Wednesday: Scientific Sessions

Plenary II: 8:30—10:00 a.m.
Overlooked and Emerging Health Topics

Welcome, Announcements, and Salute to Student Poster Winners:
Edward J. Sondik, Ph.D.
Director, National Center for Health Statistics

Pamela S. Hyde, J.D.
Administrator of the Substance Abuse and Mental Health Services Administration

Pamela S. Hyde, J.D., Administrator, Substance Abuse and Mental Health Services Administration
Pamela S. Hyde, J.D.

Pamela Hyde was nominated by President Barack Obama and confirmed by the U.S. Senate in November 2009 as Administrator of the Substance Abuse and Mental Health Services Administration (SAMHSA), a public health agency within the Department of Health and Human Services. The agency’s mission is to reduce the impact of substance abuse and mental illness on America’s communities.

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Keynote speakers:

Dr. Mohammad N. Akhter, Director, D.C. Department of Health
Dr. Mohammad N. Akhter

Under Dr. Akhter’s leadership, the D.C. Department of Health is focused on improving the quality of health care in the District of Columbia. His top priorities include implementation of health care reform, expansion of HIV services and making them available on demand, supporting training programs for D.C. residents to qualify for jobs in health care, and improving access to quality care across the District.

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Lisa Simpson, M.B., B.Ch., M.P.H., F.A.A.P., President and Chief Executive Officer, AcademyHealth
Lisa Simpson, MB, BCh, MPH, FAAP

A nationally recognized health policy researcher and pediatrician, Dr. Simpson is a passionate advocate for the translation of research into policy and practice. Her research focuses on improving the performance of the health care system and includes studies of the quality and safety of care, health and health care disparities, and the health policy and system response to childhood obesity.

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Concurrent Scientific Session IV – 10:30 a.m—12:00 p.m

SS-07. Monitoring Health Care Reform Through Provider-based Surveys: New Initiatives From the National Ambulatory Medical Care Survey and National Hospital Ambulatory Medical Care Survey
In 2012, the National Ambulatory Medical Care Survey (NAMCS) and the National Hospital Ambulatory Medical Care Survey (NHAMCS) data collection were computerized and had increased sample sizes, allowing state-specific estimates and collected supplemental data on prior visits for those patients with cardiovascular disease conditions as well as the provider’s treatment of patients with asthma and their attitudes and referral patterns for complementary and alternative medicine. This session will provide information on how NAMCS and NHAMCS data can help monitor the impact of health care reform. Find out how the new state-level NHAMCS estimates of length of visit, wait time, and visit volume can be used to monitor the effects of expansion of Medicaid programs on crowding in emergency departments. Discover how state-level NAMCS estimates of clinical care provided in physician offices and community health centers support activities of CDC and its health department partners to monitor the effect of expanded health coverage on the use of appropriate preventive services. Learn how capturing risk factors and appropriate preventive services for patients at risk for heart disease and stroke can assist in evaluating services to prevent major causes of death and disability.

SS-15. Cardiovascular Health Risk Behaviors Among Children and Adolescents
Certain risk behaviors during childhood are associated with the development of atherosclerosis. Although the process of atherosclerosis begins in childhood, clinical events such as myocardial infarction do not normally present until adulthood. Altering risk behaviors—for example, by preventing smoking initiation and optimizing nutrition and physical activity—is a component of clinical practice guidelines to reduce cardiovascular disease, including the recently released “Expert Panel on Integrated Guidelines for Cardiovascular Health and Risk Reduction in Children and Adolescents.” This session will provide a brief overview of health risk behaviors associated with cardiovascular health in childhood and will highlight selected risk behaviors, including smoking, nutrition, and physical activity.

