Find health data at Childstats.gov, a clearinghouse for kid numbers
Filed under: Children, Government, Health data, Health journalism, Public records, Tools
Time to add another link to your “federal data clearinghouses” folder, if you haven’t already. Childstats.gov, published by the Federal Interagency Forum on Child and Family Statistics, synthesizes data from the CDC, NCHS, National Children’s Survey, AHRQ, Census and other specialized programs.
Photo by nasa hq photo via FlickrThe site is anchored by its annual report, “America’s Children: Key National Indicators of Well-Being,” and the easy-to-navigate nature of its databases seems to have already inspired some discussion on Twitter, particularly in relation to child homelessness.
Many of the data tools are simply links to general surveys (like AHRQ’s National Healthcare Cost and Utilization Project) that just happen to contain child-related information, but there are some more specifically relevant data sources, the best of which I’ve listed below.
- Data Resource Center for Child & Adolescent Health
- The National Children’s Study
- The National Center for Education Statistics
- Find Youth Info (findyouthinfo.gov)
- Census Child Care data
International cooperative to share health data
Filed under: Europe, Health data, Health policy, Hot Health Headline, Public health, Public records, Tools
Writing that “the importance of data sharing in advancing health is becoming increasingly widely recognised,” 17 major public health players entities, from the CDC and AHRQ to the Bill and Melinda Gates foundation and the World Bank, have banded together to form a sort of data cooperative around the Wellcome Trust and the Hewlett foundation. In a Lancet commentary announcing the initiative, Wellcome director Mark Walport and Hewlett president Paul Brest write that, while fields such as genetics and molecular biology, a mature data-sharing system has sped up discoveries and increased efficiency, public health is lagging behind.
Much of the infrastructures, technical standards, and incentives that are needed to support data sharing are lacking, and these data can hold particular sensitivities. And some researchers are reluctant to share data. Too often, data are treated as the private property of investigators who aim to maximise their publication record at the expense of the widest possible use of the data. This situation threatens to limit both the progress of this research and its application for public health benefit.
Each organization will work within its own structure and their initial goals include the creation of data standards to facilitate sharing as well as increasing the prestige of creating public data sets. They acknowledge there will be some bumps along the way, but call on other organizations to join the initiative and to pursue the long-term goal of the widespread, fair and privacy-respecting sharing of public health data.
Video, presentations from comparative effectiveness conference available online
Filed under: Government, Health care reform, Health data, Public health, Studies, Tools
Earlier this month, ECRI’s 17th annual conference tackled the thorniest detail of comparative effectiveness research, namely that it’s rarely a simple matter of A > B. Groups and individuals respond differently.
With a theme of “Comparative Effectiveness and Personalized Medicine,” the nonprofit and its partners at NIH and Health Affairs, among others, sought to better understand how big research ideas will interface with the person-by-person decisions through which such work will ultimately be implemented.
The conference has a detailed postmortem online, including two days of video (Fair warning: Together, they’re a good 700+ minutes of conference) and slides from a number of the presentations. I strongly recommend using the conference schedule listed on the slides page as a rough guide to finding the most relevant bits of video.
In case you’re looking for a place to start, here are two of the most relevant presentations:
- Keeping the comparative effectiveness debate rational
- Comparative effectiveness research in the Veterans Health Administration (and in Kaiser Permanente, which references patient preference and participation)
The online Q and A is also interesting, though there are only a handful of answers up at present. The most relevant one so far comes from Vivian Coates (Vice President, Information Services and Health Technology Assessment, ECRI Institute), in response to a query about a central listing of comparative effectiveness projects.
The CER inventory contract was awarded to the Lewin Group Center for Comparative Effectiveness Research (CER) in June, 2010. Over the 27 month period of the contract, Lewin will design, build and launch a web-based inventory that catalogs CER outputs and activity, including research studies, relevant research methods, training of researchers, data infrastructure and approaches for dissemination and translation of comparative effectiveness research to health care providers and patients.
Drugs send more of the 45-plus crowd to hospitals
At a time when overall prescription drug use is climbing across the board, the AHRQ reports that the number of medication- and drug-related hospital visits for Americans over the age of 45 doubled between 1997 and 2008. Abuse is also on the rise in that age group, and the cost burden for the increase has fallen heavily upon Medicare and Medicaid. The numbers come from the AHRQ’s Healthcare Cost and Utilization Project, a wonderfully deep well of cost-related statistics from 2008.
A few numbers from the release:
Hospital admissions among those 45 years and older were driven by growth in discharges for three types of medication and drug-related conditions – drug-induced delirium; “poisoning” or overdose by codeine, meperidine and other opiate-based pain medicines; and withdrawal from narcotic or non-narcotic drugs.
