data. Any sampled facility which performed less than 50 ambulatory surgeries in the year prior to the data collection year was considered out-of-scope for the data collection year.Within sampled facilities, a sample of ambulatory surgery visits was selected using a systematic random sampling procedure. Selection of visits within each facility was performed separately for each location where ambulatory surgery is performed. These locations include: main operating rooms, dedicated ambulatory surgery units, cardiac catherization laboratories, laser procedure rooms, endoscopy and laparoscopy rooms, etc. Locations within facilities that specialize in or are dedicated to inpatients, den tistry, abortion, podiatry, pain block, or small procedures are excluded. However, as mentioned above, these procedures are not excluded from in-scope locations.Following selection of ambulatory surgery visits, data was abstracted from the medical record for each visit. The Medical Abstract Form used in data collection is shown in Figure 1. It contains items relating to the personal characteristics of the patient, including birth date or age, sex, race, zipcode, but not name and address; administra tive information, including the date of the surgery, dispostion of the patient, and medical record number; principal and other additional expected sources of payment; and medical information, including diagnoses and surgical and nonsurgical procedures performed. The medical record number, date of birth, and patient zip code, are confidential information and are not available to the public.Response Rate The 1994 NSAS sample included 333 FSASCs from the 1,732 facilities in the 1993 FSASC sampling frame; and 418 hospitals from the 6,267 listed in the 1993 hospital sampling frame. Of the 751 sampled facilities, 134 were found to be out-of-scope for the NSAS and 126 others were nonresponding in 1994.Medical Coding and Edit The medical information abstracted from the sampled medical records was coded centrally by NCHS contract staff. A maximum of seven diagnostic codes and six procedure codes was assigned for each sampled abstract. The system currently used for coding the diagnoses and procedures on the medical abstract forms is the International Classification of Diseases, 9th Revision, Clinical Modification, or ICD-9-CM (9).Following conversion of the data on the medical abstract to computer tape, a final medical edit was accomplished by computer inspection and by a manual review of rejected records. Priority was given to medical information in the editing decision.Users of the NSAS diagnostic and/or procedure data must take into account annual ICD-9-CM addenda. The addenda lists new codes, new fourth or fifth digits to existing codes, as well as other modifications. Changes go into effect October 1 of the calendar year. However, in order to preserve consistent coding throughout the data year, the NSAS coding for 1994 data is consistent with the ICD-9-CM and the Addenda through October 1, 1993. Appendix B lists the changes for 1986 through 1993.Population Estimates Appendix C shows population estimates provided by the U.S. Bureau of the Census. The estimates are of the U.S. civilian resident population on July l of the data year. These population estimates are consistent with those published in Current Population Reports, Series P-25; however, they are not official population estimates of the Bureau of the Census.Figure 1. Medical abstract for the 1994 National Survey of Ambulatory SurgeryMeasurement Errors and Limitations of the Data As in any survey, results are subject to nonsampling or measurement errors, which include errors due to facility nonresponse, missing abstracts, information incompletely or inaccurately recorded on abstract forms, and processing errors.In a very small number of records, the age or sex of the patient was missing. For these records, a legitimate value was imputed in such a way as to preserve the original, known distribution of the variable. Fewer than one percent of the records have an imputed age or sex value.Forty-three percent of the records were missing a value for race of the patient. No attempt was made to impute for these missing values.The determination of whether an ambulatory surgery facility is a hospital or a free standing center is based on the SMG universe from which the facility is selected. In most cases it is apparent whether a facility is a hospital or a freestanding ambulatory surgery center, but some facilities are not easily classified. For example, a "freestand ing" facility may be owned by a hospital but located some distance away. If such a facility is separately listed in the 1993 SMG Freestanding Outpatient Surgery Center Database and is selected into the NSAS sample from this universe, it is considered a freestanding facility.The distinction between ambulatory and inpatient surgery is not always clear. Accord ing to the 1994 NSAS, an estimated 1.6 percent of ambulatory surgery visits were for patients subsequently admitted to the hospital as inpatients. Some of these patients had procedures which are currently performed exclusively on inpatients, such as coronary artery bypass graft, in addition to diagnostic procedures such as cardiac catheterization. These cases and their suspected "inpatient" procedures have not been eliminated because they are operationally part of the survey design. It is left to the prerogative of the researcher whether or not to include these procedures in an analysis.Sampling errors Statistics from the NSAS are derived by a multistage estimation procedure that produces essentially unbiased estimates. The estimation procedure has three basic components: (a) inflation by reciprocals of the probabilities of sample selection, (b) adjustment for nonresponse, and (c) population weighting ratio adjustments.The standard error of a statistic is primarily a measure of sampling variability that occurs by chance because only a sample rather than the entire universe is surveyed. The relative standard error of the estimate is obtained by dividing the standard error by the estimate itself. The resulting value is multiplied by 100, so the relative standard error (RSE) is expressed as a percent of