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December 2020

STATS OF THE MONTH

In recognition of National Influenza Vaccination Week (December 6-12), we present estimates for visits to emergency departments (ED) at which an influenza test was provided, from the 2018 National Hospital Ambulatory Medical Care Survey (NHAMCS).

  • In 2018, an influenza test was provided at 5.7% of all ED visits. Children younger than 18 were tested for influenza more frequently than adults. Children were tested at 11.3% of ED visits made by children whereas adults aged 18-65 and 65 and over were tested for influenza at 3.8% and 4.9% of ED visits made by adults. (Estimates from the Public Use File)

DATA TIP OF THE MONTH

Did you know . . .

With the release of the 2005 National Ambulatory Medical Care Survey (NAMCS) and National Hospital Ambulatory Medical Care Survey (NHAMCS) public use micro-data files, provider weights became available. The variable PHYSWT on the NAMCS file allows researchers to make physician-level estimates. EDWT on the NHAMCS file allows researchers to make estimates at the emergency department level. SAS code examples to produce aggregate visits statistics at the physician or facility level are available here [PDF – 52.6 KB].

NEW PRODUCTS THIS MONTH

  • QuickStats: Emergency Department Visit Rates Related to Mental Health Disorders, by Age Group and Sex — National Hospital Ambulatory Medical Care Survey, United States,§ 2016–2018. MMWR Morb Mortal Wkly Rep 2020;69:48. This quickstats shows that during 2016–2018 there were 43.9 emergency department visits per 1,000 persons per year with a diagnosis of a mental health disorder. Rates were lowest among children aged <18 years (12.8) and highest for adults aged 18–44 years (64.9). Rates declined with age for adults aged 18–44 to ≥65 years (32.2).
  • QuickStats: Percentage of Emergency Department (ED) Visits Made by Adults with Influenza and Pneumonia That Resulted in Hospital Admission, by Age Group — United States 2017–2018. MMWR Morb Mortal Wkly Rep 2020;69:49. This quickstats shows that 37.2% of ED visits for influenza and pneumonia by adults aged ≥18 years resulted in a hospital admission during 2017–2018. The percentage increased with age from 14.4% for adults aged 18–54 years to 46.9% for adults aged 55–74 years and 69.7% for adults aged ≥75 years.
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November 2020

STATS OF THE MONTH

In recognition of the American Diabetes Month (November 1-30) we present estimates for diabetes visits to emergency departments (ED) from the 2018 National Hospital Ambulatory Medical Care Survey (NHAMCS).

  • In 2018, approximately 16.6 million visits were made by patients with diabetes mellitus* documented in their medical record, accounting for 12.8% of all ED visits. Visits made by patients with diabetes mellitus vary by age, with a higher percentage of visits being made by patients age 65 and older (28.9%) than by patients aged 45-64 (22.5%) and aged 44 and younger (4.0%) (Estimates from the Public use files)

* Include Diabetes mellitus type 1, type 2 and unspecified

DATA TIP OF THE MONTH

Did you know . . .

NAMCS and NHAMCS collect information on up to 30 drugs provided, prescribed or continued at ambulatory medical care visits. Drug entries are coded in two ways: as reported in the survey instrument using an internal NCHS classification, and also by their generic components and therapeutic classifications using Lexicon Plus®, a proprietary database of Cerner Multum, Inc. NCHS provides an online look-up tool which allows you to search for drugs in recent years of NAMCS and NHAMCS data.

NEW PRODUCTS THIS MONTH

  • The 2018 NHAMCS Emergency Department public use data file and documentation are now available for downloading, along with SAS, Stata, and SPSS files for reading and formatting the data.  In addition to the SAS, Stata, and SPSS code which can be used with the ASCII data file to create data sets, we also provide pre-made SAS, Stata, and SPSS datasets.
  • Davis D., Rui P. Urban-rural Differences in Visits to Office-based Physicians by Adults With Hypertension: United States, 2014–2016 [PDF – 276 KB]. National Health Statistics Reports no 147. Hyattsville, MD: National Center for Health Statistics. 2020. This report examines urban-rural differences in visits made by adults with documented hypertension by age, sex, and race and ethnicity during 2014–2016. The report shows that in large metro areas visits by adults with hypertension were lower than in small-medium metro and rural areas. Visits by males with hypertension were higher than visits by females, overall and in urban and rural areas. Visits by adults with hypertension increased by age, overall and in all residence areas. More visits were made by non-Hispanic black adults with hypertension than non-Hispanic white adults and Hispanic adults.

DATA TELL STORIES

Tell Us Yours! How have you used information from the National Ambulatory Medical Care Survey or the National Hospital Ambulatory Medical Care Survey? Email us a brief description at ambcare@cdc.gov. In the subject field of your email, write “My NAMCS/NHAMCS data use example”. Your examples will help us showcase the value of NAMCS and NHAMCS.

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October 2020

STATS OF THE MONTH

In recognition of National Dental Hygiene Month (October 1-31) we present estimates for visits to emergency departments (ED) for symptoms relating to teeth and gums from the 2017 National Hospital Ambulatory Medical Care Survey (NHAMCS).

  • In 2017, there were approximately 1.3 million ED visits for symptoms relating to teeth and gums, representing 0.9% of all ED visits. Among ED visits by persons aged 15-64, symptoms relating to teeth and gums was the principal reason for 1.3% of visits. Furthermore, among ED visits by males aged 15-64, this reason accounted for 2.0% of visits and was among the top 10 reasons for visiting the ED. (Estimates from Table 10 [PDF – 863 KB] and the Public Use File)

DATA TIP OF THE MONTH

Did you know . . .

For users who are interested in analyzing drug data, one method involves the isolation of those records with drugs, or drug mentions, and the creation of a separate data file of drug mentions. Each Patient Record for 2017 can have up to thirty drug mentions recorded, so whatever file is created would need to include all of them. This method can be used for obtaining estimates of drug mentions, but is not recommended for variance estimation. Etimates of drug mentions can be obtained by creating a new weight variable (called DRUGWT in this example). This variable is created by multiplying PATWT (the patient visit weight) by NUMMED (the number of medications recorded at the sampled visit) or DRUGWT=PATWT*NUMMED. DRUGWT can then be used in place of PATWT to weight one’s data; it produces the estimated number of drug mentions rather than visits.

NEW PRODUCTS THIS MONTH

Trends in office visits during which opioids were prescribed for adults with arthritis: United States, 2006-2015. Santo L, Schappert SM, Hootman JM, Helmick CG. Arthritis Care Res (Hoboken). 2020 Sep 16. doi: 10.1002/acr.24447. Online ahead of print. PMID: 32937030. This manuscript investigates national trends in opioid prescriptions during visits to office‐based physicians made by adults with arthritis in the US from 2006 to 2015. The analysis shows that office visits for arthritis increased from 2006 to 2015 and the proportion of those visits with opioids prescribed increased as well.

DATA TELL STORIES

Tell Us Yours! How have you used information from the National Ambulatory Medical Care Survey or the National Hospital Ambulatory Medical Care Survey? Email us a brief description at ambcare@cdc.gov. In the subject field of your email, write “My NAMCS/NHAMCS data use example”. Your examples will help us showcase the value of NAMCS and NHAMCS.

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September 2020

STATS OF THE MONTH

In recognition of National Recovery Month (September 1-30) we present estimates for visits to emergency departments (ED) made by patients with substance abuse or dependence documented in their medical record from the 2017 National Hospital Ambulatory Medical Care Survey (NHAMCS).