SS-22. Prevalence, Trends, and Disparities in Mental Health Disorders and Service Use Among Children and Adolescents
Mental health disorders are among the most prevalent and costly chronic childhood and adolescent conditions. About 20% of all children and adolescents are estimated to have mental health disorders causing at least mild functional impairment, and 5% to 9% are estimated to have serious emotional disturbance. However, many children and adolescents with mental health disorders do not receive treatment for these problems. NCHS collects information that can be used to monitor the prevalence of mental health conditions and the need for services among children and adolescents. The speakers will discuss the use of data from national health surveys to identify child mental health disorders and will present estimates from several NCHS surveys to describe recent trends and disparities in the prevalence of specific mental health disorders, including autism, depression, and ADHD, as well as the use of psychotropic medications in treating these conditions.

SS-31. Incorporating the Drug Abuse Warning Network Into the Emergency Department Component of the National Hospital Care Survey
The National Hospital Care Survey (NHCS) is a new survey conducted by NCHS that will integrate inpatient data formerly collected by the National Hospital Discharge Survey with the emergency department (ED) data formerly collected by Substance Abuse and Mental Health Services Administration’s (SAMHSA) Drug Abuse Warning Network (DAWN) and the ED, outpatient department, and ambulatory surgery data formerly collected by the National Hospital Ambulatory Medical Care Survey. The advantages of survey integration to SAMHSA include: increased response rate; estimates based on a large nationally representative sample of hospital EDs; having survey operations and data collection transferred to NCHS ; and expanding information that can be collected on both drug- and mental illness-related visits. Disadvantages include only being able to provide ED visit estimates for key drugs (for example, cocaine, heroin, and marijuana) and losing the ability to produce reliable estimates on drug-related ED visits for selected metropolitan statistical areas. The following approaches to increase the number of drug-related ED visits will be tested during the pretest: extension of the reporting period from 1 month to 2 months and 3 months; collection of UB-04 billing data from nonremote reporting hospitals and use of ICD–9–CM diagnosis codes to identify drug-related cases; and review of all ED visits in remote reporting hospitals with the abstraction of all likely drug-related cases and comparing this with the collection of UB-04 billing data to identify drug-related cases. SAMHSA is also interested in expanding its traditional DAWN data collection efforts beyond drug only-related ED visits to include ED visits related to mental health issues and diagnoses.

SS-33. Student Research Showcase: Highlighting Exceptional Student Research in Health Statistics
This session will feature four research studies, each conducted by a student. These four studies were selected among all student abstract submissions, and were of exceptional quality, receiving high scores from the abstract reviewers . The students were invited to present their research orally during this student scientific session, in lieu of a poster presentation. Their research topics will cover nutrition, mental health, smoking, and statistical methodology.

SS-36. Improving Civil Registration and Vital Statistics Systems Around the World
This session will provide an overview of the current status of civil registration and vital statistics (CRVS) systems around the world, with a look at challenges to achieving completeness in reporting coverage and quality of cause of death information. Past experiences in developing CRVS systems will be reviewed and the present environment of renewed interest in CRVS will be explored. This session will present various mechanisms being employed for CRVS system improvement. Discussion will include methods for conducting verbal autopsy, which is used for generating cause of death information in populations where deaths occur outside of health institutions and registration coverage is otherwise poor. The importance of physician certification in reporting causes of death will be reviewed, using examples from a successful case study in Jordan and from developed countries. Lastly, this session will examine efforts by the Millennium Villages Project to record vital events occurring in every household by incorporating community health workers as vital events reporters. This session will provide attendees with an understanding of the global status of CRVS systems and the mechanisms employed for improving them.

