Reliable information about trends in hospital admissions is of particular importance since analyses of Medicare data indicate a marked upward trend in hospital admissions for the aged population. In the first part of the paper, we compare national trends from each data source for the period 1967 to 1979 on the three major overall measures of hospital use-admissions (or in the cases of the NHDS and the NHIS, discharges 3), average length of stay (ALOS), and days of care (DOC). Finally, the paper offers some suggestions to the user of hospital care data who must often choose among data from various sources in the course of a study. ![]() Where substantial discrepancies are found, the paper attempts to explain the reasons for the differences by relating the discrepancies to the nature of the systems under study. To do this, the paper first measures how closely the selected statistics from the four systems agree with each other. Because data from each system are used to address significant hospital care issues, this paper compares data from these systems for the population age 65 years and over to determine whether or not different conclusions on basic indicators of hospital use would be reached, depending on the data system used. Each reports items not available from the others, yet all contain some variables in common with the other systems. ![]() Appendix A, “Description of Data Systems,” gives more detailed information about the four systems.Įach of the systems employs different data gathering methods and definitions. The system contains records of all claims, although diagnostic and surgical information is submitted by the fiscal intermediaries and coded in Medicare's central office for only a 20 percent sample. Medicare's hospital data system is based upon master files containing information on enrollees and participating hospitals which are linked to records of claims submitted by Medicare's fiscal intermediaries containing information on hospital use and reimbursement. The AHA National Hospital Panel Survey gathers summary hospital use and financial information through questionnaires submitted monthly by a sample of hospitals. ![]() The NHIS uses household interviews of the noninstitutionalized population to obtain a broad range of data on demographic characteristics of interviewees, illnesses, chronic conditions, impairments, health service use, and other health topics. It focuses on the demographic characteristics of patients and on their diagnoses, surgical operations, and length of stay. The NHDS is based on abstracts of hospital stays collected from a sample of hospitals. 2 From their inception, these data systems have been used extensively in many studies about the health care delivery system. These data systems are the National Center for Health Statistics (NCHS) National Hospital Discharge Survey (NHDS) the NCHS National Health Interview Survey (NHIS) the American Hospital Association (AHA) National Hospital Panel Survey 1 and the Health Care Financing Administration's (HCFA) Medicare Statistical System. Since the mid-1960's four major national data systems have been collecting data on short-stay hospital use by persons age 65 years and older. The results also point to a need for data users to consult a number of sources whenever possible. The results emphasize the need for data users to understand the nature and limitations of the data they employ. ![]() When we examined data on admissions and average length of stay by diagnosis and surgical procedure groups there was agreement among the data systems for most groups, but for certain groups wide differences occurred. Comparisons across census regions revealed agreement on average length of stay, but showed an unanticipated lack of agreement on admissions. The study shows that for national trends the four systems agreed on number of admissions, average length of stay, and days of care. The paper also offers some suggestions to the user of hospital care data. This paper examines the extent of agreement on the major statistics reported from the four systems and explains, as far as possible, the reasons for discrepancies among the data. Four major national data systems collect data on short-stay hospital use by persons age 65 years and over.
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