[Federal Register Volume 86, Number 199 (Tuesday, October 19, 2021)]
[Notices]
[Pages 57835-57836]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2021-22697]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Disease Control and Prevention

[30Day-22-0212]


Agency Forms Undergoing Paperwork Reduction Act Review

    In accordance with the Paperwork Reduction Act of 1995, the Centers 
for Disease Control and Prevention (CDC) has submitted the information 
collection request titled The National Hospital Care Survey (NHCS) to 
the Office of Management and Budget (OMB) for review and approval. CDC 
previously published a ``Proposed Data Collection Submitted for Public 
Comment and Recommendations'' notice on July 19, 2021 to obtain 
comments from the public and affected agencies. CDC received no 
comments related to the previous notice. This notice serves to allow an 
additional 30 days for public and affected agency comments.
    CDC will accept all comments for this proposed information 
collection project. The Office of Management and Budget is particularly 
interested in comments that:
    (a) Evaluate whether the proposed collection of information is 
necessary for the proper performance of the functions of the agency, 
including whether the information will have practical utility;
    (b) Evaluate the accuracy of the agencies estimate of the burden of 
the proposed collection of information, including the validity of the 
methodology and assumptions used;
    (c) Enhance the quality, utility, and clarity of the information to 
be collected;
    (d) Minimize the burden of the collection of information on those 
who are to respond, including, through the use of appropriate 
automated, electronic, mechanical, or other technological collection 
techniques or other forms of information technology, e.g., permitting 
electronic submission of responses; and
    (e) Assess information collection costs.
    To request additional information on the proposed project or to 
obtain a copy of the information collection plan and instruments, call 
(404) 639-7570. Comments and recommendations for the proposed 
information collection should be sent within 30 days of publication of 
this notice to www.reginfo.gov/public/do/PRAMain. Find this particular 
information collection by selecting ``Currently under 30-day Review--
Open for Public Comments'' or by using the search function. Direct 
written comments and/or suggestions regarding the items contained in 
this notice to the Attention: CDC Desk Officer, Office of Management 
and Budget, 725 17th Street NW, Washington, DC 20503 or by fax to (202) 
395-5806. Provide written comments within 30 days of notice 
publication.

Proposed Project

    National Hospital Care Survey (OMB Control No. 0920-0212, Exp. 03/
31/2022)--Revision--National Center for Health Statistics (NCHS), 
Centers for Disease Control and Prevention (CDC).

[[Page 57836]]

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 for National Hospital 
Care Survey (NHCS) includes the collection of all inpatient and 
ambulatory Uniform Bill-04 (UB-04) claims data, or electronic health 
record (EHR) data, as well as the collection of hospital-level 
information via a questionnaire from a sample of 608 hospitals.
    The National Ambulatory Medical Care Survey (NAMCS) was conducted 
intermittently from 1973 through 1985, and annually since 1989. The 
survey is conducted under authority of Section 306 of the Public Health 
Service Act (42 U.S.C. 242k). The National Hospital Discharge Survey 
(NHDS) (OMB Control No. 0920-0212, Exp. 01/31/2019), conducted 
continuously between 1965 and 2010, was the Nation's principal source 
of data on inpatient utilization of short-stay, non-institutional, non-
Federal hospitals, and was the principal source of nationally 
representative estimates on the characteristics of inpatients including 
lengths of stay, diagnoses, surgical and non-surgical procedures, and 
patterns of use of care in hospitals in various regions of the country. 
In 2011, NHDS was granted approval by OMB to expand its content and to 
change its name to the National Hospital Care Survey (NHCS).
    In May 2011, recruitment of sampled hospitals for the NHCS began. 
Hospitals in the NHCS are asked to provide data on all inpatients from 
their UB-04 administrative claims, or EHRs. Hospital-level 
characteristics and data on the impact of COVID-19 on the hospital are 
collected through an Annual Hospital Interview. NHCS will continue to 
provide the same national health-care statistics on hospitals that NHDS 
provided. Additionally, NHCS collects more information at the hospital 
level (e.g., volume of care provided by the hospital), which allow for 
analyses on the effect of hospital characteristics on the quality of 
care provided. NHCS data collected from UB-04 administrative claims and 
EHRs include all inpatient discharges, not just a sample. The 
confidential collection of personally identifiable information allows 
NCHS to link episodes of care provided to the same patient in the 
Emergency Department (ED) and/or Outpatient Department (OPD), and as an 
inpatient, as well as link patients to the National Death Index (NDI) 
to measure post-discharge mortality, and Medicare and Medicaid data to 
leverage comorbidities. The availability of patient identifiers also 
makes analysis on hospital readmissions possible. This comprehensive 
collection of data makes future opportunities for surveillance 
possible, including analyzing trends and incidence of opioid misuse, 
acute myocardial infarction, heart failure and stroke, as well as 
trends and point prevalence of health care acquired infections and 
antimicrobial use.
    Beginning in 2013, in addition to inpatient hospital data, 
hospitals participating in NHCS were asked to provide data on the 
utilization of health care services in their ambulatory settings (e.g., 
EDs and OPDs). Due to low response rates and high level of missing 
data, OPD data were not collected in the last approval period (2019, 
2020 and 2021). Collection of OPD may resume in future years.
    Data collected through NHCS are essential for evaluating the health 
status of the population, for the planning of programs and policy to 
improve health care delivery systems of the Nation, for studying 
morbidity trends, and for research activities in the health field. 
There are no changes to the data collection survey. The only change is 
to the burden hours due to the increase of the sample size. The new 
total annualized burden is 7,184 hours. CDC requests a three-year 
approval, and there are no costs to respondents other than their time.

                                        Estimated Annualized Burden Hours
----------------------------------------------------------------------------------------------------------------
                                                                                     Number of    Average burden
              Respondents                       Form name            Number of     responses per   per response
                                                                    respondents     respondent      (in hours)
----------------------------------------------------------------------------------------------------------------
Hospital DHIM or DHIT.................  Initial Hospital Intake              150               1               1
                                         Questionnaire.
Hospital CEO/CFO......................  Recruitment Survey                   150               1               1
                                         Presentation.
Hospital DHIM or DHIT.................  Prepare and transmit UB-             408              12               1
                                         04 or State File for
                                         Inpatient and
                                         Ambulatory (monthly).
Hospital DHIM or DHIT.................  Prepare and transmit EHR             200               4               1
                                         for Inpatient and
                                         Ambulatory (quarterly).
Hospital CEO/CFO......................  Annual Hospital                      608               1               2
                                         Interview.
----------------------------------------------------------------------------------------------------------------


Jeffrey M. Zirger,
Lead, Information Collection Review Office, Office of Scientific 
Integrity, Office of Science, Centers for Disease Control and 
Prevention.
[FR Doc. 2021-22697 Filed 10-18-21; 8:45 am]
BILLING CODE 4163-18-P