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NCHSTATS

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NCHS BLOG HAS MOVED

December 21, 2022


The NCHS Blog has moved to a new site at the following link below:

blogs.cdc.gov/nchs/

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Posted by jhl1

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QUICKSTATS: AGE-ADJUSTED RATES OF ALCOHOL-INDUCED DEATHS, BY URBAN-RURAL
STATUS — UNITED STATES, 2000–2020

November 4, 2022


The age-adjusted rate of alcohol-induced deaths in 2020 was 13.1 per 100,000
standard population.

From 2000 to 2020, the rate increased in both urban and rural counties: from 7.1
to 12.7 in urban counties and from 7.0 to 15.8 in rural counties.

From 2019 to 2020, the rate increased by 26% for urban counties and 30% for
rural counties, which was the largest increase for both urban and rural counties
during the 2000–2020 period. 

Rates were similar between rural and urban counties from 2000 to 2004, but from
2005 to 2020 rates were higher in rural counties than in urban counties.

During 2005–2020, rural rates increased at a greater pace than did urban rates.
By 2020, the rate in rural counties was 24% higher than in urban counties.

Source: National Vital Statistics System, Mortality
Data. https://www.cdc.gov/nchs/nvss/deaths.htm

https://www.cdc.gov/mmwr/volumes/71/wr/mm7144a5.htm




Leave a Comment » | Alcohol, Deaths, MMWR, QuickStats, rural, urban | Permalink
Posted by briantsai

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NEW STUDIES: GEOGRAPHIC AND DEMOGRAPHIC VARIATION IN HEALTH INSURANCE COVERAGE

November 3, 2022


Nearly 25 million working age adults in the United States (ages 18-64) were
without health insurance in 2021, according to new data from CDC’s National
Center for Health Statistics. Texas, Georgia, and North Carolina had the highest
rates of uninsured among this group.

The data are captured in two new reports using data from the National Health
Interview Survey: “Demographic Variation in Health Insurance Coverage: United
States, 2021” and “Geographic Variation in Health Insurance Coverage: United
States, 2021.”

Some of the findings from the demographic report include:

 * Overall, 28 million Americans did not have health insurance in 2021,
   including almost 3 million children.

 * Among adults ages 18-64, nearly 13% did not have health insurance.
 * Almost two-thirds of people under age 65 with health insurance are covered by
   private health insurance, including over half with employer-based coverage.

Highlights from the geographic report include:

 * Among adults under age 65, Texas (29.4%), Georgia (19.2%), and North Carolina
   (17.6%) had uninsured rates that were higher than the national rate of 12.6%.
 * Adults ages 18-64 who live in non-Medicaid expansion states (19.1%) were
   twice as likely to be uninsured compared to those living in Medicaid
   expansion states (9.4%).
 * Among adults under age 65, there were several states with uninsured rates
   that were lower than the national rate: Illinois (8.7%), Ohio (8.7%),
   Pennsylvania (8.0%), Virginia (8.0%), Washington (8.0%), Wisconsin (7.7%),
   New York (6.9%), Kentucky (6.5%), Maryland (6.5%), Michigan (6.1%), and
   Massachusetts (3.0%).

The two reports are available at the following links:

Click to access nhsr176.pdf

Click to access nhsr177.pdf

Leave a Comment » | health insurance, National Health Interview Survey |
Permalink
Posted by briantsai

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PODCAST: COVID-19 MORTALITY BY OCCUPATION AND INDUSTRY

October 28, 2022


https://www.cdc.gov/nchs/pressroom/podcasts/2022/20221028/20221028.htm



HOST:  We talked this week with Ari Minino, a statistician with the NCHS
Division of Vital Statistics and co-author on a new report out on October 28th
on COVID-19 mortality in 2020 by occupation and industry.  The report was a
collaborative analysis conducted by NCHS and NIOSH – the National Institute for
Occupational Safety and Health.

HOST:  Before we get into what your study is all about, can you briefly tell
people or caution people what your study does not cover.

ARI MININO:  The study is limited to information on what the usual occupation
and industry of the decedent was.  That is, what was the work or usual job that
the person did for most of his working life.  So this is not, for example, a
study on exactly where it was that the person contracted the condition – in this
case COVID-19.  It is a study trying to associate the co-determinant of work
which is co-determinant of health and how that relates to the, in this case the
risk of the person died from COVID-19. That is a delicate distinction, but I
think it’s important one.

