[Federal Register Volume 89, Number 89 (Tuesday, May 7, 2024)]
[Notices]
[Pages 38147-38148]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2024-09855]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Disease Control and Prevention

[60Day-24-0212; Docket No. CDC-2024-0035]


Proposed Data Collection Submitted for Public Comment and 
Recommendations

AGENCY: Centers for Disease Control and Prevention (CDC), Department of 
Health and Human Services (HHS).

ACTION: Notice with comment period.

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SUMMARY: The Centers for Disease Control and Prevention (CDC), as part 
of its continuing effort to reduce public burden and maximize the 
utility of government information, invites the general public and other 
federal agencies the opportunity to comment on a continuing information 
collection, as required by the Paperwork Reduction Act of 1995. This 
notice invites comment on a proposed information collection project 
titled the National Hospital Care Survey (NHCS). The goal of the 
project is to assess patient care in hospital-based settings and to 
describe patterns of health care delivery and utilization in the United 
States.

DATES: CDC must receive written comments on or before July 8, 2024.

ADDRESSES: You may submit comments, identified by Docket No. CDC-2024-
0035 by any of the following methods:
     Federal eRulemaking Portal: www.regulations.gov. Follow 
the instructions for submitting comments.
     Mail: Jeffrey M. Zirger, Information Collection Review 
Office, Centers for Disease Control and Prevention, 1600 Clifton Road 
NE, MS H21-8, Atlanta, Georgia 30329.
    Instructions: All submissions received must include the agency name 
and Docket Number. CDC will post, without change, all relevant comments 
to www.regulations.gov.
    Please note: Submit all comments through the Federal eRulemaking 
portal (www.regulations.gov) or by U.S. mail to the address listed 
above.

FOR FURTHER INFORMATION CONTACT: To request more information on the 
proposed project or to obtain a copy of the information collection plan 
and instruments, contact Jeffrey M. Zirger, Information Collection 
Review Office, Centers for Disease Control and Prevention, 1600 Clifton 
Road NE, MS H21-8, Atlanta, Georgia 30329; Telephone: 404-639-7570; 
Email: [email protected].

SUPPLEMENTARY INFORMATION: Under the Paperwork Reduction Act of 1995 
(PRA) (44 U.S.C. 3501-3520), federal agencies must obtain approval from 
the Office of Management and Budget (OMB) for each collection of 
information they conduct or sponsor. In addition, the PRA also requires 
federal agencies to provide a 60-day notice in the Federal Register 
concerning each proposed collection of information, including each new 
proposed collection, each proposed extension of existing collection of 
information, and each reinstatement of previously approved information 
collection before submitting the collection to the OMB for approval. To 
comply with this requirement, we are publishing this notice of a 
proposed data collection as described below.
    The OMB is particularly interested in comments that will help:
    1. 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;
    2. Evaluate the accuracy of the agency's estimate of the burden of 
the proposed collection of information, including the validity of the 
methodology and assumptions used;
    3. Enhance the quality, utility, and clarity of the information to 
be collected;
    4. 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 
submissions of responses; and
    5. Assess information collection costs.

Proposed Project

    National Hospital Care Survey (NHCS) (OMB Control No. 0920-0212, 
Exp. 12/31/2024)--Revision--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 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,

[[Page 38148]]

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 No. 0920-0212, Exp. Date 
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 information about telemedicine usage in the 
healthcare setting 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 (PII) allows NCHS to link episodes 
of care provided to the same patient in the ED and/or 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 a high level of missing 
data, OPD data were not collected in the last approval period (2022, 
2023 and 2024). 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.
    Changes to the data collection survey include the removal of COVID-
19 questions from the Annual Hospital Interview (AHI). The burden hours 
have been reduced due to a decrease in the sample size. The new total 
annualized burden is 5,826 hours. There is no cost to respondents other 
than their time to participate.

                                        Estimated Annualized Burden Hours
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                                                                     Number of      Avg. burden
          Respondents               Form name        Number of     responses per   per response    Total burden
                                                    respondents     respondent      (in hours)      (in hours)
----------------------------------------------------------------------------------------------------------------
Hospital DHIM or DHIT.........  Initial Hospital             123               1               1             123
                                 Intake
                                 Questionnaire.
Hospital CEO/CFO..............  Recruitment                   30               1               1              30
                                 Survey
                                 Presentation.
Hospital DHIM or DHIT.........  Prepare and                  356              12               1           4,272
                                 transmit UB-04
                                 or State File
                                 for Inpatient
                                 and Ambulatory
                                 (monthly).
Hospital DHIM or DHIT.........  Prepare and                  200               4               1             800
                                 transmit EHR
                                 for Inpatient
                                 and Ambulatory
                                 (quarterly).
Hospital CEO/CFO..............  Annual Hospital              601               1               1             601
                                 Interview.
                                                 ---------------------------------------------------------------
    Total.....................  ................  ..............  ..............  ..............           5,826
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Jeffrey M. Zirger,
Lead, Information Collection Review Office, Office of Public Health 
Ethics and Regulations, Office of Science, Centers for Disease Control 
and Prevention.
[FR Doc. 2024-09855 Filed 5-6-24; 8:45 am]
BILLING CODE 4163-18-P