The Nationwide Emergency Department Sample (NEDS) was created to enable analyses of emergency department (ED) utilization patterns and support public health professionals, administrators, policymakers, and clinicians in their decision-making regarding this critical source of care. The NEDS can be weighted to produce national estimates. The NEDS is the largest all-payer ED database in the United States. It was constructed using records from both the HCUP State Emergency Department Databases (SEDD) and the State Inpatient Databases (SID), both also described in healthdata.gov. The SEDD capture information on ED visits that do not result in an admission (i.e., treat-and-release visits and transfers to another hospital). The SID contain information on patients initially seen in the emergency room and then admitted to the same hospital. The NEDS contains 25-30 million (unweighted) records for ED visits for over 950 hospitals and approximates a 20-percent stratified sample of U.S. hospital-based EDs. The NEDS contains information about geographic characteristics, hospital characteristics, patient characteristics, and the nature of visits (e.g., common reasons for ED visits, including injuries). The NEDS contains clinical and resource use information included in a typical discharge abstract, with safeguards to protect the privacy of individual patients, physicians, and hospitals (as required by data sources). It includes ED charge information for over 75% of patients, regardless of payer, including patients covered by Medicaid, private insurance, and the uninsured. The NEDS excludes data elements that could directly or indirectly identify individuals, hospitals, or states.
The Healthcare Cost and Utilization Project (HCUP) Nationwide Emergency Department Sample (NEDS) is the largest all-payer emergency department (ED) database in the United States. yielding national estimates of hospital-owned ED visits. Unweighted, it contains data from over 30 million ED visits each year. Weighted, it estimates roughly 145 million ED visits nationally. Developed through a Federal-State-Industry partnership sponsored by the Agency for Healthcare Research and Quality, HCUP data inform decision making at the national, State, and community levels. Sampled from the HCUP State Inpatient Databases (SID) and State Emergency Department Databases (SEDD), the HCUP NEDS can be used to create national and regional estimates of ED care. The SID contain information on patients initially seen in the ED and subsequently admitted to the same hospital. The SEDD capture information on ED visits that do not result in an admission (i.e., treat-and-release visits and transfers to another hospital). Developed through a Federal-State-Industry partnership sponsored by the Agency for Healthcare Research and Quality, HCUP data inform decision making at the national, State, and community levels. The NEDS contain information about geographic characteristics, hospital characteristics, patient characteristics, and the nature of visits (e.g., common reasons for ED visits, including injuries). The NEDS contains clinical and resource use information included in a typical discharge abstract, with safeguards to protect the privacy of individual patients, physicians, and hospitals (as required by data sources). It includes ED charge information for over 85% of patients, regardless of expected payer, including but not limited to Medicare, Medicaid, private insurance, self-pay, or those billed as ‘no charge’. The NEDS excludes data elements that could directly or indirectly identify individuals, hospitals, or states.Restricted access data files are available with a data use agreement and brief online security training.
The Nationwide Emergency Department Sample (NEDS) is part of a family of databases and software tools developed for the Healthcare Cost and Utilization Project (HCUP). The NEDS is the largest all-payer emergency department (ED) database in the United States, yielding national estimates of hospital-based ED visits. The NEDS enables analyses of ED utilization patterns and supports public health professionals, administrators, policymakers, and clinicians in their decisionmaking regarding this critical source of care.
The Nationwide Emergency Department Sample (NEDS) was created to enable analyses of emergency department (ED) utilization patterns and support public health professionals, administrators, policymakers, and clinicians in their decision-making regarding this critical source of care. The NEDS can be weighted to produce national estimates. Restricted access data files are available with a data use agreement and brief online security training.
The NEDS is the largest all-payer ED database in the United States. It was constructed using records from both the HCUP State Emergency Department Databases (SEDD) and the State Inpatient Databases (SID), both also described in healthdata.gov. The SEDD capture information on ED visits that do not result in an admission (i.e., treat-and-release visits and transfers to another hospital). The SID contain information on patients initially seen in the emergency room and then admitted to the same hospital.
The NEDS contains 25-30 million (unweighted) records for ED visits for over 950 hospitals and approximates a 20-percent stratified sample of U.S. hospital-based EDs.
The NEDS contains information about geographic characteristics, hospital characteristics, patient characteristics, and the nature of visits (e.g., common reasons for ED visits, including injuries). The NEDS contains clinical and resource use information included in a typical discharge abstract, with safeguards to protect the privacy of individual patients, physicians, and hospitals (as required by data sources). It includes ED charge information for over 85% of patients, regardless of payer, including patients covered by Medicaid, private insurance, and the uninsured. The NEDS excludes data elements that could directly or indirectly identify individuals, hospitals, or states.
This dataset tracks the updates made on the dataset "HCUP Nationwide Emergency Department Database (NEDS) Restricted Access File" as a repository for previous versions of the data and metadata.