Admissions for all medication and drug-related conditions grew by 117 percent – from 30,100 to 65,400 – for 45- to 64-year-olds between 1997 and 2008. The rate of admissions for people ages 65 to 84 closely followed, growing by 96 percent, and for people ages 85 and older, the rate grew by 87 percent. By comparison, the number of hospital admissions for these conditions among adults ages 18 to 44 declined slightly by 11 percent.
Beyond the headline-making news involving drugs, AHRQ’s report includes data on other types of medical conditions treated in hospitals, surgical procedures and costs in 2008.
Forum offers stats on well-being of elderly
Filed under: Government, Health data, Health journalism, Studies, Tools
AgingStats.gov is an often-overlooked federal clearinghouse of aging-related data from the Federal Interagency Forum on Age-Related Statistics. It focuses on summary reports.
Its latest effort, Older Americans 2010: Key Indicators of Well-Being (174-page PDF), summarizes 37 key indicators it believes are broadly relevant and easy to understand. By my count, 24 of those are explicitly health-related.
Everything is illustrated with an abundance of charts and maps, and an emphasis on bulleted summary and analysis helps keep things accessible. Those looking for a deeper dive into the summary numbers will want to head to the appendix.
As part of its health sections, the report contains seven “Health Status” indicators, including chronic health conditions, depressive symptoms, sensory impairments and oral health, and functional limitations.
One example:
It also includes eight “Health Risks and Behaviors” – things like diet, air quality, mammography and vaccinations – and nine “Health Care” indicators, including expenditures, prescription drugs and residential services.
The forum, which nobody seems to refer to by the acronym FIFARS, has been around since 1986. Participants include the Census Bureau, a number of Health and Human Services departments (AHRQ, CMS, NCHS and others), HUD, the Bureau of Labor Statistics, the Department of Veterans Affairs, the EPA, the Office of Management and Budget, and the Social Security Administration.
Thanks to AHCJ member Eileen Beal for suggesting this as a tool other members might find helpful.
AHRQ releases ‘09 state data on health care quality
Filed under: Health data, Health journalism, Public health, Studies
The AHRQ has released the 2009 version of its state snapshots, which are particularly accessible versions of the National Healthcare Quality Report.
The state-by-state information includes, for the first time, data on health insurance, including data on health care quality categorized by source of payment, including private insurance, Medicare, Medicaid and those without insurance.
The snapshots also compare relative health care quality of each state, both overall and in specific areas such as preventive care and ambulatory care.
My favorite part is the 3.5 mb Excel file that has each state’s numbers for everything the snapshots measure. It allows relatively easy comparisons that go far beyond the simple health-o-meter snapshots themselves.
Related
- Intro to investigating health data using spreadsheets
- Finding patterns and trends in health data: Pivot tables in spreadsheets
AHRQ asks ‘Who’s paying for rising health costs?’
Filed under: Health care reform, Health data, Hospitals, Studies
The latest statistics brief out of the Agency for Healthcare Research and Quality address what researchers called the “growing burden of hospital-based medical care expenses on the government, tax payers, consumers, and employers.” In this brief, they’re looking to figure out where to put the blame for those in-patient cost jumps that occurred between 2001 and 2007 and thus divided the increases into four categories: Medicare, Medicaid, private insurance and payments from those without insurance.
The numbers hold a few interesting subplots, any one of which would benefit from further exploration. Here are a few:
- When you compare 2001 and 2007, private insurance paid for slightly fewer stays, while stays for Medicare and Medicaid were up,respectively, by 20.1 and 29.9 percent.
- “From 2001 to 2007, the number of stays with a principal diagnosis of blood infection nearly doubled (97.1 percent; 675,400 stays in 2007).”
- The cost of a hospitalization for intestinal infection jumped 148 percent, yet hospital stays for such infections were up only 69.5 percent.
- “For four of the top ten conditions—blood infection, acute kidney failure, respiratory insufficiency, arrest, or failure, and skin and subcutaneous skin infections—the uninsured demonstrated greater increases in growth in total costs and number of hospital stays than the other three payer groups.”
- Private insurance paid 55.7 more for C-section-related hospital stays over the study period, while Medicaid costs increased 95.1 percent for the same sort of visits.
Check pages seven through 10 for summary tables, including overall numbers and two tables of the ten conditions for which costs are increasing most rapidly.
