accessing and using nchs data: an overview and demonstration of nchs data access tools 2006 nchs...

Accessing and Using NCHS Data:

An Overview and Demonstration of NCHS Data Access Tools

2006 NCHS Data Users ConferenceHands-On Session 66

July 12, 2006

Ann Aikin

FASTATS A – Z

Reports, such as Health, U.S. and Advanced Data

Data Warehouse

Data Highlights

Health E-Stats

Accessing NCHS Data: Let Me Count the Ways…

Beyond 20/20 Tables: Health Data for All Ages and Trends in Health and Aging

Healthy People DATA 2010

CDC WONDER

WISQARS

Combined Health Data Sources

Accessing Data Sets (public use):


ASCII Data Sets (complete public use file) SETS (complete public use file, with

documentation and software to access files) Data Resource Center for Child and

Adolescent Health Online Query Tool (data from two SLAITS surveys--National Survey of Children with Special Health Care Needs and National Survey of Children's Health)

Research Data Center (a fee-based service that provides access to confidential data and data access for those needing assistance)

Information to Help Access Data Listservs NCHS Definitions NCHS Survey Measures Catalog: Children and

Adolescent Mental Health Coming Soon! Ambulatory Care Drug Database System

Technical Reports and Data Documentation!

Other Published Reports, such as Series Reports…


Overview of NCHS Data Access Tools

Tool Ease Level AvailableBeyond 20/20 Health Data for All Ages,

Trends in Health and Aging

CDC Wonder Mortality, Natality

DATA2010 Healthy People Objectives

WISQARS Injury Data

Child and Adolescent Health Online Query Tool

National Survey of Children's Health, National Survey of

Children with Special Health Care Needs

SETS Selected NCHS sets: Over 80 Available!

Health Insurance CoverageTo provide a complete picture of the uninsured population, the National Health Interview Survey (NHIS) tracks:persons who currently lack coverage; persons uninsured at any time in the previous year; persons who have experienced lack of coverage for more than a year.

Health care surveys also report health insurance measures, such as the National Ambulatory Care Survey (NAMCS), which reports expected source of payment from doctor visits.

Health Insurance Coverage: From the NHIS—Lack of CoverageData are released from NHIS

In ASCII (raw data files) On the Internet, as an Early Release In publications (forthcoming) In Data2010, as a Healthy People 2010 Objective In a customizable table on the Health Data for All Ages site (update to 2004 forthcoming) Other sources, such as Health, United States, FASTSTATS etc…

NHIS Early Release: Percentage of persons of all ages without health insurance coverage at the time of interview: United States, 1997–2005 From: Early

Release of Selected

Estimates Based on Data From the

2005 National Health Interview

Survey, Lack of health

insurance coverage and

type of coverage,

Figure 1.1. http://www.cdc.gov/nchs/data/nhis/earlyrelease/200606_01.pdf

http://www.cdc.gov/nchs/data/nhis/earlyrelease/200606_01.pdf

http://www.cdc.gov/nchs/data/nhis/earlyrelease/200606_01.pdf

Health Insurance Coverage: NHIS data in Health, U.S.

Health Data for All Ages also provides health insurance statistics

In this pretabulated table, NHIS data years are combined to make the statistics more reliable and

more useful for breakdowns by age, sex, race/ethnicity and geography.

Health Insurance…Expected Source of Payment from Health

Care SurveysData are released from the health care surveys

In ASCII (raw data files) On the Internet, as a Health E Stat In publications, such as Advanced Data Other sources, such as Trends in Health and Aging, Health, United States, FASTSTATS etc…

Health E-Stat Release of Doctor Visit Data: Percent Distribution of

Ambulatory Care Visits by Setting Type, According to Expected Source of

Payment, 2004

From: Health E-Stat, “Ambulatory Medical Care Utilization Estimates for 2004” Accessed on July 1, 2006.

Prescription Drug Use

Prescription drug use is in the rise in America…In 1999-2002, 45 percent of Americans used a prescription drug in the last month, while 18 percent used three or more; and use among

seniors is much higher.

NCHS Statistics on Prescription Drugs To find out more about drug use in America, we will use the following data tools:

National Survey of Children’s Health Data Resource Tool to find statistics on children’s use of prescription drugs

Trends in Health and Aging to find statistics on the distribution of drug mentions in doctor offices

Ambulatory Care Drug Database System to find the number of drug mentions for a specific drug

WISCARS to find the number of drug-related adverse effect deaths

Prescription Drug Use in SLAITS National Survey of Children’s Health

http://www.nschdata.org/Content/Default.aspx


Child and Adolescent Health Measurement Initiative (2005). National Survey of

Children’s Health, Data Resource Center on Child and Adolescent Health website.

Retrieved 06/30/2006 from www.nschdata.org.

http://www.nschdata.org/

Distribution of Drug Mentions … by Patient's Age, Sex, and Race. United States, Selected Years, 1989-2002. NAMCS, NHCS (NAD02a)

Centers for Disease Control and Prevention. National Center for Health Statistics.

