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Scientific Data Documentation
Hospital Stays, 1987

NMES87-Hospital.ZIP

This compressed file contains 2 data sets for the NMES 1987 hospital stay data:

DATA
SRC


DATA PURCHASE AND USE AGREEMENT

 Individual identifiers have been removed from the micro-data tapes available
 from the Agency for Health Care Policy and Research through NTIS.
 Nevertheless, under sections 308(d) and 903(c) of the Public Health Service
 Act (42 U.S.C. 242m and 42 U.S.C. 299 a-1), data collected by the Agency for
 Health Care Policy and Research may not be used for any purpose other than
 the purpose for which it was supplied.  The information on the micro-data
 tapes available for purchase was supplied to the Agency for statistical
 summaries and health services research.  It is necessary, therefore, that
 the individual ordering such micro-data tapes sign the following assurance:

 The undersigned gives assurance that individual elementary unit data on the
 micro-data tapes being ordered will be used solely for statistical summaries
 and health services research.


BACKGROUND

 General Information

       This documentation describes one in a series of public use
     tapes issued by the Agency for Health Care Policy and Research
     with data from the National Medical Expenditure Survey.  This
     survey provides extensive information on health expenditures by
     or on behalf of families and individuals, the financing of these
     expenditures, and each person's use of services.  The National
     Medical Expenditure Survey (NMES) is a research project of the
     Center for General Health Services Intramural Research, Agency
     for Health Care Policy and Research.

       Since the 1970s the intramural research program has given
     particular emphasis to studies of the use and financing of health
     services.  The first series of studies (NMES-1) employed data
     collected in the 1977 National Medical Care Expenditure Survey.
     NMES-1 produced information on a broad range of issues such as
     the number and characteristics of the uninsured and the
     underinsured, the tax implications of excluding employer-paid
     premiums for health insurance from employee income, and the
     differences among socioeconomic and demographic groups with
     respect to the use of health services.

       A new series of studies (NMES-2) was initiated in the 1980s.
     These studies also involve a major data collection effort - the
     1987 National Medical Expenditure Survey.  Like its  predecessor,
     NMES-2 provides information about the non-institutionalized
     population.  In addition and in contrast to the earlier studies,
     NMES-2 also provides extensive information on the population
     residing in or admitted to nursing homes and facilities for the
     mentally retarded.

       The Household Component of NMES-2 is based on a national
     probability sample of the civilian, noninstitutionalized
     population living in the community.  The sample is designed to
     provide a larger representation of population groups of special
     policy interest to the Federal Government than would have been
     obtained from a random sample. These groups include poor and low
     income families, the elderly, the functionally impaired, and
     black and Hispanic minorities.  A Survey of American Indians and
     Alaska Natives includes a separate sample of American Indians and
     Alaska Natives living on or near Federal reservations and
     eligible to receive care provided or supported by the Indian
     Health Service. The Institutional Population Component includes a
     sample of persons residing in or admitted to nursing and personal
     care homes and facilities for the mentally retarded during 1987.
     A separate Medicare Records Component provides claims data on all
     Medicare beneficiaries included in the household and
     institutional samples.

       Together, the major components of NMES-2 contain information to
     make national estimates of health status, use of health services,
     insurance coverage, expenditures, and sources of payment for the
     civilian population of the United States during the period from
     January 1 to December 31, 1987.  Oversampling of population
     groups of special interest makes possible in-depth studies of
     these groups.  The database can also be used to assess the
     implications of recent or proposed changes in public or private
     health care benefits, methods of financing both health care and
     insurance coverage, various public and private subsidies for
     health care, and  employee compensation arrangements.

 Household Survey

       Each family in the Household Survey was interviewed four times
     over a period of 16 months to obtain information about the
     family's  health and health care during calendar year 1987.
     Baseline data on household composition, employment, and insurance
     were updated at each interview, and information was obtained on
     illnesses, use of health services, and health expenditures for
     each family member.  A fifth round of interviews was conducted in
     the spring of 1988 to obtain information on the tax filing and
     medical deductions of each household.  A long term care
     supplement was administered during the first and fourth rounds of
     interviewing to permit estimates of persons with functional
     disabilities and the use of formal services or long term care
     provided by family or friends.

       In order to verify and supplement the information provided by
     household respondents, the Household Component of NMES-2
     included two additional surveys. The Medical Provider Survey
     obtained information from the physicians, hospitals, outpatient
     clinics, emergency rooms, and home health agencies used by the
     household sample during 1987.  The Health Insurance Plan Survey
     obtained information on the private insurance of persons in the
     household sample, including premiums paid by all sources and the
     provisions of their coverage.

     Survey of American Indians and Alaska Natives (SAIAN)

       This component was conducted with the same data collection
     instruments and interview procedures as the Household Component
     and covered the same reference period, calendar year 1987.  SAIAN
     also included follow-up surveys to medical providers and health
     insurers.  Consequently, the data can be used to compare American
     Indians and Alaska Natives eligible for care from the Indian
     Health Service and the general U.S. population with regard to
     such issues as health status, use of health services, and access
     to  care.  Information was obtained on services provided outside
     the Indian Health Service and on other sources of health care
     financing available for persons eligible for care from the IHS.

 Institutional Population Component

       The Institutional Population Component of NMES-2 included
     persons resident in or admitted to nursing and personal care
     homes and facilities for the mentally retarded at any time in
     calendar year 1987.  This survey provides information on the
     functional status, use of services, and health expenditures of
     the institutionalized population.  The Survey in Institutions
     (SII) collected data from facility administrators and designated
     staff on the characteristics of facilities and charges.  The
     Survey of Next of Kin (SNK) obtained data from the respondent's
     next-of-kin or other knowledgeable persons in the community on
     the financial status, insurance coverage, and personal history of
     the institutionalized person.

 Survey Samples

       All survey components were designed to provide statistically
     unbiased estimates that are representative of the civilian
     population of the United States in 1987.  The Household Survey
     sample is a stratified multistage area probability design with a
     total sample of roughly 35,000 individuals, in 14,000 households,
     who completed all rounds of data collection.  Oversampling of the
     population subgroups of special policy interest was based on a
     separate screening interview conducted in the fall of 1986 with a
     sample of 36,000 addresses.

       The Survey of American Indians and Alaska Natives adopted a
     multistage area probability sample design using an IHS-
     constructed frame of counties with individuals eligible for
     services provided or supported by the Indian Health Service and
     living on or near Federally recognized reservations or in Alaska.
     An initial screening interview was completed in approximately
     13,700 dwelling units to identify the eligible sample.  The
     screening yielded approximately 1,950 households responding for
     the full year and approximately 6,500 SAIAN persons responded for
     their entire period of eligibility in 1987.

       The institutional population sample was based on a three stage
     probability design. The first two stages were used to select
     facilities; the final stage sampled facility residents present on
     January 1, 1987.  These facilities were also used to obtain a
     sample of admissions between January 1, 1987, and December 31,
     1987.  Based on sampling specifications the Institutional
     Population Component includes 1,500 facilities, 800 nursing homes
     and 700 facilities for the mentally retarded.  There is a total
     of approximately 10,100 persons in the sample including both
     residents and new admissions.  This includes 5,700 persons in
     nursing homes and 4,400 persons in facilities for the mentally
     retarded.  The sample frame for facilities in the Institutional
     Population Component was derived from the 1986 Inventory of Long-
     Term Care Places.

       Taken in conjunction, the NMES-2 surveys yield comprehensive,
     population-based information that will support studies of most
     population groups of policy interest, including those presently
     outside the scope of various public and private financing
     mechanisms.  In contrast to information obtained from program or
     provider statistics, NMES-2 data can be used to analyze all
     public and private sources of coverage for health care services
     and out-of-pocket payments by individuals and families.

       The Agency for Health Care Policy and Research sponsored the
     NMES-2 data collection activities.  A substantial part of the
     support for the Survey of American Indians and Alaska Natives was
     provided by the Indian Health Service.  The Health Care Financing
     Administration, the National Center for Health Statistics, and
     the Office of the Assistant Secretary for Planning and Evaluation
     provided extensive technical assistance during the development of
     the survey design and instruments.  Interviews were conducted by
     the primary contractor, Westat, Inc., Rockville, Maryland and by
     The National Opinion Research Center at the University of
     Chicago; the Council of Energy Resource Tribes, Denver, Colorado;
     and Stephen R. Braund and Associates, Anchorage Alaska.  Data
     processing during the analysis stage of the project is being
     provided by Social and Scientific Systems, Inc., Bethesda,
     Maryland.

       The data were collected under the authorities of the Public
     Health Service Act and are being edited and published in
     accordance with the confidentiality provisions of that Act and
     the Privacy Act.

       Additional information on NMES-2 is available from Daniel C.
     Walden, Ph.D., Director of the Division of Medical Expenditure
     Studies; Center for General Health Services Intramural Research,
     Agency for Health Care Policy and Research; Executive Office
     Center, 2101 E. Jefferson Street, Suite 500, Rockville, MD
     20852.  (301/227-8400).


TECHNICAL AND PROGRAMMINGINFORMATION

 General Information

       This documentation describes one in a series of public use
     tapes from the Household Survey of the 1987 National Medical
     Expenditure Survey (NMES).  The tape provides information and
     related documentation on the use of and expenditures for
     inpatient hospital stays in calendar year 1987.  The data file
     contains one record for each hospital stay for each eligible
     person in the Household Survey who reported having had at least
     one hospital stay during 1987.  In addition to expenditures
     related to the stay, each record contains selected person-level
     demographic information for the respective patient, household
     reported medical conditions and procedures associated with the
     hospitalization, and information on length of stay.

       The data file can be used to construct summary variables of
     expenditures, sources of payment, and related aspects of hospital
     inpatient care.  Information on persons in the Household Survey
     without a hospitalization in 1987 is provided in NMES Public Use
     Tape 13 (Rounds 1-4 Household Survey: Population Characteristics
     and Person-level Utilization), which also contains annual
     person-level information on other health services use as well as
     detailed demographic, employment, insurance, round specific
     eligibility status indicators, and reference period dates for the
     entire civilian noninstitutionalized population.

       The data on this tape are being released as EBCDIC files only.
     The tape also includes an EBCDIC file containing programming
     statements required to create a SAS data set and a SAS format
     library for the data file on the tape.

       The records on this file can be linked to all NMES public use
     tapes from the Household Survey by using the person identifier
     (PIDX).

       The following documentation offers a brief overview of the type
     and level of data provided, the content and structure of the data
     file and the codebook, and programming information.  It contains
     the following sections:

       Data File Contents and Codebook Structure
       Coding, Edits and Imputations
       Variable Naming and Codebook Conventions
       Sample Design, Estimation and Sampling Weights, and Variance
        Estimation
       Programming Information
       References
       Data Dictionary
       Alphabetical and Position Listing of Variables
       Codebook
       Codebook Notes

       More detailed information on NMES survey instruments and data
     collection procedures, variance estimation programs, coding and
     related information, and a list of released NMES Public Use Tapes
     are in Attachments 1 to 5.  Attachment 6 contains a catalogue of
     data items released on this and other NMES public use tapes.  It
     is supplied to guide the user to the appropriate public use tape
     for the data items of interest in the NMES Household Survey.  All
     attachments are provided in hard copy only.

 Data File Contents and Codebook Structure

       This public use tape contains one data file. To expedite
     release of hospital inpatient data and ensure data processing
     efficiency, the file structure generally reflects the structure
     of the household questionnaire (see Attachment 3 for the
     instrument used).  The file contains information on hospital
     stays, household reported main reason for admission and related
     health conditions, length of stay, procedures performed, expenses
     for basic hospital and for inpatient physician services, and
     sources of payment.  These data were obtained in four rounds of
     interviews covering calendar year 1987 and in the NMES Medical
     Provider Survey (see Appendix 1).  The file contains 5,432
     records, or one record for each specific hospital stay by a
     sample person who responded for their entire period of NMES
     eligibility during 1987.  Hospital stays of zero nights (stays
     with the same admission and discharge date) are included.
     Obstetrical stays for deliveries are counted multiple times; one
     for the mother and one for each newborn.

