[Federal Register Volume 60, Number 211 (Wednesday, November 1, 1995)]
[Notices]
[Pages 55584-55586]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 95-27056]



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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Disease Control and Prevention
[INFO-95-05]


Proposed Data Collections Submitted for Public Comment and 
Recommendations

    In compliance with the requirement of Section 3506(c)(2)(A) of the 
Paperwork Reduction Act of 1995 for opportunity for public comment on 
proposed data collection projects, the Centers for Disease Control and 
Prevention (CDC) will publish periodic summaries of proposed projects. 
To request more information on the proposed projects or to obtain a 
copy of the data collection plans and instruments, call the CDC Reports 
Clearance Officer on (404) 639-3453.
    Comments are invited on: (a) Whether the proposed collection of 
information is necessary for the proper performance of the functions of 
the agency, including whether the information shall have practical 
utility; (b) the accuracy of the agency's estimate of the burden of the 
proposed collection of information; (c) ways to enhance the quality, 
utility, and clarity of the information to be collected; and (d) ways 
to minimize the burden of the collection of information on respondents, 
including through the use of automated collection techniques for other 
forms of information technology. Send comments to Wilma Johnson, CDC 
Reports Clearance Officer, 1600 Clifton Road, MS-D24, Atlanta, GA 
30333. Written comments should be received within 60 days of this 
notice.

Proposed Projects

    1. The National Ambulatory Medical Care Survey (NAMCS)--(0920-
0234)--Extension--The National Ambulatory Medical Care Survey (NAMCS) 
was conducted annually from 1973 to 1981, again in 1985, and resumed as 
an annual survey in 1989 by the National Center for Health Statistics, 
CDC. The NAMCS samples from all office visits within the United States 
made by ambulatory patients to non-Federal office-based physicians 
engaged in direct patient care. More than 70 percent of all direct 
ambulatory medical care visits occur in physicians' offices. To 
complement these data, in 1992 NCHS initiated the separate National 
Hospital Ambulatory Medical Care Survey (NHAMCS). These two surveys 
constitute the ambulatory care component of the National Health Care 
Survey (NHCS), and provide coverage of more than 90 percent of U.S. 
ambulatory medical care. NAMCS data include patients' demographic 
characteristics and medical problems, and the physicians' diagnostic 
services, therapeutic prescriptions and disposition decisions. These 
annual data may be used to monitor change and its effects and stimulate 
further improvements to the use, organization, and delivery of 
ambulatory care. Users of NAMCS data include Congress and federal 
agencies (e.g. NIMH, NIAAA, NCI, HRSA), state and local governments, 
medical schools, schools of public health, colleges and universities, 
private businesses, nonprofits, and individual practitioners and 
administrators. The total cost to respondents is estimated at 
$2,570,400.

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                                                                                               Avg.             
                                                                     No. of       No. of     burden/     Total  
                           Respondents                            respondents   responses/   response    burden 
                                                                               respondents  (in hrs.)  (in hrs.)
----------------------------------------------------------------------------------------------------------------
Private, Office-based Physicians Forms:                                                                         
  Induction.....................................................        3000            1       0.250        750
  Patient Record................................................        3000           30       0.033       2970
                                                                 -----------------------------------------------
      Total.....................................................  ...........  ...........  .........      3,720
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    2. The National Hospital Ambulatory Medical Care Survey (NHAMCS)--
(0920-0278)--Extension--The National Hospital Ambulatory Medical Care 
Survey (NHAMCS) has been conducted annually since 1992 by the National 
Center for Health Statistics, CDC. The NHAMCS is the principal source 
of data on the 153 million visits to hospital emergency and outpatient 
departments. It is the only source of nationally representative 
estimates of outpatient demographics, diagnoses, diagnostic services, 
medication therapy, and the patterns of use of care in hospitals which 
differ in size, location, and ownership. NHAMCS is also the only source 
of national estimates on causes of non-fatal injury for visits to 
emergency and outpatient departments.
    These data complement those from the National Ambulatory Medical 
Care Survey (NAMCS), on visits to non-Federal physicians in office-
based practices. NHAMCS data are essential for planning health 
services, improving medical education, determining health care work 
force needs, and assessing health. Users of NHAMCS data include 
Congress, Federal agencies such as NIH, private groups such as the 
American Heart Association, universities, and state offices of public 
health. The total cost to respondents is estimated at $180,000.