"...largest all-payer ED database in the US, yielding national estimates of hospital-owned ED visits.....Weighted, it estimates roughly 145 million ED visits." https://www.hcup-us.ahrq.gov/nedsoverview.jsp
The NIS is the largest publicly available all-payer inpatient healthcare database designed to produce U.S. regional and national estimates of inpatient utilization, access, cost, quality, and outcomes. Unweighted, it contains data from around 7 million hospital stays each year. Weighted, it estimates around 35 million hospitalizations nationally. Developed through a Federal-State-Industry partnership sponsored by the Agency for Healthcare Research and Quality (AHRQ), HCUP data inform decision making at the national, State, and community levels.
Its large sample size is ideal for developing national and regional estimates and enables analyses of rare conditions, uncommon treatments, and special populations.
IMPORTANT NOTE: Some records are missing from the Severity Measures table for 2017 & 2018, but none are missing from any of the other 2012-2020 data. We are in the process of trying to recover the missing records, and will update this note when we have done so.
Also %3Cu%3EDO NOT%3C/u%3E
use this data without referring to the NIS Database Documentation, which includes:
%3C!-- --%3E
%3C!-- --%3E
All manuscripts (and other items you'd like to publish) must be submitted to
phsdatacore@stanford.edu for approval prior to journal submission.
We will check your cell sizes and citations.
For more information about how to cite PHS and PHS datasets, please visit:
https:/phsdocs.developerhub.io/need-help/citing-phs-data-core
For additional assistance, AHRQ has created the HCUP Online Tutorial Series, a series of free, interactive courses which provide training on technical methods for conducting research with HCUP data. Topics include an HCUP Overview Course and these tutorials:
• The HCUP Sampling Design tutorial is designed to help users learn how to account for sample design in their work with HCUP national (nationwide) databases. • The Producing National HCUP Estimates tutorial is designed to help users understand how the three national (nationwide) databases – the NIS, Nationwide Emergency Department Sample (NEDS), and Kids' Inpatient Database (KID) – can be used to produce national and regional estimates. HCUP 2020 NIS (8/22/22) 14 Introduction • The Calculating Standard Errors tutorial shows how to accurately determine the precision of the estimates produced from the HCUP nationwide databases. Users will learn two methods for calculating standard errors for estimates produced from the HCUP national (nationwide) databases. • The HCUP Multi-year Analysis tutorial presents solutions that may be necessary when conducting analyses that span multiple years of HCUP data. • The HCUP Software Tools Tutorial provides instructions on how to apply the AHRQ software tools to HCUP or other administrative databases.
New tutorials are added periodically, and existing tutorials are updated when necessary. The Online Tutorial Series is located on the HCUP-US website at www.hcupus.ahrq.gov/tech_assist/tutorials.jsp.
In 2015, AHRQ restructured the data as described here:
https://hcup-us.ahrq.gov/db/nation/nis/2015HCUPNationalInpatientSample.pdf
Some key points:
%3C!-- --%3E
The Department of City Planning aggregates information about 30,000+ facilities and program sites that are owned, operated, funded, licensed, or certified by a City, State, or Federal agency in the City of New York into a central database called the City Planning Facilities Database (FacDB). These facilities generally help to shape quality of life in the city’s neighborhoods, and this dataset is the basis for a series of planning activities. This public data resource allows all New Yorkers to understand the breadth of government resources in their neighborhoods. The data is also complemented with a new interactive web map that enables users to easily filter the data for their needs. Users are strongly encouraged to read the database documentation, particularly with regard to analytical limitations.
Questions about this database can be directed to dcpopendata@planning.nyc.gov
All previously released versions of this data are available at BYTES of the BIG APPLE- Archive
The City Planning Facilities Database (FacDB) aggregates information about 35,000+ public and private facilities and program sites that are owned, operated, funded, licensed or certified by a City, State, or Federal agency in the City of New York. It captures facilities that generally help to shape quality of life in the city’s neighborhoods, including schools, day cares, parks, libraries, public safety services, youth programs, community centers, health clinics, workforce development programs, transitional housing, and solid waste and transportation infrastructure sites. To facilitate analysis and mapping, the data is available in coma-separated values (CSV) file format, ESRI Shapefile, and GeoJSon. The data is also complemented with a new interactive web map that enables users to easily filter the data for their needs. Users are strongly encouraged to read the database documentation, particularly with regard to analytical limitations.
For data dictionary, please follow this link
NED Cone Search service (search for objects Near Position). This service searches NED's master list of extragalactic objects for entries near a given position.
Attribution 4.0 (CC BY 4.0)https://creativecommons.org/licenses/by/4.0/
License information was derived automatically
Specific injuries in patients seen in the ED with football injuries by hospital admission (N = 819,000).