       Each record on the data file contains the following
     information:

               Unique person and record identifiers

               Indicator of the round of data collection

               Selected demographic variables

               Variables based on questionnaire items G1-G77 in the
               hospital inpatient stay booklet.  These include
               household reported conditions associated with the
               hospital stay coded to ICD-9, as well as codes for
               procedures performed, dates of admission and discharge,
               expenses and sources of payment as well as associated
               imputation flags.

               Weight and variance estimation variables

       Detailed information on length of stay is described in Section
     2.1.  Detailed information on coding of medical conditions and
     procedures is provided in Section 2.2.  The construction of the
     expense and source of payment variables and associated imputation
     procedures are described in Section 2.3.  Miscellaneous edits and
     omissions are discussed in Section 2.4.  Additional details for
     selected variables are also provided in the Codebook Notes, which
     immediately follow the codebook.

 Coding, Edits and Imputations

  Length of Stay

       Each record contains two edited variables for length of
     hospital stay (NUMNGHTX and NUMNT87X).  The variable NUMNGHTX
     represents the total number of nights per hospital stay for all
     hospitalizations in 1987, including stays that began in 1986 or
     extended into 1988.  The variable, NUMNT87X, represents only the
     number of nights spent in the hospital in 1987.  The method of
     constructing these variables was the same.

       Hospital stay data were obtained from linked records in the
     NMES Medical Provider Survey (MPS), which obtained provider
     information for hospital stays reported by household respondents
     (see section 4.1.2 and Appendix 1.B).  If MPS length of stay
     information was not available, the length of stay as reported by
     the household respondent was used.  If neither was available,
     length of stay was imputed, based on known values for similar
     hospitalizations.  A weighted sequential hot-deck procedure was
     used to impute data for hospital stays with complete information
     to cases with missing data but similar characteristics.
     Variables with known values were used to form groups of donors
     and groups of recipients.  Within such groups, data from donors
     were assigned to recipients, taking into account the weights
     associated with the complex NMES household survey design.  Source
     data for the imputation were MPS data, when available, or the
     Household Survey otherwise.  Classification variables in this
     imputation were household-reported reason for hospitalization,
     patient residence in the West Census Region versus other regions,
     household reported psychiatric conditions as reason for
     admission, and the number of physicians billing for the stay.
     Age, number of difficulties with activities of daily living,
     perceived general health status, source of payment, and selected
     other conditions were used as sort variables.  The file contains
     a flag (NUMNTFLG and NUM87FLG) for each length of stay variable
     indicating whether length of stay was imputed or obtained from
     the Medical Provider Survey or a household respondent.

  Medical Conditions and Procedures

   Medical Condition Coding

       This file contains up to four condition codes per hospital stay
     record.  Records for normal deliveries and healthy newborn babies
     have no condition codes attached.  For each hospital stay
     reported in the Household Survey, information on reasons for
     hospitalization in terms of related medical conditions, medical
     diagnosis, if any, related history, and parts of the body
     affected by the condition were obtained.  This respondent-
     reported information was used to code each condition for the
     reported hospitalization into one of the codes of the 9th
     Revision of the International Classification of Diseases, revised
     for use in the National Health Interview Survey (NHIS; NCHS,
     1979).  The revision takes into account the experience of the
     National Center for Health Statistics, the sponsor of the NHIS,
     in coding household-reported conditions.  One major revision of
     the ICD-9 coding procedure in surveys using the NHIS system is
     the introduction of X-codes.  These codes represent impairments
     such as blindness, deafness, and paralysis.  Coding instructions
     directed coders to favor X-codes over other ICD-9 codes that
     could be applied to a particular condition.  Attachment 4.A
     provides details of the NHIS coding scheme for X-codes.  It is
     important to note that the condition data on each record and the
     information used to code medical conditions were provided
     exclusively by the household respondent.  Any information
     regarding medical conditions related to the hospital stay that
     was obtained through the Medical Provider Survey (MPS) was not
     merged onto this file.

  Procedure Coding

       This file contains up to 3 procedure codes per record.  For
     each hospital stay reported in the Household Survey, questions
     were asked about operations or surgical procedures performed
     during that stay.  The respondent-reported procedure was used to
     code one of the codes in the 9th Revision of the International
     Classification of Diseases, Clinical Modification, 3 (ICD9-CM3)
     revised for use in the National Health Interview Survey (NHIS;
     NCHS, 1979).  The revision only uses the first two digits of the
     ICD9-CM3 which indicates the body system or region on which the
     procedure was performed.  For miscellaneous diagnostic and
     therapeutic procedures, the code represents a general procedure
     class, for example, "diagnostic radiology" or "physical or
     rehabilitative procedures".  Attachment 4B provides the codes for
     medical procedures.

  Quality Control

       Coding of medical conditions and procedures was conducted by
     trained medical coders.  Two-stage verification of the coding was
     performed first by supervisors and then by trained nosologists.
     Coders were required to maintain an error rate at or below 2
     percent throughout the coding process.  No additional editing or
     imputation was performed on these variables.  Each
     hospitalization record can have up to four ICD-9 condition codes
     (or three procedure codes) attached to it.  The first condition
     (or procedure) on the record does not necessarily reflect the
     primary condition (or procedure) associated with the stay and,
     more generally, the order of the conditions (or procedures) on
     the record does not reflect importance or severity.  In addition,
     there is a small probability that duplicate conditions (or
     procedures) may appear for the same record, since editing for
     duplications was not done.

  Expenses and Sources of Payment

   Expenses

    General Information

       The file contains three expense variables per stay: basic
     hospital facility expenses; expenses for physicians who billed
     separately for any inpatient services provided during the
     hospital stay; and total expenses, which sums facility and
     physician expenses.
       Expenses refer to charges with two exceptions.  First, they
     reflect payments rather than charges when these were reduced to
     the amounts allowed by third-party payers, such as private health
     insurers, Medicare, or Medicaid.  Second, a dollar value was
     assigned to the facility expense variable in all cases and to the
     physician expense variable in some cases where no charge was
     specified.  For example, there is no stated total charge
     (although there may be copayments) for stays by individuals
     insured through an HMO, where care is financed through a prepaid
     capitation payment.  Also, there may have been no specified
     charge for stays financed through government grants, charities,
     and other non-patient related revenue sources.  In these cases,
     an expense value was imputed from the expenses associated with
     otherwise similar stays.  This approach was also used for most
     flat fee arrangements.  An example is a lump-sum charge applied
     to a number of different services, for example, a series of
     outpatient visits associated with an inpatient stay, where there
     was no reasonable method of allocating that charge across each of
     them.  For some obstetrical stays, flat fees for physician
     expenses were allocated across different services.

  Facility Expense

       Both unedited (EXPFAC) and edited (EXPFACX) facility expense
     variables are included on this file.  Hospital facility expenses
     are all expenses for direct hospital care, including room and
     board, diagnostic and laboratory work, x-rays and similar
     charges, as well as any physician services included in the
     hospital charge.  These facility expense data were primarily
     obtained from a linked record in the Medical Provider Survey
     (MPS).  If MPS data were not available, facility expenses as
     reported by the household respondent were used.  Expenses for
     each hospital stay were imputed on a per diem basis where neither
     was available, or for extreme values reported by household
     respondents.  Missing values for facility cost per day were
     imputed, based on known values for similar hospital stays where
     expenses were derived from the Medical Provider Survey (MPS).
     Length of stay, (NUMNGHTX), source of payment, number of
     physicians billing for inpatient services, and SMSA residence
     were used as classification variables.  Sort variables were:
     expected sources of payment, surgery performed during the stay,
     patient age and sex, household reported reason for admission,
     discharge status (live or deceased), residence in the West Census
     Region versus other regions, and admission from the hospital
     emergency room.  The imputed expense per day was then multiplied
     by nights of stay (if NUMNGHTX > 0) to obtain total facility
     expense for that stay.  If NUMNGHTX was zero, then the imputed
     expense per day was used.

  Inpatient Physician Expense

       Each record contains one edited variable for the sum of all
     expenses for physicians who billed for inpatient services linked
     to the hospital stay (EXPDRX).  Because household respondents
     generally do not accurately report expenses for physicians seen
     in conjunction with a hospital stay, charges for these services
     were derived entirely from the Medical Provider Survey (MPS).  A
     zero dollar value for inpatient physician expense was assigned
     for a number of records; this reflects one or more of the
     following:  all physician charges were included in the facility
     expense; the stay was for less than 24 hours with no separate
     physician charges for inpatient visits or for post-surgical
     follow-up; or the record relates to a normal newborn for whom
     physician charges are included on the record for the mother's
     stay.

       In the Medical Provider Survey, physicians who were listed in
     the medical records for a given hospitalization were enumerated
     by specialty and contacted to determine the charges rendered for
     the hospital episode.  When only partial physician charges could
     be obtained for a given hospital stay, the missing elements were
     imputed using the median MPS charge for a physician of that
     specialty.  In cases where no charges were obtained but the
     physicians could be enumerated, a median MPS charge was also used
     to impute physician expenses.  When no MPS data were available
     for a stay, the total physician charge was imputed using the same
     procedures as those described for the facility expense variable.
     An imputation flag indicates for each record whether the
     physician expenditure data were obtained from the MPS or imputed
     using the MPS as the source of data.

   Hospital Expense

       The total hospital expense variable (EXPTOTX) is the sum of
     facility expense plus physican expense for the hospital inpatient
     stay.  Excluded from this total are any expenses for private duty
     nursing in cases where private duty nurses billed separately from
     the hospital.

  Sources of Payment

       Sources of payment were obtained from the Household Survey or
     imputed.  Each record on the file contains constructed variables
     showing the percent of the expense paid by various sources.
     Again, there are two sets of source of payment variables: one for
     hospital facility expense and one for associated inpatient
     physician expense.  Each set contains 9 variables which sum to
     100 percent, corresponding to the percent paid by each of the
     following sources:

               Out of pocket by user or family;

               Private insurance;

               Medicaid;

               Medicare;

               Other Federal (CHAMPUS, CHAMPVA, Supplemental
               Security Income (SSI), Indian Health Service facility
               or contract, Intertribal Council, Alaska Native
               Corporation, Veteran's Administration, any military and
               other federal programs such as free government
               screening services and NIH care);

               Other State and local medical assistance (such as
               community health centers but excluding local and state
               employment related insurance and welfare programs);

               Workman's compensation;

               Free from provider, including professional courtesy and
               bad debt; and

               Other, which includes automobile and car insurance,
               other kinds of insurance not specified, company (where
               the company is not the insurer or employer), school
               (where school is not the insurer or employer), union
               (where union is not the insurer or empoyer), charity,
               friend, foreign government or not otherwise specified.

       Based on household reports of the percent or amount paid by
     each of these sources of payment, the source of payment variables
     were edited and, where necessary, imputed to correct for the
     following:  (1) the household reported payer was incompatible
     with enrollment in public and private insurance programs reported
     for the person; (2) the person was not billed for the
     hospitalization and/or associated physician services so that no
     expense or sources of payment were reported; (3) the sum of the
     reported sources did not equal 100 percent; or (4) the sources of
     payment or the amounts or proportions of the payment were
     partially or completely missing.

       The inpatient physician source of payment variables were
     constructed based upon Household Survey reports of the number of
     physicians providing care.  Assuming that all physicians
     associated with a stay would have similar source of payment
     distributions, the physician source of payment variables for each
     stay were constructed as the average for all physicians
     associated with the stay for whom source of payment data were not
     missing.  When source of payment data were missing for all
     physicians associated with a stay the source of payment data were
     imputed.

       The general imputation strategy used a weighted sequential hot
     deck procedure.  The classification variables used in the source
     of payment imputation for facility and physician included
     insurance coverage, region of residence, month of stay, length of
     stay, whether the respondent had been able to report the charge
     for the hospitalization, and union membership status of the
     primary insured.  In addition, stays missing source of payment
     information and for which the Veteran's Administration was the
     site of care (HINVA = 1 or question G20 = 4), were imputed 100
     percent to the other federal category.  Each record with imputed
     values contains corresponding imputation flags.