HOST:  So, in this study your coauthors actually were from the National
Institute for Occupational Safety and Health, is that correct?

ARI MININO:  That’s correct.  Yeah, it’s important to note that this is a close
collaboration between the National Institute for Occupational Safety and Health
and the National Center for Health Statistics and this goes back many decades
ago.  We used to have data on the usual occupation and at the industry of the
decedent included as part of our mortality data for the years 1984 through
1998.  And it was only recently – and probably I’m going to say it started in
2018 – there was a signed agreement between the two agencies that we started
working towards trying to incorporate these data again into the mortality data. 
And so the first year that we’re including this data is for 2020 and we’re very
excited, very happy that these data are finally part of the mortality, national
vital statistics file, and this report that we’re discussing is kind of like our
introduction to that.  And my colleagues, Dr. Andrea Steege and Dr. Rachael
Billock, they were the true driving force for this study, and they produced most
of the coding and they did actually all of the analysis, all the analytical
work.  And they were with us in NCHS on a detail for the duration of the period
of this study, when this study was conducted.

HOST:  It’s obviously very difficult or almost impossible to determine where and
how anyone gets COVID, and so that’s one of the limitations you wanted to point
out, out front, correct?

ARI MININO:  That is correct.  One other important limitation of this work is
that this is not a complete global or universal variable in the sense that it
does not cover all of the decedents but has some specific limitations.  We only
included data for 46 States and New York City, which is a separate registration
area, and we only include information for decedents age 10 years and up to 64.

HOST:  And just for those who aren’t familiar with the terminology, when you say
“decedent” you’re talking about the people who died, in this case from COVID-19.

ARI MININO:   That is correct.  This information is entirely based on
information collected from the death certificate of all the diseases or in this
case the decedents who died from COVID-19.

HOST:  Now, turning to what your study did uncover, your study found some
interesting things about mortality from COVID-19 and occupation.  And what was
in your view the biggest finding in your new report?

ARI MININO:   Well, the biggest finding is something that was sort of expected
which is that when we discuss risk, the specific occupation that the decedent
had or the usual occupation of this varied quite substantially in terms of the
risk of dying from COVID.  For example, when we look at the death rate, which is
only one of the measures that we looked at, we found that workers in protective
service occupations were the ones who had the highest death rate from COVID.

HOST:  And when you say “protective services” give us some examples.

ARI MININO:  These are policemen, these are people working building security,
that type of occupation.  So the other group that had very high death rates were
people who worked in accommodation and food service industries.  These are
people who work in, for example, hotels.  These are people who work in
restaurants. 

HOST:  OK so these are the occupational settings where you mentioned you would
expect to see sort of higher mortality.  Were there any surprises in looking at
COVID mortality across different occupational settings?

ARI MININO:  There were some surprises.  In particular, when we looked at the
measure that we called the “proportionate mortality ratio.” And this is not an
indication necessarily of risk, but rather of a disproportionate amount of or a
disproportionate count of people who died from COVID-19 relative to all the
other decedents.  This is not a measure that can exactly relate to risk
necessarily.  This particular way of looking at decedents, we found some
variation when we look at deaths by race and Hispanic origin.  In particular, in
the way in the specific occupations that showed higher proportions of COVID-19
mortality.

HOST: I guess what you’re saying is that there were demographic groups with
higher COVID mortality and some interesting comparisons along occupational
lines, is that correct?

ARI MININO:  Yeah and something that is important is that we used two measures. 
The main measure that we use, the statistical measure, is the “proportionate
mortality ratio.”  And we use that to analyze the differences.  In particular,
among the different race and Hispanic origin groups.  That’s because we didn’t
have a good sample size with the denominator data.  And it’s very difficult to
get denominator data for these occupation and industry groups because the Census
is not geared exactly to look at that, and to produce good estimates for that. 
And so we looked at PMRs, and that is something – it’s very important to
distinguish that, for example when you look at a high PMR, it does not
necessarily mean that there is a higher risk for the condition, just because we
found a high PMR for a particular occupation.  It just means that there’s a
disproportionate number of COVID-19 deaths among the decedents, and its just the
numerator. 



HOST:  Doesn’t that sort of speak to the broader issue – that we’re not really
assessing risk with this study, right?

ARI MININO:  Yeah, with the measures that are done using the death rate, yes
they do speak to risk because we do use a denominator that was available from
census that would fit the numerators but–

HOST:  The other measures, that’s a different story.