the estimate. Estimates of sampling variability were calculated with SUDAAN software, which computes standard errors by using a first-order Taylor series approximation of the deviation of estimates from their expected values. A description of the software and the approach it uses has been published (10).Relative Standard Errors for Aggregate EstimatesTable 1 presents parameter estimates to be used in formulae for deriving the approximate relative standard errors for aggregate estimates. To provide error estimates that would be applicable to a wide variety of statistics, numerous variances were calculated and the best fit formula was derived. The formula is based on an empirically determined relationship between the size of an estimate X and its relative variance. The relative standard error is then derived by taking the square root of the relative variance. The relative standard error of an estimate X [RSE(X)], expressed as a percent, may be calculated from the formula: RSE (X)~=~100~*~~SQRT { a~+~b/X }with a and b provided in Table 1.For example, in 1994 the estimated number of ambulatory surgery visits to hospitals and free-standing ambulatory surgery centers by persons aged 65 and over with a first- listed diagnosis of cataracts (ICD-9-CM code 366.0) was 1,536,000. Using the applicable constants from Table 1 for estimates by age produces: RSE (1,536,000)~=~100~*~SQRT {.00641~+~(406.832/1,536,000)}RSE(1,536,000) = 8.17 %The relative standard error for the estimate of interest is 8.17 percent. From this the standard error is obtained by multiplying the relative standard error by the estimate:SE(1,536,000) = 1,536,000 * 8.17 % = 125,491The standard error can be employed to generate confidence intervals for statistical testing. In this example, the 95% confidence interval for the estimate of the total number visits by persons aged 65 and over with a first-listed diagnosis of cataracts is:(1,536,000 - 2*125,491)<-> (1,536,000 + 2*125,491)1,285,018 <-> 1,786,982Relative Standard Error for Estimates of PercentsApproximate relative standard errors for estimates of percents may be calculated from Table 1 also. The relative standard error for a percent, 100 p (0<p<1), (expressed as a percent), may be calculated using the formula:RSE(p)~=~100~*~ SQRT { b~*~(1~-~p)/(p~*~X) }where 100p is the percent of interest, X is the base of the percent, and b is the parameter value, b, given in Table 1.For example, in 1994 the estimated number of ambulatory surgery visits by persons in the 65 and over age group was 6,083,000. This is 32.3 percent of the estimated 18,850,000 visits for that year. Using the applicable constants from Table 1 for estimates by age produces: RSE(.323)~=~ 100~*~ SQRT {406.832~*~(1~-~.323)/(.323~*~18,850,000) }RSE (.323) = 0.673%The relative standard error for the estimate of interest is 0.673 percent. From this the standard error is obtained by multiplying the relative standard error by the estimate:SE(.323) = .323 * 0.673 % = .0022 .The standard error can be employed to generate confidence intervals for statistical testing. In this example, the 95% confidence interval for the estimate of the percentage of ambulatory surgery visits by persons in the 65 and over age group is:(.323 - 2*.0022) <-> (.323 + 2*.0022) .319 <-> .327or, equivalently, 31.9% <-> 32.7 %Table 1. Estimated parameters for relative standard error formulae for National Survey of Ambulatory Surgery aggregate statistics by statistic type: United States, 1994
Characteristic First-Listed diagnoses All-Listed procedures First-Listed diagnoses Hospital All-Listed
Procedures HospitalFirst-Listed diagnoses Freestanding All-Listed procedures
Freestandinga b a b a b a b a b a b Total 0.00300 936.205 0.00314 1042.899 0.00365 937.294 0.00398 979.808 0.01812 246.302 0.01420 756.815 Sex
Male 0.00584 243.411 0.00523 374.805 0.00703 259.441 0.00634 400.074 0.01973 148.898 0.02388 111.244 Female 0.00322 744.535 0.00376 617.095 0.00396 765.854 0.00468 609.192 0.01840 194.161 0.01200 581.791 Age
Under 15 years 0.01611 65.118 0.00971 221.957 0.01693 94.812 0.01151 232.069 0.05864 9.702 0.03108 86.170 15-44 years 0.00465 422.787 0.00402 650.560 0.00529 467.627 0.00441 733.864 0.01948 148.963 0.01980 208.036 45-64 years 0.00556 376.824 0.00749 168.935 0.00690 395.110 0.00975 118.059 0.01978 133.576 0.02466 131.183 65 years and up 0.00641 406.832 0.00434 572.577 0.00794 425.446 0.00588 577.976 0.03041 111.598 0.04404 1.419 Region
Northwest 0.01351 985.293 0.01372 857.242 0.01636 999.603 0.06862 58.778 0.07817 58.884 0.06862 58.778 Midwest 0.01064 644.607 0.01286 551.970 0.01040 653.985 0.09549 216.629 0.09150 165.353 0.09549 216.629 South 0.00982 404.800 0.00978 527.583 0.01281 346.622 0.04459 114.414 0.04682 90.105 0.04459 114.414 West 0.01790 457.195 0.01691 649.374 0.02522 411.895 0.06830 256.660 0.06264 174.679 0.06830 256.660 Source of payment Workers Comp 0.03854 31.835 0.03948 32.664 0.05125 26.390 0.05090 25.227 0.09805 6.784 0.08611 8.342 Medicare 0.00988 211.166 0.00918 136.914 0.01218 213.794 0.01160 137.695 0.03372 98.595 0.04712 1.439 Medicaid 0.01340 250.111 0.01087 344.152 0.01512 260.182 0.01266 348.100 0.07160 66.822 0.07934 36.771 Other Govt 0.04903 157.029 0.03933 226.740 0.05648 173.181 0.05198 215.742 0.21570 1.580 0.15983 23.475 Private Insurance 0.00336 777.159 0.00330 1127.336 0.00395 835.302 0.00390 1209.832 0.01397 252.713 0.01070 605.399 Self-Pay 0.02816 151.933 0.02076 293.085 0.03672 129.202 0.02781 246.163 0.10033 35.443 0.10972 39.263 NC/Other 0.07717 145.425 0.07357 149.427 0.08864 123.675 0.08341 154.664 0.25671 0.771 0.22214 0.792 Not Stated 0.06464 318.863 0.06675 381.220 0.08033 325.472 0.08540 297.599 0.20480 56.399 0.22074 115.011 Presentation of Estimates Publication of estimates for the NSAS is based on the relative standard error of the estimate and the number of sample records on which the estimate is based (referred to as the sample size). Estimates are not presented in NCHS reports unless a reasonable assumption regarding the probability distribution of the sampling error is possible.Based on consideration of the complex sample design of the NSAS, the following guidelines are used for presenting the NSAS estimates:If the sample size is