  • In 2017, there were approximately 8 million visits to the ED made by patients with substance abuse or dependence documented in their medical record, accounting for 5.8% of the visits made to the ED. A higher percentage of visits by patients aged 26-45 had substance abuse or dependence documented in their medical record (9.7% of all visits by patients aged 26-45) than visits by patients aged 25 and younger (2.9%) and visits by patients aged 46 and older (5.7%). (Estimates from Table 13 [PDF – 863 KB] and the Public Use File)

DATA TIP OF THE MONTH

Did you know . . .

When conducting a trend analysis, data users should note that, beginning with the 2002 public use files, two masked design variables were added to the file, for use with statistical software that assumes a single stage of sampling. For the 2003 public use files and beyond, only these two masked design variables are included for variance estimation. Therefore, when combining years of data from 2003 and beyond with years prior to 2002, data users will need to create these two variables for each file prior to 2002. A technical paper with instructions can be found here [PDF – 33.9 KB].

NEW PRODUCTS THIS MONTH

No new products this month.

DATA TELL STORIES

Tell Us Yours! How have you used information from the National Ambulatory Medical Care Survey or the National Hospital Ambulatory Medical Care Survey? Email us a brief description at ambcare@cdc.gov. In the subject field of your email, write “My NAMCS/NHAMCS data use example”. Your examples will help us showcase the value of NAMCS and NHAMCS.

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August 2020

STATS OF THE MONTH

In recognition of Children’s Eye Health and Safety Month (August 1-31) we present estimates for visits to emergency departments (ED) for injury of the eye from the 2016-2017 National Hospital Ambulatory Medical Care Survey (NHAMCS).

  • In 2016 and 2017, there were approximately 11.1 million injury visits to the ED made annually by children and adolescents aged 18 and younger. Among these visits, 1.2% were made for injury of the eye or orbit (Estimates from the Public Use File)

DATA TIP OF THE MONTH

Did you know . . .

A Diagnosis Master Category List (DMCL) which includes diagnosis categories appropriate for use across both inpatient and ambulatory settings is available here [PDF – 443]. The DMCL uses all ICD–10–CM codes and classifies them into 339 mutually exclusive categories. The DMCL will slightly change each year to account for annual changes to the ICD–10–CM coding system. This list was based on the 2016 ICD–10–CM coding system.

NEW PRODUCTS THIS MONTH

No new products this month.

DATA TELL STORIES

Tell Us Yours! How have you used information from the National Ambulatory Medical Care Survey or the National Hospital Ambulatory Medical Care Survey? Email us a brief description at ambcare@cdc.gov. In the subject field of your email, write “My NAMCS/NHAMCS data use example”. Your examples will help us showcase the value of NAMCS and NHAMCS.

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July 2020

STATS OF THE MONTH

In recognition of World Hepatitis Day (July 28) we present estimates for Hepatitis B and C from the 2016 National Ambulatory Medical Care Survey (NAMCS).

  • In 2016, there were approximately 1.6 million visits to office-based physicians made by patients with a diagnosis of Hepatitis B and 3.5 million visits made by patients with a diagnosis of Hepatitis C documented in their medical record. Visits made by patients with Hepatitis B accounted for 0.2% of all office-based physician visits and visits made by patients with Hepatitis C accounted for 0.4% of all office-based physician visits. The percentage of visits made by patients with Hepatitis C was higher among patients aged 45-64 (0.8%) and 65-74 (0.6%) than patients aged 45 and under (0.2%). (Estimates from Table 18 [PDF – 906 KB])

DATA TIP OF THE MONTH

Did you know . . .

The CSTRATM and CPSUM variables were created and first added to the NAMCS and NHAMCS 2002 public use files for running programs that use an ultimate cluster model. They can be used to estimate variance with SUDAAN’s with-replacement (WR) option, as well as with Stata, SPSS, SAS, and other statistical software packages utilizing an ultimate cluster model for variance estimation. These variables and their use are described in detail in the “Relative Standard Errors” section of the public use file documentation. The decision was made to include only these new variables, CSTRATM and CPSUM, and not the multi-stage design variables, beginning with the 2003 data release. For those who wish to combine data from 2003 forward with survey data from years prior to 2002 which do not contain CSTRATM and CPSUM, please see the technical paper: Using Ultimate Cluster Models with NAMCS and NHAMCS Public Use Files [PDF – 33.9 KB].

NEW PRODUCTS THIS MONTH

No new products this month.

DATA TELL STORIES

Tell Us Yours! How have you used information from the National Ambulatory Medical Care Survey or the National Hospital Ambulatory Medical Care Survey? Email us a brief description at ambcare@cdc.gov. In the subject field of your email, write “My NAMCS/NHAMCS data use example”. Your examples will help us showcase the value of NAMCS and NHAMCS.

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June 2020

STATS OF THE MONTH

In recognition of Alzheimer’s and Brain Awareness Month (June 1-30), we present estimates for visits to emergency departments (ED) made by patients with Alzheimer’s disease or dementia documented in their medical records, from the 2017 National Hospital Ambulatory Medical Care Survey (NHAMCS).

  • In 2017, approximately 1.8 million ED visits were made by patients with Alzheimer’s disease or dementia documented in their medical record, accounting for 1.7% of all ED visits made by adults. More visits were made by women with Alzheimer’s disease or dementia documented in the medical record (1.1%) than men (0.6%).  (Estimates from the Public Use File).

DATA TIP OF THE MONTH

Did you know . . .

NHAMCS public use files are provided in ASCII text format that allow the data to be used by many software products. NCHS provides sample SAS statements, SPSS and Stata code for use with NHAMCS data files from 1992 forward. The survey undergoes periodic redesign, which can make the process of combining multiple years of data challenging. NCHS staff make every effort to point out important changes in the annual public use file documentation. Staff members are also available to answer technical questions 301-458-4600.

NEW PRODUCTS THIS MONTH

  • Ashman JJ, Schappert SM, Santo L. Emergency department visits among adults aged 60 and over: United States, 2014–2017. NCHS Data Brief, no 367. Hyattsville, MD: National Center for Health Statistics. 2020. This data brief shows that in 2014–2017, the emergency department (ED) visit rate for persons aged 60 and over was 43 visits per 100 persons aged 60 and over and increased with age. About 7% of ED visits among patients aged 60 and over were made by nursing home residents, 30% of patients arrived by ambulance and unintentional falls accounted for 13% of ED visits made by patients aged 60 and over. Nearly one-quarter of ED visits among patients aged 60 and over resulted in a hospital admission, and this percentage increased with age.
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May 2020

STATS OF THE MONTH
In recognition of National Women’s Health Week (May 10-16), we present estimates for visits to emergency departments (ED) made by women from the 2017 National Hospital Ambulatory Medical Care Survey (NHAMCS).

  • In 2017, approximately 61 million visits were made to the ED by women aged 18 and over, accounting for 58.1% of all adult visits to the ED. Abdominal pain, cramps and spasms was the most common reason for visit among women 18 and over (8.7%), followed by chest pain (5.4%), headache (3.5%), shortness of breath (3.3%), and cough (2.8%). (Estimates from the Public Use File).

DATA TIP OF THE MONTH

Did you know . . .

