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NCHS
and AcademyHealth
As the nation's
principal health statistics agency, NCHS designs and maintains data systems
that are used to:
- Profile the health of Americans
and analyze changes over time;
- Monitor and analyze health care delivery;
- Examine relationships between risk
factors and health outcomes; and
- Provide information for prevention,
evaluation, planning, and policy.
NCHS is also
actively involved in a number of major initiatives within DHHS, including
Healthy People 2010, Health United States, the National Healthcare Quality
Report; and the National Healthcare Disparities Report.
AcademyHealth
is the professional home for health services researchers, policy analysts,
and practitioners, and a leading, non-partisan resource for the best in
health research and policy. AcademyHealth promotes the use of objective
research and analysis to inform health policy and practice.
Fellowship
Opportunities
The aim of
the fellowship is to foster collaboration between NCHS staff and visiting
scholars on a wide range of topics of mutual concern. The fellowship allows
visiting scholars to conduct new and innovative analyses and participate
in developmental and health policy activities related to the design and
content of future NCHS surveys.
The fellowship
offers researchers unique opportunities in areas such as the following:
- Working
with NCHS research, statistical, and computing staff to learn about
the Center's data systems; access and analyze data; participate in projects
to improve the quality and policy relevance of data systems; and develop
joint analytic products for publication.
- Access
contextual variables such as characteristics of health care providers
or the communities in which care is received. Because of NCHS' mandate
to protect the privacy and confidentiality of survey participants, contextual
variables are typically not included in public use data files. However,
by working in residence as NCHS employees, and with NCHS staff, researchers
may expand their analysis while at the same time safeguarding respondent
confidentiality.
- Create
linked or merged files, or use existing linked files where available.
Examples include elements from the Area Resource File, Medicare data,
or Census data on median income by zip code. Opportunities also exist
for analysis of provider characteristics from membership organizations
such as the American Medical Association or American Hospital Association
master files.
The vast
array of government and health policy resources in Washington, D.C. provides
a rich experience for visiting scholars. Fellows may participate in activities
throughout the area, in planned fellowship activities such as AcademyHealth's
Annual Research Meeting and National Health Policy Conference, and in
special conferences and seminars at NCHS. At the same time, the fellowship
offers protected time for the investigator to support a successful research
endeavor leading to the development of new knowledge, the creation of
new data linkages, and the disseminate research findings through scientific
publication.
Health
Policy Issues
NCHS data
systems may be used to study a variety of
health services research
and
health policy-related issues, including:
- Factors
affecting trends in the use of clinical preventive services;
- The influence
of geographic proximity of providers on access to health care services
and health outcomes;
- Increases
in hospital transfers to long-term care facilities;
- Factors, such as Medicare payment,
affecting hospice length of stay;
- Use of emergency departments and their
role as safety net providers;
- Use of
complementary and alternative medicine within the U.S.;
- Trends
in appropriate use of antimicrobials;
- Variations
in treatment patterns by payer, provider, and patient characteristics;
- Variation in caseload among urban and
rural hospitals and the effect of caseload on demand
for specialized services, per patient costs,
and clinical outcomes;
- Effects of Medicaid expansions on use of ambulatory,
emergency, and inpatient services;
- Trends in usual source of care and
health insurance coverage;
- Trends in emergency department utilization
for adverse effects of medical treatment;
- Trends in use of family planning services;
and
- Patterns in use of infertility therapies.
NCHS Data
Systems
NCHS conducts
an array of surveys and maintains statistical systems that may be used
independently or linked with other data sets. These data systems may be
grouped into three broad categories.
-
Provider/establishment-based surveys. The National Health Care
Survey (NHCS) comprises a family of establishment-based surveys designed
to provide nationally representative data on the use of health care
services for the major sectors of the U.S. health care delivery system.
NHCS component surveys collect information directly from health care
providers and their records including characteristics of the practice
and patients visiting the practice, patients' complaints and diagnoses,
therapeutic and treatment services received, and disposition of care.
The component surveys of the NHCS span the major sectors of the U.S.
health care system and include the National Ambulatory Medical Care
Survey, National Hospital Ambulatory Medical Care Survey, National Hospital
Discharge Survey, National Survey of Ambulatory Surgery, National Nursing
Home Survey, and the National Home and Hospice Care Survey.
- Vital
records. The Vital Statistics System is a
federal/state partnership to collect information
via state-operated registries on births, deaths,
and fetal deaths. These data may be used for
studying issues such as cause of death, e.g.,
in-hospital mortality or deaths due to complications
of medical care; disproportionate
mortality rates for minority populations, which
may result from problems with accessing care;
adequacy of prenatal care; and variations in
birth outcomes and relevant factors.
- Population-based
surveys.
The National
Health Interview Survey (NHIS), the State and
Local Area Integrated Telephone Survey
(SLAITS), the National Immunization Survey
(NIS), and the National Survey of Family Growth
(NSFG) may be used to examine questions about
access to care, satisfaction with care, and receipt of appropriate preventive services. The ongoing
NHIS includes core and supplemental questions,
has been the basis for targeted studies on
children's mental health, complementary and
alternative medicine, and tracking Healthy
People 2010 objectives. SLAITS, which provides
subnational and subpopulation estimates to
address emergent health-related data needs, has
addressed asthma and children with special
needs. The NSFG, which addresses a variety of
reproductive health and health care issues,
oversamples teenagers, blacks, and Hispanics.
Also included
in this group is the National Health and Nutrition Examination Survey
(NHANES), which is based on interviews, medical exams, laboratory data,
and physical measurements on a nationally representative sample of the
U.S. population. Data from this survey have been used to estimate the
percentage of the U.S. population with selected diseases (such as high
blood pressure, diabetes, and heart disease) or at risk for them; to study
prevalence and the relationship between diet, nutrition, and health; to
assess timely and adequate treatment for selected conditions; and to explore
emerging public health issues and new technologies.
For additional
information on NCHS programs, consult the publication: National Center
for Health Statistics...Programs and Activities, available at
cdc.gov/nchs/data/misc/proact02.pdf.
Potential
applicants are also encouraged to visit the Center's Web site: cdc.gov/nchs
to find information on these and the full range of NCHS data systems,
a list of public use data files with documentation, and information on
other NCHS programs such as the Healthy People 2010, Health United States,
and the Trends in Health and Aging Data Warehouse. A bibliography of current
publications and other NCHS products may be found on cdc.gov/nchs/products.htm.
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