Overview of the 2019 National Health Interview Survey Questionnaire Redesign.

Federal health surveys, like the National Health Interview Survey (NHIS), represent important surveillance mechanisms for collecting timely, representative data that can be used to monitor the health and health care of the US population. Conducted by the National Center for Health Statistics (NCHS), NHIS uses an address-based, complex clustered sample of housing units, yielding data representative of the civilian noninstitutionalized US population. Survey redesigns that reduce survey length and eliminate proxy reporting may reduce respondent burden and increase participation.

COVID-19 Pandemic Impact on the National Health Care Surveys.

While underscoring the need for timely, nationally representative data in ambulatory, hospital, and long-term-care settings, the COVID-19 pandemic posed many challenges to traditional methods and mechanisms of data collection. To continue generating data from health care and long-term-care providers and establishments in the midst of the COVID-19 pandemic, the National Center for Health Statistics had to modify survey operations for several of its provider-based National Health Care Surveys, including quickly adding survey questions that captured the experiences of providing care during the pandemic. With the aim of providing information that may be useful to other health care data collection systems, this article presents some key challenges that affected data collection activities for these national provider surveys, as well as the measures taken to minimize the disruption in data collection and to optimize the likelihood of disseminating quality data in a timely manner.

National Health Interview Survey, COVID-19, and Online Data Collection Platforms: Adaptations, Tradeoffs, and New Directions.

High-quality data are accurate, relevant, and timely. Large national health surveys have always balanced the implementation of these quality dimensions to meet the needs of diverse users. The COVID-19 pandemic shifted these balances, with both disrupted survey operations and a critical need for relevant and timely health data for decision-making.

Advancements in the National Vital Statistics System to Meet the Real-Time Data Needs of a Pandemic.

The National Center for Health Statistics' (NCHS's) National Vital Statistics System (NVSS) collects, processes, codes, and reviews death certificate data and disseminates the data in annual data files and reports. With the global rise of COVID-19 in early 2020, the NCHS mobilized to rapidly respond to the growing need for reliable, accurate, and complete real-time data on COVID-19 deaths. Within weeks of the first reported US cases, NCHS developed certification guidance, adjusted internal data processing systems, and stood up a surveillance system to release daily updates of COVID-19 deaths to track the impact of the COVID-19 pandemic on US mortality.

A National Framework to Improve Mortality, Morbidity, and Disparities Data for COVID-19 and Other Large-Scale Disasters.

Timely and accurate data on COVID-19 cases and COVID-19‒related deaths are essential for making decisions with significant health, economic, and policy implications. A new report from the National Academies of Sciences, Engineering, and Medicine proposes a uniform national framework for data collection to more accurately quantify disaster-related deaths, injuries, and illnesses. This article describes how following the report's recommendations could help improve the quality and timeliness of public health surveillance data during pandemics, with special attention to addressing gaps in the data necessary to understand pandemic-related health disparities.

Is prescribing by PAs and NPs comparable to physician prescribing?

PAs and NPs have broad prescribing authority in the United States, yet little is known about how the quality of their prescribing practices compares with that of physicians. The quality of prescribing practices of physicians, PAs, and NPs was investigated through a serial cross-sectional analysis of the 2006-2012 National Ambulatory Medical Care Survey (NAMCS) and National Hospital Ambulatory Medical Care Survey (NHAMCS). Ambulatory care services in physician offices, hospital EDs, and outpatient departments were evaluated using a nationally representative sample of patient visits to physicians, PAs, and NPs.

HUD Housing Assistance Associated With Lower Uninsurance Rates And Unmet Medical Need.

To investigate whether receiving US Department of Housing and Urban Development (HUD) housing assistance is associated with improved access to health care, we analyzed data on nondisabled adults ages 18-64 who responded to the 2004-12 National Health Interview Survey that were linked with administrative data from HUD for the period 2002-14. To account for potential selection bias, we compared access to care between respondents who were receiving HUD housing assistance at the time of the survey interview (current recipients) and those who received HUD assistance within twenty-four months of completing the survey interview (future recipients). Receiving assistance was associated with lower uninsurance rates: 31.

Housing Assistance Programs and Adult Health in the United States.

Objectives: To examine whether access to housing assistance is associated with better health among low-income adults.

Methods: We used National Health Interview Survey data (1999-2012) linked to US Department of Housing and Urban Development (HUD) administrative records (1999-2014) to examine differences in reported fair or poor health and psychological distress. We used multivariable models to compare those currently receiving HUD housing assistance (public housing, housing choice vouchers, and multifamily housing) with those who will receive housing assistance within 2 years (the average duration of HUD waitlists) to account for selection into HUD assistance.

Barriers to Health Care Among Adults Identifying as Sexual Minorities: A US National Study.

Objectives: To assess the extent to which lesbian, gay, and bisexual (LGB) adults aged 18 to 64 years experience barriers to health care.

Methods: We used 2013 National Health Interview Survey data on 521 gay or lesbian (291 men, 230 women), 215 bisexual (66 men, 149 women), and 25 149 straight (11 525 men, 13 624 women) adults. Five barrier-to-care outcomes were assessed (delayed or did not receive care because of cost, did not receive specific services because of cost, delayed care for noncost reasons, trouble finding a provider, and no usual source of care).