less than 30, the value of the estimate is not reported.If the sample size is 30-59, the value of the estimate is reported but should not be assumed reliable.If the sample size is 60 or more and the relative standard error is less than 30 percent, the estimate is reported.If the sample size is 60 or more but the relative standard error is over 30 percent, the estimate is reported but should not be assumed reliable.How to Use the Data Tape The NSAS records are weighted to allow inflation to national or regional estimates. The weight applied to each record is found in tape location 21-25. To produce an estimate of the number of discharges, the weights for the desired records must be summed.Appendix D contains unweighted and weighted frequencies for selected descriptive variables on the data tape. These may be used as a cross-check when processing the data on the user's system.Questions Questions concerning data on the tape should be directed to Maria Owings, Ph.D., Hospital Care Statistics Branch, Division of Health Care Statistics, National Center for Health Statistics, Presidential Building, Room 956, 6525 Belcrest Road, Hyattsville, Maryland 20782, (301)-436-7125.REFERENCES1. New surgical technologies reshape hospital strategies. Hospitals 66(9):30-36, 38, 40-42. 1992. 2. Leader S and Moon M. Medicare trends in ambulatory surgery. Health Affairs Spring: 158-170. 1989. 3. Durant G. Ambulatory surgery centers: surviving, thriving into the 1990's. Medical Group Management Journal 36(2): 16-18, 20. 1989. 4. SMG Marketing Group, Inc. Outpatient surgery centers exceed 3 million cases. SMG Market Letter 8(5). 1994. 5. Graves EJ and Gillum BS. 1994 summary: National Hospital Discharge Survey. Advance data from Vital and Health Statistics; no 278. Hyattsville, Maryland: National Center for Health Statistics. 1996. 6. SMG Marketing Group, Inc. Hospital Market Database. Chicago: Healthcare Information Specialists. April 1993. 7. SMG Marketing Group, Inc. Freestanding Outpatient Surgery Centers Database. Chicago: Healthcare Information Specialists. 1993. 8. Health Care Financing Administration. Provider of Services Public Use File. Baltimore: 1993. 9. Public Health Service and Health Care Financing Administration. International Classification of Diseases, 9th Revision, Clinical Modification. Washington: Public Health Service. 4th ed. 1991. 10. Shah BV, Barnwell BG, Bieler GS. SUDAAN User's Manual: Software for Analysis of Correlated Data, Release 6.40. Research Triangle Park, NC: Research Triangle Institute. 1995.II. TECHNICAL DESCRIPTION OF TAPEData Set Name----------------------------------NSAS.YR1994 Number of REELS or CARTRIDGES------------------1 Number of Recording Tracks, REEL---------------9 Number of Recording Tracks, CARTRIDGE----------18 Density for REEL (bpi)-------------------------6,250 Density for CARTRIDGE (bpi)--------------------38,000 Language---------------------------------------EBCDIC Parity-----------------------------------------Odd Record Length----------------------------------97 Block Size-------------------------------------32,689 Number of Records------------------------------117,861III. RECORD FORMAT: Location and Coding of Data ElementsThis section provides detailed information for each sampled record on the tape, with a description of each item included in the record. Data elements are arranged sequentially according to their physical location on the tape record. Data are derived from the abstract form; the SMG Hospital Market Tape is an alternative source of data; some items are computer generated.Item Tape Number of Number Location Positions Item Description and Codes ______ ________ _________ __________________________ 1 1-2 2 Survey Year: 94 2 3 1 Facility Type: 1=Hospitals 2=Free-Standing Ambulatory Surgery Center 3 4 1 Units for Age: 1 = Years 2 = Months 3 = Days 4 5-6 2 Age in years, months, or days: If Units = Years: 0-99* If Units = Months: 01-11 If Units = Days: 00-31 5 7 1 Age Flag: 1 = Value for Age was Imputed 2 = Value for Age was Not Imputed 6 8 1 Sex: 1 = Male 2 = Female 7 9 1 Sex Flag: 1 = Value for Sex was Imputed 2 = Value for Sex was Not Imputed 8 10 1 Race: 1 = White 2 = Black 3 = American Indian/Eskimo 4 = Asian/Pacific Islander 5 = Other 9 = Race Not Stated 9 11 1 Discharge Status: 1 = Routine discharge to customary residence 2 = Discharge to observation status 3 = Discharge to recovery care center 4 = Admitted to hospital as inpatient 5 = Surgery cancelled or terminated 6 = Other, specified 9 = Discharge Status Not Stated 10 12-13 2 Month of Surgery: 01 = January to 12 = December 11 14 1 Geographic Region 1 = Northeast 2 = Midwest 3 = South 4 = West 12 15-16 2 Principal Expected Source of Payment 0 = No Charge 1 = Worker’s Compensation 2 = Medicare 3 = Medicaid 4 = CHAMPUS 5 = Other Government Payments 6 = Blue Cross/Blue Shield 7 = HMO/PPO 8 = Other private or commercial insurance 9 = Self Pay 10 = Other, specified 99 = No expected source of payment 13 17-18 2 Other Additional Source of Payment #1: Same coding as Principal ESOP 14 19-20 2 Other Additional Source of Payment #2: Same coding as Principal ESOP 15 21-25 5 Analysis Weight: Use to Obtain Weighted Estimates 16-25 26-35 10 Type of Anesthesia: 10 types/options 1 = Option Checked 0 = Not Checked/Blank 16 26 1 Type of Anesthesia: Topical/Local 17 27 1 Type of Anesthesia: IV Sedation 18 28 1 Type of Anesthesia: Monitored Anesthesia Care 19 29 1 Type of Anesthesia: Regional, Epidural 20 30 1 Type of Anesthesia: Regional, Spinal 21 31 1 Type of Anesthesia Regional, Retrobulbar block 22 32 1 Type of Anesthesia: Regional, Peribulbar block 23 33 1 Type of Anesthesia: Regional, Block 24 34 1 Type of Anesthesia: General 25 35 1 Type of Anesthesia: Other, specified 26-28 36-38 3 Anesthesia Administrator: 3 givers/options 1 = Option Checked 0 = Not checked/Blank 26 36 1 Anesthesia Administrator: Anesthesiologist 27 37 1 Anesthesia Administrator: Certified Registered Nurse Anesthetist 28 38 1 Anesthesia Administrator: Other Surgeon/Physician 29 39-43 5 Diagnosis ICD9-CM ** Code #1 30 44-48 5 Diagnosis ICD9-CM ** Code #2 31 49-53 5 Diagnosis ICD9-CM ** Code #3 32 54-58 5 Diagnosis ICD9-CM ** Code #4 33 59-63 5 Diagnosis ICD9-CM ** Code #5 