ARI MININO:  It’s a different story, yeah.  You see that the results when we
look at PMRs and in particular when we look at PMRs by race and Hispanic origin,
we find that when we look at the non-Hispanic American Indian and Alaska Native
population, for example, as well as for non-Hispanic white, we find that the
highest PMRs were for people with occupations in community and social services
types of occupations.  However, when we look at non-Hispanic Asian and
non-Hispanic Black, decedents were observed among those in protective service
occupations – same as we found for the overall population.

HOST:  And again, that is using the “proportionate mortality ratio.”

ARI MININO:  Uh-huh.

HOST:  And you indicated that that isn’t necessarily a measure that defines risk
but rather—

ARI MININO:  A disproportionate number of COVID-19 deaths among that particular
group when compared with the rest of all of the decedents in that particular
group for all other occupations.

HOST:  So we would close then by asking if there’s anything else you’d like to
mention about your study?

ARI MININO:   I think this is a good introductory study for bringing in
awareness about how we have these data for 2020.  Because these data, even
though we had industry and occupation data for a selected number of states
between 1984 and 1998, this is the first time that we’ve included these data in
the mortality file.  And I think – well, because of course of the pandemic
situation – I think I thought that it was a very good idea to do an introductory
study focusing on COVID.  But this is only the first of a series of studies that
we have planned.  And we’re gonna be looking at drug overdose and industry and
occupation on how those how those two relate in terms of mortality.

HOST:  Well thanks very much for joining us Ari.

MUSIC

HOST: October was a busy month for NCHS, starting with the release of the latest
quarterly provisional birth data in the United States on October 11th.  The
quarterly dashboard features data on a number of measures, including the
fertility rate in the United States.  The general fertility rate is the number
of births per 1,000 females ages 15-44, and the rate increased from 55.2 to 56.4
in the one-year ending in Quarter 2 of 2022 compared with the previous year. 

The next day, on October 12th, NCHS released the latest summary health
statistics for children and adults in the United States, based on data from the
National Health Interview Survey or NHIS.  This dashboard features a wealth of
data on a variety of measures, including smoking.  The NHIS data shows the
percentage of adults in the U.S. who smoke cigarettes has declined from 14% in
2019 to 11.5% in 2021. 

The same day, NCHS released the latest provisional monthly estimates of drug
overdose deaths in the nation.  108,022 Americans died from overdoses in the
one-year period ending in May of 2022.

The following day, on October 13, NCHS released a new report on telemedicine use
for 2021.  The study, featuring data from the NHIS, showed that 4 in 10 adults
in the United States used telemedicine in the past year. 

That busy week closed out on October 14 with a new study on COVID-19 mortality
among older Americans age 65 and up.  The study showed that during the first
year of the pandemic, the death rate from COVID for people age 85 and up was
nearly three times higher than the rate for people ages 75-84, and seven times
higher than the rate for people ages 65-74.

The following week, on October 19, NCHS released a new report on fetal deaths in
the United States from 2018 to 2020.  The study showed that there were nearly
47,000 fetal deaths at 20 weeks of pregnancy or longer during this period.

NCHS rounded out the month with three new data releases in the last week,
starting with an October 25 study on COVID-19 mortality during the first year of
the pandemic by urban-rural status, showing as expected that people living in
the most urban areas of the country had higher mortality from COVID than in
other geographic areas.

And on October 26, NCHS updated another of its quarterly dashboards, this one on
leading causes of death in the country, through the one year period ending in
Quarter 1 of 2022.  The data show a drop in the country’s death rate during this
period compared to the year before.

Leave a Comment » | COVID-19, Deaths, podcasts | Permalink
Posted by briantsai

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QUICKSTATS: AGE-ADJUSTED DEATH RATES FOR STROKE AMONG ADULTS AGED ≥ 65 YEARS, BY
REGION AND METROPOLITAN STATUS — NATIONAL VITAL STATISTICS SYSTEM, UNITED
STATES, 2020

October 28, 2022


In 2020, the age-adjusted death rate for stroke among adults aged ≥65 years was
260.5 deaths per 100,000 population with rates lower in metropolitan compared
with nonmetropolitan areas (259.4 versus 265.5).

The rate was highest among those living in the South (288.2) and lowest among
those living in the Northeast (199.1). In the Northeast, the death rate for
stroke was lower among adults in metropolitan areas (197.4) than in
nonmetropolitan areas (215.7).

