Ambulatory surgery in the United States, 1996

OBJECTIVES: This report presents estimates of surgical and nonsurgical procedures performed on an ambulatory basis in hospitals and freestanding ambulatory surgery centers in the United States during 1996. Data are presented by types of facilities, age and sex of the patient, and geographic region. Major categories of procedures and diagnoses are shown by age, sex, and region. METHODS: The estimates are based on data collected by the 1996 National Survey of Ambulatory Surgery conducted by the National Center for Health Statistics. The 1996 data were abstracted from 125,000 medical records in 488 hospitals and freestanding ambulatory surgery centers.     

National nutrition data: contributions and challenges to monitoring dietary supplement use in women

Survey data from three nationally representative surveys--the National Health and Nutrition Examination Survey, National Health Interview Survey and Continuing Survey of Food Intakes by Individuals--indicate that, in general, women are greater consumers of dietary supplements than men in terms of overall prevalence of use and number of supplements taken. However, monitoring dietary supplement use over time and aggregation or comparison of findings over different surveys is hampered by a lack of comparability between survey data collection and analysis. Differences exist in the types of dietary supplements queried, use of a referent time frame, specificity regarding the supplement taken and level of detail collected relating to personal usage. Some comparability in supplement data collection may be possible but some inconsistencies may persist because of differences in survey goals or collection procedures. Collection of data on dietary supplement use is challenging and collection of very detailed and precise data are time consuming and expensive. Consequently, the level of detail and precision necessary for monitoring, research, and policy uses is an issue that should be addressed in view of the high monetary and time costs of detailed dietary supplement data collection, as well as increased demands on survey respondent time.     

第八次全国学生体质与健康调研结果发布

根据国务院1987年同意建立的全国学生体质与健康调研制度, 2019年, 教育部等部署开展了第八次全国学生体质与健康调研工作。发现中国学生体质与健康状况总体有所改善, 并提出了促进学生体质与健康水平提高的主要因素, 针对本次调研发现的问题提出以下相关安排: 全面加强和改进学校体育工作、落实学校卫生与健康教育政策要求、持续综合防控儿童青少年近视、实施全国健康学校建设计划。     

Prevalence of artificial hip implants and use of health services by recipients.

Data from the 1988 Medical Device Implant Supplement to the National Health Interview Survey are used to summarize information about the prevalence of artificial hips among adults in the United States. The 1988 National Health Interview Survey was a cross-sectional survey of the civilian noninstitutionalized United States population, and included 122,310 persons in 47,485 households in a multistage probability sample. The supplement supplied the first population-based estimates of prevalence and morbidity of selected medical devices. Projected to the United States population, the survey results indicate that an estimated 674,000 adults were using 811,000 hip implants. Hip implant recipients were significantly more likely to be older, to be white, and to have lower educational, income, and activity levels than the general population of adults. After age-stratification, however, only differences in activity limitation and race remained. Current economic outlays for hip replacement surgery are substantial. With the aging population, use of health services by patients with artificial hips will probably increase unless measures to reduce the need for replacement surgery are instituted. These measures include reducing injuries and improving biomaterials. Further investigation is needed to examine the activity limitation and racial difference in prevalence found in this study.     

Meta-analysis on the therapeutic state of hypertensive population in Japan: focusing on the impact of new diagnostic criteria of Japanese Guideline for the Management of Hypertension 2000

A Meta-analysis on the therapeutic state of hypertensive population in Japan is performed by the three nation-wide governmental surveys focusing on the impact of new diagnostic criteria described in the Guidelines for the Management of Hypertension in Japan 2000. These surveys are the National Survey of Circulatory Disorders, National Nutrition Survey and Patient Survey in 1990. The meta-analysis approach is used to evaluate the validity and reliability of these three national data sets, particularly the National Nutrition Survey. The population with history of hypertensive treatment and without previous diagnosis was calculated using the old and new diagnostic criteria. The results of three national surveys are fairly consistent. National Nutrition survey can be used to monitor the overall therapeutic status of Japanese population if the definition is considered judiciously. The impact of new diagnostic criteria is extensive as demonstrated by the results of the analysis on the National Nutrition Survey of 1999. The hypertensive population doubled and one half of the Japanese population over the age of 30 is now defined as hypertensive. A policy to manage this newly diagnosed hypertensive population is urgently needed to lessen the burden on Japanese health care system.     