34 64-68 5 Diagnosis ICD9-CM ** Code #6 35 69-73 5 Diagnosis ICD9-CM ** Code #7 36 74-77 4 Procedure ICD9-CM ** Code #1 37 78-81 4 Procedure ICD9-CM ** Code #2 38 82-85 4 Procedure ICD9-CM ** Code #3 39 86-89 4 Procedure ICD9-CM ** Code #4 40 90-93 4 Procedure ICD9-CM ** Code #5 41 94-97 4 Procedure ICD9-CM ** Code #6 ------------------------------------------------------------------------------------------------------------------ * Ages 100 and over were recoded to 99. ** Codes are in compliance with the International Classification of Diseases, 9th Revision, Clinical Modification, (ICD-9-CM). For diagnosis codes, there is an implied decimal between positions 3 and 4. For V-Codes and E-codes, the implied decimal is between positions 4 and 5. For inapplicable 4th or 5th digits, a dash is inserted. For procedure codes, there is an implied decimal between positions 2 and 3. For inapplicable 3rd or 4th digits, a dash is inserted.APPENDIX ADEFINITION OF TERMSHospitals- Short-stay hospitals or hospitals whose specialty is general (medical or surgical), or children's general. Hospitals must have 6 beds or more staffed for patients use. Federal hospitals and hospital units of institutions are not included.Free- Standing Ambulatory Surgery Centers-Facilities listed in the 1993 Freestanding Outpatient Surgery Center Database and Medicare-certified facilities included in the HCFA Provider-of-Services (POS) file. Facilities specializing in dentistry, podiatry, abortion, family planning, or birthing are excluded.Ambulatory Surgery- Scheduled outpatient surgery performed in any of the following locations: general or main operating room, satelitte operating room, cystoscopy room, endoscopy room, cardiac catherterization lab, laser procedures room.First-listed diagnosis- The coded diagnosis which is listed first on the face sheet of the medical record. The number of first-listed diagnoses is equivalent to the number of ambulatory surgery visits.Procedures- Surgical or nonsurgical operations, procedures, or special treatments listed by the physician on the medical record. In the NSAS, all terms listed on the face sheet (summary sheet) of the medical record under the caption "operation," "operative procedures," "operations and/or special treatment," and the like are transcribed in the order listed. A maximum of six procedures is coded.Rate of procedures- The ratio of the number of procedures during a year to the number of persons in the civilian population on July 1 of that year.Age- The age of the patient on the birthday prior to the date of surgery.Population- Civilian population is the resident population excluding members of the Armed Forces.Geographic region- Hospitals are classified by location in one of the four geographic regions of the United States corresponding to those used by the U.S. Bureau of the Census:
Geographic Region States includedNortheast.............Maine, New Hampshire, Vermont Massachusetts, Rhode Island, Connecticut, New York, New Jersey, and PennsylvaniaMidwest..............Michigan, Ohio, Illinois, Indiana, Wisconsin, Minnesota, Iowa, Missouri, North Dakota, South Dakota, Nebraska, and KansasSouth..................Delaware, Maryland, District of Columbia, Virginia, West Virginia, North Carolina, South Carolina, Georgia, Florida, Kentucky, Tennessee, Alabama, Mississippi, Arkansas, Louisiana, Oklahoma, and TexasWest...................Montana, Idaho, Wyoming, Colorado, New Mexico, Arizona, Utah, Nevada, Washington, Oregon, California, Hawaii, and AlaskaAPPENDIX BThe International Classification of Diseases, 9th Revision, Clinical Modification, which is used for coding NSAS data, undergoes annual updating. Assignment of new diagnostic and procedure codes, fourth and fifth digit expansion of codes, as well as code deletions, are contained in addenda developed by the ICD-9-CM Coordination and Maintenance Committee and approved by the Director of NCHS and the Administrator of the Health Care Financing Administration. Addenda to the ICD-9-CM become effective on October 1 of the calendar year and have been released for 1986 through 1994.As described earlier in this document, all data collected for the 1994 NSAS were coded using the third edition of the ICD-9-CM, which includes the addenda for 1986 through 1993. Although the October 1994 Addendum was available, it was decided not to implement those code changes, since the other nine months of data were coded to the 1993 Addendum. This was done in order to prevent NSAS data users from mistaking partial year estimates for annual estimates.In order to assist users in data retrieval and analysis, a conversion table is provided that shows the date of introduction of each new code and the previously assigned code equivalent, which had been used for reporting the selected diagnosis or procedure prior to issuance of the new code.DIAGNOSIS CODES Effective Current code(s) assignment October 1 Previous code(s) assignment 008.00-008.09 1992 008.0 008.43-008.47 1992 008.49 008.61-008.69 1992 008.6 041.00-041.09 1992 041.0 041.10-041.19 1992 041.1 041.81-041.89 1992 041.8 042.0-042.9 1986 279.19 043.0-043.9 1986 279.19 044.0-044.9 1986 279.19 070.20-070.21 1991 070.2 070.30-070.31 1991 070.3 070.41-070.49 1991 070.4 070.51-070.59 1991 070.5 077.98-077.99 1993 077.9 078.10-078.11,078.19 1993 078.1 078.88 1993 078.89 079.4 1993 079.8 079.50-079.53,079.59 1993 079.8 079.88-079.89 1993 079.8 079.98-079.99 1993 079.9 088.81,088.89 1989 088.8 088.82 1993 088.89 099.40-099.49 1992 099.4 099.50-099.59 1992 078.89 112.84-112.85 1992 112.89 114.4-114.5 1993 114.3 176.0-176.9 1991 173.0-173.9 203.00 1991 203.0 203.01 1991 V10.79 203.10 1991 203.1 203.11 1991 V10.79 203.80 1991 203.8 203.81 1991 V10.79 204.00 1991 204.0 204.01 1991 V10.61 204.10 1991 204.1 204.11 1991 V10.61 204.20 1991 204.2 204.21 1991 V10.61 204.80 1991 204.8 204.81 1991 V10.61 204.90 1991 204.9 204.91 1991 V10.61 205.00 1991 205.0 205.01 1991 V10.62 205.10 1991 205.1 205.11 1991 V10.62 205.20 1991 205.2 205.21 1991 V10.62 205.30 1991 205.3 205.31 1991 V10.62 205.80 1991 205.8 205.81 1991 V10.62 205.90 1991 205.9 205.91 1991 V10.62 206.00 1991 206.0 206.01 1991 V10.63 206.10 1991 206.1 206.11 1991 V10.63 206.20 1991 206.2 206.21 