In the Midwest and West, death rates for stroke were higher among adults in
metropolitan areas (278.0 and 255.4, respectively) than in nonmetropolitan areas
(261.4 and 236.4, respectively).

No statistically significant difference was observed between metropolitan and
nonmetropolitan areas in the South (287.4 versus 290.9).

Source: National Center for Health Statistics, National Vital Statistics System,
Mortality Data, 2020. https://www.cdc.gov/nchs/nvss/deaths.htm

https://www.cdc.gov/mmwr/volumes/71/wr/mm7143a4.htm

Leave a Comment » | Deaths, MMWR, QuickStats, stroke | Permalink
Posted by briantsai

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QUICKSTATS: EMERGENCY DEPARTMENT VISIT RATES BY AGE GROUP — UNITED
STATES, 2019–2020

October 21, 2022


The emergency department (ED) visit rate for infants aged <1 year declined by
nearly one half from 123 visits per 100 infants during 2019 to 68 during 2020.

The ED visit rate for children and adolescents aged 1–17 years also decreased
from 43 to 29 visits per 100 persons during the same period.

Decreases among adults aged 18–44 (47 to 43 per 100 adults), 45–74 (41 to 39),
and ≥75 years (66 to 63) from 2019 to 2020 were not statistically significant.
ED visit rates were highest for infants aged <1 year followed by adults aged ≥75
years.

Source: National Center for Health Statistics, National Hospital Ambulatory
Medical Care Survey, 2019–2020.

https://www.cdc.gov/mmwr/volumes/71/wr/mm7142a5.htm

Leave a Comment » | emergency department, MMWR, National Hospital Ambulatory
Medical Care Survey | Permalink
Posted by briantsai

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QUICKSTATS: AGE-ADJUSTED DEATH RATES FROM STROKE AMONG ADULTS AGED ≥65 YEARS, BY
RACE AND HISPANIC ORIGIN — NATIONAL VITAL STATISTICS SYSTEM, UNITED
STATES, 2000–2020

October 14, 2022


Age-adjusted death rates from stroke among adults aged ≥65 years generally
declined from 425.9 deaths per 100,000 standard population in 2000 to 250.0 in
2019 before increasing to 260.5 in 2020.

During 2019–2020, stroke death rates increased for Hispanic adults (from 221.6
to 234.0), non-Hispanic Asian or Pacific Islander adults (from 203.9 to 216.4),
non-Hispanic Black adults (from 328.4 to 352.2), and non-Hispanic White adults
(from 246.2 to 255.0); changes for non-Hispanic American Indian or Alaska Native
adults were not significant.

Throughout the 2000–2020 period, death rates for non-Hispanic Black adults were
higher than those for adults in other race and Hispanic origin groups.

Source: National Vital Statistics System, Mortality
Data. https://www.cdc.gov/nchs/nvss/deaths.htm

https://www.cdc.gov/mmwr/volumes/71/wr/mm7141a5.htm

Leave a Comment » | Deaths, MMWR, National Vital Statistics System, QuickStats,
race/ethnicity, stroke, Vital Statistics System | Permalink
Posted by briantsai

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QUICKSTATS: PERCENTAGE OF RESIDENTIAL CARE COMMUNITIES THAT OFFER ANNUAL
INFLUENZA VACCINATION TO RESIDENTS AND TO EMPLOYEES AND CONTRACT STAFF MEMBERS,
BY COMMUNITY BED SIZE — UNITED STATES, 2020

October 7, 2022


In 2020, 87.2% of residential care communities offered annual influenza
vaccination to residents, and 77.8% offered annual influenza vaccination to all
employees and contract staff members.

The percentage of residential care communities offering annual influenza
vaccination to residents and to all employees and contract staff members
increased with increasing community bed size.

The percentage of communities offering vaccination to residents ranged from
75.2% of communities with four to 10 beds to 91.7% with 11–25 beds, 97.0% with
26–100 beds, and 99.1% with more than 100 beds.

Communities offering vaccination to all employees and contract staff members
ranged from 60.9% of communities with four to 10 beds to 80.3% with 11–25 beds,
92.9% with 26–100 beds, and 96.4% with more than 100 beds.