Missing values are imputed every year for some items. Starting with 2010 data, the imputation of patient race and ethnicity was performed using a model-based single, sequential regression method. The model used to impute race and ethnicity in 2017 NHAMCS included the following variables: Census variables for ZIP code level race and ethnicity population estimates and an indicator for whether it was patient or hospital ZIP (used when patient ZIP was not available); patient age, sex, race, and ethnicity; triage level; log of ED wait time; primary expected source of payment derived from a hierarchical recode of the expected source of payment question; grouped 3-digit ICD-10-CM codes for primary diagnosis; year of visit; type of ESA area; provider’s MSA status; and ED weighting and volume variables. The list of items with a nonresponse rate greater than 5% and the list of the imputed items can be found here starting on page 13 [PDF – 14 KB].

NEW PRODUCTS THIS MONTH

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April 2020

STATS OF THE MONTH
In recognition of Alcohol Awareness Month (April 1-30), we present estimates for visits to emergency departments (ED) made by patients with alcohol misuse, abuse, or dependence, documented in the medical record from the 2017 National Hospital Ambulatory Medical Care Survey (NHAMCS).

  • In 2017, patients with alcohol misuse, abuse, or dependence, documented in the medical record accounted for 3.1% of all visits to the ED. Visits made by patients with alcohol misuse, abuse, or dependence in the medical record varied by sex, with a higher percentage of visits being made by males (4.7%) than females (1.8%). (Estimates from Table 13 [PDF – 864 KB] and Public Use File)

DATA TIP OF THE MONTH

Did you know . . .

For NHAMCS 2017, anomalies between 2017 and 2016 data were assessed. To accomplish this, more than 20 tables of 2017 estimates were compared with the same tables of 2016 estimates. The variables that were compared included most of those published in the annual survey web tables available here. Significant changes between the two years were noted and investigated. More information about the changes can be found in the 2017 NHAMCS Public use file documentation.

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March 2020

STATS OF THE MONTH
In recognition of National Kidney Month (March 1-31), we present estimates for visits to emergency department (ED) for chronic kidney disease (CKD) from the 2017 National Hospital Ambulatory Medical Care Survey (NHAMCS).

  • In 2017, patients with CKD documented in the medical record accounted for 2.9% of all visits to the ED and for 3.7% of all visits to the ED visits made by adults aged 18 and over. Visits made by adults patients with CKD in the medical record increased by age, more visits were made by adult aged 65 and over (10%) than adult aged 45-64 (4.4%) and adults aged 18-44 (0.6%). (Estimates from Table 13 [PDF- 863 KB] and Public Use File)

DATA TIP OF THE MONTH

Did you know . . .

A new template for producing Methods sections of journal articles using NHAMCS data covering data years 1992-2016 is available here [PDF – 28 KB]. The document also provides a useful checklist for NHAMCS article submission.

NEW PRODUCTS THIS MONTH

  • Santo L, Ward BW, Rui P, Ashman JJ. Antineoplastic drugs prescription during visits by adult cancer patients with comorbidities: findings from the 2010-2016 National Ambulatory Medical Care Survey. Cancer Causes Control. 2020 Feb 21. doi: 10.1007/s10552-020-01281-5. This manuscript uses 2010-2016 National Ambulatory Medical Care Survey to describe the frequency of comorbidities at visits by patients with breast, prostate, colorectal, and lung cancer and the frequency of a prescription for antineoplastic drugs being included in the treatment received at visits by patients with cancer and concomitant comorbidities. The authors show that among US visits by adult patients with breast, prostate, colorectal, or lung cancer, 56.3% were by patients with ≥ 1 comorbidity. Hypertension was the most frequently observed comorbidity (37.7%), followed by hyperlipidemia (19.0%) and diabetes (12.3%). Antineoplastic drugs were prescribed in 33.5% of the visits.
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February 2020

STATS OF THE MONTH

In recognition of American Heart Month (February 1-29), we present estimates for visits to emergency department (ED) for coronary artery disease, ischemic heart disease, or history of myocardial infarction (MI) from the 2017 National Hospital Ambulatory Medical Care Survey (NHAMCS).

  • In 2017, patients with coronary artery disease, ischemic heart disease, or history of MI documented in the medical record accounted for 6.1% of all  visits to the ED and for 22.3% of the ED visits made by adults aged 65 and over.  More visits were made by male aged 65 and over (28.1%) than female aged 65 and over (18.2%) with coronary artery disease, ischemic heart disease, or history of MI documented in the medical record.  (Estimates from Table 13 and Public Use File)
  • In 2017, chest pain and related symptoms was the primary reason for visit in 5.7% of all visits to the emergency department (ED) made by adults aged 18 and over. Visits with chest pain and related symptoms as primary reason for visit were higher among patients aged 55 and over (6.9%) than among patients aged 18-54 (5.1%). (Estimates from the Public Use File)

DATA TIP OF THE MONTH

Did you know . . .

To  calculate department-level estimates an emergency department weight (EDWT) can be used. When running an analysis of facility-level characteristics using EDWT, it is recommended to select only those records where EDWT is greater than 0. This will result in correct sample counts of variables, which is useful for assessing reliability. Estimates at the ED level generated using EDWT reflect only the characteristics of facilities which participated in the survey.

NEW PRODUCTS THIS MONTH

  • 2017 NHAMCS EMERGENCY DEPARTMENT SUMMARY WEB TABLES – The Ambulatory and Hospital Care Statistics Branch is pleased to release the most current nationally representative data on ambulatory care visits to hospital emergency departments (ED) in the United States. Estimates are presented on selected hospital, patient, and visit characteristics using data collected in the 2017 NHAMCS.
  • QuickStats: Percentage of Emergency Department Visits for Pain at Which Opioids Were Given or Prescribed, by Geographic Region of the Hospital — United States, 2005–2017. MMWR Morb Mortal Wkly Rep 2020;69:53. This quickstas shows that the percentage of ED visits for pain at which an opioid was given or prescribed increased from 37.4% in 2005 to 43.1% in 2010 and then decreased to 30.9% in 2017. A similar pattern was observed in all four regions. In 2017, the percentage was 21.1% in the Northeast, compared with 32.0% in the Midwest, 32.0% in the South, and 34.7% in the West.
  • QuickStats: Percentage of Emergency Department Visits for Acute Viral Upper Respiratory Tract Infection at Which an Antimicrobial Was Given or Prescribed, by Age — United States, 2010–2017. MMWR Morb Mortal Wkly Rep 2020;69:174. This quickstats shows that the percentage of ED visits for acute viral upper respiratory tract infection that had an antimicrobial given or prescribed, decreased from 23.4% in 2010-2013 to 17.6% in 2014-2017. A decline was seen for ED visits by children, decreasing from 17.9% to 10.1%, but not for ED visits by adults.
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January 2020

 YEAR IN REVIEW

Publications from NAMCS in 2019

NCHS reports and data briefs

Web tables

  • 2013 NAMCS Community Health Center (CHC) Web Tables [PDF – 669 KB]. Rui P, Kang K, Yacisin K, Okeyode T. National Ambulatory Medical Care Survey – Community Health Centers: 2013 State and National Summary Tables. Nationally representative data on ambulatory care visits to community health centers in the United States are presented on selected provider, patient, and visit characteristics using data collected in the 2014 NAMCS Community Health Center component.
  • 2016 NAMCS SUMMARY WEB TABLES [PDF – 906 KB] – The most current nationally representative data on ambulatory care visits to physician offices in the United States are presented on selected physician, patient, and visit characteristics using data collected in the 2016 NAMCS.
  • 2014 NAMCS Community Health Center Summary Tables [PDF – 584 KB]: The most current nationally representative data on ambulatory care visits to community health centers in the United States are presented on selected provider, patient, and visit characteristics using data collected in the 2014 NAMCS Community Health Center component.