1991 V10.63 206.80 1991 206.8 206.81 1991 V10.63 206.90 1991 206.9 206.91 1991 V10.63 207.00 1991 207.0 207.01 1991 V10.69 207.10 1991 207.1 207.11 1991 V10.69 207.20 1991 207.2 207.21 1991 V10.69 207.80 1991 207.8 207.81 1991 V10.69 208.00 1991 208.0 208.01 1991 V10.60 208.10 1991 208.1 208.11 1991 V10.60 208.20 1991 208.2 208.21 1991 V10.60 208.80 1991 208.8 208.81 1991 V10.60 208.90 1991 208.9 208.91 1991 V10.60 237.70-237.72 1990 237.7 250.02 1993 250.90 250.03 1993 250.91 250.12 1993 250.10 250.13 1993 250.11 250.22 1993 250.20 250.23 1993 250.21 250.32 1993 250.30 250.33 1993 250.31 250.42 1993 250.40 250.43 1993 250.41 250.52 1993 250.50 250.53 1993 250.51 250.62 1993 250.60 250.63 1993 250.61 250.72 1993 250.70 250.73 1993 250.71 250.82 1993 250.80 250.83 1993 250.81 250.92 1993 250.90 250.93 1993 250.91 283.10-283.11,283.19 1993 283.1 320.81-320.89 1992 320.8 337.20-337.22,337.29 1993 337.9 344.81-344.89 1993 344.8 345.00-345.01 1989 345.0 345.10-345.11 1989 345.1 345.40-345.41 1989 345.4 345.50-345.51 1989 345.5 345.60-345.61 1989 345.6 345.70-345.71 1989 345.7 345.80-345.81 1989 345.8 345.90-345.91 1989 345.9 346.00-346.01 1992 346.0 346.10-346.11 1992 346.1 346.20-346.21 1992 346.2 346.80-346.81 1992 346.8 346.90-346.91 1992 346.9 355.71 1993 354.4 355.79 1993 355.7 371.82 1992 371.89 374.87 1990 374.89 403.00-403.01 1989 403.0 403.10-403.11 1989 403.1 403.90-403.91 1989 403.9 404.00-404.03 1989 404.0 404.10-404.13 1989 404.1 404.90-404.93 1989 404.9 410.00-410.02 1989 410.0 410.10-410.12 1989 410.1 410.20-410.22 1989 410.2 410.30-410.32 1989 410.3 410.40-410.42 1989 410.4 410.50-410.52 1989 410.5 410.60-410.62 1989 410.6 410.70-410.72 1989 410.7 410.80-410.82 1989 410.8 410.90-410.92 1989 410.9 411.81 1989 410.9 411.89 1989 411.8 429.71 1989 410.0-410.9 429.79 1989 410.0-410.9 433.00-433.01 1993 433.0 433.10-433.11 1993 433.1 433.20-433.21 1993 433.2 433.30-433.31 1993 433.3 433.80-433.81 1993 433.8 433.90-433.91 1993 433.9 434.00-434.01 1993 434.0 434.10-434.11 1993 434.1 434.90-434.91 1993 434.9 437.7 1992 780.9 440.20-440.22 1992 440.2 440.23 1993 440.20 & 707.1 or 707.8 or 707.9 440.24 1993 440.20 & 785.4 440.29 1993 440.20 441.6 1993 441.1 & 441.3 441.7 1993 441.2 & 441.4 446.20-446.21,446.29 1990 446.2 451.82-451.84 1993 451.89 482.30-482.39 1992 482.3 482.81-482.89 1992 482.8 483.0 1992 483 483.8 1992 483 491.20-491.21 1991 491.2 493.20 1989 493.90 493.21 1989 493.91 518.81 1987 799.1 518.82-518.89 1987 518.8 524.00-524.09 1992 524.0 524.10-524.19 1992 524.1 524.60-524.69 1991 524.6 524.70-524.79 1992 524.8 530.10-530.11, 530.19 1993 530.1 530.18 1993 530.1 530.82-530.84, 530.89 1993 530.8 535.00-535.01 1991 535.0 535.10-535.11 1991 535.1 535.20-535.21 1991 535.2 535.30-535.31 1991 535.3 535.40-535.41 1991 535.4 535.50-535.51 1991 535.5 535.60-535.61 1991 535.6 537.82 1990 537.89 537.83 1991 537.82 562.02 1991 562.00 562.03 1991 562.01 562.12 1991 562.10 562.13 1991 562.11 569.84 1990 557.1 569.85 1991 569.84 596.51-596.53 1992 596.5 596.54 1992 344.61 596.55-596.59 1992 596.5 599.81-599.89 1992 599.8 645.0 1991 645 651.30-651.31,651.33 1989 651.00-651.01,651.03 651.40-651.41,651.43 1989 651.10-651.11,651.13 651.50-651.51,651.53 1989 651.20-651.21,651.23 651.60-651.61,651.63 1989 651.80-651.81,651.83 654.20-654.21,654.23 1990 654.2,654.9 654.90-651.94 1990 654.2,654.9 657.0 1991 657 659.60,659.61,659.63 1992 659.80,659.81,659.83 665.10,665.11 1992 665.10,665.11,665.12,665.14 Note: The title for the subcategory, 665.1 has been changed, making the fifth-digit subclassification, 665.12 and 665.14 invalid. Effective Current code(s) assignment October 1 Previous code(s) assignment 670.0 1991 670 672.0 1991 672 692.72-692.74 1992 692.79 692.82-692.83 1992 692.89 702.0-702.8 1991 702 704.02 1993 704.09 710.5 1992 288.3,729.1 733.10-733.16, 733.19 1993 733.1 738.10-738.19 1992 738.1 747.60-747.64, 747.69 1993 747.6 747.82 1993 747.89 753.10-753.17,753.19 1990 753.1 759.81-759.89 1989 759.8 760.75 1991 760.79 764.00-764.09 1988 764.0 764.10-764.19 1988 764.1 764.20-764.29 1988 764.2 764.90-764.99 1988 764.9 765.00-765.09 1988 765.0 765.10-765.19 1988 765.1 780.01-780.09 1992 780.0 780.03 1993 780.01 780.57 1992 780.51,780.53 788.20-788.21, 788.29 1993 788.2 788.30-788.39 1992 788.3 788.41-788.43 1993 788.4 788.61-788.62, 788.69 1993 788.6 790.91 1993 790.9 790.92 1993 286.9 790.93, 790.99 1993 790.9 795.8 1986 795.7 864.05 1992 864.09 864.15 1992 864.19 925.1-925.2 1993 925 995.60-995.69 1993 995.0 996.51-996.59 1987 996.5 996.60-996.69 1989 996.6 996.70-996.79 1989 996.7 996.80-996.89 1987 996.8 996.85 1990 999.8 V05.3-V05.4 1993 V05.8 V07.4 1992 V07.8 V09.0-V09.91 1993 No previous code assignments V25.43 1992 V25.49 V25.5 1992 V25.8 V29.0-V29.8 1992 V71.8 V29.9 1992 V71.9 V30.00-V30.01 1989 V30.0 V31.00-V31.01 1989 V31.0 V32.00-V32.01 1989 V32.0 V33.00-V33.01 1989 V33.0 V34.00-V34.01 1989 V34.0 V35.00-V35.01 1989 V35.0 V36.00-V36.01 1989 V36.0 V37.00-V37.01 1989 V37.0 V39.00-V39.0l 1989 V39.0 V72.81-V72.85 1993 V72.8 V73.88-V73.89 1993 V73.8 V73.98-V73.99 1993 V73.9 1/ Before October 1986 contents of current code 36.05 would have been assigned to 36.0.2/ Codes 78.90-78.99 were retitled as "Insertion of bone growth stimulator" in October 1987; the previous contents of codes 78.90-78.99 were reassigned to codes 78.40-78.49.3/ Codes 99.71-99.79 were deleted in October 1987; their contents were not transferred elsewhere. In the October 1988 revision, codes 99.71-99.79 were reclassified as "Therapeutic apheresis."