Racial Disparities in Functional Limitations Among Hispanic Women in the United States.

This article assesses whether there are race differences in functional health among Hispanic women in the United States; ascertains whether the race differences in functional health vary by age; and examines the extent to which race differences in functional health are attributable to key dimensions of demographic, geographic, and socioeconomic heterogeneity. The analysis is based on 15 years of aggregated data from the National Health Interview Survey. Both U.

In which states are physician assistants or nurse practitioners more likely to work in primary care?

Objective: Examine availability of physician assistants (PAs) or nurse practitioners (NPs) in primary care physician practices by state and by state PA and NP scope-of-practice laws.

Methods: Availability of PAs and NPs in primary care practices was examined in multivariate analysis using a 2012 state-based, nationally representative survey of office-based physicians. Covariates included practice characteristics, state, and in a separate model, PA and NP scope-of-practice variables.

Medicaid enrollment gap length and number of Medicaid enrollment periods among US children.

Objectives: We examined gap length, characteristics associated with gap length, and number of enrollment periods among Medicaid-enrolled children in the United States.

Methods: We linked the 2004 National Health Interview Survey to Medicaid Analytic eXtract files for 1999 through 2008. We examined linkage-eligible children aged 5 to 13 years in the 2004 National Health Interview Survey who disenrolled from Medicaid.

Control of risk factors among people with diagnosed diabetes, by lower extremity disease status.

Introduction: We examined the control of modifiable risk factors among a national sample of diabetic people with and without lower extremity disease (LED).

Methods: The sample from the 1999-2004 National Health and Nutrition Examination Survey consisted of 948 adults aged 40 years or older with diagnosed diabetes and who had been assessed for LED. LED was defined as peripheral arterial disease (ankle-brachial index <0.

Hospital collaboration with public safety organizations on bioterrorism response.

Objective: To identify hospital characteristics that predict collaboration with public safety organizations on bioterrorism response plans and mass casualty drills.

Methods: The 2003 and 2004 Bioterrorism and Mass Casualty Supplements to the National Hospital Ambulatory Medical Care Survey examined collaboration with emergency medical services (EMS), hazardous materials teams (HAZMAT), fire departments, and law enforcement. The sample included 112 geographic primary sampling units and 1,110 hospitals.

Payment source and length of use among home health agency discharges.

Purpose: Our study compared (1) length of use among home health care (HHC) discharges with Medicare, Medicaid, or private health insurance between 1991 and 2000 and (2) factors associated with length of HHC use among discharges with Medicare, Medicaid, or private health insurance.

Methods: Data were obtained from the 1992, 1994, 1996, 1998, and 2000 National Home and Hospice Care Surveys (n = 18,416). Logistic regressions and stratified analyses by primary payment source were applied.

Inappropriate medication prescribing for elderly ambulatory care patients.

Background: Inappropriate medication use in elderly patients has been linked to a large share of adverse drug reactions and to excess health care utilization.

Methods: Trends in the prevalence of potentially inappropriate drug prescribing at ambulatory care visits by elderly persons from 1995 to 2000 were examined with data from office-based physicians in the National Ambulatory Medical Care Survey and from hospital outpatient departments in the National Hospital Ambulatory Medical Care Survey. Explicit criteria were used to identify potentially inappropriate prescribing.

Breast and cervical cancer screening: sociodemographic predictors among White, Black, and Hispanic women.

Objectives: We evaluated the relationship between breast and cervical cancer screening and a variety of variables across race/ethnicity groups.

Methods: Using logistic regression models, we analyzed data from the 1998 National Health Interview Survey to assess the relative importance of the independent variables in predicting use of cancer screening services.

Results: Having a usual source of care was the most important predictor of cancer screening use for all race/ethnicity groups.

Reference data for arm muscle and arm adipose tissue areas in Mexican Americans from the Hispanic Health and Nutrition Examination survey (HHANES 1982-1984): Comparisons with whites and blacks from NHANES II (1976-1980).

Data for arm muscle area (AMA) and arm adipose tissue area (AATA) from 3695 Mexican American children 6 months to 18 years of age included in HHANES (1982-1984) were used to obtain age-and gender-specific means and selected percentiles. These statistics were compared with those for non-Hispanic white and non-Hispanic black children from NHANES II (1976-1980). In comparison with non-Hispanic white and non-Hispanic black children, the Mexican American children tended to have smaller means and percentile values for AMA but larger values for AATA.

Head circumference for Mexican American infants and young children from the Hispanic health and nutrition examination survey (HHANES 1982-1984): Comparisons with Whites and Blacks from NHANES II (1976-1980).

This study presents descriptive statistics for head circumference in Mexican American children 6 months to 7 years of age using data from the Hispanic Health and Nutrition Examination Survey (HHANES, 1982-1984) and compares these statistics with national estimates of head circumference for non-Hispanic White children and non-Hispanic Black children from the Second National Health and Nutrition Examination Survey (NHANES II, 1976-1980). Head circumference was measured in the same standardized fashion in the two surveys. The patterns of change with age in means and in empirical percentiles were similar for both genders and for all three ethnic groups.