Manuscripts

  • Akinbami LJ, Salo PM, Cloutier MM, Wilkerson JC, Elward KS, Mazurek JM, Williams S, Zeldin DC. Primary care clinician adherence with asthma guidelines: the National Asthma Survey of Physicians. J Asthma. 2019 Mar 1:1-13. This article examines adherence to asthma guidelines by using the 2012 National Asthma Survey of Physicians (NAS): a one-time provider questionnaire supplement to National Ambulatory Medical Care Survey (NAMCS). The authors found that pediatricians were more likely to report high adherence than other clinicians and adherence was higher for history-taking recommendations and lower for recommendations involving patient education, equipment and expertise.
  • Santo L, Rui P, Hales CM, Arem H, Ogden CL. Am J Prev Med. 2019 Nov;57(5):716-717. Trends in Preventive Visits Among U.S. Youth Where Weight and Height Were Recorded: 2005-2016. This research letter provides trends in preventive visits from 2005 through 2016 in which weight and height were recoded among children and adolescents. The authors found that overall, the percentage of preventive visits in which weight and height were recorded increased from 87.6% in 2005 to 95.6% in 2016. Similar trends were found among children and adolescents.

Publications from NHAMCS in 2019

NCHS reports, data briefs and quickstats

Web tables

  • 2016 NHAMCS EMERGENCY DEPARTMENT SUMMARY WEB TABLES [PDF- 978 KB] – The Ambulatory and Hospital Care Statistics Branch is pleased to release the most current nationally representative data on ambulatory care visits to hospital emergency departments (ED) in the United States. Estimates are presented on selected hospital, patient, and visit characteristics using data collected in the 2016 NHAMCS.

NEW PRODUCTS THIS MONTH

  • Trends in opioids prescribed at discharge from emergency departments among adults: United States, 2006–2017 [PDF – 436 KB]. Rui P, Santo L, Ashman JJ. National Health Statistics Reports; no 135. Hyattsville, MD: National Center for Health Statistics. 2020. This report describes trends in ED visits made by adult patients at which opioids were prescribed at discharge from 2006-2007 to 2016-2017. The authors found that the percentage of ED visits by adults with opioids prescribed at discharge increased from 2006–2007 (19.0%) through 2010–2011 (21.5%) and then decreased from 2010–2011 through 2016–2017 (14.6%). The top five diagnoses associated with an opioid prescribed at discharge were dental pain, urolithiasis, fracture injuries, back pain, and extremity pain.
  • Physician office visits at which benzodiazepines were prescribed: Findings from 2014–2016 National Ambulatory Medical Care Survey [PDF – 376]. Santo L, Rui P, Ashman JJ. National Health Statistics Reports; no 137. Hyattsville, MD: National Center for Health Statistics. 2020. This report describes visits to office-based physicians made by adult patients at which benzodiazepines were prescribed, including visits were opioids were coprescribed. The authors found that during 2014–2016, the rate of visits at which benzodiazepines were prescribed was 27 annual visits per 100 adults and one-third of these visits involved an overlapping opioid prescription. Mental disorders were the most frequent primary diagnosis category for visits at which benzodiazepines were prescribed, whereas diseases of the musculoskeletal system and connective tissue was the most frequent primary diagnosis category for visits at which benzodiazepines were coprescribed with opioids.

DATA TELL STORIES

Tell Us Yours! How have you used information from the National Ambulatory Medical Care Survey or the National Hospital Ambulatory Medical Care Survey? Email us a brief description at ambcare@cdc.gov. In the subject field of your email, write “My NAMCS/NHAMCS data use example”. Your examples will help us showcase the value of NAMCS and NHAMCS.

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December 2019

STATS OF THE MONTH

In recognition of World AIDS Day (December 1), we present estimates for HIV/AIDS from the 2014-2016 National Ambulatory Medical Care Survey (NAMCS).

  • In 2014-2016, there were approximately 2.47 million visits per year to office-based physicians made by adults with HIV or AIDS in their medical record, accounting for 0.3% of all office-based physician visits made by adults. Visits made by men with HIV or AIDS in the medical record accounted for 0.6% of the visits made by men aged 18 and over, whereas visits made by women accounted for 0.1% of the visits made by women aged 18 and over. (Estimates from the Public Use File)

In recognition of National Influenza Vaccination Week (December 1-7), we present estimates for visits to emergency departments (ED) at which an influenza test was provided from the 2017 National Hospital Ambulatory Medical Care Survey (NHAMCS).

  • In 2017, an influenza test was provided at 4.1% of all ED visits. Children and adolescents younger than 18 were tested for influenza more frequently than adults. Children and adolescents were tested at 7.5% of the ED visits made by children and adolescents whereas adults aged 18-65 and 65 and over were tested for influenza at 3.1% and 2.7% of the visits made by adults. (Estimates from the Public Use File)

DATA TIP OF THE MONTH

Did you know…

The National Center for Health Statistics considers an estimated number of visits or a visit rate to be reliable if it has a relative standard error of 30 percent or less, and it is based on at least 30 sample records. NCHS recently released new guidelines for determining the reliability of proportions. These standards are based on a minimum denominator sample size and on the absolute and relative widths of a confidence interval calculated using the Clopper-Pearson method. The guidelines can be found here [PDF – 144 MB].

NEW PRODUCTS THIS MONTH

 

November 2019

STATS OF THE MONTH

In recognition of COPD awareness month (November 1-30), we present estimates for chronic obstructive pulmonary disease (COPD) visits from the 2016 National Ambulatory Medical Care Survey (NAMCS).

  • In 2016, patients with COPD documented in the medical record accounted for 3.6% of the visits made to office-based physicians. Visits by patients with COPD increased with age. Only 0.5% of visits made by patients aged 45 and under had COPD in the medical record whereas 4.3% of visits made by patients aged 45-64, 7.0% of visits made by patients aged 65-74 and 8.8% of visits made by patients aged 75 and over had COPD in the medical record. (Estimates from Table 18 [PDF – 907 KB])

In recognition of American Diabetes Month (November 1-30), we present estimates for visits to emergency departments (ED) for diabetes from the 2016 National Hospital Ambulatory Medical Care Survey (NHAMCS).

    • In 2016, adults with diabetes* documented in the medical record accounted for 14.5% of all ED visits made by adults. Visits by adults with diabetes increased with age; 5.3% of visits made by adults aged 18-44 had diabetes in the medical record whereas 20.6% and 27.6% of visits made by adults aged 45-64 and 65 and over, respectively, had diabetes in the medical record (Estimates from the Public Use File)

*includes diabetes mellitus type 1, type 2 and unspecified.

DATA TIP OF THE MONTH

Did you know…

Multiple years of data can be combined to improve reliability of estimates, which is necessary for rare estimates. When combining multiple years, it is easier for the reader to understand an average annual estimate rather than the total number of visits that occurred during the study period. For example, it is preferable to report that from 2012-2016, the average annual number of office-based physician visits for condition X was 5 million rather than from 2012-2016, there were 25 million visits for condition X.