APPENDIX CCivilian Population* by Sex, Age, Geographic Region and Race United States, July 1, 1994[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 258,932 125,836 133,096 Northeast 51,310 24,697 26,622 Midwest 61,290 29,777 31,513 South 89,918 43,391 46,527 West 56,405 27,970 28,435 White 215,375 105,157 110,217 Black 32,405 15,274 17,131 All other 11,152 5,404 5,747 Under 15 years 57,338 29,354 27,985 Under 1 year 3,870 1,981 1,889 1-4 years 15,857 8,114 7,743 5-14 years 37,611 19,260 18,352 Northeast 10,593 5,425 5,168 Midwest 13,513 6,921 6,592 South 19,830 10,142 9,689 West 13,402 6,866 6,536 White 45,510 23,351 22,159 Black 8,921 4,523 4,398 All other 2,908 1,480 1,428 15-44 years 117,585 58,467 59,118 15-24 years 35,397 17,872 17,525 25-34 years 40,811 20,199 20,612 35-44 years 41,377 20,396 20,981 Northeast 23,066 11,430 11,635 Midwest 27,634 13,757 13,877 South 40,671 19,998 20,673 West 26,214 13,281 12,933 White 96,334 48,325 48,009 Black 15,634 7,412 8,223 All other 5,616 2,730 2,886 45-64 years 50,850 24,540 26,311 45-54 years 55-64 years 29,834 14,557 15,277 21,016 9,982 11,034 Northeast Midwest 10,422 4,977 5,446 South 12,035 5,833 6,202 West 17,887 8,570 9,317 10,506 5,160 5,346 White Black 43,780 21,352 22,428 All other 5,170 2,303 2,867 1,901 885 1,015 65 years & over 33,158 13,475 19,683 65-74 years 18,712 8,290 10,422 75-84 years 10,925 4,206 6,719 85 years and over 3,522 980 2,542 Northeast 7,238 2,865 4,373 Midwest 8,107 3,266 4,841 South 11,530 4,681 6,849 West 6,283 2,663 3,620 White 29,751 12,130 17,621 Black 2,680 1,036 1,644 All other 727 309 419 *The NSAS used the civilian noninstitutional population to calculate hospital utilization rates from 1965 through 1980. Beginning in 1981, the civilian resident population has been used to calculate rates. If you have purchased NSAS tapes for years before 1981 and calculated rates using the civilian noninstitutionalized population provided in the documentation, these rates will have to be adjusted to be comparable to 1994 rates using the civilian resident population.Civilian Population of the United States, July 1, 1994. Estimates by Age, Sex, and Region Data are consistent with the estimates announced in Census Advisory CB94-43. Methodology is described in Current Population Report Series P25-1106. Release date 3/15/94 United States Northeast Midwest South West Age Total Male Female Total Male Female Total Male Female Total Male Female Total Male Female _________________________________________________________________________________________________________________________ Civilian Population in Thousands _________________________________________________________________________________________________________________________ All 258,932 125,836 133,096 51,319 24,697 26,622 61,290 29,777 31,513 89,918 43,391 46,527 56,405 27,970 28,4350-14 57,338 29,354 27,985 10,593 5,425 5,168 13,513 6,921 6,592 19,830 10,142 9,689 13,402 6,866 6,536 0-4 19,727 10,094 9,633 3,681 1,885 1,796 4,444 2,274 2,170 6,786 3,471 3,316 4,816 2,465 2,351 5-9 18,859 9,657 9,201 3,533 1,812 1,722 4,471 2,291 2,180 6,494 3,320 3,174 4,360 2,234 2,126 10-14 18,753 9,602 9,150 3,379 1,729 1,650 4,598 2,356 2,242 6,550 3,351 3,199 4,226 2,167 2,05915-44 117,585 58,467 59,118 23,066 11,430 11,635 27,634 13,757 13,877 40,671 19,998 20,673 26,214 13,281 12,933 15-19 17,517 8,951 8,566 3,189 1,624 1,565 4,294 2,194 2,101 6,216 3,162 3,054 3,817 1,972 1,846 20-24 17,880 8,921 8,959 3,433 1,712 1,722 4,235 2,112 2,123 6,340 3,109 3,232 3,871 1,989 1,882 25-29 18,881 9,360 9,521 3,800 1,882 1,918 4,281 2,116 2,165 6,480 3,167 3,314 4,319 2,195 2,124 30-34 21,930 10,838 11,091 4,394 2,169 2,225 5,048 2,495 2,553 7,504 3,665 3,839 4,984 2,509 2,475 35-39 21,771 10,750 11,020 4,355 2,146 2,208 5,135 2,549 2,586 7,415 3,616 3,799 4,865 2,439 2,427 40-44 19,606 9,645 9,961 3,895 1,897 1,997 4,640 2,291 2,349 6,715 3,280 3,435 4,357 2,177 2,18045-64 50,850 24,540 26,311 10,422 4,977 5,446 12,035 5,833 6,202 17,887 8,570 9,317 10,506 5,160 5,346 45-49 16,649 8,152 8,496 3,374 1,630 1,744 3,875 1,901 1,975 5,795 2,827 2,968 3,605 1,795 1,810 50-54 13,186 6,405 6,781 2,701 1,297 1,405 3,114 1,515 1,599 4,625 2,233 2,392 2,745 1,360 1,386 55-59 10,935 5,243 5,692 2,233 1,062 1,171 2,625 1,264 1,361 3,879 1,843 2,036 2,197 1,074 1,123 60-64 10,082 4,739 5,342 2,114 988 1,126 2,421 1,153 1,268 3,588 1,667 1,921 1,959 932 1,02765+ 33,158 13,475 19,683 7,238 2,865 4,373 8,107 3,266 4,841 11,530 4,681 6,849 6,283 2,663 3,620 65-69 9,970 4,500 5,471 2,150 958 1,191 2,383 1,088 1,296 3,531 1,583 1,948 1,907 871 1,035 70-74 8,741 3,790 4,951 1,887 801 1,087 2,073 897 1,176 3,083 1,331 1,752 1,698 761 937 75-79 6,574 2,655 3,919 1,456 569 886 1,625 647 977 2,248 907 1,342 1,245 532 713 80-84 4,351 1,550 2,801 955 328 627 1,092 382 709 1,500 532 969 804 308 496 85+ 3,522 980 2,542 790 209 582 935 251 683 1,167 329 838 629 191 439Civilian Population of the United States, July 1, 1994. Estimates by Age, Sex, and Race (Consistent with the 1990 Census, as enumerated.)All races White Black Other races Age Total Male Female Total Male Female Total Male Female Total Male Female ______________________________________________________________________________________________________________ Civilian Population in Thousands ______________________________________________________________________________________________________________Total 258,932 125,836 133,096 215,375 105,157 110,217 32,405 15,274 17,131 11,152 5,404 5,7470-4 19,727 10,094 9,633 15,592 7,995 7,597 3,119 1,581 1,538 1,017 519 498 0 3,870 1,981 1,889 3,041 1,560 1,481 619 314 305 210 107 103 1 3,878 1,985 1,893 3,060 1,569 1,491 616 313 303 202 103 99 2 3,956 2,023 1,933 3,132 1,604 1,528 619 314 305 205 105 100 3 3,990 2,041 1,949 3,163 1,622 1,541 623 315 308 204 104 100 4 4,032 2,064 1,968 3,195 1,640 1,556 642 325 317 195 100 955-9 18,859 9,657 9,201 14,997 7,695 7,302 2,939 1,491 1,448 923 471 452 5 3,884 1,989 1,894 3,063 1,572 1,491 630 319 311 190 98 93 6 3,792 1,940 1,852 3,011 1,544 1,468 595 302 293 186 95 91 7 3,747 1,917 1,830 2,985 1,531 1,454 582 294 287 180 92 88 8 3,595 1,841 1,754 2,874 1,475 1,399 544 276 268 177 90 87 9 3,841 1,969 1,872 3,063 1,574 1,490 588 299 289 189 96 9310-14 18,753 9,602 9,150 14,921 7,661 7,260 2,864 1,452 1,412 968 490 478 10 3,744 1,920 1,824 2,984 1,535 1,450 567 288 279 192 98 95 11 3,770 1,931 1,840 3,010 1,545 1,465 566 287 279 194 99 96 12 3,768 1,927 1,841 2,994 1,535 1,459 580 294 286 195 98 97 13 3,722 1,903 1,818 2,962 1,519 1,443 562 285 278 197 99 98 14 3,748 1,921 1,828 2,971 1,526 1,444 588 298 289 190 96 9415-19 17,517 8,951 8,566 13,955 7,152 6,803 2,717 1,372 1,345 845 428 417 15 3,602 1,848 1,754 2,849 1,466 1,383 572 291 281 181 92 89 16 3,515 1,808 1,707 2,802 1,444 1,357 544 277 267 169 86 83 17 3,561 1,834 1,726 2,836 1,465 1,371 555 283 272 170 87 83 18 3,324 1,692 1,631 2,657 1,357 1,300 510 256 