The health status of the elderly population: what do we need to know?

The objective of this research was to evaluate the data on the health of the elderly population available in the Brazilian information system and their correspondence with the North American statistics using the Internet. The North American publication "Older Americans 2000: Key Indicators of Well-Being" was used as a standard. The databases and instruments used in the North American and Brazilian surveys are presented. The North American data are based on the Supplement on Aging and Second Supplement on Aging; Health and Retirement Study; National Health Interview Survey and National Long Term Care Survey. The Brazilian data were collected from the Mortality Information System; Information System of the National Program of Immunizations; National Household Sample Survey conducted in 1998 and 2003 and from the Household Survey on Risk Behavior and Morbidity from Not Transmissible Diseases of 2002-2003. There is a great number of Brazilian information about the aged population of the Country available in the Internet and with few exceptions the information on aged Brazilians corresponds to the information available about aged North Americans.     

Psychological distress, hopelessness and welfare.

This article assesses the validity of the claim that welfare in itself has deleterious psychological consequences for single mothers. The analysis compares single mothers who are recipients of AFDC with single mothers who are not recipients in terms of their depressive symptoms (as measured by the CES-D) and hopelessness (as measured by Pearlin Mastery Scale). The analysis uses data from the National Longitudinal Survey of Youth and the National Survey of Families and Households. The authors find that higher levels of both depression and hopelessness among welfare recipients can be explained by their material hardship rather than the stigma attached to welfare. They show that AFDC recipients report similar levels of depression and hopelessness as jobless non-recipients as well as low-wage non-recipients. An additional finding is that long-term welfare recipients do not experience greater emotional problems than short-term welfare recipients. Finally, the paper shows that feelings of hopelessness mediate the relationship between material deprivation and psychological distress for both recipients and non-recipients.     

Does increasing the beer tax reduce marijuana consumption?

Previous studies suggest that alcohol and marijuana are economic substitutes, so recent policies restricting the availability of alcohol have led to an increase in the amount of marijuana consumed. Using micro-level data from the National Longitudinal Survey of Youth (NLSY) to estimate individual demand equations for alcohol and marijuana, this research finds that alcohol and marijuana are economic complements, not substitutes. Further, this research finds that increases in the federal tax on beer will generate a larger reduction in the unconditional demand for marijuana than for alcohol in percentage terms.     

Does procedure profitability impact whether an outpatient surgery is performed at an ambulatory surgery center or hospital?

Ambulatory surgery centers (ASCs) are small (typically physician owned) healthcare facilities that specialize in performing outpatient surgeries and therefore compete against hospitals for patients. Physicians who own ASCs could treat their most profitable patients at their ASCs and less profitable patients at hospitals. This paper asks if the profitability of an outpatient surgery impacts where a physician performs the surgery. Using a sample of Medicare patients from the National Survey of Ambulatory Surgery, we find that higher profit surgeries do have a higher probability of being performed at an ASC compared to a hospital. After controlling for surgery type, a 10% increase in a surgery's profitability is associated with a 1.2 to 1.4 percentage point increase in the probability the surgery is performed at an ASC. Copyright © 2010 John Wiley & Sons, Ltd.     

Insights into the 'healthy immigrant effect': health status and health service use of immigrants to Canada

This paper combines multiple cross-sections of data drawn from the National Population Health Survey and Canadian Community Health Survey to confirm the existence of the 'healthy immigrant effect', specifically that immigrants are in relatively better health on arrival in Canada compared to native-born Canadians, and that immigrant health converges with years in Canada to native-born levels. The paper finds robust evidence that the healthy immigrant effect is present for the incidence of chronic conditions for both men and women, and results in relatively slow convergence to native-born levels. There is only weak evidence in terms of self-assessed health status. The inclusion of controls for region of origin and year of arrival does not account for the observed effects, although region of origin is an important determinants of immigrant health. The paper then considers some alternative explanations for the observed differences, and support is found for the idea that the healthy immigrant effect reflects convergence in physical health rather than convergence in screening and detection of existing health problems.     