Source: National Post-acute and Long-term Care Study, 2020
data. https://www.cdc.gov/nchs/npals/questionnaires.htm

https://www.cdc.gov/mmwr/volumes/71/wr/mm7140a6.htm

Leave a Comment » | elderly, Flu, Influenza, MMWR, QuickStats, residential care
communities, vaccinations | Permalink
Posted by briantsai

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UPDATED COVID-19 DATA FEATURED IN LATEST RELEASE FROM HOUSEHOLD PULSE SURVEY

October 5, 2022


As part of its ongoing partnership with the Census Bureau, NCHS recently added
questions to assess the prevalence of post-COVID-19 conditions, sometimes called
“long COVID,” on the experimental Household Pulse Survey.

Today, NCHS released the latest round of Pulse data, collected from September
14-26, 2022.  This latest release includes new data on how Long COVID reduces
people’s ability to carry out day-to-day activities compared with the time
before they had COVID-19.

Data on this topic is available at the following link:

WEB DASHBOARD: https://www.cdc.gov/nchs/covid19/pulse/long-covid.htm

KEY FINDINGS:

·        4 out of 5 people with ongoing symptoms of COVID lasting 3 months or
longer are experiencing a least some limitations in their day-to-day activities.



·        1 out of 4 adults (25.1%) with long COVID have symptoms that
significantly impact their ability to carry out day-to-day activities.



·        Out of all U.S. adults, nearly 2% (1.8%) had COVID-19 and still have
long COVID symptoms that have a significant impact on their ability to carry out
day-to-day activities more than 3 months later.



·        14.2% of adults had ever experienced COVID symptoms that lasted 3
months or longer that they had not had prior to their COVID-19 infection.



·        Among the 14.2% who have ever had long COVID symptoms, more than half
(7.2%) currently have long COVID symptoms.  



·        1 out of 3 adults in the U.S. who’d had COVID-19 (29.6%) reported ever
having long COVID symptoms.



·        15% of those who’d had COVID-19 reported currently having long COVID
symptoms.





Leave a Comment » | COVID-19, Household Pulse Survey, National Health Interview
Survey | Permalink
Posted by briantsai

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PODCAST: THE TOLL OF COVID-19 ON PHYSICIAN PRACTICES

September 30, 2022


https://www.cdc.gov/nchs/pressroom/podcasts/2022/20220930/20220930.htm



HOST:  The COVID-19 pandemic took a major toll on the U.S. health care system. 
In a new report released on September 28, data from the National Ambulatory
Medical Care Survey were used to examine how COVID-19 impacted physician
practices around the country.

Joining us to discuss that new study is Zach Peters, a health statistician with
the NCHS Division of Health Care Statistics.

HOST:  What did you hope to achieve with this study?

ZACK PETERS:  This study was intended to produce nationally representative
estimates of experiences at physician offices.  So it’s a physician level study
and we really wanted to highlight some of the important experiences physicians
had due to the pandemic, such as shortages of personal protective equipment. 
And it highlights whether testing was common in physician, whether physicians
were testing positive or people in their office were testing positive for
COVID-19 given that they were on the front lines of helping to treat patients. 
So we really wanted to touch on a broad set of experiences faced by physicians. 
This certainly isn’t the first study to assess experiences and challenges faced
by health care providers during the pandemic but often times those other studies
are limited to specific facilities or locations or cohorts and can’t be
generalized more broadly.  So a big benefit of a lot of the NCHS surveys is that
we can produce nationally representative estimates and this study is an example
of that.

HOST:  And what kind of impact has the pandemic had on physicians and their
practices?

ZACH PETERS:  In having done quite a bit of literature review for this project
it became pretty clear – and I think just listening to the news you sort of
understood a lot of the impact.  A lot of research has shown that that health
care providers experienced a lot of burnout or fatigue.  There was a lot of
exposure and what not to COVID-19.  Long hours… So there’s a lot out there in in
the literature that sort of cites some of the challenges.  What we really, what
this study highlighted was it was the level of shortages of personal protective
equipment that were faced.  About one in three physicians said that they had
they had experienced personal protective equipment shortages due specifically to
the pandemic .  The study highlighted that a large portion of physicians had to
turn away patients who were either COVID confirmed or suspected COVID-19
patients.  And I think the last thing this really helped to show was the shift
in the use of telemedicine due to the pandemic.  So prior to March of 2020 there
were less than half of physicians at physician offices who were using
telemedicine for patient care and that number, that percentage jumped to nearly
90% of office based physicians using telemedicine after March of 2020.  So this
is sort of adding to the broader literature with some nationally representative
estimates of experiences that providers had due to and during the pandemic.