254 157 79 78 19 3,515 1,769 1,746 2,811 1,420 1,392 536 265 271 168 84 8420-24 17,880 8,921 8,959 14,369 7,212 7,157 2,587 1,248 1,339 924 461 463 20 3,389 1,697 1,692 2,708 1,362 1,346 513 252 262 168 84 84 21 3,397 1,698 1,699 2,703 1,357 1,345 516 252 264 178 89 89 22 3,509 1,751 1,759 2,815 1,413 1,402 510 246 264 184 92 92 23 3,750 1,865 1,885 3,024 1,514 1,510 531 253 278 195 98 97 24 3,834 1,910 1,924 3,118 1,566 1,553 517 245 272 199 99 10025-29 18,881 9,360 9,521 15,368 7,693 7,675 2,558 1,201 1,357 956 466 489 25 3,689 1,837 1,853 3,009 1,511 1,498 488 230 257 192 95 97 26 3,619 1,792 1,826 2,937 1,469 1,468 495 232 262 187 91 95 27 3,721 1,844 1,877 3,032 1,518 1,514 501 235 266 187 91 96 28 3,618 1,788 1,830 2,948 1,471 1,477 491 230 261 179 87 92 29 4,234 2,099 2,136 3,442 1,724 1,718 582 273 310 210 102 10830-34 21,930 10,838 11,091 18,104 9,047 9,056 2,786 1,288 1,497 1,040 503 537 30 4,301 2,126 2,175 3,532 1,765 1,767 562 261 301 207 100 106 31 4,281 2,115 2,166 3,524 1,759 1,765 547 254 293 210 101 109 32 4,382 2,165 2,217 3,625 1,811 1,814 553 255 297 204 99 105 33 4,385 2,158 2,227 3,640 1,813 1,827 540 247 293 205 98 107 34 4,581 2,275 2,306 3,782 1,900 1,882 585 271 313 214 104 111Civilian population in thousands35-39 21,771 10,750 11,020 18,093 9,035 9,059 2,695 1,247 1,448 983 469 514 35 4,480 2,215 2,265 3,711 1,855 1,856 562 261 302 207 100 107 36 4,397 2,170 2,227 3,664 1,828 1,836 537 248 289 196 94 102 37 4,432 2,188 2,244 3,683 1,838 1,845 552 255 297 197 94 103 38 4,019 1,975 2,044 3,348 1,665 1,683 489 225 264 182 85 96 39 4,442 2,202 2,240 3,687 1,848 1,839 554 258 296 200 95 10540-44 19,606 9,645 9,961 16,445 8,186 8,259 2,292 1,056 1,237 869 404 465 40 4,197 2,067 2,130 3,508 1,747 1,761 502 232 270 187 88 99 41 3,991 1,960 2,031 3,349 1,664 1,685 460 210 249 182 85 97 42 3,904 1,920 1,984 3,289 1,637 1,652 449 206 243 167 78 89 43 3,702 1,812 1,890 3,091 1,533 1,559 436 199 236 175 81 94 44 3,813 1,887 1,926 3,208 1,605 1,602 446 208 238 159 73 8645-49 16,649 8,152 8,496 14,222 7,039 7,183 1,737 791 946 690 322 367 45 3,650 1,793 1,857 3,088 1,534 1,554 406 187 219 156 72 84 46 3,542 1,736 1,806 3,030 1,502 1,528 368 167 200 145 67 78 47 3,836 1,880 1,956 3,316 1,642 1,674 374 170 204 146 68 78 48 2,648 1,289 1,360 2,266 1,114 1,151 266 119 147 116 55 62 49 2,972 1,455 1,517 2,523 1,247 1,275 322 147 175 127 60 6650-54 13,186 6,405 6,781 11,350 5,568 5,782 1,339 602 738 497 236 261 50 2,888 1,407 1,481 2,482 1,221 1,261 293 132 161 113 54 59 51 2,930 1,428 1,501 2,548 1,253 1,294 278 126 152 104 49 55 52 2,548 1,237 1,312 2,190 1,074 1,116 263 118 145 95 45 50 53 2,440 1,182 1,258 2,098 1,026 1,072 250 111 138 92 44 48 54 2,380 1,151 1,229 2,032 993 1,039 256 114 141 92 44 4955-59 10,935 5,243 5,692 9,435 4,573 4,863 1,110 487 623 389 183 206 55 2,283 1,098 1,184 1,950 947 1,003 246 110 136 87 41 45 56 2,280 1,095 1,185 1,966 955 1,011 234 102 133 80 38 42 57 2,178 1,043 1,134 1,876 908 968 224 98 126 78 37 41 58 2,021 966 1,055 1,758 849 909 195 85 110 69 32 37 59 2,173 1,041 1,132 1,886 914 972 212 92 119 75 35 4060-64 10,082 4,739 5,342 8,772 4,172 4,601 984 424 560 325 144 181 60 1,981 934 1,046 1,714 817 897 198 86 111 69 31 38 61 1,953 923 1,030 1,693 810 883 194 84 110 66 29 36 62 1,965 921 1,044 1,705 809 896 196 84 112 64 28 36 63 2,065 971 1,094 1,810 861 949 192 82 110 63 28 35 64 2,118 990 1,128 1,850 875 975 204 88 116 65 28 3765-69 9,970 4,500 5,471 8,792 3,998 4,794 906 386 520 273 116 157 65 2,059 948 1,111 1,796 836 960 202 86 116 61 26 35 66 2,071 948 1,124 1,822 839 983 193 85 108 56 24 33 67 2,003 905 1,098 1,765 805 960 184 77 107 54 23 31 68 1,897 845 1,052 1,678 752 926 168 71 96 52 22 30 69 1,940 854 1,086 1,730 766 965 159 67 92 51 21 2970-74 8,741 3,790 4,951 7,840 3,420 4,419 694 279 415 208 91 117 70 1,875 824 1,051 1,674 742 932 153 61 92 48 21 27 71 1,801 786 1,015 1,611 706 904 146 59 86 45 20 25 72 1,811 791 1,020 1,630 716 913 138 56 83 43 19 24 73 1,695 729 966 1,527 661 866 130 52 79 38 16 21 74 1,559 659 899 1,398 594 804 127 51 76 34 14 20Civilian population in thousands75-79 6,574 2,655 3,919 5,949 2,414 3,534 499 188 311 126 53 73 75 1,473 614 859 1,326 555 771 117 47 70 30 12 18 76 1,369 563 806 1,243 513 730 101 39 62 25 10 15 77 1,294 524 770 1,173 478 695 96 36 61 25 11 14 78 1,254 496 758 1,139 453 686 92 33 59 24 10 14 79 1,184 459 725 1,068 415 653 94 34 60 23 10 1380-84 4,351 1,550 2,801 3,962 1,412 2,550 316 107 210 72 31 41 80 1,048 393 655 953 359 594 77 26 51 18 8 10 81 966 352 614 878 321 557 72 24 47 16 7 9 82 855 306 549 783 279 504 58 20 38 14 6 8 83 784 268 516 716 244 471 55 18 37 13 5 7 84 699 232 467 633 209 424 54 18 36 12 5 785+ 3,522 980 2,542 3,209 885 2,324 265 76 188 48 18 300-14 57,338 29,354 27,985 45,510 23,351 22,159 8,921 4,523 4,398 2,908 1,480 1,428 15-44 117,585 58,467 59,118 96,334 48,325 48,009 15,634 7,412 8,223 5,616 2,730 2,886 45-64 50,850 24,540 26,311 43,780 21,352 22,428 5,170 2,303 2,867 1,901 885 1,01515+ 201,593 96,482 105,112 169,865 81,807 88,058 23,484 10,750 12,734 8,244 3,924 4,320 45+ 84,008 38,015 45,994 73,531 33,482 40,049 7,850 3,339 4,511 2,628 1,194 1,434 65+ 33,158 13,475 19,683 29,751 12,130 17,621 2,680 1,036 1,644 727 309 419 75+ 14,446 5,185 9,261 13,120 4,712 8,408 1,080 371 709 247 103 144APPENDIX DUNWEIGHTED FREQUENCIES FOR SELECTED NSAS VARIABLESSURVEY Cumulative Cumulative YEAR Frequency Percent Frequency Percent -------------------------------------------------- 94 117861 100.0 117861 100.0FACILITY Cumulative Cumulative TYPE Frequency Percent Frequency Percent ----------------------------------------------------- 1 71521 60.7 71521 60.7 2 46340 39.3 117861 100.0UNITS FOR Cumulative Cumulative AGE Frequency Percent Frequency Percent ------------------------------------------------------ 1 116089 98.5 116089 98.5 2 1718 1.5 117807 100.0 3 54 0.0 117861 100.0AGE IMPUTATION Cumulative Cumulative FLAG Frequency Percent Frequency Percent ----------------------------------------------------- 1 1056 0.9 1056 0.9 2 116805 99.1 117861 100.0Cumulative Cumulative SEX Frequency Percent Frequency Percent ------------------------------------------------- 1 50941 43.2 50941 43.2 2 66920 56.8 117861 