Concurrent Scientific Session V – 1:30—3:00 p.m

SS-03. Measuring Electronic Health Record Adoption and Its Impact
Electronic health record (EHR) adoption has varied among physicians and hospitals leading to different experiences in health care. A goal of the 2009 Health Information Technology for Economic and Clinical Health Act (HITECH) is to advance the use of health information technology (HIT) by providing Medicare and Medicaid incentives to encourage physicians and hospitals to exchange patient information and enhance care through clinical decision support. Researchers and policymakers have examined data from the National Ambulatory Medical Care Survey (NAMCS), National Hospital Ambulatory Medical Care Survey, National Home and Hospice Care Survey, and the National Survey of Residential Care Facilities to measure use of EHR systems in physicians’ offices and hospitals, and with long-term care providers. Complementing the measures of HIT adoption, the 2011 NAMCS Physician Workflow mail survey examines attitudes and beliefs of office-based physicians including perceived benefits, barriers, and the impact of policies associated with EHR system use, including the impact of EHRs on their clinical workflow. Additionally, NAMCS data has been used to measure and explain the state of health information exchange among providers, which is a HITECH policy goal. NCHS data and other data sources have been used in creative ways to track state estimates of EHR adoption.

SS-19. Health Data From the Revised Birth Certificate: Was It Worth the Wait?
This session will present the findings of several recent studies designed to assess the quality of the medical and health data from the 2003 revision of the birth certificate. A number of important birth certificate medical and health items newly released by NCHS will be highlighted, and changes in how these data are collected, as well as ongoing efforts to improve data quality, will be discussed. The presentations on data quality will show summary results of interviews with birth information specialists in four states. Also presented will be results of studies fielded in four vital statistics jurisdictions, which compare birth certificate data with data abstracted from hospital medical records, and in some instances with data from the Pregnancy Risk Factor and Monitoring System (PRAMS). The data highlights presentation will give information for a 28-state reporting area representing 66% of all 2009 births. Newly released items to be discussed include maternal body mass index (BMI), quitting smoking before pregnancy, use of the WIC program, whether the pregnancy resulted from infertility treatment, source of payment for the delivery, and maternal infections (e.g., chlamydia) and morbidities (e.g., ruptured uterus). Also discussed will be fundamental changes in how vital statistics birth data are collected—for example, the advent of electronic health records—and ongoing efforts to assess and enhance the quality of the new birth data.

SS-24. Healthy Life Expectancy: Measuring Population Health Based on the Combined Effects of Fatal and Nonfatal Health Outcomes
Healthy life expectancy (HLE) is generically used to describe population health measures that combine fatal and nonfatal health outcomes. Such health measures include expected years of life in good or better health and expected years free of disability, chronic conditions, or activity limitations. In each case, a demographic or epidemiologic model is used to combine life expectancy estimates from a life table with age-specific prevalence rates of self-assessed health and chronic condition, activity limitation, or disability status to produce measures that reflect both average length and quality of remaining years of life. This session will focus on the application of HLE for: tracking the overall health of the U.S. population; summarizing health disparities at the national, regional, and state levels; showing the relationship between expected years of life without insurance and the high risk of medical need; and describing health disparities among the major subgroups of the U.S. population.

SS-29. Does Social Media Have a Role in Federal Statistics?
Social media is a powerful communication tool that can be used to turn communication into interactive dialogue among organizations, communities, and individuals. This session will bring together a panel of representatives from federal statistical agencies to discuss what is working, what is not working, and how social media can help to improve survey participation rates. Topics will include discussions on social media governances, case studies on the effective use of social media for the enhancement of data dissemination activities, and improvement of survey participation rates.

SS-32. To Be or Not To Be: The Dilemma of Suicide in America
Suicide is a major public health issue in the United States. Each year, more Americans die by suicide than die in motor vehicle traffic events. With nearly 37,000 suicides occurring in 2009, suicide now ranks as the 10th leading cause of death in the United States. As tragic as they are, deaths reveal only a portion of the problem. Of additional concern is the number of people who have attempted suicide or have suicidal thoughts. Estimates from the National Hospital Ambulatory Medical Care Survey suggest that each year approximately 420,000 individuals are seen in emergency departments for attempted suicide or self-inflicted injury. This session will describe suicide trends, patterns, and populations at risk using a variety of national surveillance systems and provide recommendations on how these data can be used to inform suicide prevention efforts.