Trends in Health and Aging. http://www.cdc.gov/nchs/hdi.htm. June 30, 2006.

Using WISQARS for Adverse Drug Deaths

(Fatal Injuries) Statistics

Centers for Disease Control and Prevention, National Center for Injury Prevention and Control. Web-based Injury Statistics Query and Reporting System (WISQARS). June 30,

2006. Available from URL: www.cdc.gov/ncipc/wisqars.


(Fatal Injuries) StatisticsStep 1:

For our example, we will choose “All Intents”



For our example, we will choose “Drugs, adverse effects” in the Adverse Effects injury category



For our example, we will choose the default settings for geography, race,

Hispanic origin, sex and Output Options. For years, we will choose “1999 to 2003.”


(Fatal Injuries) StatisticsSteps 4 and 5:

Under Advanced Options, we will select the age groups “20-24 and 60-64” and we will leave the age-adjusted default to the year

2000. We will also select output group 1 to “Age Group”


(Fatal Injuries) StatisticsOutput Table:

Using the Ambulatory Care Drug Database System to Find the Number of Drug Mentions

for a Specific Drug


for a Specific Drug- LOPRESSOR, a Beta Blocker

Used by Heart PatientsStep 1: Type in the name of the drug in the drug

name box.

Step 2: You can also select the 2-digit) NDC Class Category 05 and the Prescription

Status of Prescription

Drug.

Step 3: Select the

Search Database button.



Used by Heart Patients

In 2004, there were over 4 million drug mentions for Lopressor. If you click

any of the highlighted words, you will bring up the drug characteristics

information.



Used by Heart Patients

Using CDC Wonder to Create Parkinson’s Disease Table


Step 1

For this example, we will leave the defaults for area, population, and

years


Step 2

Click the box to age-adjust to year 2000. Please note WONDER provides more information on

age-adjustment.


Step 3: Selecting Cause of Death

Type in “Parkinson” and hit the Keyword Search button.

Select the Keyword Search button and


Step 3: Selecting Cause of Death

Select G20 and G21, per

NVSR 54 #13 Table 9, page 29, the codes used

for Parkinson’sDisease. Hit the “Move Individual

Codes” button.


Steps 4 and 5

In step 4, summarize the data by ‘Year” and keep the defaults for step

5.


Output table:

Cesarean Delivery Statistics: Healthy People Objectives, Health Data for

All Ages, and SETSLowering the cesarean rate in the United States has been a

goal for the past 25 years. Separate objectives were

formulated for low-risk women giving birth for the first time (a subset of all women having a

first birth) and for low-risk women who had a prior

cesarean birth. The objectives set a target of 15 percent for

cesarean delivery and 63 percent for repeat cesarean

delivery.

From: National Vital Statistics Reports, Vol. 54, No. 4, September 22, 2005, Table 1. Cesarean rates for first births to low-risk women by age and race and Hispanic origin of mother: United States… page 6.

Healthy People Objectives--Cesarean Delivery

Step 1: Type in “cesarean” in the keyword box and the button. The Healthy People Objectives with the word “cesarean” will

appear in the objective box below. In this case, there were two objectives with cesarean:

Objective 16-09a and 16-09b.

Healthy People Objectives--Cesarean Delivery

Step 2: Choose the Submit button and the 16-09a table with the base line year and

percent, the data years 1998-2005 and the 2010 target will appear.

Health Data for All Ages produces a table on cesarean rates for low-

risk women

Customizing the Cesarean Deliveries Table for To Show Only

Prior Cesarean Deliveries

Step 1: Click on the Cesarean cell.

Step 2: Deselect the default selections by choosing the button. Select “Prior Cesarean” from the list. Choose the table button and the table will only show prior cesarean deliveries.

Customizing for Specific Locations

Step 3: To further customize the table, I would only like to look at Maryland, Washington DC, and Virginia. To do this, you need to select Location, deselect the defaults, and

check the appropriate boxes for the locations I want to view. Select the table icon

again to view your selections.

Looking at Race and Ethnicity

Step 4: To look at specific race and ethnicity, we want to further customize our table view. To do this, we need to physically drag and drop the Race/Ethnicity cell into the Cesarean cell. (The Cesarean cell the moves to the old position). Move the cells so the order is Maternal Age, Race/Ethnicity, Location.

Prior Cesarean Delivery among Low-Risk Women in Maryland, the District of Columbia, and Virginia by Race and Ethnicity for All Ages

Prior Cesarean Delivery among Low-Risk Women in Maryland, the District of Columbia, and Virginia by Race and Ethnicity for All Ages

These data can also be charted or

exported. To chart, select the chart button and then the printer friendly button.

Using SETS to Create a Cesarean Delivery Table

To match estimates published in our reports,

such as the Trends in Cesarean Rates for First

Births and Repeat Cesarean Rates for Low-

Risk Women: United States, 1990-2003. From: National Vital Statistics

Reports, Vol. 54, No. 4, September 22, 2005, Table 1. Cesarean rates for first births to low-risk women by age and race and Hispanic origin of mother: United States… page 6.

