Title: Hospital Utilization and Access to Care
Contact Number: 1-866-441-NCHS
Years of Content: 2007
First Published: September, 2009
Access Constraints: None
Use Constraints: None
Geographic Coverage: National
Subject:Self-reported health status and use of health care providers during the previous 12 months.
Record Source: NHANES 2007
Survey Methodology: NHANES 2007
is a stratified multistage probability sample of the civilian non-institutionalized population of the U.S.
Medium: NHANES Web site; SAS transport files
The Hospital Utilization and Access to Care section (variable name prefix HUQ) provides SP level interview data on self-reported health status and access to health care topics.
All survey participants respond to this section. HUQ020 was asked of participants 1 year and older. HUQ090 was asked of participants 4 years and older.
Interview Setting and Mode of Administration
The Hospital Utilization and Access to Care questionnaire was done before the physical examination, in the home, using the Computer-Assisted Personal Interviewing-CAPI (interviewer administered) system. Persons 16 years of age and older and emancipated minors were interviewed directly. A proxy provided information for survey participants who were under 16 years of age and for individuals who could not answer the questions themselves.
Quality Assurance & Quality Control
The CAPI system is programmed with built-in consistency checks to reduce data entry errors. CAPI also uses online help screens to assist interviewers in defining key terms used in the questionnaire.
Data Processing and Editing
HUQ010: This identical question is asked in the Current Health Status section of the Mobile Examination Center (MEC) CAPI Interview questionnaire (HSD010). There is a small difference in administration of the two questions: participants age 12-15 have proxy responses in the household questionnaire but provide self-reported responses for the MEC interview. Many participants of all ages gave different responses to this question in the household compared to the MEC, so analysts should consider which of the two versions of the question to use in analyses.
Question HUQ071, in NHANES 2007-2008, is comparable to HUQ071 in NHANES 2003-2004, NHANES 2005-2006 and to question HUD070 in NHANES 2001-2002 and HUQ070 in NHANES 1999-2000.
Question HUQ080/HUD080 (questionnaire/data release file) asks how many times the survey participant spent one or more nights in the hospital during the past 12 months. For NHANES 2007-2008 an additional English instruction was added for interviewers to provide to survey participants. This stated: “Do not count total number of nights, just total number of hospital admissions for stays which lasted 1 or more nights.” The purpose of this instruction was to clarify the distinction between total numbers of admissions versus total number of nights. The former number is the one sought. There is the possibility that some answers given during previous survey cycles, may have reflected total nights rather than total admissions.
For NHANES 2001-2002, there wasn’t a limit to the number of responses that could be given for HUQ080 (number of overnight hospitalizations in past 12 months). In all other cycles of the continuous NHANES, the derived question, HUD080, was given an upper limit of “6 or more.” Data users will need to recode HUQ080 to make it comparable to HUD080 when comparing the 2001-2002 data to the other 2-yr cycles.
Questions on long-term care (HUQ081-HUQ089) were included in NHANES 2001-2002 and NHANES 2003-2004. These questions were not included in NHANES 2007-2008, NHANES 2005-2006 or NHANES 1999-2000.
All other similarly named questions are comparable between the two surveys.
Although these data were collected as part of the household questionnaire, if they are merged with the MEC exam data, exam sample weights should be used for the analyses.
Please refer to the NHANES Analytic Guidelines and the on-line NHANES Tutorial for further details on the use of sample weights and other analytic issues. Both of these are available on the NHANES website.