NEW PRODUCTS THIS MONTH

  • Emergency department visits for injuries sustained during sports and recreational activities by patients aged 5-24 years, 2010-2016 [PDF – 961 KB]. Rui P, Ashman JJ, Akinseye A. National Health Statistics Reports; no 133. 2019. This report describes ED visits made by patients aged 5-24 years for injuries sustained during sports and recreational activities, treatments provided at these visits, and variation by activity, patient age, and patient sex. The authors found that during 2010-2016, there were approximately 2.7 million annual ED visits for sports injuries. The top five most frequent activities that caused these visits were football, basketball, pedal cycling, soccer, and ice/rollerskating or skateboarding.
  • Trends in Preventive Visits Among U.S. Youth Where Weight and Height Were Recorded: 2005-2016. Santo L, Rui P, Hales CM, Arem H, Ogden CL. Am J Prev Med. 2019 Nov;57(5):716-717. This research letter provides trends in preventive visits from 2005 through 2016 in which weight and height were recoded among children and adolescents. The authors found that overall, the percentage of preventive visits in which weight and height were recorded increased from 87.6% in 2005 to 95.6% in 2016. Similar trends were found among children and adolescents.

 

OCTOBER 2019

STATS OF THE MONTH

In recognition of National Primary Care week (October 1-5), we present estimates for primary care visits from the 2016 National Ambulatory Medical Care Survey (NAMCS).

  • In 2016, approximately 374 million visits were made to primary care providers, accounting for 42.3% of all visits made to office-based physicians. Approximately 95% of the visits to primary care providers were made by established patients and 5% by new patients. (Estimates from Table 7 [PDF – 906 KB])

In recognition of Respiratory Care week (October 20-26), we present estimates for visits to emergency departments (ED) related to diseases of the respiratory system from the 2016 National Hospital Ambulatory Medical Care Survey (NHAMCS).

  • In 2016, diseases of the respiratory system were the primary diagnosis at approximately 15 million visits to the ED, accounting for 10.2% of all ED visits. (Estimates from Table 11 [PDF – 978 KB])
  • In 2016, patients with asthma documented in the medical record accounted for 10.1% of all ED visits, whereas patients with chronic obstructive pulmonary disease accounted for 5.6% of all ED visits. (Estimates from Table 13 [PDF – 978 KB])

DATA TIP OF THE MONTH

Did you know…

The Research Data Center contains records for NAMCS physicians who are not included on the public use files for various reasons (did not see patients during reporting week or did not submit visit forms). Including these physicians in one’s analysis along with those who saw patients can provide national estimates of all office-based physicians.

NEW PRODUCTS THIS MONTH

 

September 2019

STATS OF THE MONTH

In recognition of Prostate Cancer Awareness Month (September 1-30), we present estimates for prostate cancer visits from the 2016 National Ambulatory Medical Care Survey (NAMCS).

  • In 2016, malignant neoplasm of prostate was the primary diagnosis at approximately 2.5 million visits made to office-based physicians accounting for 0.3% of all office-based physicians visits and 10.5% of all visits with a primary diagnosis of a malignant neoplasm. (Estimates from Table 15 [PDF – 906 KB] and the Public Use File)

In recognition of Pain Awareness Month (September 1-30), we present estimates for visits to emergency departments (ED) related to stomach and abdominal pain, cramps, and spasms from the 2016 National Hospital Ambulatory Medical Care Survey (NHAMCS).

  • In 2016, stomach and abdominal pain, cramps, and spasms was the top principal reason for visiting an ED, accounting for 8.6% of all ED visits. Abdominal pain visits for females were higher than visits for males for both younger and older age groups (females aged 15-64 (7.0%) and males aged 15-64 (3.3%) and females aged 65 and over (4.7%) and males aged 65 and over (2.9%)). (Estimates from Table 10 [PDF – 978 KB])

DATA TIP OF THE MONTH

Did you know…

A problem was found with the checkbox for CHF (Congestive Heart Failure) in the item: “Regardless of the diagnoses written above, does the patient now have:”. This checkbox is typically edited to ensure that any diagnoses of CHF reported in the survey items DIAG1-DIAG5 (Diagnosis #1 – Diagnosis #5) are also reflected in the CHF check box. It was recently discovered that the ICD-10-CM codes I50.1-I50.9 (Heart Failure) were not included in the edit. In all, 28 2016 NAMCS records and 45 2016 NHAMCS ED records with a diagnosis of Heart Failure reported in DIAG1-DIAG5 should have had the CHF checkbox checked but did not. More information is available here.

 

August 2019

STATS OF THE MONTH

In recognition of National Immunization Awareness Month we present estimates for immunization from the 2016 National Ambulatory Medical Care Survey (NAMCS).

  • In 2016, an immunization was provided at 32.2% of the preventive care visits made by patients aged 18 and younger. The percentage of preventive care visits in which an immunization was provided was higher among children aged 6 and younger (41.1%) than children and adolescents aged 7 -18 (17.1%). (Estimates from the Public Use File)

DATA TIP OF THE MONTH

Did you know…

To make estimates at the physician level [PDF – 1.19 MB] the PHYSWT variable can be used. When running physician-level analysis, it is recommended that only records with a PHYSWT greater than zero be selected; this will give the correct sample counts and will not affect estimation of variance. Beside generating estimates for physician characteristics at the physician level, the addition of PHYSWT allows you to link visit data with physician data.

NEW PRODUCTS RELEASED THIS MONTH

  • Diagnosis Master Category List, 2016 [PDF – 444 KB] – The Ambulatory and Hospital Care Statistics Branch is pleased to release the diagnosis categories table. The table displays diagnosis categories according to the 2016 National Center for Health Statistics, Division of Health Care Statistics, Diagnosis Master Category List, a classification scheme that can be used across inpatient and ambulatory settings when analyzing diagnosis data.

DATA TELL STORIES 

Tell Us Yours! How have you used information from the National Ambulatory Medical Care Survey or the National Hospital Ambulatory Medical Care Survey? Email us a brief description at ambcare@cdc.gov. In the subject field of your email, write “My NAMCS/NHAMCS data use example”. Your examples will help us showcase the value of NAMCS and NHAMCS.

 

June 2019

STATS OF THE MONTH

In recognition of Alzheimer’s & Brain Awareness Month (June 1-30) we present estimates for Alzheimer’s disease and dementia from the 2016 National Ambulatory Medical Care Survey (NAMCS).

  • In 2016, patients with Alzheimer’s disease or dementia documented in the medical record accounted for 0.7% of all office-based physician visits. Visits by patients with Alzheimer’s disease or dementia increased with age. Only 0.4% of visits made by patients aged 45-64 and 0.8% visits made by patients aged 65-74 had Alzheimer’s disease or dementia in the medical record whereas 3.5% of visits made by patients aged 75 and over had Alzheimer’s disease or dementia in the medical record. (Estimates from Table 18 [PDF – 793 KB])

In recognition of National Safety Month (June 1-30) we present estimates for injury visits to emergency departments (ED), from the 2016 National Hospital Ambulatory Medical Care Survey (NHAMCS).