Using SETS to Create a Cesarean Delivery Table—

Getting StartedStep 2:

Choose the correct drive, and the NCHS

folder.

Step 3: Choose the Nata2003

file.

Step 4: Accept the

usage requirements

.

Step 1: Open the SETS folder and the

SETS Interface.

Using SETS to Create a Cesarean Delivery Table—

Getting Started

Step 3: From the menu, go to Table and Assist.

Step 2: Choose the 2003 Natality File in the Data

Folder…and Tabulate data.

Step 1: Go to file, and select Open, and Set.

Using SETS to Create a Cesarean Delivery Table– Selecting only U.S. Born

Residents1. Go to Records and the choose Select. Click Assist. 2. Double click on the empty Field box. Add choose

4. Choose RESTATUS (Resident Status) from the list and Select. Choose the =! Operator from the pull down list and double click on

the Code box and choose 4 (FOREIGN RESIDENTS).

3. Type “foreign” in the search box and choose OK.

5. Go back to the list of Field boxes…

Using SETS to Create a Cesarean Delivery Table– Selecting only Low Risk

Pregnanciesfull-term pregnancy (at least 37 completed weeks of gestation

RGEST3=, or “37 Weeks and over”),

singleton pregnancy (not a multiple pregnancy ),

safe fetal presentation (head in a downward position in

the birth canal).

6. To look at only low risk pregnancy, we need to select the our records:

Please note: RESTATUS =! 4 was selected previously. We also need to select “Detailed Total Birth Order” or RTBO = 01 (first birth) to recreate the Table 1 in the report, which only includes first births.

7. Accept the record selection and choose Select, when prompted.

Using SETS to Create a Cesarean Delivery Table-

Recoding a FieldTo create the age groups

used in the table, we need to create a recode in SETS. To do this:

1. Go to Recodes and Create.

2. Type in the file name of your recode and save to your hard drive (c) and go to Recode and Assist.

3. Double click on the Based on field box, and4. Type in age and choose OK. Choose RMAGE9, or Age of Mother Recode 9 and choose the Select button.


Creating a Recode1. Type in a new recode

name, and double click the first codes box (agerecode).

2. Choose codes 1 and 2 and Select. Type in an optional category label, such as, “Under age 20 years.”

3. Double click on the second code box and choose code 3.

4. Continue this process until you’ve created 6 categories to match the ones in the publication.


Creating a Recode5. Go to Recodes and select

Attach.

6. Your age recode will now show up in the fields and recodes list.


Step 1: Go to Table and Assist. This brings up the Table Assistance

template.

Step 2: Select your age recode and the RDELMTH field by highlighting it and selecting the Add button. So they

appear in the Table fields box to the

right.


Step 3. Go to the Nesting options table (2), leave the defaults and go to table 3, Generate Statements.

Step 4. Choose the Generate button and go to the Begin tabulation table (4). Select

the Begin button.


The table from SETS matches the table

produced in the NVSR report!

Using SETS to Create a Cesarean Delivery Table with

our Age Recode

How would you create this table in SETS?

In SETS, you can also browse the data….

or chart and export your data

or create and edit your own data sets using the SETS Designer Kit

and Editor

For more information, please see

www.cdc.gov/nchs/sets.htm

Now It’s Your Turn! Can You….

Find the age-adjusted rate for Drug-Induced Deaths (Healthy People Objective, 26-03)

Using DATA2010, create a table for Healthy People Objective 26-03 for the District of

Columbia


Can you find the percent of children (ages 0-17) uninsured in two parent households and mother-only households for the District of

Columbia and the US using the Data Resource Center’s National Survey of

Children’s Health?

Hint: Select Healthy People 2010 Goals, and Goal #1 (Access to Quality Health Services). Then choose Objective 1-1 (% of children

uninsured)


Find the death rate for Parkinson’s disease?

Using Trends in Health and Aging, chart the trends in death rates from 1981-2003. Can you also customize the chart so it shows the

trends by sex?

Hint: go to the mortality folder, and choose the second table, Death Rates by Age, Sex, Race, and Underlying Cause. United States, 1981-

2003 (NMR03a)


Find the number of vaginal births in the District of Columbia for 2003? For extra

credit…can you tell me how many of primary c-sections in DC there were in 2003? What

about the total number of births to white and black mothers in DC in 2003?

Hints: To create this table, you will need to use the field “STRESEXP” or expanded State of Residence. Don’t forget to exclude foreign

residents before you create the table! When you go to create the table, you will want to run a table using the field “RDELMTH” or the

method of delivery recode.

Contact Information

Ann Aikin (NCHS Data Tools Specialist)[email protected]

Avay Dolberry (SETS Specialist)[email protected]

919.541.2700

Phyllis Chappell (Beyond 20/20 Specialist)[email protected]

919.541.4466Connie Banks (Beyond 20/20 and SETS Specialist)

[email protected]

Susan Temple (Beyond 20/20 and SETS Specialist)[email protected]

919.541.4923

mailto:[email protected]





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