  Other Edits and Omissions

       Many of the data items from the hospital inpatient stay booklet
     were omitted from this file because they were components or
     probes used to construct the summary variables provided.  Omitted
     variables were not considered to be of independent analytic
     interest but rather were methodological probes to insure that the
     respondent had provided complete information.  The summary
     variables included on this file reflect all of the components
     collected in the hospital stay section of the questionnaire.

       Unless indicated, all Hospital Stay Booklet variables are
     unedited.  Skip patterns associated with unedited variables have
     not been reconciled.

      No editing was performed on the round indicator that is on this
     file.  Editing was performed on all link variables except
     PLACEIDX (see Codebook Notes section).

       This data file contains 497 records where the length of the
     hospital stay was zero nights (NUMNGHTX = 0).  These records were
     not used in the construction of the person-level hospital
     inpatient use variables on NMES Public Use Tape 13, where they
     were considered hospital outpatient department visits.  (See
     section 4.2.1)

 Variable Naming and Codebook Conventions

       The codebook provides unweighted and weighted frequencies for
     all variables on the file. The codebook contains variable
     information and frequency distributions for a total of 5,432
     records.  Weighted, these records represent 34,436,582 hospital
     inpatient stays by 26,370,883 people (4,051 unweighted persons).

       Complete variable listings in alphabetical order and by file
     position are provided for cross-reference. Most variable
     descriptions in the codebook are abbreviated versions of
     questionnaire items, preceded by indicators of item number.  A
     copy of the hospital inpatient stay booklet is included as
     Attachment 3 to this public use tape to permit a full
     understanding of the content and wording of each item, the
     structure of questionnaire sections, skip patterns and
     administrative information.

       The codebook describes an EBCDIC data set and provides the
     following programming identifiers for each variable:

       IDENTIFIER                       DESCRIPTION

       NAME                   Variable name (maximum of 8
                              characters)

       DESCRIPTION            Variable descriptor (maximum of 40
                              characters)

       FORMAT                 Number of bytes and decimal places

       TYPE                   Type of data:  numeric (indicated by
                              NUM) or character (indicated by CHAR)


       START                  Beginning column position of variable in
                              the record

       END                    Ending column position of variable
                              in the record

       NOTES                  Indicator of an explanatory note(s)
                              corresponding to the variable

       In general, variable names reflect the content of the variable,
     with an 8 character limitation.  For edited versions of original
     variables, the edited variable name is identical to the original
     variable with an "X" appended (and truncated when necessary to
     comply with the 8 character limitation).  For variables
     corresponding to specific questionnaire items, the question
     number is included in the variable label.

       The following reserved code values are used:

       VALUE                            DEFINITION

       -1 INAPPLICABLE        Question was not asked due to skip
                              pattern

       -5 NEVER KNOW          Question was asked and respondent
                              did not know and never will know the
                              answer

       -7 REFUSED             Question was asked and respondent
                              refused to answer the question

       -8 DK                  Question was asked and respondent did
                              not know the answer

       -9 NOT ASCERTAINED     Interviewer did not record the data


 Sample Design, Estimation Procedures, and Sampling Weights

  Sample Design and Response Rates

   Household Survey

       The NMES household survey was designed to produce national
     estimates representative of the civilian noninstitutionalized
     population of the United States as of 1987.  For sample
     selection, the household component of NMES used two independent
     national multistage area samples from Westat, Inc. and the
     National Opinion Research Center at the University of Chicago.
     To improve the quality of the data and to allow for analysis of
     trends during 1987, it was conducted as a panel survey over four
     core rounds of interviewing.

       Sampling specifications required the selection of about 17,500
     households for the first core household interview.  Data were
     obtained for about 86 percent of eligible households in the first
     interview and 80 percent by the fourth interview.  Approximately
     6 percent of all survey participants provided data for only some
     of the time in which they were eligible to respond.  These
     persons were considered total nonrespondents and a standard
     nonresponse weight adjustment was used to account for possible
     selection bias in this respect.  For a detailed description of
     the survey design and of sampling, estimation, and adjustment
     methods see Cohen, DiGaetano, and Waksberg (1991).

  The Medical Provider Survey

       The NMES Medical Provider Survey (MPS) was primarily designed
     to reduce the bias associated with national medical expenditure
     estimates derived from household reported data; this bias is a
     function of item nonresponse and poor quality data.  By selec-
     tively targeting individuals who were most likely to misreport or
     not possess adequate knowledge about their medical expenditures
     and medical care events that were expected to be associated with
     expense data of questionable quality, optimal use could be made
     of medical provider reported data to improve the accuracy of
     national medical expenditure survey estimates.  See Attachment 1B
     for a full discussion of MPS design and response rates.

  Estimation and Sampling Weights

       The application of appropriate sampling weights is essential to
     the derivation of estimates when using this public use file.  The
     weight provided for use with hospital stay data, INCALPER,
     reflects adjustments for complete nonresponse to the NMES survey
     and poststratification to the Census Bureau 1987 Current
     Population Survey (CPS) cross-classified by age, race/ethnicity,
     gender and poverty status.  All persons who were eligible at any
     time during 1987 and responded for the entire period of their
     eligibility have positive INCALPER weights.  Only the 4,051
     persons who have positive INCALPER weights and who had at least
     one hospital stay are represented on this file.  In order to
     produce national estimates related to the frequency, doctor
     expenses, facility expenses, total expenses and sources of
     payment for hospital care, the value in each record contributing
     to the estimates must be multiplied by the weight (INCALPER)
     contained on that record.  It should be noted that the weight,
     INCALPER, can also serve as a person-level estimation weight (see
     NMES Public Use Tape 13).

       For estimates involving persons in the Household Survey not on
     this file (e.g., persons without a hospital stay in 1987) or for
     detailed person-level characteristics of users, including round
     specific eligibility status and reference period dates, the data
     on this file should be merged with NMES Public Use Tape 13 (see
     section 3.3) using the person-level identification variable PIDX.

   Basic Estimates of Utilization and Expenditures

    General Information

       This file is constructed for efficient estimation of
     utilization and expenditures for hospital care.  Such estimates
     include the total number of and expenses for hospital stays.

   Basic Estimates of Utilization

       In order to estimate the total number of hospital stays,
     regardless of the length of the hospital stay, simply sum the
     weight INCALPER across all records.

       This file includes hospital stay records for which the length
     of stay is zero nights (i.e. stay with same day admission and
     discharge).  There are two variables on this file that measure
     the length of a hospital stay (NUMNGHTX and NUMNT87X; see Section
     2.1).  Either of these variables can have a value that indicates
     the length of the hospital stay was zero nights.  In order to
     replicate hospital inpatient utilization data provided on NMES
     Public Use Tape 13, records with zero night stays (specifically
     records with NUMNGHTX = 0) should be excluded from the estimate
     (weighted, the number of hospital stays with at least one night
     in the hospital are 31,225,348, by 24,169,932 people; unweighted
     number of persons are 3,719).  (In order to replicate the
     variable HOSPNGHT on Tape 13, the variable NUMNGHTX should be
     used.)

       It should be noted that on the current file, stays for
     deliveries are counted as multiple stays; one for the mother and
     one for each newborn.  To exclude the 500 newborns (3,690,243
     weighted stays) from the estimate of hospital stays, records with
     RSNINHOS = 5 should be dropped. (However, the expenditure portion
     associated with newborns should be added to the mother's
     expenditures when estimating hospital expenses).

   Basic Estimates of Expenditures

       As an example of a basic expenditure estimate, the mean expense
     for a hospital stay regardless of length should be calculated as
     the weighted sum of the total expenses across all records in the
     file (sum of EXPTOTX x INCALPER) divided by weighted sum of the
     number of stays (sum of INCALPER).  Thus, the numerator is the
     national estimate for total expenses for hospital care and the
     denominator is the population estimate for the total number of
     hospital stays.

       While most hospitalizations began and ended during 1987, there
     are 105 records on this file with admission dates prior to
     January 1, 1987 or with 1988 as the year of discharge.  The
     edited expense variables on this file (EXPDRX, EXPFACX and
     EXPTOTX)  reflect expenses for hospitalization from time of
     admission to time of discharge, regardless of the year (i.e.,
     based on the variable NUMNGHTX).  The variable NUMNT87X
     constrains the length of stay to only those hospital nights which
     occurred during calendar year 1987.  To approximate expenses
     incurred only during 1987, one must first make new expense
     variables by calculating the relevant per night expense (e.g.,
     EXPTOTX/NUMNGHTX) and multiplying by the restricted number of
     nights (NUMNT87X).

       There are some records for newborns on this file with values
     for doctor expense (EXPDRX) of zero because all doctor expenses
     associated with the birth appear on the mother's record.  However
     in all instances the facility expense (EXPFACX) for the newborn
     is on the newborn's record.

       Subsetting to records based on characteristics of interest
     expands the scope of potential estimates.  For example, the
     number of hospital stays of at least one night where the facility
     expense was paid for, totally or in part, by Medicare is
     estimated by summing INCALPER across all records where the length
     of stay (NUMNGHTX) is greater than zero and the Medicare source
     of payment variable (SOPFMCR) is greater than zero.

  Person-Based Ratio Estimates

   Person-Based Ratio Estimates for Persons with Hospital Stays

       When calculating ratio estimates where the denominator is
     persons, not hospital stays, care should be taken to properly
     define and estimate this denominator.  If the estimate of
     interest, for example, is the mean expense for all hospital-
     izations across all persons with hospital stays, the following
     strategy should be considered:  All expenses for a person on this
     file should be summed and a person-level total expense variable
     created (e.g., the variable X).  The mean national estimate would
     then be derived by obtaining the ratio of the weighted sum of
     total expense per person across all unique persons on the file
     (sum of (INCALPER times X)) divided by the weighted number of
     unique persons on the file (sum of INCALPER).  Only one INCALPER
     value for each PIDX (i.e., each person) should contribute to the
     calculation of the sums for both the numerator and the
     denominator.

  Person-Based Ratio Estimates Relative to the Entire Population

       If the ratio relates to the entire population, this file cannot
     be used to calculate the denominator, as only those persons with
     at least one hospital stay are represented on it.  In this case,
     Public Use Tape 13 which has data for all sampled people, must be
     used to estimate persons.  For example, to estimate the
     proportion of persons 65 and over with at least one
     hospitalization for a circulatory disease, the current file is
     used to calculate the numerator and NMES Tape 13 is used to
     calculate the denominator.

 Sampling Weights for Merging Previous Releases of NMES Household
 
   Data with the Current Tape

       There have been several previous releases of NMES Household
     Survey public use data (see Attachment 5).  Unless a variable
     name common to several tapes is provided, the sampling weights
     contained on these tapes are tape-specific.  The tape-specific
     sampling weights reflect minor adjustments to eligibility and
     response indicators due, among other factors, to birth, death, or
     institutionalization among respondents.  Adjustments to the
     weights have also included post-stratification adjustments to
     control for the distribution of the U.S. noninstitutionalized
     population by poverty status and, where appropriate, nonresponse
     adjustments for round-specific supplemental questionnaires (e.g.,
     the health status questionnaires).

       For estimates from a NMES data file that do not require merging
     with variables on other NMES files, the sampling weights provided
     on that tape are the appropriate weights.  When merging a NMES
     household survey tape to another NMES household survey tape, the
     major analytical variable (i.e., the dependent variable)
     determines the correct sampling weight to use.  For example, for
     1987 estimates of hospital use or expenditures (from the present
     household survey tape) using health status variables from NMES
     Public Use Tape 9, the full-year weight, INCALPER, on the present
     tape should be used.  By contrast, the weight HSQACCWT from
     Public Use Tape 9 should be used when the major dependent
     variable is health status and hospital utilization is an
     independent variable.  Three exceptions to this general sampling
     weight and merger rule are noted below.  For details concerning
     the appropriate weight specific to each tape, see the hard copy
     information specific to each tape.

