Survey Methods and Analytic Guidelines
Please note that complete documentation including survey methodology for all survey years can be downloaded for NAMCS and NHAMCS. Additional information on using NAMCS and NHAMCS data can also be found under Research Tools.
Survey Methods and Related Documentation
- National Ambulatory Medical Care Survey: Background and Methodology: United States, 1967-72 Cdc-pdf[PDF – 4.3 MB]
- The National Ambulatory Medical Care Survey: Symptom Classification Cdc-pdf[PDF – 2.5 MB]
- Reason for Visit Classification for Ambulatory Care Cdc-pdf[PDF – 3.6 MB]
- Collection and Processing of Drug Information: National Ambulatory Medical Care Survey: United States, 1980 Cdc-pdf[PDF – 6.4 MB]
- Sample Design, Sampling Variance and Estimation Procedures for the National Ambulatory Medical Care Survey Cdc-pdf[PDF – 3.1 MB]
- Effects of Form Length and Item Format on Response Patterns and Estimates of Physician Office and Hospital Outpatient Department Visits–National Ambulatory Medical Care Survey and National Hospital Ambulatory Medical Care Survey, 2001 Cdc-pdf[PDF – 5.7 MB]
- Plan and Operation of the National Hospital Ambulatory Medical Care Survey. Cdc-pdf[PDF – 5.8 MB]
- Methodology Used to Create “Initial Visit” for 2005 and 2006 NHAMCSCdc-pdf[PDF – 37 KB]
- For additional citations of methodological studies related to NAMCS and NHAMCS data, see NAMCS and NHAMCS List of Publications Cdc-pdf[PDF – 903 KB].
Nonresponse Bias Analysis
- Nonresponse Bias in Estimates from the 2012 National Ambulatory Medical Care Survey Cdc-pdf[PDF – 3.4 MB]
Classification Systems Used with NAMCS and NHAMCS
- International Classification of Diseases
- National Drug Code DirectoryExternal (used in NAMCS and NHAMCS prior to 2006)
- MultumExternal (used in NAMCS and NHAMCS starting in 2006)
- Reason for Visit Classification, Drug Entry List, Generic Ingredient List: These classifications are updated on an annual basis and printed in the documentation for each survey year. In addition, text formats for reason for visit, drug entry, and generic ingredient codes are all available in downloadable SAS formats for data years 1992-2015, and SPSS syntax files and Stata do and dictionary files for 1992-2015. The SAS and SPSS formats also include text labels for the following codes: diagnosis, cause of injury, procedures, and therapeutic class of drug.
Survey Items over Time
- NAMCS and NHAMCS Survey Content Brochure, 1973-2012. NAMCS and NHAMCS Survey Content BrochureCdc-pdf[PDF – 1.5 MB] [Revised 11/2012]
- NAMCS List of Data Items, 1973-2004. NAMCS Cdc-pdf[PDF – 24 KB]
- NHAMCS List of Data Items, 1992-2004. NHAMCS Cdc-pdf[PDF – 27 KB]
Variance Estimation: Using complex sample design software such as SUDAAN, Stata, SPSS, R, SAS survey procedures, etc.
Currently, NAMCS public-use files for 1993-2015 and NHAMCS public-use files for 1992-2015 contain sample design variables in masked form. The initial release of the 2000-2015 public-use files includes masked sample design variables. We re-released the 1993-99 NAMCS and 1992-99 NHAMCS files to include these variables. For re-released files, file names and layouts are essentially the same, but the design variables were appended to each file according to a generic file layout that is available for downloading.
However, data users should note that, 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. For the 2003 public use files and beyond, the decision was made to include only these two masked design variables for variance estimation. Therefore, data users who wish to combine years of data from 2003 and beyond with years prior to 2002 will need to create these two variables for each file prior to 2002. A technical paper, Using Ultimate Cluster Models with NAMCS and NHAMCS Public Use Files Cdc-pdf[PDF – 34 KB], gives instructions.
- SAS Code to Produce Aggregated Visit Statistics at the Physician or Facility LevelCdc-pdf[PDF – 34 KB]
Additional data analysis resources can be found at Research Tools.