Report: Health care disparities aren’t getting better
In their coverage of AHRQ’s latest annual quality and disparities reports (Quality PDF | Disparities PDF), most outlets focused on disheartening news on health-care-associated infections, but the disparities report also deserves a second look. It’s 302 pages that can be oversimplified as “disparities still exist, they’re not getting better, and they’re worse in some areas than in others.”
Here are a few of the more interesting bullet points, all pulled from the first 16 pages of summary information.
- For Blacks, Asians, and Hispanics, at least two-thirds of measures of quality of care are not improving (gap either stayed the same or increased).
- For Blacks, only about 20% of measures of disparities in quality of care improved (gap decreased).
- For poor people, disparities are improving for almost half of the quality measures.
- The largest disparities for Blacks, AI/ANs, and Hispanics included the rate of new AIDS cases. The rate for Blacks was almost 10 times as high as the rate for Whites, for Hispanics more than 3 times as high, and for AI/ANs 1.4 times as high.
- Asians were 1.5 times as likely as Whites to report they sometimes or never get care for illness or injury as soon as wanted. Poor people were more than twice as likely as high-income people to report this
problem. - Hispanics were 1.7 times as likely as Whites and poor people were 3 times as likely as high-income people to report poor provider-patient communication.
- Blacks, Asians, AI/ANs, and Hispanics all experienced disparities in the percentage of adults age 50 and
over who received a colonoscopy, sigmoidoscopy, proctoscopy, or fecal occult blood test and in
commended hospital care for pneumonia. - Blacks and Hispanics both had worsening disparities in colorectal cancer mortality from 2000 to 2006.
The report doesn’t stop with bullet points, of course. Anyone who takes a few minutes to page through the other 280-some-odd pages will be rewarded with in-depth information on disparities in a number of specific diseases and issues – including breast cancer, diabetes, HIV, palliative care, mental health and access to health care – all buttressed with charts, graphs, explanations and data.
AHRQ interviews Ornstein, talks medical errors
Filed under: Health data, Health journalism, Hospitals, Public records
Robert Wachter, M.D., (bio), editor of AHRQ WebM&M (Morbidity and Mortality), interviewed AHCJ President Charles Ornstein, of ProPublica, for a recent issue (get the audio version here). Their conversation began as a general discussion of health journalism, then zeroed in on hospital errors and the Pulitzer Prize-winning series on King/Drew Medical Center in Los Angeles that Ornstein did with Tracy Weber when both were at the LA Times.
The whole thing is worth a read. In this excerpt Ornstein discusses how health journalists find stories:
Good reporters have a variety of sources of information. Reporters who routinely cover the hospitals in their communities should be constantly looking at state inspection reports, lawsuit data about payouts, their Joint Commission accreditation, and how they’re doing with their training program. All these types of things should be on the radar screen and monitored regularly. But nothing can replace talking to employees in the facilities and the patients that receive care there—trying to get an on-the-ground perspective.
In a companion piece, Wachter reflected on the role the media has played in shaking the medical profession out of a dangerous rut of complacency:
What do we need from reporters who cover the medical errors beat? … reporters need to know enough about error science that they appreciate the importance of searching for systems factors, without immediately zeroing in on more dramatic and obvious sharp-end errors. They need to get the facts right. And, while raising the appropriate concerns, they need to avoid sensationalism and place the error, or the topic, in broader context. When they do these things, they are providing a unique and critical service to patients and caregivers.
AHRQ names decade’s five costliest conditions
According to the Agency for Healthcare Research and Quality, the five costliest conditions from 1996 to 2006 were heart disease, trauma-related disorders, cancer, mental disorders and asthma (five-page PDF).
While costs are up for all five, the AHRQ reports, mental disorders has outpaced the others in terms of cost growth (from $35.2 to $57.5 billion) with trauma-related disorders also making a significant jump (from $46.2 to $68.1 billion). When ranked in terms of per-person expenditures instead of by aggregate, cancer ($5,176 in 2006) and heart disease $3,964 in 2006) were found to be most expensive while asthma ($1,059) had the lowest cost-per person but affected the most people (48.5 million).
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- Data gives depth to investigation of patient safety
- What reporters should know about Alzheimer’s and related dementias
- Apply for fellowships to attend Health Journalism 2012
- AHCJ asks Supreme Court to permit broadcast of arguments in health reform case
- Tips for print, online journalists to embrace broadcast opportunities
- Numbers reveal how often, or how rarely, states check doctors’ disciplinary records
- How I did it: Falsified charts in nursing homes linked to patient care
- Access Denied: Looking at a lack of health care availability
- Transparency & medical errors: Public reporting of patient harm is a potent force