               (1) For estimates of round one data from NMES Public
               Use Tape 3 (preliminary round one person
               characteristics and functional health status data), the
               round one weight (WGTR1PER) provided on NMES Public Use
               Tape 13 should be used.  It should be noted that as a
               result of further response and eligibility edits, not
               all persons with positive round one weights on Tape 3
               will link when merging it to Tape 13.  In those
               instances, an imputation or weighting strategy can be
               developed to adjust for all persons with positive
               WGTR1PER weights.  The preferred approach is to use the
               round one data and the round one weight released on
               NMES Tape 13.

               (2) For point in time estimates of persons with
               activity of daily living and instrumental activity of
               daily living difficulties (Tape 10), the round one or
               four weight (WGTR1PER and WGTR4PER, respectively),
               provided on NMES Tape 13 should be used in all
               instances of merged data regardless of the type of
               analysis.

               (3) NMES Public Use Tape 4, which contains prescribed
               medicine data for the Medicare beneficiary population,
               should not be merged with the current tape (or any
               other NMES public use file) because of adjustments to
               the sampling weights made after the release of Tape 4.

       It should be noted that the sampling weight provided on NMES
     Tape 9 (HSQACCWT) reflects nonresponse adjustments specific to
     the health status questionnaire and access to care supplement
     data on that tape.  This further nonresponse adjustment requires
     additional considerations in merging Tape 9 with the current
     tape.

               (1) When making estimates for data in the current tape,
               the sampling weights provided on the current tape
               should be used.  Since this would include persons not
               on Tape 9 in the analysis, data items from Tape 9 will
               have missing values for these persons.

               (2) When making estimates of health status or access to
               care indicators, the Tape 9 weight, HSQACCWT, should be
               used.  This weight adjusts for the exclusion of persons
               included on the present tape.

  Variance Estimation

       Variance estimates of sample statistics require that the
     complex nature of the NMES Household Survey design be taken into
     account for hypothesis testing and for the construction of
     confidence intervals.  To obtain variance estimates of statistics
     by means of statistical programs that use the Taylor series
     method of variance estimation, variables must be used that denote
     the strata and the primary sampling unit (PSU) within a given
     stratum.  The variables STRATUMX and SPSU are these variables,
     respectively, and are included on the data file.

       There are variance estimation programs that account for the
     complex survey design.  A list of available variance estimation
     programs is produced in Attachment 2.

 Programming Information

       These files are contained on a standard label, 9 track, 6250
     bpi tape.  The specifications for each file on the tape are as
     follows:


     FILE 1:
     Description:   NMES Household Survey Hospital Inpatient Stay Data
                    File
     Dataset Name:  NMES.PUF144.DATA
     Number of Observations:  5,432
     Number of Variables:  74
     Record Length:  400
     Block Size:  16,000
     Record Format:  FB

     FILE 2:
     Description:  Technical and Programming Information and Data
                   Dictionary for the NMES Hospital Inpatient Stay
                   Data File
     Dataset Name:  NMES.PUF144.DOC
     Record Length:  133
     Block Size:  19,950
     Record Format:  FB

     FILE 3:
     Description:  Additional Documentation for SAS Users for the
                   NMES HHS Hospital Inpatient Stay Data File
     Dataset Name:  NMES.PUF144.SRC
     Record Length:  80
     Block Size:  800
     Record Format: FB

       File 1 was created using the SAS (Statistical Analysis System,
     version 5.18) computer software, and converted to EBCDIC format.
     File 2 contains the technical documentation stored as an
     Operating System (OS) EBCDIC file containing ASA carriage control
     characters in the first byte in each record, which will direct
     the line printer to skip lines, begin a new page, etc.  This
     technical documentation can be copied to disk and retrieved on-
     line to view, to modify with a text editor program such as
     WYLBUR, or to make additional copies.  File 3 is an EBCDIC file
     containing the following additional documentation for SAS users:
     INPUT statement to create the SAS file, including a LABEL
     statement; SAS statements which assign a format name to each
     variable; and SAS statements describing formats.


 References

     Cohen, S.B., DiGaetano, R. and Waksberg, J. (1991).  National
       Medical Expenditure Survey:  Sample Design of the 1987
       Household Survey, Methods 3.  AHCPR Pub. No. 91-0037.  DHHS:
       U.S. Public Health Service.

     National Center for Health Statistics (1979).  Medical Coding
       Manual: National Health Interview Survey.  DHHS: U.S. Public
       Health Service.


DATA DICTIONARY

 Alphabetical Listing of Variables

             NMES EVENTS -- HOSPITAL STAYS CODEBOOK
        ALPHABETICAL AND POSITIONAL LISTING OF VARIABLES
                  DATE:       JUNE 1, 1992
         -----ALPHABETICAL LISTING OF VARIABLES-----

  START      END   NAME       DESCRIPTION
  -----      ---   ----       -----------
    142      143   ANYOPER    G16 OPERATION DURING HOSP STAY
    128      129   BABYBORN   G11 DELIVERY DURING HOSPITAL STAY
    140      141   BABYNORM   G14 BABY NORMAL
     51       52   DATEBDD    G2 DATE PID ENTERED HOSPITAL - DAY
     49       50   DATEBMM    G2 DATE PID ENTERED HOSPITAL - MONTH
     53       54   DATEBYY    G2 DATE PID ENTERED HOSPITAL - YEAR
     57       58   DATEEDD    G3 DATE PID LEFT HOSPITAL - DAY
     55       56   DATEEMM    G3 DATE PID LEFT HOSPITAL - MONTH
     59       60   DATEEYY    G3 DATE PID LEFT HOSPITAL - YEAR
      9       11   EN         EVENT NUMBER
     20       31   EVENTIDX   EVENT ID (ODU+PN+EN)
    250      250   EXPDRFLG   IMPUTATION FLAG FOR EDITED DOC EXPENSE
    242      249   EXPDRX     EDITED DOCTOR EXPENSE
    150      158   EXPFAC     G21 ORIGINAL FACILITY CHARGE
    159      167   EXPFACX    EDITED FACILITY EXPENSE/STAY
    168      168   EXPFCFLG   IMPUTATION FLAG FOR EDITED FAC EXPENSE
    335      341   EXPNRS     G62 TOTAL NURSE EXPENSE/STAY
    324      332   EXPTOTX    EDITED TOTAL EXPENSE/HOSPITAL STAY
     71       72   HINVA      G5 HOSPITAL IS A VA FACILITY
    106      109   ICD1       G7/G9/G10/G13/G15 ICD9 CODE-CONDITION 1
    110      113   ICD2       G7/G9/G10/G13/G15 ICD9 CODE-CONDITION 2
    114      117   ICD3       G7/G9/G10/G13/G15 ICD9 CODE-CONDITION 3
    118      121   ICD4       G7/G9/G10/G13/G15 ICD9 CODE-CONDITION 4
    342      343   IHSFAC     G77 HOSPITAL IS IHS OR TRIBE/ANC
    344      355   INCALPER   FULL-YEAR WEIGHT
     34       36   LASTAGE    ED PID AGE AT END OF LAST ELIGIBLE ROUND
    130      131   NORMDELV   G12 NORMAL DELIVERY
     63       65   NUMNGHTX   G4 ED NUMBER OF NIGHTS PER HOSPITAL STAY
     61       62   NUMNIGHT   G4 NUMBER OF NIGHTS PER HOSPITAL STAY
     66       66   NUMNTFLG   IMPUTATION FLAG FOR NUMNGHTX
     67       69   NUMNT87X   ED NUMBR OF 1987 NIGHTS PER HOSPITL STAY
     70       70   NUM87FLG   IMPUTATION FLAG FOR NUMNT87X
    333      334   NURSCARE   G58 SPECIAL/PRIV DUTY NURSE REQUIRED
      1        5   ODUX       ORIGINAL DWELLING UNIT OF PERSON
     12       19   PIDX       PERSON ID (ODU+PN)
     41       48   PLACEIDX   G1 ID OF FACILITY
      6        8   PN         PERSON NUMBER
    105      105   PREGFLG    STAY RELATED TO PREGNANCY
    132      139   PREGIDX    PREGNANCY ID (ODU+COUNTER)
    122      123   PROCODE1   G8 1ST PROCEDURE CODE
    124      125   PROCODE2   G8 2ND PROCEDURE CODE
    126      127   PROCODE3   G8 3RD PROCEDURE CODE
    144      145   PROCODE4   G17 1ST PROCEDURE CODE
    146      147   PROCODE5   G17 2ND PROCEDURE CODE
    148      149   PROCODE6   G17 3RD PROCEDURE CODE
     39       39   RACE3      PID RACE/ETHNICITY
     38       38   RACE6      ED PID RACE
     32       33   ROUND      DATA COLLECTION ROUND
     75      104   RSNHOSOS   G6 OTHER REASON FOR ADMISSION
     73       74   RSNINHOS   G6 MAIN REASON FOR ADMISSION
     37       37   SMPSEXR    PID SEX
    315      322   SOPDFFP    PCT PAYMENT FREE FROM PROVIDER-DR EXP
    323      323   SOPDFLG    IMPUTATN FLG FOR SOURC PAYM INFO-DOC EXP
    275      282   SOPDMCD    PCT PAYMENT FROM MEDICAID-DR EXP
    267      274   SOPDMCR    PCT PAYMENT FROM MEDICARE-DR EXP
    283      290   SOPDOTFD   PCT PAYMENT FROM OTHER FEDERAL-DR EXP
    307      314   SOPDOTHR   PCT PAYMENT FROM OTHER-DR EXP
    291      298   SOPDOTST   PCT PAYMENT FROM OTHER STATE-DR EXP
    259      266   SOPDPRVT   PCT PAYMENT FROM PRIVATE INSUR-DR EXP
    251      258   SOPDSELF   PCT PAYMENT FROM SELF OR FAMILY-DR EXP
    299      306   SOPDWC     PCT PAYMENT FROM WORKERS COMP-DR EXP
    233      240   SOPFFFP    PCT PAYMENT FREE FROM PROVIDER-FAC EXP
    241      241   SOPFFLG    IMPUTATN FLG FOR SOURC PAYM INFO-FAC EXP
    193      200   SOPFMCD    PCT PAYMENT FROM MEDICAID-FAC EXP
    185      192   SOPFMCR    PCT PAYMENT FROM MEDICARE-FAC EXP
    201      208   SOPFOTFD   PCT PAYMENT FROM OTHER FEDERAL-FAC EXP
    225      232   SOPFOTHR   PCT PAYMENT FROM OTHER-FAC EXP
    209      216   SOPFOTST   PCT PAYMENT FROM OTHER STATE-FAC EXP
    177      184   SOPFPRVT   PCT PAYMENT FROM PRIVATE INSUR-FAC EXP
    169      176   SOPFSELF   PCT PAYMENT FROM SELF OR FAMILY-FAC EXP
    217      224   SOPFWC     PCT PAYMENT FROM WORKERS COMP-FAC EXP
    359      359   SPSU       PSEUDO PSU
     40       40   SREGION    PID CENSUS REGION
    356      358   STRATUMX   SAMPLING STRATUM

 Positional Listing of Variables

           NMES EVENTS -- HOSPITAL STAYS CODEBOOK
      ALPHABETICAL AND POSITIONAL LISTING OF VARIABLES
                  DATE:       JUNE 1, 1992
         -----POSITIONAL LISTING OF VARIABLES-----