  • In 2016, injury visits accounted for 29.0% of all ED visits. There were approximately 42 million injury visits to the ED representing a rate of 13.3 visits per 100 persons. Visit rates by Black or African American persons were higher than visit rates by White persons (20.4 versus 13.1 visits per 100 persons). (Estimates from Table 15 [PDF – 738 KB])

DATA TIP OF THE MONTH

Did you know…

NAMCS and NHAMCS are national probability sample surveys that use stratified, multistage sampling designs.  That is, visits are always clustered within providers and providers are sometimes clustered within geographic primary sampling units.  The sampling design affects the standard errors of estimates based on data collected from the sample.  Therefore, data users should always calculate standard errors for the survey estimates using statistical software that takes the complex sampling design into account.  Such software includes SUDAAN, SAS (SURVEYFREQ and SURVEYMEANS procedures), Stata, and SPSS Complex Samples, among others. Make sure all of the sample records – and not just those in a subset of the sample – are included in the analysis in order to obtain the best variance estimates.  This can be accomplished with a SUBPOPN statement in SUDAAN, or by using the DOMAIN statement in SAS, for example.

NEW PRODUCTS RELEASED THIS MONTH

DATA TELL STORIES 

Tell Us Yours! How have you used information from the National Ambulatory Medical Care Survey or the National Hospital Ambulatory Medical Care Survey? Email us a brief description. In the subject field of your email, write “My NAMCS/NHAMCS data use example”. Your examples will help us showcase the value of NAMCS and NHAMCS.

May 2019

  • STATS OF THE MONTH

In recognition of National Osteoporosis Month (May 1-31)  we present estimates for osteoporosis from the 2016 National Ambulatory Medical Care Survey (NAMCS).

  • In 2016, adult patients with osteoporosis documented in the medical record accounted for 3.0% of all office-based physician visits made by adults. Visits by patients with osteoporosis differ by sex. 4.3% of visits made by adult women had osteoporosis in the medical record whereas 1.1% of visits made by adult men had osteoporosis in the medical record. (Estimates from the Public Use File)

In recognition of National Stroke Awareness Month (May 1-31), we present estimates for visits to emergency departments (ED) for cerebrovascular disease or history of stroke or transient ischemic attack, from the 2016 National Hospital Ambulatory Medical Care Survey (NHAMCS).

  • In 2016, patients with cerebrovascular disease or history of stroke or transient ischemic attack (CVA) documented in the medical record accounted for 3.2% of all visits made to the ED. Visits by patients with CVA increased with age. 1.5% of visits made by patients aged 18-54 had CVA in the medical record whereas 5.4% of visits made by patients aged 55-64 and 11.6% visits made  by patients aged 65 and over had CVA in the medical record. (Estimates from Table 13 [PDF – 740 KB] and the Public Use File)
  • DATA TIP OF THE MONTH

Did you know…

In 2005, data for the initial visit to ED (EPISODE=1) was not collected. For researchers interested in the episode of care for visits in 2005, an imputed variable (INITVIS; included in the 2005 public use file) was created based on a regression model-based imputation strategy using data from 2003-04. It should be noted that because this is an imputed variable, it is not comparable to the EPISODE variable from other years (starting in 2001) and should be used with caution when conducting any year-to-year trend analysis. More information on the methodology and limitations of the imputation model can be found here [PDF – 37 KB].

  • NEW PRODUCTS RELEASED THIS MONTH
    • 2016 NAMCS SUMMARY WEB TABLES [PDF – 793 KB] – The Ambulatory and Hospital Care Statistics Branch is pleased to release the most current nationally representative data on ambulatory care visits to physician offices in the United States. Estimates are presented on selected physician, patient, and visit characteristics using data collected in the 2016 NAMCS.
  • DATA TELL STORIES

Tell Us Yours! How have you used information from the National Ambulatory Medical Care Survey or the National Hospital Ambulatory Medical Care Survey? Email us a brief description. In the subject field of your email, write “My NAMCS/NHAMCS data use example”. Your examples will help us showcase the value of NAMCS and NHAMCS.

 

April 2019

  • STATS OF THE MONTH

In recognition of World Health Day (April 7)  we present estimates for preventive visits from the 2016 National Ambulatory Medical Care Survey (NAMCS).

  • From NAMCS: In 2016, preventive care was the major reason for visit in 23.1% of all office-based physician visits. Preventive visits made by patients aged 0-18  and by patients aged 19-44 were 31.4 % and 32% of all office-based physician visits, higher than the percentage of preventive visits made by patients aged 45-64 (17.7%) and by patients aged 65 and over (14.5%). (Estimates from the Public Use File)

In recognition of Alcohol Awareness Month (April 1-30), we present estimates for visits to emergency departments (ED) for alcohol-related problems, from the 2016 National Hospital Ambulatory Medical Care Survey (NHAMCS).

  • From NHAMCS: In 2016, alcohol-related problems* were a reason for visit for 1.6% of all ED visits made by adolescents and adults aged 13 and over, with a higher percentage of visits made by males (2.4%) than females (1%). (Estimates from the Public Use File)
    * alcohol related problems (1145.0); alcoholism (2320.0); adverse effect of alcohol (5915.0); alcohol poisoning (5916.0) indicated by patients as any reason for visit. Based on A Reason for Visit Classification (RVC) for Ambulatory Care, National Center for Health Statistics. Vital Health Stat 2(78) 1979
  • DATA TIP OF THE MONTH

Did you know…

Beginning with the 2002 public use files, two new masked design variables were added to the file, for use with statistical software that assumes a single stage of sampling. Data users who wish to combine years of data from 2002 and beyond with years prior to 2002 need to create these two masked design variables for data file years prior to 2002. A technical paper gives instructions on how to do this, and is available here [PDF – 34 KB].

  • NEW PRODUCTS RELEASED THIS MONTH
    • 2016 NHAMCS EMERGENCY DEPARTMENT SUMMARY WEB TABLES [PDF – 738 KB] – The Ambulatory and Hospital Care Statistics Branch is pleased to release the most current nationally representative data on ambulatory care visits to hospital emergency departments (ED) in the United States. Estimates are presented on selected hospital, patient, and visit characteristics using data collected in the 2016 NHAMCS.
    • An updated 2014 NAMCS Public Use Data File is now available, which corrects the ‘new’ or ‘continued’ status of reported medications. Due to a data processing issue, these items were often set to missing instead of to a new or continued status. The revision affects the variables NCMED1-NCMED30, NUMNEW and NUMCONT. Pre-made SAS, SPSS, and Stata datasets have also been recreated.
    • New pre-made SPSS datasets for NHAMCS 2002-2014 are now available for downloading here.
    • Akinbami LJ, Salo PM, Cloutier MM, Wilkerson JC, Elward KS, Mazurek JM, Williams S, Zeldin DC.  Primary care clinician adherence with asthma guidelines: the National Asthma Survey of Physicians.  J Asthma. 2019 Mar 1:1-13. This article examines adherence to asthma guidelines by using the 2012 National Asthma Survey of Physicians (NAS): a one-time provider questionnaire supplement to National Ambulatory Medical Care Survey (NAMCS). The authors found that pediatricians were more likely to report high adherence than other clinicians and adherence was higher for history-taking recommendations and lower for recommendations involving patient education, equipment and expertise.

 

March 2019

  • STATS OF THE MONTH

In recognition of American Diabetes Alert Day (March 26)  we present estimates for diabetes from the 2016 National Ambulatory Medical Care Survey (NAMCS).

  • From NAMCS: In 2016, adults patients with diabetes* documented in the medical record accounted for 14.3% of all office-based physician visits made by adults. Visits by patients with diabetes increased with age. 2.9% of visits made by patients aged 18-44  had diabetes in the medical record whereas 16.2% of visits made by patients aged 45-64 and 22.5% visits made by patients aged 65 and over had diabetes in the medical record. (Estimates from the Public Use File)
    *includes both Type I diabetes mellitus (insulin dependent or IDDM), Type II diabetes mellitus (non-insulin dependent or NIDDM), and diabetes with type unspecified.