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                                                                                              Avg.              
                                                                    No. of       No. of      burden/     Total  
                          Respondents                            respondents   responses/   response     burden 
                                                                              respondents   (in hrs.)  (in hrs.)
----------------------------------------------------------------------------------------------------------------
Noninstitutional, general and short stay, hospital outpatient                                                   
 and emergency departments forms:                                                                               
  Hospital Induction...........................................         600            1         1.0         600

[[Page 55585]]
                                                                                                                
  Ambulatory Unit Induction....................................         600            1         1.2         720
  Emergency Department Patient Record..........................         600           50         0.06      1,800
  Outpatient Department Patient Record.........................         600          150         0.06      5,400
                                                                ------------------------------------------------
      Total....................................................  ...........  ...........  ..........      8,520
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    3. TB Statistics and Evaluation Activity--(0920-0026)--Revision--
This is a request to revise the currently approved data collection, 
which authorizes the collection of information that constitutes a 
national information system for tuberculosis. These data provide 
reliable and consistent information on the extent and distribution of 
TB in the U.S. Two forms will be deleted from the current information 
package: CDC 72.16 Tuberculosis Program Management Report, Contact 
Follow-up; and CDC 72.21 Tuberculosis Program Management Report, 
Completion of Preventive Therapy. The burden for those two forms is 351 
hours. Performance Measurement Report, Contact Investigation and 
Preventive Therapy for Contacts will replace form 72.16; Performance 
measurement Report, Preventive Therapy will replace form 72.21, and the 
new form Performance Measurement Report, Screening will be added. The 
total burden for these three new forms is 238 hours, a decrease of 113 
hours over the burden in the current package.
    The existing form for contact follow-up (72.16) is being replaced 
because it does not stratify the contacts by the sputum smear status of 
the index case. Sputum smear cases are most likely to be highly 
infectious and their contacts should receive the highest priority for 
identification, evaluation, and preventive therapy. Furthermore, it 
does not reflect whether or not the contacts to a specific cohort of TB 
cases who were started on preventive therapy actually complete a 
recommended course of medication. Recently infected contacts are one of 
the highest risk groups for developing active TB and therefore should 
receive high priority for completing preventive therapy. The existing 
form on completion of preventive therapy (72.21) is being replaced 
because it does not stratify persons starting and completing preventive 
therapy by HIV status, the highest risk factor ever identified for 
developing active TB. Furthermore, it does not separate those who are 
at high risk because they are more likely to be infected with TB or 
because they are more likely to develop TB disease once infected. 
Finally, it does not specify the activity or group (e.g., correctional 
facility or drug treatment center) in which the preventive therapy is 
being carried out. The new screening form is being added because there 
is currently no mechanism for systematically collecting information 
from TB grant recipients on TB screening activities in various risk 
groups (e.g., persons with HIV infection) or in various settings (e.g., 
correctional facilities, drug treatment centers). The new form also 
collects data that determines of those screened, the number and percent 
found to have TB infection and who were subsequently placed on 
preventive therapy. CDC cannot currently determine whether grant 
recipients are appropriately carrying out these activities.