  START      END   NAME       DESCRIPTION
  -----      ---   ----       -----------
      1        5   ODUX       ORIGINAL DWELLING UNIT OF PERSON
      6        8   PN         PERSON NUMBER
      9       11   EN         EVENT NUMBER
     12       19   PIDX       PERSON ID (ODU+PN)
     20       31   EVENTIDX   EVENT ID (ODU+PN+EN)
     32       33   ROUND      DATA COLLECTION ROUND
     34       36   LASTAGE    ED PID AGE AT END OF LAST ELIGIBLE ROUND
     37       37   SMPSEXR    PID SEX
     38       38   RACE6      ED PID RACE
     39       39   RACE3      PID RACE/ETHNICITY
     40       40   SREGION    PID CENSUS REGION
     41       48   PLACEIDX   G1 ID OF FACILITY
     49       50   DATEBMM    G2 DATE PID ENTERED HOSPITAL - MONTH
     51       52   DATEBDD    G2 DATE PID ENTERED HOSPITAL - DAY
     53       54   DATEBYY    G2 DATE PID ENTERED HOSPITAL - YEAR
     55       56   DATEEMM    G3 DATE PID LEFT HOSPITAL - MONTH
     57       58   DATEEDD    G3 DATE PID LEFT HOSPITAL - DAY
     59       60   DATEEYY    G3 DATE PID LEFT HOSPITAL - YEAR
     61       62   NUMNIGHT   G4 NUMBER OF NIGHTS PER HOSPITAL STAY
     63       65   NUMNGHTX   G4 ED NUMBER OF NIGHTS PER HOSPITAL STAY
     66       66   NUMNTFLG   IMPUTATION FLAG FOR NUMNGHTX
     67       69   NUMNT87X   ED NUMBR OF 1987 NIGHTS PER HOSPITL STAY
     70       70   NUM87FLG   IMPUTATION FLAG FOR NUMNT87X
     71       72   HINVA      G5 HOSPITAL IS A VA FACILITY
     73       74   RSNINHOS   G6 MAIN REASON FOR ADMISSION
     75      104   RSNHOSOS   G6 OTHER REASON FOR ADMISSION
    105      105   PREGFLG    STAY RELATED TO PREGNANCY
    106      109   ICD1       G7/G9/G10/G13/G15 ICD9 CODE-CONDITION 1
    110      113   ICD2       G7/G9/G10/G13/G15 ICD9 CODE-CONDITION 2
    114      117   ICD3       G7/G9/G10/G13/G15 ICD9 CODE-CONDITION 3
    118      121   ICD4       G7/G9/G10/G13/G15 ICD9 CODE-CONDITION 4
    122      123   PROCODE1   G8 1ST PROCEDURE CODE
    124      125   PROCODE2   G8 2ND PROCEDURE CODE
    126      127   PROCODE3   G8 3RD PROCEDURE CODE
    128      129   BABYBORN   G11 DELIVERY DURING HOSPITAL STAY
    130      131   NORMDELV   G12 NORMAL DELIVERY
    132      139   PREGIDX    PREGNANCY ID (ODU+COUNTER)
    140      141   BABYNORM   G14 BABY NORMAL
    142      143   ANYOPER    G16 OPERATION DURING HOSP STAY
    144      145   PROCODE4   G17 1ST PROCEDURE CODE
    146      147   PROCODE5   G17 2ND PROCEDURE CODE
    148      149   PROCODE6   G17 3RD PROCEDURE CODE
    150      158   EXPFAC     G21 ORIGINAL FACILITY CHARGE
    159      167   EXPFACX    EDITED FACILITY EXPENSE/STAY
    168      168   EXPFCFLG   IMPUTATION FLAG FOR EDITED FAC EXPENSE
    169      176   SOPFSELF   PCT PAYMENT FROM SELF OR FAMILY-FAC EXP
    177      184   SOPFPRVT   PCT PAYMENT FROM PRIVATE INSUR-FAC EXP
    185      192   SOPFMCR    PCT PAYMENT FROM MEDICARE-FAC EXP
    193      200   SOPFMCD    PCT PAYMENT FROM MEDICAID-FAC EXP
    201      208   SOPFOTFD   PCT PAYMENT FROM OTHER FEDERAL-FAC EXP
    209      216   SOPFOTST   PCT PAYMENT FROM OTHER STATE-FAC EXP
    217      224   SOPFWC     PCT PAYMENT FROM WORKERS COMP-FAC EXP
    225      232   SOPFOTHR   PCT PAYMENT FROM OTHER-FAC EXP
    233      240   SOPFFFP    PCT PAYMENT FREE FROM PROVIDER-FAC EXP
    241      241   SOPFFLG    IMPUTATN FLG FOR SOURC PAYM INFO-FAC EXP
    242      249   EXPDRX     EDITED DOCTOR EXPENSE
    250      250   EXPDRFLG   IMPUTATION FLAG FOR EDITED DOC EXPENSE
    251      258   SOPDSELF   PCT PAYMENT FROM SELF OR FAMILY-DR EXP
    259      266   SOPDPRVT   PCT PAYMENT FROM PRIVATE INSUR-DR EXP
    267      274   SOPDMCR    PCT PAYMENT FROM MEDICARE-DR EXP
    275      282   SOPDMCD    PCT PAYMENT FROM MEDICAID-DR EXP
    283      290   SOPDOTFD   PCT PAYMENT FROM OTHER FEDERAL-DR EXP
    291      298   SOPDOTST   PCT PAYMENT FROM OTHER STATE-DR EXP
    299      306   SOPDWC     PCT PAYMENT FROM WORKERS COMP-DR EXP
    307      314   SOPDOTHR   PCT PAYMENT FROM OTHER-DR EXP
    315      322   SOPDFFP    PCT PAYMENT FREE FROM PROVIDER-DR EXP
    323      323   SOPDFLG    IMPUTATN FLG FOR SOURC PAYM INFO-DOC EXP
    324      332   EXPTOTX    EDITED TOTAL EXPENSE/HOSPITAL STAY
    333      334   NURSCARE   G58 SPECIAL/PRIV DUTY NURSE REQUIRED
    335      341   EXPNRS     G62 TOTAL NURSE EXPENSE/STAY
    342      343   IHSFAC     G77 HOSPITAL IS IHS OR TRIBE/ANC
    344      355   INCALPER   FULL-YEAR WEIGHT
    356      358   STRATUMX   SAMPLING STRATUM
    359      359   SPSU       PSEUDO PSU

 Codebook

  General Information

              NMES EVENTS -- HOSPITAL STAYS CODEBOOK
                     DATE:       JUNE 1, 1992
                     ________________________

 THIS CODEBOOK PROVIDES UNWEIGHTED AND WEIGHTED FREQUENCIES FOR THE
 USE OF HOSPITAL SERVICES FOR CALENDAR YEAR 1987.  THE DATA FILE
 CONTAINS ONE RECORD PER HOSPITAL STAY FOR EACH PERSON IN THE
 HOUSEHOLD SURVEY WHO REPORTED HAVING HAD A HOSPITAL STAY BEGINNING
 OR TERMINATING IN CALENDAR YEAR 1987.  ALL STAYS INVOLVING
 DELIVERIES HAVE MULTIPLE RECORDS, ONE FOR THE MOTHER AND ONE
 FOR EACH CHILD.  BASIC DEMOGRAPHIC INFORMATION FOR EACH PATIENT,
 MAIN REASON FOR ADMISSION AND ADDITIONAL CONDITIONS AS REPORTED
 IN THE HOUSEHOLD SURVEY, LENGTH OF STAY, AND ALL HOSPITAL EXPENSES
 AND SOURCES OF PAYMENT INCLUDING THOSE FOR INPATIENT PHYSICIAN CARE
 ARE INCLUDED ON EACH RECORD.  FOR VARIABLES CORRESPONDING DIRECTLY
 TO QUESTIONNAIRE ITEMS, THE ITEM NUMBER IS PROVIDED IN THE VARIABLE
 DESCRIPTOR, WHICH ALSO IDENTIFIES EDITED VARIABLES.  FOR VARIABLES
 WITH AN ASTERISK IN THE RIGHTMOST COLUMN, EXPLANATORY NOTES ARE
 PROVIDED AT THE END OF THE CODEBOOK IN ALPHABETICAL ORDER OF THE
 VARIABLE NAME.  TO OBTAIN NATIONAL ESTIMATES FOR THE VARIABLES ON
 THIS FILE, THE WEIGHT DESCRIBED AT THE END OF THIS CODEBOOK MUST
 BE USED.  INFORMATION CONSERNING SAMPLE DESIGN AND ESTIMATION IS
 PROVIDED IN THE FILE DOCUMENTATION.

 Variable Positions 1-55

 NAME       DESCRIPTION                   FORMAT  TYPE  START    END     NOTE
 ----       -----------                   ------  ----  -----    ---     ----
 ODUX       ORIG DWELG UNIT OF PERSON        5.0   NUM      1      5
                     VALUE            UNWEIGHTED     WEIGHTED BY INCALPER
                     20001-37615           5,432               34,436,582
                     TOTAL                 5,432               34,436,582

 PN         PERSON NUMBER                 3.0   NUM      6      8
                     VALUE            UNWEIGHTED     WEIGHTED BY INCALPER
                     10-266                5,432               34,436,582
                     TOTAL                 5,432               34,436,582

 EN         EVENT NUMBER                  3.0   NUM      9     11       *
                     VALUE            UNWEIGHTED     WEIGHTED BY INCALPER
                     11-813                5,432               34,436,582
                     TOTAL                 5,432               34,436,582

 PIDX       PERSON ID (ODU+PN)            8.0  CHAR     12     19
                     VALUE            UNWEIGHTED     WEIGHTED BY INCALPER
                     VALID PERSON ID       5,432               34,436,582
                     TOTAL                 5,432               34,436,582

 EVENTIDX   EVENT ID (ODU+PN+EN)          12.0  CHAR     20     31       *
                     VALUE            UNWEIGHTED     WEIGHTED BY INCALPER
                     VALID EVENT ID        5,432               34,436,582
                     TOTAL                 5,432               34,436,582

 ROUND      DATA COLLECTION ROUND         2.0   NUM     32     33       *
                     VALUE            UNWEIGHTED     WEIGHTED BY INCALPER
                     -9 NOT ASCERTAIN         59                  378,632
                      1                    1,243                7,955,273
                      2                    1,989               12,549,603
                      3                    1,231                7,736,197
                      4                      910                5,816,876
                     TOTAL                 5,432               34,436,582

 LASTAGE    ED PID AGE AT END LT ELIG RD  3.0   NUM     34     36       *
                     VALUE            UNWEIGHTED     WEIGHTED BY INCALPER
                      0-17                   956                6,775,785
                     18-44                 1,504               11,048,156
                     45-64                   999                7,238,212
                     65+                   1,973                9,374,429
                     TOTAL                 5,432               34,436,582

 SMPSEXR    PID SEX                       1.0   NUM     37     37
                     VALUE            UNWEIGHTED     WEIGHTED BY INCALPER
                     1 MALE                2,133               13,720,333
                     2 FEMALE              3,299               20,716,249
                     TOTAL                 5,432               34,436,582

 RACE6      ED PID RACE                   1.0   NUM     38     38       *
                     VALUE            UNWEIGHTED     WEIGHTED BY INCALPER
                     1 AMER INDIAN            41                  263,524
                     3 ASIAN/PACIFIC          45                  401,154
                     4 BLACK               1,136                4,575,130
                     5 WHITE               4,057               28,359,769
                     6 OTHER                 153                  837,004
                     TOTAL                 5,432               34,436,582

 RACE3      PID RACE/ETHNICITY            1.0   NUM     39     39       *
                     VALUE            UNWEIGHTED     WEIGHTED BY INCALPER
                     1 HISPANIC              421                2,120,285
                     2 BLACK NONHISP       1,132                4,556,718
                     3 OTHER               3,879               27,759,578
                     TOTAL                 5,432               34,436,582

 SREGION    PID CENSUS REGION             1.0   NUM     40     40
                     VALUE            UNWEIGHTED     WEIGHTED BY INCALPER
                     1 NORTHEAST           1,059                6,966,252
                     2 MIDWEST             1,390                9,006,066
                     3 SOUTH               2,050               12,442,611
                     4 WEST                  933                6,021,652
                     TOTAL                 5,432               34,436,582

 PLACEIDX   G1 ID OF FACILITY             8.0  CHAR     41     48
                     VALUE            UNWEIGHTED     WEIGHTED BY INCALPER
                      VALID PLACE ID       5,432               34,436,582
                     TOTAL                 5,432               34,436,582

