New CDC data pinpoint heart disease hot spots
Data from Medicare records of more than 28 million people each year between 2000 and 2006 in the 50 states, Washington, D.C., Puerto Rico and the U.S. Virgin Islands were used to create a county-level report on hospitalizations because of heart disease.
The CDC’s “Atlas of Heart Disease Hospitalizations Among Medicare Beneficiaries” shows that the highest hospitalization rates occur among blacks compared to other racial and ethnic groups and rates were highest in Appalachia, the Mississippi Delta, Texas and Oklahoma.
For more county-level health data, be sure to take a look at the County Health Rankings recently released by the Robert Wood Johnson Foundation and the University of Wisconsin.
Drug data could inform stories about elder care
The 2007 National Home and Hospice Care Survey (NHHCS ) Medication Public-Use File and Documentation are now available for downloading.
One group of researchers used earlier NHHCS data to “examine changes in hospice services over time, as they were collected during the period from 1992 to 2000, paralleling the period of substantial growth in hospice use and spending.”
With recent studies and news about the increase in use of antipsychotics in the elderly, this data might be useful in reporting such stories and documenting the increase, as well as stories about how treatments have changed.
The 2007 NHHCS Medication Public-Use Data File is supported by SAS, SPSS, and STATA input statements. The documentation includes three PDF files: technical notes, a data dictionary, and a PDF file that provides drug name codes, drug estimates and rates, and drug characteristics.
HHS releases FOIA report in less-than-ideal format
Bob Garfield of WNYC’s “On the Media” talked to John Wonderlich, policy director at the Sunlight Foundation, about last week’s announcement of the Open Government Directive.
Wonderlich says the initiative “is the administration making a real commitment to systemic change within the government.” He also brings up the issue of how information will be made available, pointing out that spreadsheets and datasets are more valuable than paper records to journalists as well as other businesses.
He points out that government agencies report each year on how well they are responding to Freedom of Information Act requests and says that last week – for the first time – the Department of Justice released that information for 2008 in spreadsheets.
Unfortunately that’s not quite the case. The reports from most nearly all of the departments are in spreadsheet form but a few, including the report from the Department of Health and Human Services, are in other formats that may be more difficult to analyze.
There is, however, a bit of good news. The 2007 report from HHS showed that there were more than 28,000 pending requests. The agency has made an effort to reduce its backlog and the 2008 tally is just more than 19,000.
Obama initiatives include VA hospital report cards
Filed under: Government, Health journalism, Hospitals, Public records
Saying that “commitment to open government goes beyond the making of government-wide policy for the future,” the White House announced a number of “open government” initiatives on Tuesday.
The initiatives come with an “Open Government Directive” (PDF) from Peter Orszag, director of the White House’s Office of Management and Budget, that sets out steps toward creating a more open government and establishes deadlines for action:
- Publish Government Information Online - Includes a requirement that each agency create an Open Government Web page within 60 days.
- Improve the Quality of Government Information - Within 45 days each agency must designate an official to be accountable for the quality and objectivity of federal spending information
- Create and Institutionalize a Culture of Open Government - Within 120 days, each agency will publish on its Open Government Web page an a plan about how it will improve transparency and public participation.
- Create an Enabling Policy Framework for Open Government - Officials will review OMB policies to find impediments to open government and propose changes to increase openness.
Photo by Ed Dame via Flickr
The specific initiatives just announced come from all departments of the cabinet. One of the most notable is a hospital report card that will include raw data for veterans administration hospitals:
To empower Veterans and the public at large to track quality, safety, and access to Veterans Health Administration (VHA) facilities, the Department of Veterans Affairs is publishing hospital “report cards,” including raw data on care provided in outpatient and hospital settings, quality of care within given patient populations, and patient satisfaction and outcomes.
Other health-related initiatives include:
Department of Health and Human Services, Department of Agriculture, Department of Commerce, Department of Energy & the National Aeronautics and Space Administration: National Assets for High-Tech Economic Growth
Fledgling businesses need easier ways to identify and assess entrepreneurial opportunities that will create jobs and strengthen economic growth. Towards that goal, the National Institutes of Health (NIH) and Food and Drug Administration (FDA) in the Department of Health and Human Services (HHS), the Agricultural Research Service in the U.S. Department of Agriculture, the National Institute of Standards and Technology (NIST) in the Department of Commerce, the Department of Energy, and the National Aeronautics and Space Administration are increasing access to information on 1) new technologies available for commercial licensing, 2) Cooperative Research and Development (CRADA) awards and opportunities, 3) Small Business Innovation Research (SBIR) awards and opportunities, 4) Small Business Technology Transfer (STTR) awards and opportunities, and 5) projects sponsored through grants and contracts.