HOST:  So what sort of personal protective equipment was most affected during
this study?

ZACH PETERS:  It’s a good question.  The way in which we asked the questions
about shortages of “PPE” – I’ll call it I guess – don’t allow us from really
untangling that question.  We asked about face mask shortages, N-95 respirator
shortages specifically, but then the second question we asked sort of grouped
isolation gowns, gloves, and eye protection into one question.  So physicians
didn’t really have the chance to check off specifically what they had shortages
of other than face masks.  So it’s somewhat hard to untangle that but these
results show that about one in five physicians faced N-95 respirator, face mask
shortages due to the pandemic and a slightly higher – though we didn’t test
significance in this in this report – a slightly higher percentage, about 25% of
physicians, had shortages of isolation gowns,  gloves, or eye protection or some
combination of those three. 

HOST:  And you say that nearly four in 10 physicians had to turn away COVID
patients.  Now, was this due to a high volume of patients or a lack of staff?

ZACH PETERS:  Again that’s another great question. I think unfortunately we
weren’t able to ask a lot of these really interesting follow-ups to some of
these experiences. We didn’t get to pry physicians on some of the reasons why
they had these experiences, including why they had to turn away patients.  So
unfortunately we’re not able to answer some of the “why” questions that we would
like with these data.

HOST:  And do you have any data on where these patients were referred to, the
ones that were turned away?  Do you have any information on that?

ZACH PETERS:  Again unfortunately this specific question wasn’t something that
we asked in the set of new COVID questions introduced in the 2020 NAMCS we did
ask a question about whether physicians who had to turn away patients had a
location where they could refer COVID-19 patients.  So there are a few reasons –
we haven’t assessed that measure in this work so far, but it’s certainly an area
we can dig into more especially as we have additional data from the 2021 NAMCS
and can try to combine over time.

HOST:  Does it look like the shift to telemedicine visits is here to stay?

ZACH PETERS:  The broader literature sort of highlights that these changes are
broad and likely indicate that physician offices and different health care
settings have built up the infrastructure to allow for telemedicine use in the
future.  And so it’ll be interesting to see if, as waves of COVID or other
infections ebb and flow, if we see that the use of telemedicine kind of ebbs and
flows along with that.  But I think the option for telemedicine is something
that health care settings won’t get rid of now that they have them. 



HOST:  Sticking with the topic of telemedicine – did physicians list any
benefits to telemedicine visits other than limiting exposure to COVID-19?

ZACH PETERS:  The set of questions that we asked physicians were limited in
scope and we didn’t really have that level of follow-up.  There are some
additional questions about telemedicine use that we asked and hope to be able to
dig into further.  We asked physicians what percentage of their visits they had
used telemedicine and some other questions about just kind of the scope of use,
but not necessarily the benefits that they felt they received due to using
telemedicine.

HOST:  Is it possible that you might be getting some data on these questions in
the future?

ZACH PETERS:  These questions were introduced part way through the 2020 survey
year, so we were only able to ask half of our physician sample about these
experiences in the 2020 survey.  But we kept the exact same set of COVID related
questions in the 2021 NAMCS survey year and so we’re working to finalize the
2021 data and hope to be able to look into some of the more nuanced aspects of
this that we might be interested in, such as trends over time if we combine
years.  So we might be able to assess differences in experiences based on the
characteristics of physicians.  So yeah, we asked these specific questions in
the 2021 survey year so hope to have some additional information to put out for
folks.

HOST:  You were talking a little bit about the fact that you made changes to the
National Ambulatory Medical Care Survey, which this study is based on, which
allowed you to collect more complete data during this period. Could you again
sort of go over what sort of changes you made?

ZACH PETERS:  Yes the NAMCS team with the Division of Health Care Statistics, we
made changes to a few of our surveys partway through the 2020 survey year. 
Partly out of necessity and partly out of just interest in an unfolding public
health crisis.  So for NAMCS two big changes were made. The first was that we
had to cancel visit record abstraction at physician offices.  So historically we
have collected a sample of visit records or encounter records from physicians to
be able to publish estimates on health care utilization at physician offices due
to sort of wanting to keep our participants safe, our data collectors safe, and
patients safe.  We cancelled abstraction partly into the 2020 survey year so
that was an important change in that we won’t be able to produce visit estimates
from the survey year.  But the other change that we made – I think I alluded to
it earlier – was that partway through the survey year we introduced a series of
COVID-19 related questions, which is what this report summarizes.  And the
reason it came partway through the survey year is simply due to the fact that
adding a series of new questions to a national survey takes a lot of planning
and a lot of levels of review and approval.  So this is partly why we were only
able to ask these questions of half of our survey sample.