 DATEBMM    G2 DATE PID ENTERED HOSP-MNTH 2.0   NUM     49     50
                     VALUE            UNWEIGHTED     WEIGHTED BY INCALPER
                     -9 NOT ASCERTAIN         15                   79,404
                     -8 DON'T KNOW             8                   34,907
                     -5 NEVER KNOW             2                    5,512
                      1 JANUARY              480                3,069,914
                      2 FEBRUARY             429                2,633,507
                      3 MARCH                473                3,005,815
                      4 APRIL                467                2,950,052
                      5 MAY                  444                2,843,070
                      6 JUNE                 426                2,760,088
                      7 JULY                 484                3,113,523
                      8 AUGUST               410                2,628,548
                      9 SEPTEMBER            414                2,689,164
                     10 OCTOBER              448                2,838,573
                     11 NOVEMBER             451                2,794,959
                     12 DECEMBER             481                2,989,543
                     TOTAL                 5,432               34,436,582

 DATEBDD    G2 DATE PID ENTERED HOSP-DAY  2.0   NUM     51     52
                     VALUE            UNWEIGHTED     WEIGHTED BY INCALPER
                     -9 NOT ASCERTAIN         33                  172,678
                     -8 DON'T KNOW           128                  639,265
                     -5 NEVER KNOW            31                  146,935
                      1-31                 5,240               33,477,702
                     TOTAL                 5,432               34,436,582

 DATEBYY    G2 DATE PID ENTERED HOSP-YR   2.0   NUM     53     54
                     VALUE            UNWEIGHTED     WEIGHTED BY INCALPER
                     -9 NOT ASCERTAIN         12                   61,191
                     -8 DON'T KNOW             2                   10,196
                     -5 NEVER KNOW             1                    3,846
                      85                       1                    8,465
                      86                      66                  408,813
                      87                   5,350               33,944,069
                     TOTAL                 5,432               34,436,582

 DATEEMM    G3 DATE PID LEFT HOSP-MNTH    2.0   NUM     55     56
                     VALUE            UNWEIGHTED     WEIGHTED BY INCALPER
                     -9 NOT ASCERTAIN        125                  826,365
                     -8 DON'T KNOW            12                   60,658
                     -5 NEVER KNOW             7                   26,462
                      1 JANUARY              477                3,073,297
                      2 FEBRUARY             406                2,490,604
                      3 MARCH                456                2,881,388
                      4 APRIL                472                2,997,258
                      5 MAY                  449                2,837,850
                      6 JUNE                 417                2,718,414
                      7 JULY                 456                2,956,253
                      8 AUGUST               414                2,639,498
                      9 SEPTEMBER            397                2,510,957
                     10 OCTOBER              442                2,899,864
                     11 NOVEMBER             419                2,606,863
                     12 DECEMBER             429                2,621,110
                     95 STILL IN HOSP         54                  289,742
                     TOTAL                 5,432               34,436,582

 Variable Positions 57-110

 NAME       DESCRIPTION                   FORMAT  TYPE  START    END     NOTE
 ----       -----------                   ------  ----  -----    ---     ----
 DATEEDD    G3 DATE PID LEFT HOSP-DAY        2.0   NUM     57     58
                     VALUE            UNWEIGHTED     WEIGHTED BY INCALPER
                     -9 NOT ASCERTAIN        153                  992,915
                     -8 DON'T KNOW           123                  632,386
                     -5 NEVER KNOW            29                  137,372
                     -1 INAPPLICABLE          54                  289,742
                      1-31                 5,073               32,384,167
                     TOTAL                 5,432               34,436,582

 DATEEYY    G3 DATE PID LEFT HOSP-YEAR    2.0   NUM     59     60
                     VALUE            UNWEIGHTED     WEIGHTED BY INCALPER
                     -9 NOT ASCERTAIN         58                  345,513
                     -5 NEVER KNOW             2                    9,699
                     -1 INAPPLICABLE          54                  289,742
                      87                   5,298               33,671,285
                      88                      20                  120,344
                     TOTAL                 5,432               34,436,582

 NUMNIGHT   G4 # OF NIGHTS PER HOSP STAY  2.0   NUM     61     62
                     VALUE            UNWEIGHTED     WEIGHTED BY INCALPER
                     -9 NOT ASCERTAIN        160                1,036,417
                     -8 DON'T KNOW            35                  160,347
                     -1 INAPPLICABLE       5,067               32,367,319
                      0                       18                   79,879
                      1-2                     39                  236,147
                      3-5                     41                  220,318
                      6-10                    42                  207,915
                      11+                     30                  128,240
                     TOTAL                 5,432               34,436,582

 NUMNGHTX   G4 ED # OF NIGHTS PER HOSP STAY 3.0   NUM     63     65     *
                     VALUE            UNWEIGHTED     WEIGHTED BY INCALPER
                      0                      497                3,211,233
                      1-2                  1,362                9,327,856
                      3-5                  1,729               11,281,755
                      6-10                 1,003                5,833,612
                      11+                    841                4,782,125
                     TOTAL                 5,432               34,436,582

 NUMNTFLG   IMPUTATION FLAG FOR NUMNGHTX  1.0   NUM     66     66
                     VALUE            UNWEIGHTED     WEIGHTED BY INCALPER
                     1 FROM HS             2,676               16,619,031
                     2 FROM MPS            2,599               16,846,690
                     3 IMPUTED               157                  970,861
                     TOTAL                 5,432               34,436,582

 NUMNT87X   ED # OF 1987 NIGHTS PER HOSP STAY 3.0   NUM     67     69   *
                     VALUE            UNWEIGHTED     WEIGHTED BY INCALPER
                      0                      496                3,195,361
                      1-2                  1,392                9,531,367
                      3-5                  1,727               11,253,768
                      6-10                   995                5,788,533
                      11+                    822                4,667,553
                     TOTAL                 5,432               34,436,582

 NUM87FLG   IMPUTATION FLAG FOR NUMNT87X  1.0   NUM     70     70
                     VALUE            UNWEIGHTED     WEIGHTED BY INCALPER
                     1 FROM HS             2,627               16,379,465
                     2 FROM MPS            2,650               17,105,529
                     3 IMPUTED               155                  951,588
                     TOTAL                 5,432               34,436,582

 HINVA      G5 HOSPITAL IS A VA FACILITY  2.0   NUM     71     72
                     VALUE            UNWEIGHTED     WEIGHTED BY INCALPER
                     -9 NOT ASCERTAIN         60                  376,225
                     -1 INAPPLICABLE       4,700               29,661,930
                      1 YES                  112                  646,242
                      2 NO                   560                3,752,185
                     TOTAL                 5,432               34,436,582

 RSNINHOS   G6 MAIN REASON FOR ADMISSION  2.0   NUM     73     74       *
                     VALUE            UNWEIGHTED     WEIGHTED BY INCALPER
                     -9 NOT ASCERTAIN         30                  187,518
                     -1 INAPPLICABLE          31                  156,786
                      1 MEDICAL CONDT      2,464               14,521,352
                      2 OPER/SURG PRO      1,473                9,416,604
                      3 DIAGNOSTC TES        276                1,724,698
                      4 TO HAVE A BAB        508                3,751,830
                      5 CHILD BORN           500                3,690,243
                     91 OTHER                150                  987,551
                     TOTAL                 5,432               34,436,582

 RSNHOSOS   G6 OTHER REASON FOR ADMISSION  30.0  CHAR     75    104     *
                     VALUE            UNWEIGHTED     WEIGHTED BY INCALPER
                     -1 INAPPLICABLE       5,282               33,449,031
                     -8 DON'T KNOW             1                   10,124
                     -9 NOT ASCERTAIN          2                   12,744
                        TEXT FIELD           147                  964,683
                     TOTAL                 5,432               34,436,582

 PREGFLG    STAY RELATED TO PREGN         1.0   NUM    105    105       *
                     VALUE            UNWEIGHTED     WEIGHTED BY INCALPER
                     1 YES                 1,105                8,101,302
                     2 NO                  4,327               26,335,280
                     TOTAL                 5,432               34,436,582

 ICD1       G7/G9/G10/G13/G15 ICD9 CODE-COND1    4.0  CHAR    106    109
                     VALUE            UNWEIGHTED     WEIGHTED BY INCALPER
                     -1 INAPPLICABLE         920                6,673,222
                     -9 NOT ASCERTAIN         44                  248,181
                        V001-V999            125                  823,694
                        X00X-X999            124                  778,025
                        0001-9999          4,219               25,913,459
                     TOTAL                 5,432               34,436,582

 ICD2       G7/G9/G10/G13/G15 ICD9 CODE-COND 2   4.0  CHAR    110    113
                     VALUE            UNWEIGHTED     WEIGHTED BY INCALPER
                     -1 INAPPLICABLE       4,908               31,375,257
                     -9 NOT ASCERTAIN         44                  248,181
                        V001-V999              4                   29,417
                        X00X-X999             16                   69,427
                        0001-9999            460                2,714,300
                     TOTAL                 5,432               34,436,582

 Variable Positions 114-150

 NAME       DESCRIPTION                   FORMAT  TYPE  START    END     NOTE
 ----       -----------                   ------  ----  -----    ---     ----
 ICD3       G7/G9/G10/G13/G15 ICD9 CODE-COND3 4   CHAR    114    117
                     VALUE            UNWEIGHTED     WEIGHTED BY INCALPER
                     -1 INAPPLICABLE       5,280               33,593,312
                     -9 NOT ASCERTAIN         44                  248,181
                        X00X-X999              2                   10,373
                        0001-9999            106                  584,716
                     TOTAL                 5,432               34,436,582

 ICD4       G7/G9/G10/G13/G15 ICD9 CODE-COND4     4.0  CHAR    118    121
                    VALUE             UNWEIGHTED     WEIGHTED BY INCALPER
                     -1 INAPPLICABLE        5,355               33,987,668
                     -9 NOT ASCERTAIN          44                  248,181
                        X00X-X999               1                    5,489
                        0001-9999              32                  195,244
                     TOTAL                  5,432               34,436,582

 PROCODE1   G8 1ST PROCEDURE CODE     2.0  CHAR    122    123
                     VALUE            UNWEIGHTED     WEIGHTED BY INCALPER
                     -1 INAPPLICABLE       3,959               25,019,978
                     -9 NOT ASCERTAIN         54                  336,255
                      00-99                1,419                9,080,349
                     TOTAL                 5,432               34,436,582

 PROCODE2   G8 2ND PROCEDURE CODE         2.0  CHAR    124    125
                     VALUE            UNWEIGHTED     WEIGHTED BY INCALPER
                     -1 INAPPLICABLE       5,180               32,720,157
                     -9 NOT ASCERTAIN         66                  409,505
                      00-99                  186                1,306,919
                     TOTAL                 5,432               34,436,582

 PROCODE3   G8 3RD PROCEDURE CODE         2.0  CHAR    126    127
                     VALUE            UNWEIGHTED     WEIGHTED BY INCALPER
                     -1 INAPPLICABLE       5,350               33,906,177
                     -9 NOT ASCERTAIN         58                  360,506
                      00-99                   24                  169,899
                     TOTAL                 5,432               34,436,582

 BABYBORN   G11 DELIVERY DURING HOSPITAL STAY      2.0   NUM    128    129
                      VALUE               UNWEIGHTED     WEIGHTED BY INCALPER
                     -9 NOT ASCERTAIN             1                    9,453
                     -1 INAPPLICABLE          4,921               30,665,482
                      1 YES                     491                3,644,995
                      2 NO                       17                  109,170
                      3 STILLBIRTH                2                    7,481
                     TOTAL                    5,432               34,436,582

 NORMDELV   G12 NORMAL DELIVERY           2.0   NUM    130    131
                     VALUE            UNWEIGHTED     WEIGHTED BY INCALPER
                     -9 NOT ASCERTAIN          9                   51,201
                     -1 INAPPLICABLE       4,940               30,785,592
                      1 YES                  380                2,800,009
                      2 NO                   103                  799,779
                     TOTAL                  5,432               34,436,582