Department of Veterans Affairs: Geographic Distribution of Expenditures
The National Center for Veterans Analysis and Statistics will release three years of raw data on estimated annual VA spending in each county and congressional district. The data represent payments to Veterans and dependents, services provided to Veterans, and general operating expenses. These data will be used by state and local Veteran agencies, Veteran advocacy groups, and the public to compare to and plan for local Veteran needs. Making the raw data available will enable its combination with local-population and veteran-related data, fostering new knowledge and improved services for Veterans.
Department of Agriculture: Promoting a Healthier America
To unleash innovative approaches to improving the health of America’s children, the Department of Agriculture is releasing nutrition data for over 1,000 commonly consumed foods and launching a national competition for creative, mobile and web-based games. The competition will challenge entrepreneurs, software developers, and students to leverage the newly released data to develop games to help children make healthy eating decisions.
Department of Labor: Keeping America’s Workers Out of Harm’s Way
For the first time, the Occupational Safety and Health Administration in the Department of Labor is systematically publishing employer-specific information about occupational fatalities online. Employers with reported fatalities will have an incentive to take steps to improve safety and prevent future accidents. In addition, responsible employers will be able to use the database to identify dangerous conditions and take proactive precautions.
Department of Veterans Affairs: Veteran Population Model
The Veteran Population Model - using combined data from the Department of Veterans Affairs (VA), Department of Defense (DoD), and Bureau of the Census - provides the official estimates and projections of the veteran population for each year from April 1, 2000, through September 30, 2036. Previously available only through predefined queries, access to the raw data will enable public and private-sector service organizations to incorporate VetPop data into their models to project future demand based on population and demographic estimates.
Q&A on achieving a more open government
Chief Technology Officer Aneesh Chopra and Chief Information Officer Vivek Kundra take questions on the directive and the move to a more transparent government.
Sunshine Week: Online health data varies by state
Filed under: Government, Health journalism, Public records
The Sunshine Week 2009 Survey of State Government Information Online found that while more and more government records are being posted online, some of the most important information is being left offline. And in some cases governments are charging taxpayers to access records that they already paid for, such as death certificates.
Sunshine Week 2009:
March 15-21
Sunshine Week is a national initiative to open a dialogue about the importance of open government and freedom of information. Participants include print, broadcast and online news media, civic groups, libraries, nonprofits, schools and others interested in the public’s right to know.
Teams of surveyors scanned government Web sites in every U.S. state to look for 20 different kinds of public records.
The survey (PDF) included nursing home inspection reports, hospital inspection reports and death certificates. It found that nursing home inspection reports are available online in 29 states, hospital inspection reports are available online in 17 states and death certificates are available online in five states.
The report says that “Death certificates are apparently a revenue source for many states, as they charge relatives and “legitimately” interested parties for copies of the records, or farm out the work to a third-party service such as VitalChek. Some states provide historical access online to older death certificates, mostly prior to 1960, although there generally is a fee for hard copies.”
Other health-related highlights in the report:
In Oklahoma, hospital inspection reports are said to be “confidential by statute” and would not be disclosed publicly unless there was a case involving a licensing question or revocation/suspension of a license.
Louisiana: “We have a problem with the legality of it,” a Louisiana Department of Transportation official told the survey reporter who called the office after failing to find bridge inspection reports online. Calls to other Louisiana agencies after finding neither hospital or nursing home inspections, nor environmental citations online yielded otherwise unlinked URLs for information.
Maryland: Nursing home information got high marks for facilitating online search and for allowing users to “compare data in a variety of ways.”
Minnesota: The state’s Department of Human Services says it expects corrections orders and licensing sanctions, not currently posted, to be online “in the near future.”
California: Because the state of California is so large, surveyors looked at whether individual departments and agencies posted their audits and personal financial disclosure forms, including audits from the Department of Health Care Services. They found that the data is not clearly linked from the department’s home page, though it is free to view and download. The most recent audit reports online where from 2007.
Department of Health and Human Services
University of Missouri graduate students reviewed the Web site of the Department of Health and Human Services and reported on what documents are available in electronic reading rooms. The students noted that the HHS Web site is difficult to navigate because it is comprised of so many divisions that “vary in content, organization and utility.”
They found multiple problems with many of the HHS administrative manuals and other documents, including documents that were locked because someone else was viewing them and documents that were not clear about when they were created or modified.
Consider source when reporting hospital rankings
HealthGrades, a health care ratings company, has released a report (PDF) that says “Medicare patients treated at top-rated hospitals nationwide across the most common Medicare diagnoses and procedures are 27 percent less likely to die, on average, than those admitted to all other hospitals.”
The report also names the hospitals that HealthGrades has deemed “Distinguished Hospitals for Clinical Excellence.”