Dental health and public policy: the social impact of dental disease.

This paper analyzes the potential of using measures of social function as health indicators in dental research. It discusses existing methodologies and presents findings from a cross-section of studies that adopt a social function perspective in the investigation of oral health status. While the literature in this area is small, much of the research concerns disability days associated with dental problems. The United States National Health Interview Survey reported in 1981 that 4.87 million dental conditions caused 17.7 million days of restricted activity, 6.73 million days of bed disability, and 7.05 million days of work loss. Other reports suggest that these data may be underestimates due to the National Health Survey's definition of disability days. Several other studies have found work loss to affect from 15 per cent to 33 per cent of samples studied resulting in many more work loss days than reported by the National Health Survey. Our study concludes that traditional measures of oral health status--such as decayed, missing, and filled teeth and the periodontal index--should be linked to measures of social outcome in order to place dental conditions within the broader context of health status in terms that are relevant to policy makers.     

Estimating the long-term care population: prevalence rates and selected characteristics.

To facilitate manpower and service need estimates, the long-term care population must be defined in terms of dependency on human assistance in daily functioning. Such a definition of dependency is applied to national population data bases, using the 1977 National Nursing Home Survey and the 1977, 1979, and 1980 National Health Interview Surveys. The four categories of dependency are personal care, mobility, household activities, and home-administered health care services. Although projections to the year 2000 show a doubling of the nursing home population, estimates of the overall prevalence of functional dependency remain smaller than is popularly believed.     

The Internet as a health information source: findings from the 2007 Health Information National Trends Survey and implications for health communication

A wealth of health information is available online, but we do not fully understand the implications for health communication. This study examined whether health information seekers who turn to the Internet first differ from those who turn elsewhere. Data from the 2,338 respondents to the mail portion of the National Cancer Institute's Health Information National Trends Survey (HINTS) 2007 who reported looking for health information for themselves were analyzed. Logistic regression was used to examine whether health information seekers turning to the Internet first differed in terms of demographics, information preferences and seeking confidence, and communication with providers from those using other sources. In the final model, Internet users were younger, more educated, higher income, preferred numbers rather than words to describe chance, and think it is very important to get personal medical information electronically. There were no differences in terms of gender, health status, confidence seeking health information, or communication with providers. Health information seekers who turn to the Internet first are different, both in terms of demographics and information preferences. As the use of communication technologies increases, health communicators need to be attentive to the potential for communication inequalities.     

The effectiveness of preventive care at reducing curative care risk for the Taiwanese elderly under National Health Insurance

Whether provision of free preventive care for the elderly under National Health Insurance has reduced the risk for curative care use raises much concern in Taiwan. This study analyzes the relationship by examining the impact of health examination utilization on the utilizations of outpatient care and inpatient care. Data come from the 2005 National Health Interview Survey and National Health Insurance Research Database. A two-stage method is used in the estimation. We found a negative relationship between the utilization of preventive care and hospitalization care in terms of length of stay and medical expenditures. On average, the elderly people who used preventive care tended to have 16 shorter hospitalization stays and NTD64,220 lower hospitalization expenditures than their counterparts. In order to improve the health of the elderly and reduce the escalation of medical expenditures due to aging, including preventive care in the health insurance is a very effective strategy.     

National health data for policy and planning.

The role of the National Center for Health Statistics (NCHS) in providing data for health policy and planning at the national and local level is discussed. Four specific examples are considered. First, data from the Hospital Discharge Survey are used to identify surgical procedures with large increases between 1965 and 1976: 30 percent rise in the incidence of hysterectomy, 169 percent increase in cesarean section, 100 percent increase in lens extraction, and 35 percent increase in orthopedic surgery. The extent to which such increases represent unnecessary utilization and their impact on costs are discussed. Second, the combination of data from two sources (Health Interview Survey and Health and Nutrition Examination Survey) is illustrated by considering selected policy issues related to hypertension. Next, the problem of designating medically underserved areas is discussed in relation to the difficulties in implementing federal policies at the local level without local data. The potential for national data systems to provide guidance for these policies is also considered. The final example discusses the use of vital statistics to provide small area data for local health planning. In conclusion several areas are considered which need development in order to maximize the use of data for policy and planning: research on measurement of health status, with particular emphasis on how health policy can affect health status; research on appropriate levels of health resources and services; development of shared data systems to reduce cost and respondent burden; and training, especially at the undergraduate level and in interdisciplinary graduate programs.     