In recognition of National Kidney Month (March 1-31), we present estimates for visits to emergency departments (ED) for Chronic Kidney Disease (CKD), from the 2015-2016 National Hospital Ambulatory Medical Care Survey (NHAMCS).

  • From NHAMCS: In 2015 and 2016, visits made by adults with CKD in the medical record accounted for 3.5% of all visits made to the ED. The percentage of visits made by adults with CKD varied by sex. 4.1% of visits made by men had CKD in the medical record whereas 2.7% of visits made by women had CKD in the medical record. A higher percentage of visits were made by non-Hispanic black men with CKD than women (5.0% compared with 2.4%). No difference in ED visits by sex for Hispanic and non-Hispanic white adults was found. (National Hospital Ambulatory Medical Care Survey, 2015–2016. MMWR Morb Mortal Wkly Rep 2019;68:23)
  • DATA TIP OF THE MONTH

Did you know…

The method of collecting payment data in NAMCS/NHAMCS 2005-2007 was different than survey years 2008-present. In 2005-2007 (2005 was the first year that allowed collection of multiple expected sources of payment per visit), beneficiaries of both Medicare and Medicaid (dual eligibles) were assigned Medicaid as the primary expected source of payment (PAYTYPE); from 2008-present, dual eligibles were assigned Medicare as the primary source (PAYTYPER) based on research and analysis which determined that the Medicaid-dominant hierarchy is inconsistent with insurance industry practices. Therefore, when analyzing trends across these two time periods, researchers should keep in mind that two different methods were used to collect payment data. More information can be found in this document [PDF – 43 KB] and the 2008 public use file documentation [PDF – 1.4 MB].

  • NEW PRODUCTS RELEASED THIS MONTH
    • New pre-made SPSS datasets for NAMCS 2002-2014 are now available for downloading here.
    • For NHAMCS-OPD 2002-2003, corrected Stata code to be used with ASCII data to create Stata datasets, along with pre-made Stata datasets, are available for downloading here.

 

February 2019

  • STATS OF THE MONTH

In recognition of Low Vision Awareness Month (February 1-28) we present estimates for retinal/eye exam ordered or provided from the 2016 National Ambulatory Medical Care Survey (NAMCS).

  • From NAMCS: In 2016, retinal/eye exam was ordered or provided in 13.6% of all office-based physician visits made by adults aged 18 and over. The percentages of visits in which retinal/eye exam was ordered or provided increased with age. Only 7.1% of visits made by patients aged 18-34 had an eye/retinal exam ordered or provided whereas 12.4% of the visits made by patients aged 35-64 and 18.9% of visits made by patients aged 65 and over had a retinal/eye exam ordered or provided. (Estimates from the Public Use File)

In recognition of American Heart Month (February 1-28), we present estimates for visits to emergency departments (ED) for chest pain and related symptoms, from the 2016 National Hospital Ambulatory Medical Care Survey (NHAMCS).

  • From NHAMCS: In 2016, chest pain and related symptoms was the primary reason for visit in 6.4% of all visits to the emergency department (ED) made by adults aged 18 and over. Visits with chest pain and related symptoms as primary reason for visit were higher among patients aged 55 and over (7.5%) than among patients aged 18-54 (5.7%). (Estimates from the Public Use File)
  • DATA TIP OF THE MONTH

Did you know…

A template for producing the Methods section of a journal article using NHAMCS data is available on the Ambulatory Health Care Data website and is linked here [PDF – 27 KB].

  • NEW PRODUCTS RELEASED THIS MONTH
    • We are pleased to announce the 2016 NAMCS public use data file and documentation are now available for downloading, along with SAS, Stata and SPSS files.
    • Ashman JJ, Rui P, Okeyode T. Characteristics of office-based physician visits, 2016. NCHS Data Brief, no 331. Hyattsville, MD: National Center for Health Statistics. 2019. This report examines visit rates by age and sex. It also examines visit characteristics—including insurance status, reason for visit, and services—by age. For example, in 2016, there were an estimated 278 office-based physician visits per 100 persons.  The visit rate among females exceeded the rate for males, and the rates for both infants and older adults exceeded the rates for those aged 1–64 years.
    • QuickStats: Percentage of Emergency Department (ED) Visits Made by Patients with Chronic Kidney Disease Among Persons Aged ≥18 Years, by Race/Ethnicity and Sex — National Hospital Ambulatory Medical Care Survey, 2015–2016. MMWR Morb Mortal Wkly Rep 2019;68:23. This QuickStats shows that during 2015-2016, a higher percentage of visits to the ED were made by adult men with chronic kidney disease than women. Same pattern was observed for non-Hispanic black men and women but not for Hispanic and non-Hispanic white adults.
    • NOTICE: A new version of the 2016 NHAMCS Emergency Department public use file was uploaded in January.  This version modifies the formatting for various diagnosis codes (DIAG1-DIAG5; HDDIAG1-HDDIAG5).  The earlier version contained codes which were incorrectly aggregated to a broader category within the same diagnosis group. New versions of the pre-made SAS, Stata, and SPSS files have also been uploaded. More information is available on the Ambulatory Health Care Data website.

 

January 2019

  • STATS OF THE MONTH

In recognition of Cervical Health Awareness Month (January 1-31) we present estimates for Pap test ordered or provided from the 2015 National Ambulatory Medical Care Survey (NAMCS).

  • From NAMCS: In 2015, Pap test was ordered or provided in 4.9% of all office-based physician visits made by females. The percentage of visits made by females in which Pap test was ordered or provided was higher among physicians in metropolitan areas (5.0%) than nonmetropolitan areas (2.5%). (Estimates from Table 21 [PDF – 785 KB] and the Public Use File)

In recognition of National Drug and Alcohol Facts Week (January 22–27), we present estimates for visits to emergency departments (ED) for Drug and Alcohol-related problems, from the 2016 National Hospital Ambulatory Medical Care Survey (NHAMCS).

  • From NHAMCS: In 2016, Drug and Alcohol-related problems* were the primary reason for visit for approximately 1.6 million visits to the emergency department (ED) representing 1.1% of all the visits to the ED.  Visits made by males were higher than visits made by females (1.7% versus 0.6%). (Estimates from the Public Use File)
    *refer to alcohol related problem, alcoholism, adverse effect of alcohol, alcohol poisoning, abnormal drug usage, drug addiction, drug dependence, intoxication with drugs, overdose unintentional, substance abuse NOS
  • DATA TIP OF THE MONTH

Did you know…

When examining trends and/or combining multiple years of data, it is important to check that the variables of interest were collected in all of the years contained in your analysis and that the wording of the item and/or answer categories did not change in a way that might impact the analysis. NCHS staff make every effort to point out important changes in the annual public use file documentation, both in the summary of changes at the beginning of the document and in the codebook section.

  • COMING SOON
    • The 2016 National Ambulatory Medical Care Survey Public Use Data File and Documentation are expected to be released later this month.  Please check the Ambulatory Health Care Data website’s What’s New page in a few weeks.
    • Ashman JJ, Rui P, Okeyode T. Characteristics of office-based physician visits, 2016. NCHS Data Brief, no. 331. Hyattsville, MD: National Center for Health Statistics. 2019.  Expected release date: January 23, 2019.

 

December 2018

  • STATS OF THE MONTH

In recognition of National Influenza Vaccination Week (December 4-11), we present estimates for influenza vaccination from the 2015 National Ambulatory Medical Care Survey (NAMCS).

