What are the major national-level sources for health services research? Describe the major features of these data sources.

What will be an ideal response?

The major national-level data sources commonly used for health services research include the following:
• The National Center for Health Statistics (NCHS) collects statistics through national representative surveys on illness and disability in the U.S. population; the impact of illness and disability in the population on the U.S. economy and on other aspects of the well-being of the U.S. population; environmental, social, and other health hazards; determinants of health; health resources; utilization of health care; health care costs and financing; and family formation, growth, and dissolution.
• The Area Resource File pools data from various sources to facilitate health analysis both cross-sectionally and longitudinally. Each data series is available at the levels of county, state, and aggregate United States. The major unit of observation is the county, and the four major types of variables include demographics, health professions, health facilities, and health status.
• The Behavioral Risk Factor Surveillance System (BRFSS) has as its unit of observation the noninstitutionalized adult population. Data elements include weight control, hypertension, physical activity, obesity, mammography, alcohol consumption, seat belt use, tobacco use, HIV/AIDS, preventive health practices, and demographic information.
• The Medicare Current Beneficiary Survey (MCBS) targets a representative national sample of the Medicare population and collects data on expenditures and payments for health care services used by Medicare beneficiaries; the types of insurance held by Medicare beneficiaries; changes over time in beneficiaries’ health status, satisfaction with care, and usual source of care; and the impact of Medicare program changes on beneficiaries.
• The Survey of Mental Health Organizations (SMHO) contains information on types of mental health services; number of inpatient beds; number of inpatient, outpatient, and partial-care additions; average daily census; patient characteristics; staffing characteristics; expenditures; and revenue by sources. It provides valuable information on the sociodemographic, clinical, and treatment characteristics of patients served by mental health facilities.
• The National Ambulatory Medical Care Survey (NAMCS) obtains data through a national sample of office-based physicians and a systematic random sample of physician office visits during a seven-day period. The unit of observation is the patient visit as recorded in the patient record. These national estimates describe the provision and utilization of ambulatory medical care services in the United States and provide information on demographic characteristics of the patient, clinical aspects of the visit, and physician specialty and practice type. They offer indirect measures of health status via diagnostic information.
• The National Health Interview Survey (NHIS) is a cross-sectional interview survey that is conducted of households, with most of its data made publicly available. The units of observation are the household and the individual members of the household. The major categories of information include region of residence, reported health conditions, doctor visits, hospital stays (in the prior 12 months), household characteristics, and personal characteristics. Specific health conditions include acute and chronic conditions, restricted activity days, bed days, work- and school-loss days, doctor visits, hospital stays, and long-term limitations of activity.
• The National Health and Nutrition Examination Survey (NHANES) is a continuous survey with a changing focus on various health and nutrition measurements. The unit of observation is the individual person, and the surveys provide measures of prevalence of a variety of physical, physiological, and psychological diseases in the U.S. general population and nutrition status.
• The National Hospital Discharge Survey (NHDS) is a continuous survey of inpatient utilization of short-stay hospitals nationwide and allows for sampling at the census division level. The unit of observation is the patient’s medical records, and data elements include patient characteristics, expected payment sources, admission and discharge rates, discharge status and disposition, length of stay, hospital characteristics, patient diagnoses, surgical and nonsurgical procedures, dates of procedures, and residence zip code. A hospital may also be used as a unit of analysis.
• The Medical Expenditure Panel Survey (MEPS) consists of three related surveys: (1) the Household Component Survey, which collects medical expenditure data at the individual and household levels from the U.S. civilian noninstitutionalized population; (2) the Medical Provider Component Survey, which surveys medical providers and pharmacies identified by household respondents to verify and supplement information; and (3) the Insurance Component Survey, which collects data on private- and public-sector employer-sponsored health insurance plans. It provides information on expenditures for health care, use of health services, payment sources or insurance coverage, and individual health status.
• The National Nursing Home Survey (NNHS) has as its major units of observation nursing home residents and staff of nursing home facilities. Data are collected on four major areas: (1) nursing homes (size, ownership, license and Medicare and Medicaid certification status, number of beds, services offered, staffing patterns and characteristics, and costs); (2) residents (demographics, activities of daily living, status and living arrangements prior to admission, condition at admission and at interview, receipt of services, cognitive and emotional services, charges, sources of payment, history of nursing home utilization, and hospitalization during stay); (3) discharged residents (demographics, history of nursing home utilization, hospitalization during stay, status at discharge, condition at admission and discharge, and sources of payment); and (4) follow-up with the next of kin of the current or discharged residents (living arrangements, health, and functional status prior to admission; history of previous nursing home use; activities of daily living; and Medicaid spend-downs). The NNHS provides a series of national samples of nursing homes, residents, and staff.
• The Health and Retirement Study (HRS) is a national panel study on older adults in the United States. Information collected includes demographics, health status, housing, family, previous and current employment, disability, retirement plans, net worth, income, and health and life insurance coverage. It is also linked to employer information and administrative data, such as Social Security benefits, Medicare claims, and pension information. The unit of analysis is the individual, and several different cohorts of individuals are tracked and interviewed every two years from the time they enter the survey until death. Every six years, the HRS adds the birth cohort that is between 51 and 56 years old that year.
• The National Vital Statistics System (NVSS) obtains data from birth and death certificates provided by states, and the unit of observation is the individual. It is a national registration system for vital statistics, including natality, fetal death, mortality, and their contributing causes. The most relevant health status databases are the following mortality types: Mortality: Detail; Mortality: Local Area Summary; and Mortality: Cause of Death Summary. All databases include data on age, race, sex, and residence.