Use of adjustment factors with a brief food frequency questionnaire to obtain nutrient values

The 100-item National Cancer Institute (Block) Food Frequency Questionnaire was created to measure an individual's relative nutrient intake as well as absolute nutrient values. A 60-item, brief questionnaire was then developed; its results correlate well with results from the 100-item questionnaire and with food record data. Adjustment factors, presented here, were developed that allow investigators to use the shorter questionnaire while obtaining nutrient values nearer the correct absolute values than those from the brief questionnaire alone. Data from the National Health and Nutrition Examination Survey II (1976-1980) and the first quarter of the National Health Interview Survey (1987) were used in developing the adjustment factors. The brief questionnaire was administered to approximately 22,000 subjects in the National Health Interview Survey. When the adjustment factors were applied to data from the second, third, and fourth quarters of the National Health Interview Survey, the adjusted values of 17 micro- and macronutrients were on average within 0.51% and 1.17% of estimates obtained by 24-hour recall in the National Health and Nutrition Examination Survey II, for men and women, respectively. Correlations between the adjusted nutrient values and absolute nutrient consumption, as measured by diet diaries in three smaller studies, were nearly the same or somewhat better than correlations with the unadjusted brief questionnaire.     

Gender bias in the language of the health questionnaire of the Spanish National Health Survey 2003

To identify possible gender bias in the language of the adults' and children's questionnaires of the Spanish National Health Survey, 2003, its style and language was analyzed for inaccurate generalizations, inequalities due to the use of terms that reflect social stereotypes and hide unequal social roles, and grammatical gender disagreement. Both questionnaires show language bias, mainly lexical, as they use masculine singular nouns to refer to all individuals (for example, carer, employer, worker, doctor, interviewer, interviewee). Gender stereotypes are reinforced by the use of the term "carer", referring to women, and by examples of jobs traditionally done by men. Equally, specific sex denomination for relatives in the same category such as brother/sister is lacking, despite the distinct social roles played by women and men. In conclusion, women are less visible than men in the Spanish National Health Survey, 2003. This study could contribute to the identification and elimination of gender bias in the language of other questionnaires.     

The epidemiology of cancer and the delivery of medical care services

Data collected primarily for epidemiologic purposes can be used to address questions concerning medical care for cancer in the United States. This was done directly for the period 1969-71 through an interview survey of a sample of cancer patients identified in the Third National Cancer Survey to obtain information on length of hospital stay, cost of care, source of payment, and related issues. Since that time the Surveillance, Epidemiology, and End Results (SEER) Program was established by the National Cancer Institute to measure cancer incidence and cancer patient survival in 10 percent of the U.S. population on a continuing basis. Using the SEER data and those from the earlier cancer surveys, evidence is presented for the increasing need for medical care resources for some of the major cancers, such as cancers of the lung and prostate. Data from the National Hospital Discharge Survey for 1979 reveal an average length of stay of 12.3 days for each hospital discharge with a diagnosis of cancer, ranging from 8.5 days for those with cancer of the cervix uteri to 20 days for those with brain cancer. Some suggestions are made for applying hospital data on length of stay from the National Hospital Discharge Survey to estimates of cancer incidence from the SEER Program to obtain estimates of numbers of hospital days required during the first period of hospitalization for cancer. This estimate for the United States for 1983 was almost 11 million hospital days for all cancers combined.     

The validity of household budget survey (HBS) data: estimation of individual food availability in an epidemiological context

Household budget surveys (HBS) are conducted in most European countries and they represent a unique source of dietary data. However, the information on food availability is at the family level, which limits the investigation of the dietary habits of individuals. The key stages required to establish the validity of HBS data at the household and individual level are reviewed. Using examples from British data, the paper identifies some of the limitations and valid applications of HBS data. A statistical method is proposed to estimate the food availability of household members of different types, for example different age groups, based on the family composition. The validity of the method is presented by using British data from the National Food Survey and the National Diet and Nutrition Survey.