[Federal Register Volume 73, Number 149 (Friday, August 1, 2008)]
[Notices]
[Pages 45012-45013]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: E8-17605]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Disease Control and Prevention

[30Day-08-0212]


Agency Forms Undergoing Paperwork Reduction Act Review

    The Centers for Disease Control and Prevention (CDC) publishes a 
list of information collection requests under review by the Office of 
Management and Budget (OMB) in compliance with the Paperwork Reduction 
Act (44 U.S.C. Chapter 35). To request a copy of these requests, call 
the CDC Reports Clearance Officer at (404) 639-5960 or send an e-mail 
to [email protected]. Send written comments to CDC Desk Officer, Office of 
Management and Budget, Washington, DC or by fax to (202) 395-6974. 
Written comments should be received within 30 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.
    In 2008, a sample of 30 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 (last 4 digits), 
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

[[Page 45013]]

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, research 
organizations, foundations, and a variety of users in the print media. 
There is no cost to respondents other than their time to participate. 
The total estimated annualized burden hours are 5,591.

                                   Table 1--Estimated Annualized Burden Hours
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                                                                                        Average
                                                       Number of       Number of      burden per
              Type of data collection                 respondents   responses  per   response  (in
                                                                       respondent       hours)
--------------------------------------------------------------------------------------------------
Current NHDS Primary Procedure Hospitals Sample                 13              12           25/60
 Listing Sheet....................................
Current NHDS Primary Procedure Hospitals Medical                13             250            5/60
 Abstract Form....................................
Current NHDS Primary Procedure Hospitals                        13              12            1/60
 Transmittal Notice...............................
Current NHDS Alternate Procedure Hospitals                      41             250            1/60
 locating medical records.........................
Current NHDS In-House Tape or Printout Hospital--               29              12           13/60
 computer programming and submission..............
Current NHDS Hospital Interview Questionnaire.....              10               1               2
Redesigned pretest Survey presentation to hospital              10               1               1
Redesigned pretest Facility questionnaire.........              10               1               4
Redesigned pretest Sample discharges within                     10              10           14/60
 hospital, obtain UB-04 & payment data............
Redesigned pretest Verify sampling & reabstract                  2              10           14/60
 medical records..................................
Redesign pretest Debrief hospital staff...........              10               1               1
Redesigned 2010-2011 Survey presentation to                     80               1               1
 hospital.........................................
Redesigned 2010-2011 Facility questionnaire.......              80               1               4
Redesigned 2010-2011 Sample discharges within                  160             120           14/60
 hospital, obtain UB-04 & payment data............
Redesigned 2010-2011 Verify sampling & re-abstract               3              25           14/60
 medical records..................................
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    Dated: July 24, 2008.
Maryam I. Daneshvar,
Acting Reports Clearance Officer, Centers for Disease Control and 
Prevention.
[FR Doc. E8-17605 Filed 7-31-08; 8:45 am]
BILLING CODE 4163-18-P