100.0SEX IMPUTATION Cumulative Cumulative FLAG Frequency Percent Frequency Percent ----------------------------------------------------- 1 715 0.6 715 0.6 2 117146 99.4 117861 100.0Cumulative Cumulative RACE Frequency Percent Frequency Percent -------------------------------------------------- 1 58374 49.5 58374 49.5 2 6089 5.2 64463 54.7 3 261 0.2 64724 54.9 4 1417 1.2 66141 56.1 5 1192 1.0 67333 57.1 9 50528 42.9 117861 100.0Cumulative Cumulative DISPOSITION Frequency Percent Frequency Percent ------------------------------------------------------ 1 106588 90.4 106588 90.4 2 2772 2.4 109360 92.8 3 2026 1.7 111386 94.5 4 1551 1.3 112937 95.8 5 98 0.1 113035 95.9 6 1050 0.9 114085 96.8 9 3776 3.2 117861 100.0MONTH OF Cumulative Cumulative SURGERY Frequency Percent Frequency Percent ----------------------------------------------------- 01 8957 7.6 8957 7.6 02 8964 7.6 17921 15.2 03 10717 9.1 28638 24.3 04 9938 8.4 38576 32.7 05 10151 8.6 48727 41.3 06 10528 8.9 59255 50.3 07 9277 7.9 68532 58.1 08 10498 8.9 79030 67.1 09 9550 8.1 88580 75.2 10 9780 8.3 98360 83.5 11 9977 8.5 108337 91.9 12 9524 8.1 117861 100.0Cumulative Cumulative REGION Frequency Percent Frequency Percent ---------------------------------------------------- 1 23991 20.4 23991 20.4 2 27126 23.0 51117 43.4 3 43990 37.3 95107 80.7 4 22754 19.3 117861 100.0PRINCIPAL EXPECTED SOURCE Cumulative Cumulative OF PAYMENT Frequency Percent Frequency Percent ------------------------------------------------------ 00 768 0.7 768 0.7 01 2862 2.4 3630 3.1 02 36521 31.0 40151 34.1 03 8607 7.3 48758 41.4 04 633 0.5 49391 41.9 05 846 0.7 50237 42.6 06 13471 11.4 63708 54.1 07 13669 11.6 77377 65.7 08 27891 23.7 105268 89.3 09 3690 3.1 108958 92.4 10 1991 1.7 110949 94.1 99 6912 5.9 117861 100.0ADDITIONAL Cumulative Cumulative ESOP #1 Frequency Percent Frequency Percent ------------------------------------------------------ 00 14 0.0 14 0.0 01 30 0.1 44 0.1 02 806 2.5 850 2.6 03 3660 11.3 4510 14.0 04 258 0.8 4768 14.8 05 425 1.3 5193 16.1 06 9393 29.1 14586 45.2 07 1336 4.1 15922 49.3 08 12979 40.2 28901 89.6 09 2364 7.3 31265 96.9 10 1008 3.1 32273 100.0Frequency Missing = 85588ADDITIONAL Cumulative Cumulative ESOP #2 Frequency Percent Frequency Percent ------------------------------------------------------ 00 4 1.1 4 1.1 01 1 0.3 5 1.4 03 10 2.8 15 4.2 04 1 0.3 16 4.4 05 6 1.7 22 6.1 06 59 16.4 81 22.5 07 10 2.8 91 25.3 08 110 30.6 201 55.8 09 103 28.6 304 84.4 10 56 15.6 360 100.0Frequency Missing = 117501 WEIGHTED FREQUENCIES FOR SELECTED NSAS VARIABLESSURVEY Cumulative Cumulative YEAR Frequency Percent Frequency Percent -------------------------------------------------- 94 18849556 100.0 18849556 100.0FACILITY Cumulative Cumulative TYPE Frequency Percent Frequency Percent ----------------------------------------------------- 1 15972629 84.7 15972629 84.7 2 2876927 15.3 18849556 100.0UNITS FOR Cumulative Cumulative AGE Frequency Percent Frequency Percent ------------------------------------------------------ 1 18652656 99.0 18652656 99.0 2 189619 1.0 18842275 100.0 3 7281 0.0 18849556 100.0AGE IMPUTATION Cumulative Cumulative FLAG Frequency Percent Frequency Percent ----------------------------------------------------- 1 272188 1.4 272188 1.4 2 18577368 98.6 18849556 100.0Cumulative Cumulative SEX Frequency Percent Frequency Percent ---------------------------------------------------- 1 8178160 43.4 8178160 43.4 2 10671396 56.6 18849556 100.0SEX IMPUTATION Cumulative Cumulative FLAG Frequency Percent Frequency Percent ----------------------------------------------------- 1 103341 0.5 103341 0.5 2 18746215 99.5 18849556 100.0Cumulative Cumulative RACE Frequency Percent Frequency Percent -------------------------------------------------- 1 11409374 60.5 11409374 60.5 2 1118206 5.9 12527580 66.5 3 67768 0.4 12595348 66.8 4 180743 1.0 12776091 67.8 5 138030 0.7 12914121 68.5 9 5935435 31.5 18849556 100.0Cumulative Cumulative DISPOSITION Frequency Percent Frequency Percent ------------------------------------------------------ 1 16887324 89.6 16887324 89.6 2 580532 3.1 17467856 92.7 3 234252 1.2 17702108 93.9 4 310740 1.6 18012848 95.6 5 17498 0.1 18030346 95.7 6 140717 0.7 18171063 96.4 9 678493 3.6 18849556 100.0MONTH OF Cumulative Cumulative SURGERY Frequency Percent Frequency Percent ----------------------------------------------------- 01 1499478 8.0 1499478 8.0 02 1492826 7.9 2992304 15.9 03 1754314 9.3 4746618 25.2 04 1637671 8.7 6384289 33.9 05 1637262 8.7 8021551 42.6 06 1698481 9.0 9720032 51.6 07 1454186 7.7 11174218 59.3 08 1630010 8.6 12804228 67.9 09 1483253 7.9 14287481 75.8 10 1509868 8.0 15797349 83.8 11 1546426 8.2 17343775 92.0 12 1505781 8.0 18849556 100.0Cumulative Cumulative REGION Frequency Percent Frequency Percent ---------------------------------------------------- 1 4232868 22.5 4232868 22.5 2 4896485 26.0 9129353 48.4 3 6251021 33.2 15380374 81.6 4 3469182 18.4 18849556 100.0PRINCIPAL EXPECTED SOURCE Cumulative Cumulative OF PAYMENT Frequency Percent Frequency Percent ------------------------------------------------------ 00 69740 0.4 69740 0.4 01 449207 2.4 518947 2.8 02 5690802 30.2 6209749 32.9 03 1245640 6.6 7455389 39.6 04 92071 0.5 7547460 40.0 05 135824 0.7 7683284 40.8 06 2435412 12.9 10118696 53.7 07 2620924 13.9 12739620 67.6 08 4209070 22.3 16948690 89.9 09 492910 2.6 17441600 92.5 10 399418 2.1 17841018 94.6 99 1008538 5.4 18849556 100.0ADDITONAL Cumulative Cumulative ESOP #1 Frequency Percent Frequency Percent ------------------------------------------------------ 00 1555 0.0 1555 0.0 01 6705 0.1 8260 0.2 02 127199 2.6 135459 2.8 03 535074 11.0 670533 13.8 04 37661 0.8 708194 14.6 05 61531 1.3 769725 15.8 06 1519805 31.3 2289530 47.1 07 236322 4.9 2525852 52.0 08 1813413 37.3 4339265 89.3 09 356499 7.3 4695764 96.6 10 164278 3.4 4860042 100.0Frequency Missing = 13989514ADDITONAL Cumulative Cumulative ESOP #2 Frequency Percent Frequency Percent ------------------------------------------------------ 00 1214 1.6 1214 1.6 01 9 0.0 1223 1.6 03 623 0.8 1846 2.4 04 81 0.1 1927 2.5 05 118 0.2 2045 2.7 06 13346 17.6 15391 20.3 07 1475 1.9 16866 22.3 08 16405 21.7 33271 44.0 09 11834 15.6 45105 59.6 10 30537 40.4 75642 100.0Frequency Missing = 18773914
