2012 National Healthcare Quality and Disparities Reports
Data Sources—Professional Organizations and Associations
American Hospital Association.
AHA conducts an annual survey of all hospitals in the United States, including registered and nonregistered hospitals. The focus is on four main areas: organization, facilities, community benefit, and utilization. In 2008, AHA administered a supplemental information technology (IT) mail survey to gather information on the extent to which hospitals have fully functional health information systems, the characteristics of these systems, and the functions available to and used by hospital staff.
Survey Sample Design
AHA registered hospitals make up 98% of the surveyed hospitals, which means the hospital meets the AHA criteria for registration as a hospital facility. In 2008, 951,045 registered hospitals were involved in the surveys. State and local associations, Medicare and Medicaid centers, national organizations, and governmental bodies help identify nonregistered hospitals, which helps to yield a high response rate.
If data are missing, estimates are generated from the previous year's responses and from comparisons to hospitals of similar size and orientation. The reporting period is on a fiscal year basis.
Primary Survey Content
The AHA Hospital Survey reports on statistics including current and historic data on utilization, personnel, revenue, expenses, managed care contracts, community health indicators, physician models, technology, electronic record system, number of beds and admissions, and urban/rural status. The 2008 IT supplement queries hospital representatives about the adoption of electronic medical records and the scope of computer functions used by the facility.
All hospitals in the United States.
Combined with the core survey, information collected includes identifying information, organizational structure, facilities and services, utilization data, community orientation indicators, physician arrangements, managed care relationships, expenses, staffing, use of electronic medical records, use of electronic systems for prescribing, and sharing of patient information across providers.
Data Collection Schedule
National and regional.
Agency home page: http://www.aha.org.
Wolf L, Harvell J, Jha AK. Hospitals ineligible for federal meaningful-use incentives have dismally low rate of adoption of electronic health records. Health Aff 2012;31(3):505-13.
National Hospice and Palliative Care Organization (NHPCO).
The FEHC survey is administered by participating hospices to family members of deceased hospice patients and assesses multiple areas of care delivery. The surveys are usually completed by paper and pencil and returned to the hospice program or a data vendor hired by the hospice to mail the surveys and compile results. A published version for telephone administration with an associated script is also available.
Individual hospices electronically submit data to NHPCO via a Web-based submission system and vendors submit client data files on a quarterly schedule. NHPCO maintains a multiyear FEHC data repository.
Survey Sample Design
The FEHC is a postdeath survey that asks questions about families' perceptions of the care provided to the patient, as well as their own hospice experience.
Participation in the FEHC is entirely voluntary, although NHPCO encourages all hospices nationwide to take part. Hospices are asked to contact bereaved family members anywhere from 1 to 3 months after the patient's death to invite them to participate in the survey. The national average response rate during 2011 quarter 2 was 38%.
Primary Survey Content
Among information gathered are caregivers' perceptions of the hospice's performance and patient's experience in the following areas: patient comfort and emotional support, coordination of care, decisionmaking, information sharing, respect for the patient, and emotional support to the family.
Age, gender, race/ethnicity, and educational level of decedents and respondents.
Organization home page: http://www.nhpco.org.
Connor SR, Teno J, Spence C, et al. Family Evaluation of Hospice Care: results from voluntary submission of data via website. J Pain Symptom Manage 2005 Jul;30:9-17.
Operation of the NCDB is jointly supported by the Commission on Cancer (CoC) of the American College of Surgeons and the American Cancer Society.
NCDB is a nationwide facility-based oncology database that annually captures 70% of all newly diagnosed cancer cases in the United States. NCDB holds information on more than 29 million cases of reported cancer diagnoses since 1985 and continues to grow.
All CoC-accredited hospital cancer programs are annually required to submit data for all patients diagnosed or treated for a cancer diagnosis. More than 1,500 participating hospitals respond to a call for data, submitting case reports for a specified calendar year approximately 9 months after the calendar year.
CoC-accredited cancer program registries collect and submit data elements to NCDB using nationally standardized data item and coding definitions. These are found in CoC's Facility Oncology Registry Data Standards (FORDS) and the North American Association of Central Cancer Registries' nationally standardized data transmission format specifications.
Primary Survey Content
NCDB contains standardized data elements on patient demographics, patient insurance status, tumor site, stage and morphology, comorbidities, first course of treatment, disease recurrence, and survival information. In addition, NCDB contains information on patient ZIP Code and county of residence, which is used to incorporate area-based sociodemographic characteristics. Selected characteristics of the reporting health care facility are also collected.
Cancer patients in the United States.
Gender, age at cancer diagnosis, and race/ethnicity.
Continuously since 1985.
National; U.S. Census Bureau regions; metropolitan and nonmetropolitan areas.
NCDB home page: http://www.facs.org/cancer/ncdb/.
Bilimoria KY, Stewart AK, Winchester DP, et al. The National Cancer Data Base: a powerful initiative to improve cancer care in America. Ann Surg Oncol 2008 Mar;15(3):683-90. Epub 2008 Jan 9.
Stewart AK, Bland KI, McGinnis LS, et al. Clinical highlights from the National Cancer Data Base. CA Cancer J Clin 2000;50:171-83.
Sylvester J, Blankenship C, Carter A, et al. Quality control: the American College of Surgeons Commission on Cancer Standards, National Cancer Data Base, and Cancer Liaison Program. J Reg Mgmt 2000;27:68-74.