 PREGIDX    PREGNANCY ID (ODU+COUNTER)    8.0  CHAR    132    139
                     VALUE            UNWEIGHTED     WEIGHTED BY INCALPER
                     -1 INAPPLICABLE       4,327               26,335,280
                      VALID PREG ID        1,105                8,101,302
                     TOTAL                 5,432               34,436,582

 BABYNORM   G14 BABY NORMAL               2.0   NUM    140    141
                     VALUE            UNWEIGHTED     WEIGHTED BY INCALPER
                     -9 NOT ASCERTAIN          6                   41,119
                     -1 INAPPLICABLE       4,932               30,746,339
                      1 YES                  464                3,432,771
                      2 NO                    30                  216,353
                     TOTAL                 5,432               34,436,582

 ANYOPER    G16 OPERATN DURING HOSP STAY  2.0   NUM    142    143
                     VALUE            UNWEIGHTED     WEIGHTED BY INCALPER
                     -9 NOT ASCERTAIN        110                  758,510
                     -8 DON'T KNOW             1                    5,150
                     -1 INAPPLICABLE       1,538                9,804,742
                      1 YES                  623                4,302,351
                      2 NO                 3,160               19,565,828
                     TOTAL                 5,432               34,436,582

 PROCODE4   G17 1ST PROCEDURE CODE        2.0  CHAR    144    145
                     VALUE            UNWEIGHTED     WEIGHTED BY INCALPER
                     -1 INAPPLICABLE       4,811               30,145,224
                     -9 NOT ASCERTAIN          6                   37,559
                      00-99                  615                4,253,798
                     TOTAL                 5,432               34,436,582

 PROCODE5   G17 2ND PROCEDURE CODE        2.0  CHAR    146    147
                     VALUE            UNWEIGHTED     WEIGHTED BY INCALPER
                     -1 INAPPLICABLE       5,340               33,878,340
                     -9 NOT ASCERTAIN         11                   66,638
                      00-99                   81                  491,603
                     TOTAL                 5,432               34,436,582

 PROCODE6   G17 3RD PROCEDURE CODE        2.0  CHAR    148    149
                     VALUE            UNWEIGHTED     WEIGHTED BY INCALPER
                     -1 INAPPLICABLE       5,411               34,291,246
                     -9 NOT ASCERTAIN          6                   37,559
                      00-99                   15                  107,777
                     TOTAL                 5,432               34,436,582

 EXPFAC     G21 ORIGINAL FACILITY CHARGE  9.2   NUM    150    158
                     VALUE            UNWEIGHTED     WEIGHTED BY INCALPER
                     -9 NOT ASCERTAIN        155                  966,449
                     -8 DON'T KNOW           757                4,424,760
                     -5 NEVER KNOW           280                1,662,516
                     -1 INAPPLICABLE       2,039               12,475,062
                      1 TO 200                97                  610,698
                      GT 200 TO 500          167                1,182,877
                      GT 500 TO 1000         247                1,764,626
                      GT 1000 TO 2000        525                3,746,696
                      GT 2000 TO 5000        711                4,708,631
                      GT 5000-10000          256                1,674,100
                      GT 10000               198                1,220,166
                     TOTAL                 5,432               34,436,582

 Variable Positions 159-241

 NAME       DESCRIPTION                   FORMAT  TYPE  START    END     NOTE
 ----       -----------                   ------  ----  -----    ---     ----
 EXPFACX    EDITED FACILITY EXPENSE/STAY     9.2   NUM    159    167       *
                      VALUE           UNWEIGHTED     WEIGHTED BY INCALPER
                      0                       2                   14,477
                      1 TO 200               67                  361,192
                      GT 200 TO 500         360                2,595,633
                      GT 500 TO 1000        669                4,558,741
                      GT 1000 TO 2000     1,229                8,190,883
                      GT 2000 TO 5000     1,759               10,820,171
                      GT 5000-10000         749                4,517,573
                      GT 10000              597                3,377,910
                     TOTAL                5,432               34,436,582

 EXPFCFLG   IMPUTA FLAG FOR EDITED FAC EXP   1.0   NUM    168    168   *
                     VALUE            UNWEIGHTED     WEIGHTED BY INCALPER
                     1 EXP FROM HS           782                5,445,823
                     2 EXP FROM MPS        2,620               16,311,896
                     3 EXP IMPUTED         2,030               12,678,862
                     TOTAL                 5,432               34,436,582

 SOPFSELF   PCT PAYM FROM SELF OR FAMILY-FAC EXP  8.4   NUM    169    176
                      0               3,752               22,767,565
                      GT 0 TO 20      1,071                7,429,188
                      GT 20 TO 40       229                1,738,415
                      GT 40 TO 60        57                  367,257
                      GT 60 TO 80        28                  198,336
                      GT 80 TO LT 100    11                   82,658
                      100               284                1,853,162
                     TOTAL            5,432               34,436,582

 SOPFPRVT   PCT PAYM FROM PRIVATE INSUR-FAC EXP    8.4   NUM    177    184
                     VALUE            UNWEIGHTED     WEIGHTED BY INCALPER
                      0                    2,547               14,653,427
                      GT 0 TO 20             678                3,394,072
                      GT 20 TO 40            114                  645,388
                      GT 40 TO 60             44                  307,008
                      GT 60 TO 80            386                2,960,489
                      GT 80 TO LT 100        467                3,721,152
                      100                  1,196                8,755,046
                     TOTAL                 5,432               34,436,582

 SOPFMCR    PCT PAYM FROM MEDICARE-FAC EXP     8.4   NUM    185    192
                     VALUE            UNWEIGHTED     WEIGHTED BY INCALPER
                      0                    3,779               26,385,688
                      GT 0 TO 20              43                  191,244
                      GT 20 TO 40             29                  152,999
                      GT 40 TO 60             74                  368,940
                      GT 60 TO 80            662                3,263,716
                      GT 80 TO LT 100        615                3,002,212
                      100                    230                1,071,782
                     TOTAL                 5,432               34,436,582

 SOPFMCD    PCT PAYMENT FROM MEDICAID-FAC EXP     8.4   NUM    193    200
                     VALUE            UNWEIGHTED     WEIGHTED BY INCALPER
                      0                    4,481               29,303,082
                      GT 0 TO 20             176                  808,065
                      GT 20 TO 40             46                  201,406
                      GT 40 TO 60             23                  100,054
                      GT 60 TO 80              5                   19,759
                      GT 80 TO LT 100         11                   49,799
                      100                    690                3,954,418
                     TOTAL                 5,432               34,436,582

 SOPFOTFD   PCT PAYMENT FROM OTHER FED-FAC EXP    8.4   NUM    201    208
                     VALUE            UNWEIGHTED     WEIGHTED BY INCALPER
                      0                    5,022               31,847,056
                      GT 0 TO 20              10                   66,657
                      GT 20 TO 40              3                   14,463
                      GT 60 TO 80             16                  147,661
                      GT 80 TO LT 100         21                  172,791
                      100                    360                2,187,953
                     TOTAL                 5,432               34,436,582

 SOPFOTST   PCT PAYM FROM OTHER STATE-FAC EXP     8.4   NUM    209    216
                     VALUE            UNWEIGHTED     WEIGHTED BY INCALPER
                      0                    5,267               33,503,806
                      GT 0 TO 20              85                  440,674
                      GT 20 TO 40             18                   91,272
                      GT 40 TO 60              6                   40,682
                      GT 60 TO 80             10                   64,937
                      GT 80 TO LT 100          2                   12,666
                      100                     44                  282,545
                     TOTAL                 5,432               34,436,582

 SOPFWC     PCT PAYMENT FROM WORKERS COMP-FAC EXP   8.4   NUM    217    224
                      VALUE           UNWEIGHTED     WEIGHTED BY INCALPER
                      0                   5,372               33,968,985
                      GT 80 TO LT 100         2                    8,424
                      100                    58                  459,172
                     TOTAL                5,432               34,436,582

 SOPFOTHR   PCT PAYM FROM OTHER-FAC EXP   8.4   NUM    225    232
                     VALUE            UNWEIGHTED     WEIGHTED BY INCALPER
                      0                    5,301               33,630,675
                      GT 0 TO 20              35                  176,433
                      GT 20 TO 40              3                   13,552
                      GT 40 TO 60              2                   15,208
                      GT 60 TO 80             14                   97,695
                      GT 80 TO LT 100         15                   78,542
                      100                     62                  424,477
                     TOTAL                 5,432               34,436,582

 SOPFFFP    PCT PAYM FREE FROM PROVIDER-FAC EXP    8.4   NUM    233    240
                     VALUE            UNWEIGHTED     WEIGHTED BY INCALPER
                      0                    5,240               33,140,087
                      GT 0 TO 20              42                  227,234
                      GT 20 TO 40             20                  147,637
                      GT 40 TO 60             12                   82,067
                      GT 60 TO 80             16                  134,796
                      GT 80 TO LT 100         54                  386,294
                      100                     48                  318,467
                     TOTAL                 5,432               34,436,582

 SOPFFLG    IMPUTATN FLG FOR SOURC PAYM INFO-FAC EXP 1.0   NUM    241    241
                     VALUE            UNWEIGHTED     WEIGHTED BY INCALPER
                     0 NO EXPENSES             2                   14,477
                     1 ALL SOP FRM HS      2,945               20,013,910
                     2 ALL SOP IMPUTD      2,485               14,408,195
                     TOTAL                 5,432               34,436,582

 Variable Positions 242-315

 NAME       DESCRIPTION                   FORMAT  TYPE  START    END     NOTE
 ----       -----------                   ------  ----  -----    ---     ----
 EXPDRX     EDITED DOCTOR EXPENSE            8.2   NUM    242    249       *
                      VALUE           UNWEIGHTED     WEIGHTED BY INCALPER
                      0                   1,744               11,416,150
                      1 TO 50                41                  212,869
                      GT 50 TO 100           85                  591,575
                      GT 100 TO 200         368                2,355,094
                      GT 200 TO 500         952                6,051,818
                      GT 500 TO 1000        696                4,207,304
                      GT 1000 TO 5000     1,356                8,423,293
                      GT 5000               190                1,178,477
                     TOTAL                5,432               34,436,582

 EXPDRFLG   IMPUTAT FLAG FOR EDITED DOC EXPENSE   1.0   NUM    250    250*
                     VALUE            UNWEIGHTED     WEIGHTED BY INCALPER
                     2 EXP FROM MPS        3,841               24,371,514
                     3 EXP IMPUTED         1,591               10,065,067
                     TOTAL                 5,432               34,436,582

 SOPDSELF   PCT PAYM FROM SELF OR FAMILY-DR EXP    8.4   NUM    251    258
                     VALUE            UNWEIGHTED     WEIGHTED BY INCALPER
                      0                    3,997               24,891,336
                      GT 0 TO 20             664                4,496,174
                      GT 20 TO 40            218                1,516,954
                      GT 40 TO 60            149                  993,846
                      GT 60 TO 80             49                  255,081
                      GT 80 TO LT 100         16                   94,829
                      100                    339                2,188,361
                     TOTAL                 5,432               34,436,582

 SOPDPRVT   PCT PAYM FROM PRIVATE INSUR-DR EXP    8.4   NUM    259    266
                     VALUE            UNWEIGHTED     WEIGHTED BY INCALPER
                      0                    3,685               22,656,333
                      GT 0 TO 20             337                1,750,661
                      GT 20 TO 40            141                  743,321
                      GT 40 TO 60            108                  727,120
                      GT 60 TO 80            283                2,182,067
                      GT 80 TO LT 100        193                1,604,861
                      100                    685                4,772,220
                     TOTAL                 5,432               34,436,582

 SOPDMCR    PCT PAYM FROM MEDICARE-DR EXP 8.4   NUM    267    274
                      VALUE           UNWEIGHTED     WEIGHTED BY INCALPER
                      0                   4,330               29,012,597
                      GT 0 TO 20             33                  145,199
                      GT 20 TO 40            60                  300,322
                      GT 40 TO 60           131                  690,797
                      GT 60 TO 80           623                3,097,476
                      GT 80 TO LT 100       123                  596,682
                      100                   132                  593,510
                     TOTAL                5,432               34,436,582