HOST:  Are there any other changes forthcoming in the NAMCS or for that matter
any of your other health care surveys?

ZACH PETERS:  Historically there have been a few different types of providers
that have been excluded from our sample frame.  We didn’t include
anesthesiologists working in office-based settings, radiologists working in
office-based settings.  So we had a few different types of promoting specialties
that we couldn’t speak to in terms of their office characteristics and their
care that they provided.  In future years we are hoping to expand to include
other provider types that we haven’t in the past so I think that’s the big
change going forward for the traditional NAMCS.  We also have a kind of a second
half of NAMCS that looks at health centers in the U.S., and the big change for
that survey in the 2021 survey years that we are in is instead of abstracting a
sample of visit records, are we are starting to collect electronic health record
data from health centers.  So that’s another a different portion of NAMCS but
those are a couple of the big changes at high level that are implementing in
NAMCS. 

HOST:  What would you say is the main take-home message you’d like people to
know about this study?

ZACH PETERS:  I think the main strength of using data from NCHS in general is
that many of our surveys allow for nationally representative estimates and NAMCS
is the same in that regard.  We sampled physicians in a way that allows us to
produce nationally representative estimates.  And so I think this study
highlights how we’re able to leverage our surveys in a way that other studies
that you might see in the literature can’t in that they’re more cohort-based. 
So I think another important aspect of this is just that it highlights an
example of some of the adaptations that DHCS end and NCHS more broadly, some of
the adaptations that we made during the pandemic to better collect data and
disseminate data.  And so outside of the topic being hopefully important to
understand how physicians nationally experienced various things related to the
pandemic, this highlights some of the ways in which NCHS was able to remain
nimble during a public health crisis.

MUSIC

HOST:  On September 1, NCHS released a new report looking at emergency
department visits for chronic conditions associated with severe COVID illness. 
The data, collected through the National Hospital Ambulatory Medical Care
Survey, were collected during the pre-pandemic period of 2017-2019 and serve as
a useful baseline, since it is well established that chronic conditions increase
the risk of hospitalization among COVID patients.  The report showed that during
this pre-pandemic period, hypertension was present in one-third of all emergency
department visits by adults, and diabetes and hypertension were also present
together in one-third of these visits.

On the 7th of September, NCHS released a study focusing on mental health
treatment among adults during both the pre-pandemic and pandemic period, 2019 to
2021.  It has been documented by the Household Pulse Survey and other studies
that anxiety and depression increased during 2020 and the beginning of 2021, and
this new study focuses on the use of counseling or therapy, and/or the use of
medication for mental health during this period.   The study found there was a
small increase in the use of mental health treatment among adults from 2019 to
2021, with slightly larger increases among non-Hispanic white and Asian people.



Also this month, NCHS updated two of its interactive web dashboards, featuring
data from the revamped National Hospital Care Survey.  On September 12, the
dashboard on COVID-19 data from selected hospitals in the United States was
updated, and two days later the dashboard featuring data on hospital encounters
associated with drug use was updated. 

On the same day, September 14, NCHS released the latest monthly estimates of
deaths from drug overdoses in the country, through April of this year, showing
108,174 people died from overdoses in the one-year period ending in April.  This
death total was a 7% increase from the year before.  Over two-thirds of these
overdose deaths were from fentanyl or other synthetic opioids. 

On September 29, the latest infant mortality data for the U.S. was released,
based on the 2020 linked birth and infant death file, which is based on birth
and death certificates registered in all 50 states and DC. 

Finally, September is Suicide Prevention Month, and on the final day of the
month, NCHS released its first full-year 2021 data on suicides in the country. 
For the first time in three years, suicide in the United States increased.  A
total of 47,646 suicides took place in 2021, according to the provisional data
used in the report.  The rate of suicide was 14 suicides per 100,000 people.

MUSIC FADES

Leave a Comment » | COVID-19, Division of Health Care Statistics, Drug Overdose
Deaths, infant mortality, National Ambulatory Medical Care Survey, podcasts,
suicide | Permalink
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