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                                                                                              Avg.              
                                                                     No. of      No. of      burden/     Total  
                           Respondents                            respondents  responses/   response     burden 
                                                                               respondent   (in hrs.)  (in hrs.)
----------------------------------------------------------------------------------------------------------------
Performance Measurement Report, Contact Investigation and                                                       
 Preventive Therapy for Contacts................................          68            2        0.5          68
Performance Measurement Report, Preventive Therapy..............          68            2        1.0         136
Performance Measurement Report, Screening.......................          68            2        0.25         34
                                                                 -----------------------------------------------
      Total.....................................................  ...........  ..........  ..........        238
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    4. Hanford Environmental Dose Reconstruction (HEDR) Project Milk 
Producers Survey--New--OMB approved the information collections for the 
``Hanford Thyroid Disease Full Epidemiology Study'' under OMB No. 0920-
0296 to determine the health effects to the public from radioactive 
releases from the Hanford Nuclear Site Operations during the 1940's and 
1950's. A primary component of these releases was radioactive iodine. 
Consumption of fresh milk from cows that have eaten contaminated 
vegetation and fresh leafy vegetables and eggs from chickens with 
access to outdoor vegetation are important pathways of radioactive 
iodine to the human body which adversely affects the thyroid gland. To 
estimate the doses to the thyroid that individuals and populations 
could have received, historical milk cow and chicken feeding and 
distribution practices must be reconstructed for the downwind area. 
This information is particularly important for use in this ongoing 
study and its relation to radiation exposures. Researchers from LTG 
Associates will collect information from a representative sample of 
individuals who farmed in 7 counties within the study area during the 
periods of 1945 and 1951. There are no costs to the respondents.

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                                                                                              Avg.              
                                                                    No. of       No. of      burden/     Total  
                          Respondents                            respondents   responses/   response     burden 
                                                                              respondents   (in hrs.)  (in hrs.)
----------------------------------------------------------------------------------------------------------------
Contact Potential Sources of Names of farmers..................          50            1         0.16          8

[[Page 55586]]
                                                                                                                
Initial Contact of Potential Candidates........................       1,600            1         0.16        267
Scheduling Interview...........................................         400            1         0.08         33
Telephone Interview............................................         400            1         2           800
                                                                ------------------------------------------------
      Total....................................................  ...........  ...........  ..........      1,108
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    5. State-Based Evaluation of Trends and Risk Factors in Morbidity 
and Mortality from Sickle Cell Disease after Newborn Screening--New--
Children with sickle cell disease are at increased risk for mortality 
and morbidity, especially in the first three years of life. The need 
for early diagnosis and preventive medical intervention is the 
rationale for newborn hemoglobinopathy screening programs, now 
operating in more than 40 states. Although clinical trials have clearly 
demonstrated the efficacy of early medical intervention, more 
information is needed regarding the actual utilization of available 
therapies and preventive measures in large populations, health statuses 
of children identified by newborn screening programs, and risk factors 
for adverse health outcomes. Potential risk factors include extent of 
medical care follow-up, location of treatment, the use of penicillin 
prophylaxis, immunization patterns, as well as parental social, 
demographic and educational factors. In FY 1995, CDC awarded $150,000 
to three state health departments to assist in their efforts to 
ascertain health status and risk factors for young children with sickle 
cell disease. States will be using these funds to obtain information 
about individual children through structured questionnaires directed 
toward their parents and physicians. There are no costs to the 
respondents.

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                                                                                             Avg.               
                                                                    No. of      No. of      burden/      Total  
                          Respondents                            respondents  responses/   response     burden  
                                                                              respondent   (in hrs.)   (in hrs.)
----------------------------------------------------------------------------------------------------------------
Parents........................................................       3,000            1         1.5         4.5
Physicians.....................................................       4,500            1         1           4.5
                                                                ------------------------------------------------
      Total....................................................  ...........  ..........  ..........         9  
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    Dated: October 26, 1995.
Joseph R. Carter,
Acting Associate Director for Management and Operations, Centers for 
Disease Control and Prevention (CDC).
[FR Doc. 95-27056 Filed 10-31-95; 8:45 am]
BILLING CODE 4163-18-P