[Federal Register Volume 73, Number 5 (Tuesday, January 8, 2008)]
[Notices]
[Pages 1354-1355]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: E8-51]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Disease Control and Prevention

[60Day-08-0212]


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 404-639-5960 
and send comments to Maryam I. Daneshvar, CDC Acting Reports Clearance 
Officer, 1600 Clifton Road, MS-D74, Atlanta, GA 30333 or send an e-mail 
to [email protected].
    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 or other 
forms of information technology. Written comments should be received 
within 60 days of this notice.

Proposed Project

    National Hospital Discharge Survey--Revision--The National Hospital 
Discharge Survey (NHDS) (OMB 0920-0212), National Center for 
Health Statistics (NCHS), Centers for Disease Control and Prevention 
(CDC).

Background and Brief Description

    Section 306 of the Public Health Service (PHS) Act (42 U.S.C. 
242k), as amended, authorizes that the Secretary of Health and Human 
Services (DHHS), acting through NCHS, shall collect statistics on the 
extent and nature of illness and disability of the population of the 
United States. This three-year clearance request includes the data 
collection in 2008 and 2009 using the current NHDS design; a pretest of 
a new design; and data collection for 2010 and 2011 of the survey using 
the new design.

Current NHDS

    The National Hospital Discharge Survey (NHDS) has been conducted 
continuously by the National Center for Health Statistics, CDC, since 
1965. It is the principal source of data on inpatient utilization of 
short-stay, non-Federal hospitals and is the principal annual source of 
nationally representative estimates on the characteristics of 
discharges, the lengths of stay, diagnoses, surgical and non-surgical 
procedures, and the patterns of use of care in hospitals in various 
regions of the country. It is the benchmark against which special 
programmatic data sources are measured. The data items collected are 
the basic core of the variables contained in the Uniform Hospital 
Discharge Data Set (UHDDS) in addition to several variables (admission 
source and type, admitting diagnosis and present on admission 
indicators) which are identical to those needed for billing of 
inpatient services for Medicare patients. In the current survey, data 
are obtained in one of three ways: Abstracted by hospital staff; 
abstracted by Bureau of the Census Staff under an interagency 
agreement; and provided in electronic format. Due to budgetary 
constraints, the number of hospitals and the number of discharges for 
the 2008 and 2009 NHDS data collections will decrease by approximately 
50% from previous years.

Redesigned NHDS

    Although the current NHDS is still fulfilling its intended 
functions, it is based on concepts from the health care delivery 
system, as well as the hospital and patient universes, of previous 
decades. It has become clear that a redesign of the NHDS that provides 
greater depth of information is necessary.

[[Page 1355]]

    In 2008, a sample of 40 hospitals will be selected for a pretest. 
These hospitals will not be a probability sample, but instead will be 
intentionally selected to include hospitals of differing size, location 
and other characteristics related to their service and patient 
clientele.
    In 2010, a redesigned NHDS will be implemented and will consist of 
a completely new sample of approximately 240 hospitals. The redesigned 
NHDS will use a modified two stage design. The first stage sampling 
will be hospitals. The second stage of sampling will be discharges. A 
stratified, random sample of 120 discharges is targeted within each 
hospital. In the redesigned survey all data will be abstracted by 
trained health care staff under contract. All data will be obtained 
from hospital records and charts and computer systems.
    The current data items will be collected with significant 
additional details. Patient level data items to be collected include 
personal identifiers such as Social Security number, name and medical 
record number; clinical laboratory results such as hematocrit and white 
blood cell count; and financial billing and record data. The survey 
includes detailed questions for three modules: Acute myocardial 
infarction; infectious disease; and end of life issues. Facility level 
data items include demographic information, clinical capabilities, and 
financial information.
    Users of NHDS data include, but are not limited to the CDC; the 
Congressional Research Office; the Office of the Assistant Secretary 
for Planning and Evaluation (ASPE); American Health Care Association, 
Centers for Medicare and Medicaid Services (CMS), and Bureau of the 
Census. Data collected through the NHDS are essential for evaluating 
health status of the population, for the planning of programs and 
policy to elevate the health status of the Nation, for studying 
morbidity trends, and for research activities in the health field. NHDS 
data have been used extensively in the development and monitoring of 
goals for the Year 2000 and 2010 Healthy People Objectives. In 
addition, NHDS data provide annual updates for numerous tables in the 
Congressionally-mandated NCHS report, Health, United States. Other 
users of these data include universities, contract research 
organizations, many in the private sector, foundations, and a variety 
of users in the print media. There is no cost to respondents other than 
their time to participate.

                                        Estimated Annualized Burden Hours
----------------------------------------------------------------------------------------------------------------
                                                                     Number of                       Response
                    Hospitals                        Number of     responses per     Hours per        burden
                                                    respondents     respondent       response         (hours)
----------------------------------------------------------------------------------------------------------------
Current NHDS:
    Primary Procedure abstracting...............              13             250            6/60             325
    Alternate (Census) Procedure (pulling &                   41             250            1/60             171
     refiling records)..........................
    In-House Tape or Printout Hospital                        29              12           13/60              75
     (programming)..............................
    Induction...................................              10               1               2              20
                                                 ---------------------------------------------------------------
        Sub-total...............................  ..............  ..............  ..............             591
Redesign HDS Pre-test:
    Survey presentation to hospital.............              13               1               1              13
    Facility questionnaire......................              13               1             4.1              53
    Sample discharges and obtain data...........              13              10           14/60              30
    Debrief hospital staff......................              13               1               1              13
    Quality control.............................               2              25           14/60              12
                                                 ---------------------------------------------------------------
        Sub-total...............................  ..............  ..............  ..............             121
Redesign Survey 2010 & 2011:
    Survey presentation to hospital.............             160               1               1             160
    Facility questionnaire......................              80               1             4.1             328
    Sample discharges and obtain data...........             160             120           14/60           4,480
    Pre-testing of new data elements............              13             120            5/60             130
    Quality control.............................               3              25           14/60              18
    Non-response study..........................              27               1               2              54
                                                 ---------------------------------------------------------------
        Sub-total...............................  ..............  ..............  ..............           5,170
                                                 ---------------------------------------------------------------
            Total...............................  ..............  ..............  ..............           5,882
----------------------------------------------------------------------------------------------------------------


    Dated: December 27, 2007.
Maryam I. Daneshvar,
Acting Reports Clearance Officer, Centers for Disease Control and 
Prevention.
 [FR Doc. E8-51 Filed 1-7-08; 8:45 am]
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