Understanding and Interpreting the National Hospital Ambulatory Medical Care Survey: Key Questions and Answers

McCaig, Linda F.; Burt, Catharine W.

doi:10.1016/j.annemergmed.2012.07.010

Cited by 201 publications

(178 citation statements)

References 5 publications

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“…33 Second, NHAMCS surveys may include inaccuracies in self-reported data fields, such as insurance status. 34 However, we would not expect differential misreporting or misclassification to occur over time to confound our results. Third, because there is as high as a 15% nonresponse rate to race and ethnicity, with nonresponse being more frequent in the first years included in this study, imputations for missing data were performed, and this could introduce errors in demographic categories.…”

Section: Limitationsmentioning

confidence: 88%

Trends in Pediatric Visits to the Emergency Department for Psychiatric Illnesses

Pittsenbarger

Mannix

2013

Academic Emergency Medicine

125

106

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Objectives: While recent studies have demonstrated an overall increase in psychiatric visits in the emergency department (ED), none have focused on a nationally representative pediatric population. Understanding trends in pediatric psychiatric ED visits is important because of limited outpatient availability of pediatric specialists, as well as long wait times for psychiatric appointments. The study aim was to evaluate the trends in ED psychiatric visits for children between 2001 and 2010 with comparison by sociodemographic characteristics.Methods: This was a retrospective, cross-sectional analysis of ED psychiatric visits for children < 18 years of age using the National Hospital Ambulatory Medical Care Survey (NHAMCS). Visits were identified by International Classification of Diseases, Ninth Revision (ICD-9), codes. Outcome measures included frequency of visits for children with psychiatric diagnosis codes and odds and adjusted odds of psychiatric visits controlling for temporal, demographic, and geographic factors.

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Section: Limitationsmentioning

confidence: 88%

Trends in Pediatric Visits to the Emergency Department for Psychiatric Illnesses

Pittsenbarger

Mannix

2013

Academic Emergency Medicine

125

106

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“…The main limitations of this study reflect the use of survey administrative data for this type of analysis [37,38]. Although the multistage sampling of the NHAMCS database is designed to make the sample representative, these estimates may contain minor inaccuracies and sampling bias; however, the consistency and rigor of the NHAMCS methodology should protect against major inaccuracies [38].…”

Section: Limitationsmentioning

confidence: 99%

“…Although the multistage sampling of the NHAMCS database is designed to make the sample representative, these estimates may contain minor inaccuracies and sampling bias; however, the consistency and rigor of the NHAMCS methodology should protect against major inaccuracies [38]. NHAMCS is a national-level database that includes information pertaining to visits, not specific patients.…”

Section: Limitationsmentioning

confidence: 99%

Trends in Emergency Department Resource Utilization for Poisoning-Related Visits, 2003–2011

et al. 2016

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In recent years, there has been an increase in poisoning-related emergency department (ED) visits. This study examines trends in ED resource utilization for poisoning-related visits over time. A retrospective review of data from the National Hospital Ambulatory Medical Care Survey, 2003-2011, was conducted. All ED visits with a reason for visit or ICD-9 code related to poisoning were included. We examined the number of ED visits and resources used including diagnostic studies and procedures performed, medications provided, admission rates, and length of stay. The proportion of visits involving resource use was tabulated and trends analyzed using survey-weighted logistic regression, grouping into 2-year periods to ensure adequate sample size. Of an estimated 843 million ED visits between 2003 and 2011, 8 million (0.9 %) were related to poisoning. Visits increased from 1.8 million (0.8 %) visits in [2003][2004] to 2.9 million (1.1 %) visits in 2010-2011, p = 0.001. Use of laboratory studies, EKGs, plain radiographs, and procedures remained stable across the study period. CT use was more than doubled, increasing from 5.2 to 13.7 % of visits, p = 0.001. ED length of stay increased by 35.5 % from 254 to 344 min, p = 0.001. Admission rates increased by 45.3 %, from 15.0 to 21.8 %, p = 0.046. Over the entire study period, 52.0 % of poisoned patients arrived via ambulance, and 3.0 % of patients had been discharged from the hospital within the previous 7 days. Poisoning-related ED visits increased over the 8-year study period; poisonings are resource-intensive visits and require increasingly longer lengths of ED stay or hospital admission.

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“…The survey is conducted over a random 4-week period. The surveys are annual, multistage, probability surveys carried out by sampling 1)112 geographic primary sampling units 2) approximately 480 hospitals within each sampling unit and 3) patient visits within hospital service areas [18]. Trained hospital staff workers extract data into a structured data entry form that includes patient and provider characteristics, the source of payment, the reason for the visit, vital signs and ICD-9-M codes for patient diagnosis, injury, procedures and diagnostic tests ordered.…”

Section: Methodsmentioning

confidence: 99%

Factors that Predict Outpatient Department Utilization amongst Sickle Cell Disease Patients in the USA

Lanzkron¹,

Bollinger²

2017

J Hematol Thrombo Dis

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Individuals with sickle cell disease (SCD) frequently present in the emergency room due to various complications that may arise from their condition. Optimal healthcare for people with SCD utilizes outpatient department (OPD) diagnostic and preventive care services. This paper investigates the factors associated with OPD visits compared to Emergency department (ED) visits in patients with SCD. SCD-related OPD visits and ED visits were obtained from the openly available National Hospital Ambulatory Medical Care Survey (NHAMCS) and National Ambulatory Medical Care Survey (NAMCS) data for the years 2009-2010. A total of 822,353 weighted visits by people with SCD were analyzed. Descriptive data include patient demographics, geographical location, and socioeconomic status associated with hospital OPD visits. Of the 812,366 weighted visits, 361,024 were made to the ED and 451,342 were made to the OPD. The median predicted probability of using the OPD amongst patients with SCD was 50%. We found that patients with SCD who had a below median probability of using OPD services were mostly female (66.12%), African-American (98.35%), Medicaid-insured (61.98%) and between the ages of 20-30 years old (42.98%). Individuals with SCD residing in neighborhoods with average income below $52,000 (96.69%), more than 10% below poverty level (86.55%) and less than 20% with a bachelor degree or higher (63.87%) made up the majority of people with below median probability of making OPD visits. This study suggests that there are sociodemographic differences in the utilization of outpatient services amongst people with SCD. Efforts at improving OPD use amongst patients with sickle cell disease should target these patients.

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Understanding and Interpreting the National Hospital Ambulatory Medical Care Survey: Key Questions and Answers

Cited by 201 publications

References 5 publications

Trends in Pediatric Visits to the Emergency Department for Psychiatric Illnesses

Trends in Pediatric Visits to the Emergency Department for Psychiatric Illnesses

Trends in Emergency Department Resource Utilization for Poisoning-Related Visits, 2003–2011

Factors that Predict Outpatient Department Utilization amongst Sickle Cell Disease Patients in the USA

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