  • From NAMCS: In 2015, influenza vaccination was administered or prescribed in 2.3% of all office-based physician visits. Influenza vaccination was administered or prescribed in 4.9% of the visits made by patients younger than 18, whereas it was administered or prescribed in only 1.9% of the visits made by adults aged 18 and older.

In recognition of World AIDS Day (December 1), we present estimates for visits to emergency departments (ED) made by patients with HIV/AIDS documented in the medical record, from the 2016 National Hospital Ambulatory Medical Care Survey (NHAMCS).

  • From NHAMCS: In 2016, there were an estimated 726,000 visits made to the ED by patients with HIV/AIDS documented in the medical record, representing 0.5% of all visits to the ED. Males with HIV/AIDS documented in their medical records accounted for 0.8% of all ED visits made by males. Females with HIV/AIDS documented in their medical records accounted for 0.3% of all ED visits made by females.

These statistics can be produced using NAMCS and NHAMCS Public Use Datasets and Documentation.

  • DATA TIP OF THE MONTH

Did you know…

When examining trends and/or combining multiple years of data, it is important to check that the variables of interest were collected in all of the years contained in your analysis and that the wording of the item and/or answer categories did not change in a way that might impact the analysis. NCHS staff make every effort to point out important changes in the annual public use file documentation, both in the summary of changes at the beginning of the document and in the codebook section.

 

November 2018

  • STATS OF THE MONTH

In recognition of U.S. Antibiotic Awareness Week (November 13-19), we present estimates on antimicrobial use for acute viral upper respiratory tract infection at emergency department (ED) visits from the 2008-2015 National Hospital Ambulatory Medical Care Survey (NHAMCS).

  •  From 2008–2011 to 2012–2015, the percentage of visits for acute viral upper respiratory tract infection that had an antimicrobial ordered or prescribed decreased from 37.1% to 25.5% among emergency departments (EDs) located in nonmetropolitan statistical areas, but this decline was not seen among EDs in metropolitan statistical areas. (Antimicrobials is a more general drug category that includes antibiotics.) http://dx.doi.org/10.15585/mmwr.mm6703a7

In recognition of Chronic Obstructive Pulmonary disease (COPD) Awareness Month (November 1-30), we present estimates for COPD from the 2015 National Ambulatory Medical Care Survey (NAMCS).

  • In 2015, patients with COPD documented in the medical record accounted for 3.2% of all office-based physician visits. Visits by patients with COPD increased with age. Only 0.5% of visits made by patients under age 45 and 2.8% of visits made by patients age 45-64 had COPD, whereas 6.8% of visits made by patients 65-74 years and 7.4 % visits made by patients 75 years and older had COPD in the medical record. (Table 19 NAMCS [PDF – 785 KB])
  • DATA TIP OF THE MONTH

Did you know…

For 2012, estimates of visits to all providers (traditional NAMCS physicians and providers sampled within Community Health Center [CHC] strata) can be derived by combining physician data from the 2012 traditional NAMCS public use file with provider data from the 2012 NAMCS CHC public use data file. [PDF – 982 KB] New variables available only on the CHC public use file include type of CHC sampled provider (physician, nurse practitioner, physician assistant, or nurse midwife) and imputed time spent with non-physician clinician.

  • NEW PRODUCTS RELEASED THIS MONTH

2016 NHAMCS Emergency Department Public Use Data File and Documentation are now available.

 

October 2018

  • STATS OF THE MONTH

In recognition of National Breast Cancer Awareness Month (October 1-31), we present estimates for breast examination and mammography from the 2015 National Ambulatory Medical Care Survey (NAMCS). In 2015, breast examination and screening was ordered or provided in 6.0% of all office-based physician visits made by females. Mammography was ordered or provided in 3.8% of all office-based physician visits made by females. (Table 21 [PDF – 785 KB])

In recognition of Eye Injury Prevention Month (October 1-31), we present estimates for eye injury from the 2015 National Hospital Ambulatory Medical Care Survey (NHAMCS). In 2015, there were an estimated 473,000 emergency department (ED) visits by patients with eye injury, representing 1.2% of the injury visits made to the ED. (Table 18 [PDF – 676])

  • DATA TIP OF THE MONTH

Did you know…

NAMCS and NHAMCS data can be used to estimate annual visit rates per unit of population (e.g., per 1,000 population) by dividing the number of visits by the population denominator of interest. Using rates removes the influence of different population sizes (e.g., for adults aged 65-74 and 75+) so that data can be compared across these groups. (2015 NAMCS Public Use File Documentation [PDF – 1.6 MB])

  • NEW PUBLICATIONS RELEASED THIS MONTH

There aren’t any new publications this month, but check out our Survey Results and Products page for a listing of all NAMCS and NHAMCS publications.

 

September 2018

  • STATS OF THE MONTH

In recognition of National Recovery Month (September 1-30) we present estimates for substance abuse or dependence from the 2015 National Ambulatory Medical Care Survey (NAMCS). In 2015, patients with substance abuse or dependence documented in their medical record accounted for 2.3% of all office-based physician visits. Visits by patients with substance abuse or dependence were higher for males (3.0% of visits) than females (1.8% of visits) (Table 19 [PDF – 785 KB]).

In recognition of National Traumatic Brain Injury Awareness Month (September 1-30) we present estimates for traumatic brain injury visits from the 2015 National Hospital Ambulatory Medical Care Survey (NHAMCS). In 2015, there we an estimated 556,000 emergency department (ED) visits by patients with traumatic brain injury, representing 1.4% of the injury visits made to the ED (Table 18 [PDF – 676 KB]).

  • DATA TIP OF THE MONTH

Did you know…

Estimates and standard errors of drug mentions can be obtained by creating a new weight variable (e.g., DRUGWT) by multiplying PATWT (the patient visit weight) by NUMMED (the number of medications recorded at the visit) or DRUGWT=PATWT*NUMMED. DRUGWT can then be used in place of PATWT to produce the estimated number of drug mentions rather than visits. (2015 NAMCS Public Use File Documentation [PDF – 1.6 MB])

  • NEW PUBLICATION RELEASED THIS MONTH

Yang NS, Ward BW, Cummings NA. Patient health information shared electronically by office-based physicians: United States, 2015 [PDF – 311 KB]. This report provides the first national estimates for types of PHI that are electronically sent, received, integrated, and searched for by physicians with EHR systems, and could be used as a benchmark for future studies.

 

August 2018

  • STAT OF THE MONTH

In recognition of Children’s Eye Health and Safety Month (August 1-31), we present estimates for retinal or eye examination and screening from the 2015 National Ambulatory Medical Care Survey (NAMCS). In 2015, retinal or eye examinations and screenings were provided or ordered in approximately 31 million visits made by patients age 0-17, representing 21% of all office-based physician visits made by patients age 0-17. The percentage of visits in which retinal or eye examinations and screenings were provided or ordered was higher among children age 0-12 (23%) than among adolescents age 13-17 (13%). (Table 21 [PDF – 785 KB])

  • DATA TIP OF THE MONTH

Did you know…

The NAMCS and NHAMCS datasets that are available to approved users of the NCHS Research Data Center contain additional variables not included on the public use datasets.

  • NEW PUBLICATIONS THIS MONTH

There aren’t any new publications this month, but check out our Survey Results and Products page for a listing of all NAMCS and NHAMCS publications.

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