That study (PDF) and the designations for hospitals are prompting a number of news articles reporting that local hospitals have been named as “top hospitals.”
But there are some things to think about when examining hospital rankings. For one thing, hospitals pay HealthGrades to use its information as promotional material. In addition, the data HealthGrades uses can be out of date and is based only on Medicare patients. A 2002 review found that “ratings on individual hospitals were often misleading.”
Charles Ornstein of ProPublica wrote a thorough tip sheet about how to cover your local hospital, including information about HealthGrades and other hospital rankings.
For a more balanced comparison of local hospitals, consider using the Hospital Compare patient survey data from the Department of Health and Human Services. AHCJ has made it easier for journalists to compare hospitals in their regions by generating spreadsheet files from the HHS database, allowing members to compare more than a few hospitals at a time, using spreadsheet or database software.
AHCJ provides key documentation and explanatory material to help you understand the data possibilities and limits. Need help analyzing Excel files? AHCJ offers a tutorial about investigating health data using spreadsheets.
CMS adds rating system to nursing home data
The Centers for Medicare and Medicaid Services is expected to launch a “5 Star Quality Rating System” addition to its Nursing Home Compare Web site on Thursday. The ratings system is intended to be easier for consumers to use, as well as incorporating more data that has not been used in the past.
According to The Bakersfield Californian, “The new rating tool will use federal data to score each facility’s performance in three areas: health inspections, staffing and quality measures.”
While the link on the CMS Web site to the press release is not currently working, more information was available in an e-mail from CMS:
“The five-star information has been added to the site to condense the large amount of rich quality information already available on Nursing Home Compare. The more detailed information on quality measures, inspections, and staffing will remain available even after the five-star information is added.
The five-star system uses 10 of the 19 key quality measures currently posted on the Nursing Home Compare Web site, including the percent of residents who had pressure ulcers, the number of residents whose mobility deteriorated after admission, and whether residents received the proper medical care, as well as staffing levels in long-term care facilities.”
Ombudsman explores nuances of science writing
Making sense of health reporting is not always easy, especially when clinical trials are concerned. Results may be interpreted in different ways to suit different views. Agendas of those involved may not always be evident. And sometimes, even expert sound bites oversimplify any murkiness. That was the takeaway from a recent column by Deborah Howell, The Washington Post ombudsman, who cited the recent debate over the results of a study of the widely used Crestor cholesterol fighter.
That particular study, known as Jupiter, highlighted the difficulties that can arise when weighing competing statistics. In this case, the debate was over relative risk versus absolute risk, two very different ways to measure whether Crestor can reduce the likelihood of a cardiovascular event compared with a placebo. Howell notes that media coverage was chastised for highlighting the measure touted by AstraZeneca, which sells Crestor and funded the research. Critics say that by describing drug as a blockbuster and emphasizing relative risk overstated the case in favor of the drugmaker. In fact, the Post’s own story was mentioned.
Her weekend essay raised the delicate and difficult balancing act that can occur when coverage requires a nuanced approach to often complicated data and concepts. In the end, she suggests something most health journalists, hopefully, know already - above and beyond anything else, look for and examine the evidence.
Just in case, here are some tip sheets:
- Evidence-based medical reporting: A brief primer
- Evidence-based medical reporting
- Understanding the scientific article
- Understanding medical publications
- What you need to know about risks, rates and ratios
- Medicine 101: Words, numbers and journals
- Lies, damned lies and medical statistics - how to interpret the evidence
Easier-to-use Hospital Compare data
The Sarasota Herald-Tribune’s David Gulliver was among several reporters who reported earlier this year about the U.S. Health and Human Services’ release of a new component of its Hospital Compare database - the results of a patient satisfaction survey announced at Health Journalism 2008 in March. He recently followed up using updated data in a more comprehensive story, analyzing all three components of the Hospital Compare database - “process” measures, or accepted standards of care; the patient survey; and “outcome” measures - the percentage of patients who died within 30 days of admission from heart attack, heart failure or pneumonia. HHS now updates the patient survey data quarterly, and AHCJ has made it easier for journalists to make their own comparisons. AHCJ has begun generating spreadsheet files, allowing members to use spreadsheet or database software with precision. AHCJ provides key documentation and explanatory material to help you understand the data possibilities and limits.
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Health Journalism 2010, AHCJ's annual conference, features a world-class program with story ideas, sources, stronger reporting skills, chances to meet newsmakers and network with other journalists.
- Health and education: Covering these intersecting beats
- Reporting on the business of health care
- Health reporting resources for journalists on state and local government beats
- Shortened Lives: How location, lifestyle affect health
- Covering a complex story for the long haul
- Aging in the 21st Century: Presentations and tip sheets
- AHCJ calls for better information from Joint Commission Web site