 SOPDMCD    PCT PAYM FROM MEDICAID-DR EXP 8.4   NUM    275    282
                     VALUE            UNWEIGHTED     WEIGHTED BY INCALPER
                      0                    4,846               31,269,781
                      GT 0 TO 20             133                  625,710
                      GT 20 TO 40             42                  186,525
                      GT 40 TO 60             15                   69,867
                      GT 60 TO 80              6                   53,814
                      GT 80 TO LT 100          5                   26,590
                      100                    385                2,204,294
                     TOTAL                 5,432               34,436,582

 SOPDOTFD   PCT PAYM FROM OTHER FEDERAL-DR EXP    8.4   NUM    283    290
                     VALUE            UNWEIGHTED     WEIGHTED BY INCALPER
                      0                    5,073               32,298,114
                      GT 0 TO 20               1                    3,161
                      GT 20 TO 40              2                    8,125
                      GT 40 TO 60              3                   27,347
                      GT 60 TO 80              6                   56,488
                      GT 80 TO LT 100          3                   19,598
                      100                    344                2,023,747
                     TOTAL                 5,432               34,436,582

 SOPDOTST   PCT PAYM FROM OTHER STATE-DR EXP      8.4   NUM    291    298
                     VALUE            UNWEIGHTED     WEIGHTED BY INCALPER
                      0                    5,272               33,555,939
                      GT 0 TO 20              57                  307,058
                      GT 20 TO 40             35                  160,652
                      GT 40 TO 60              5                   31,319
                      GT 60 TO 80              1                    4,621
                      100                     62                  376,992
                     TOTAL                 5,432               34,436,582

 SOPDWC     PCT PAYM FROM WORKERS COMP-DR EXP     8.4   NUM    299    306
                     VALUE            UNWEIGHTED     WEIGHTED BY INCALPER
                      0                    5,400               34,193,640
                      GT 60 TO 80              1                    3,907
                      100                     31                  239,035
                     TOTAL                 5,432               34,436,582

 SOPDOTHR   PCT PAYM FROM OTHER-DR EXP    8.4   NUM    307    314
                     VALUE            UNWEIGHTED     WEIGHTED BY INCALPER
                      0                    5,315               33,605,904
                      GT 0 TO 20              14                   63,478
                      GT 20 TO 40              3                   18,748
                      GT 40 TO 60              9                   57,164
                      GT 60 TO 80             23                  149,671
                      GT 80 TO LT 100         21                  166,915
                      100                     47                  374,701
                     TOTAL                 5,432               34,436,582

 SOPDFFP    PCT PAYM FREE FROM PROVIDER-DR EXP    8.4   NUM    315    322
                     VALUE            UNWEIGHTED     WEIGHTED BY INCALPER
                      0                    5,322               33,631,581
                      GT 0 TO 20              44                  330,016
                      GT 20 TO 40             14                   80,343
                      GT 40 TO 60              8                   61,189
                      GT 60 TO 80             13                  104,239
                      GT 80 TO LT 100         12                  107,976
                      100                     19                  121,238
                     TOTAL                 5,432               34,436,582

 Variable Positions 323-344

 NAME     DESCRIPTION                      FORMAT  TYPE  START    END  NOTE
 ----     -----------                      ------  ----  -----    ---  ----
 SOPDFLG  IMPUTA FLG FOR SRC PAYM INFO-DOC EXP  1   NUM    323    323     *
                     VALUE            UNWEIGHTED     WEIGHTED BY INCALPER
                     0 NO EXPENSES         1,744               11,416,150
                     1 ALL SOP FRM HS      1,889               12,573,786
                     2 ALL SOP IMPUTD      1,799               10,446,646
                     TOTAL                 5,432               34,436,582

 EXPTOTX    EDITED TOTAL EXPENSE/HOSP STAY      9.2   NUM    324    332 *
                     VALUE            UNWEIGHTED     WEIGHTED BY INCALPER
                      0                        2                   14,477
                      1 TO 200                50                  269,721
                      GT 200 TO 500          254                1,818,538
                      GT 500 TO 1000         561                3,862,486
                      GT 1000 TO 2000      1,015                6,802,907
                      GT 2000 TO 5000      1,795               11,222,400
                      GT 5000-10000          977                5,977,290
                      GT 10000               778                4,468,762
                     TOTAL                 5,432               34,436,582

 NURSCARE   G58 SPECIAL/PRIV DUTY NRS REQUIRED    2.0   NUM    333    334
                     VALUE            UNWEIGHTED     WEIGHTED BY INCALPER
                     -9 NOT ASCERTAIN        244                1,619,710
                     -8 DON'T KNOW            10                   73,945
                     -1 INAPPLICABLE          54                  296,694
                      1 YES                  135                  798,809
                      2 NO                 4,989               31,647,424
                     TOTAL                 5,432               34,436,582

 EXPNRS     G62 TOTAL NURSE EXPENSE/STAY  7.2   NUM    335    341
                     VALUE            UNWEIGHTED     WEIGHTED BY INCALPER
                     -9 NOT ASCERTAIN        108                  644,209
                     -1 INAPPLICABLE       5,297               33,637,773
                      GT 0                    27                  154,600
                     TOTAL                 5,432               34,436,582

 IHSFAC     G77 HOSP IS IHS OR TRIBE/ANC  2.0   NUM    342    343
                     VALUE            UNWEIGHTED     WEIGHTED BY INCALPER
                     -9 NOT ASCERTAIN         24                  146,093
                     -1 INAPPLICABLE       5,385               34,144,761
                      2 TRIBE/ANC              4                   25,953
                      3 NOT IHS/TRIBE         19                  119,775
                     TOTAL                 5,432               34,436,582

 INCALPER   FULL-YEAR WEIGHT              12.6   NUM    344    355       *
                     VALUE            UNWEIGHTED     WEIGHTED BY INCALPER
                     781.59-24900.84       5,432                  N/A
                     TOTAL                 5,432                  N/A

 STRATUMX   SAMPLING STRATUM              3.0   NUM    356    358
                     VALUE            UNWEIGHTED     WEIGHTED BY INCALPER
                     301-401               5,432               34,436,582
                     TOTAL                 5,432               34,436,582

 SPSU       PSEUDO PSU                    1.0   NUM    359    359       *
                     VALUE            UNWEIGHTED     WEIGHTED BY INCALPER
                     1                     2,758               17,235,016
                     2                     2,674               17,201,566
                     TOTAL                 5,432               34,436,582


CODEBOOK NOTES

     An asterisk in the rightmost column of the codebook indicates
     that an explanatory note provides greater detail on information
     necessary for the use of this variable.  These notes are listed
     below in alphabetical order by variable name.

     VARIABLE                           NOTE

     EN             EN is an event number where each event is a unique
     EVENTIDX       hospital stay.  EVENTIDX is the unique record
                    identifier on the file for these events.

     EXPDRX         Constructed expense variables.  The constructed
     EXPFACX        doctor expense variable (EXPDRX) is equal to the
     EXPTOTX        sum of expenses for all physicians billing
                    separately for inpatient services during the
                    hospital stay.  The constructed facility expense
                    variable (EXPFACX) is the sum of all expenses for
                    hospital care, including room and board,
                    laboratory charges, x-rays, and services provided
                    by physicians not billing independently from the
                    hospital.  The total hospital expense variable
                    (EXPTOTX) is the sum of facility expense (EXPFACX)
                    and physician expense (EXPDRX).  See section 2.3.1
                    for details.

     EXPDRFLG       A flag indicating whether the physician expense
                    for that record was imputed or provided from the
                    Medical Provider Survey.

     EXPFCFLG       A flag indicating whether the facility expense for
                    that record was imputed, provided by the household
                    respondent or taken from the Medical Provider
                    Survey.

     INCALPER       Weight adjusted for nonresponse and post-
                    stratified to U.S. Census data.  Estimates of
                    utilization and expenditure for hospital stays
                    require the use of weighted data.  For details on
                    this weight, see the Technical and Programming
                    section on this file and the hard copy
                    documentation accompanying this tape.

     LASTAGE        An edited variable which identifies person age, in
                    years, as of the end of the last round in 1987 for
                    which the person was eligible.  Less than 0.1
                    percent of the cases were edited.
     NUMNGHTX       NUMNGHTX is an edited variable indicating the
     NUMNTFLG       number of nights in the hospital for this stay.
                    See section 2.1 for details.  NUMNTFLG
                    is a flag indicating whether the number
                    of nights for the record was imputed,
                    provided by the household respondent, or
                    taken from the MPS.

     NUMNT87X       NUMNT87X is an edited variable indicating
     NUM87FLG       the number of hospital nights in 1987
                    for this stay.  Stays starting in 1986 or ending
                    in 1988 were truncated to show only the nights in
                    the hospital in 1987.  NUM87FLG is a flag
                    indicating whether the number of nights in 1987
                    for the record was imputed, provided by the
                    household respondent or taken from the MPS.

     PLACEIDX       Responses to question G1 were converted to
                    numerical identifiers for the facility where the
                    hospital stay occurred.  This variable may be used
                    as a link to similar variables on NMES Pubic Use
                    Tapes 9, 14.2, and 14.5 (usual source of care,
                    home health visit, and ambulatory medical visit
                    data).  The identifier consists of the ODUX
                    variable plus a three digit number, which was
                    assigned to each facility reported within a
                    dwelling unit.  Since this number was assigned
                    within a dwelling unit, this identifier is not
                    unique across dwelling units.  In order to link
                    the files all identification variables provided
                    for medical providers, physicians and place of
                    care (PLACEIDX, DOCRIDX, PROVIDX and IHSANIDX; the
                    last three are not provided on the current tape
                    but on NMES Tapes 9, 14.2 and 14.5) must first be
                    renamed to a common variable name.  Consistancy
                    across files for provider type has not been
                    verified, e.g., a medical provider identified on
                    the current file may link to a place of care on
                    another file rather than a medical provider.  It
                    should be noted that if a respondent saw a
                    provider in more than one location then it was
                    possible to have a different ID for each location.
     PREGFLG        A constructed variable which indicates whether the
                    stay was associated with a pregnancy.  Pregnancy
                    related events were identified using the following
                    criteria: i) any condition code in the ranges
                    6300-6769, V220-V222, V230-V239, V240-242 and
                    V300-392; ii) a procedure code in the range 72-75;
                    iii) category 4 or 5 given for the visit in
                    RSNINHOS; iv) coverage by a flat fee which also
                    covers events having any of characteristics i) -
                    iii).  It is set to 1 for both mothers and
                    newborns.  To identify all newborn stays in which
                    the birth occurred use RSNINHOS=5.

     PREGIDX        An identification variable to link hospital
                    records for delivering mothers and newborn babies.

     RACE3          A person-level variable constructed to facilitate
                    the poststratification of the NMES person-level
                    sampling weights by race and ethnicity,
                    considering three mutually exclusive
                    classifications:  Hispanic, Black--non-Hispanic,
                    and white or other.

     RACE6          An edited variable indicating race.  Less than 0.2
                    percent of cases were edited.

     ROUND          Indicator of the round of data collection.
                    Reference period dates specific to each person's
                    rounds of data collection are provided on NMES
                    Public Use Tape 13.

     RSNINHOS       Categories 4 and 5 can be used to identify most
                    pregnancy related stays.  To identify all
                    pregnancy related stays, see PREGFLG.  To identify
                    all newborn stays in which a birth occurred
                    category 5 should be used.

     SOPDFLG        Flags indicating whether all the source of payment
     SOPFFLG        percentages for the physician (SOPDFLG) and
                    facility (SOPFFLG) expense for a stay were
                    provided by the household respondent or imputed.

     SPSU           To obtain variance estimates of sample statistics
     STRATUMX       by means of standard statistical programs that use
                    the Taylor series linearization method of variance
                    estimation, variables must be used that denote the
                    strata and primary sampling unit (PSU) within a
                    given stratum.  The variables STRATUMX and SPSU
                    are these variables, respectively.  For details on
                    sampling weights and variance estimation, see the
                    Technical and Programming section on this file and
                    the hard copy documentation accompanying this




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