Open the Data Resource: https://star.chesapeakebay.net/ The Chesapeake Bay Program's Strategic Science and Research Framework (SSRF) was developed to identify and assess the partnership's short- and long-term science needs. These science needs are captured and tracked in this continually updated database. The science needs that are captured in this database were:
Identified as necessary to make progress toward a Chesapeake Bay Watershed Agreement goal or outcome, Expressed through the Chesapeake Bay Program's Strategy Review System process, and/or Listed as a recommendation within a Scientific and Technical Advisory Committee workshop report.
The Chesapeake Bay Program uses this database to engage stakeholders, identify opportunities to better align or evolve resources, update activities and workgroups to address needs, and inform STAC of its research priorities. This database can also be used by science providers to identify projects or collaborations of interest on which to engage the program. Science providers can represent a wide range of entities including, but not limited to, academic institutions, federal and state agencies, local entities, non-profit organizations and citizen science programs.
This dataset provides information about the number of properties, residents, and average property values for Neds Fork cross streets in Mc Dowell, KY.
The 2010 NEDS is similar to the 2004 Nigeria DHS EdData Survey (NDES) in that it was designed to provide information on education for children age 4–16, focusing on factors influencing household decisions about children’s schooling. The survey gathers information on adult educational attainment, children’s characteristics and rates of school attendance, absenteeism among primary school pupils and secondary school students, household expenditures on schooling and other contributions to schooling, and parents’/guardians’ perceptions of schooling, among other topics.The 2010 NEDS was linked to the 2008 Nigeria Demographic and Health Survey (NDHS) in order to collect additional education data on a subset of the households (those with children age 2–14) surveyed in the 2008 Nigeria DHS survey. The 2008 NDHS, for which data collection was carried out from June to October 2008, was the fourth DHS conducted in Nigeria (previous surveys were implemented in 1990, 1999, and 2003).
The goal of the 2010 NEDS was to follow up with a subset of approximately 30,000 households from the 2008 NDHS survey. However, the 2008 NDHS sample shows that of the 34,070 households interviewed, only 20,823 had eligible children age 2–14. To make statistically significant observations at the State level, 1,700 children per State and the Federal Capital Territory (FCT) were needed. It was estimated that an additional 7,300 households would be required to meet the total number of eligible children needed. To bring the sample size up to the required target, additional households were screened and added to the overall sample. However, these households did not have the NDHS questionnaire administered. Thus, the two surveys were statistically linked to create some data used to produce the results presented in this report, but for some households, data were imputed or not included.
National
Households Individuals
Sample survey data [ssd]
The eligible households for the 2010 NEDS are the same as those households in the 2008 NDHS sample for which interviews were completed and in which there is at least one child age 2-14, inclusive. In the 2008 NDHS, 34,070 households were successfully interviewed, and the goal here was to perform a follow-up NEDS on a subset of approximately 30,000 households. However, records from the 2008 NDHS sample showed that only 20,823 had children age 4-16. Therefore, to bring the sample size up to the required number of children, additional households were screened from the NDHS clusters.
The first step was to use the NDHS data to determine eligibility based on the presence of a child age 2-14. Second, based on a series of precision and power calculations, RTI determined that the final sample size should yield approximately 790 households per State to allow statistical significance for reporting at the State level, resulting in a total completed sample size of 790 × 37 = 29,230. This calculation was driven by desired estimates of precision, analytic goals, and available resources. To achieve the target number of households with completed interviews, we increased the final number of desired interviews to accommodate expected attrition factors such as unlocatable addresses, eligibility issues, and non-response or refusal. Third, to reach the target sample size, we selected additional samples from households that had been listed by NDHS but had not been sampled and visited for interviews. The final number of households with completed interviews was 26,934 slightly lower than the original target, but sufficient to yield interview data for 71,567 children, well above the targeted number of 1,700 children per State.
Face-to-face [f2f]
The four questionnaires used in the 2004 Nigeria DHS EdData Survey (NDES)— 1. Household Questionnaire 2. Parent/Guardian Questionnaire 3. Eligible Child Questionnaire 4. Independent Child Questionnaire—formed the basis for the 2010 NEDS questionnaires. These are all available in Appendix D of the survey report available under External Resources.
More than 90 percent of the questionnaires remained the same; for cases where there was a clear justification or a need for a change in item formulation or a specific requirement for additional items, these were updated accordingly. A one day workshop was convened with the NEDS Implementation Team and the NDES Advisory Committee to review the instruments and identify any needed revisions, additions, or deletions. Efforts were made to collect data to ease integration of the 2010 NEDS data into the FMOE’s national education management information system. Instrument issues that were identified as being problematic in the 2004 NDES as well as items identified as potentially confusing or difficult were proposed for revision. Issues that USAID, DFID, FMOE, and other stakeholders identified as being essential but not included in the 2004 NDES questionnaires were proposed for incorporation into the 2010 NEDS instruments, with USAID serving as the final arbiter regarding questionnaire revisions and content.
General revisions accepted into the questionnaires included the following: - A separation of all questions related to secondary education into junior secondary and senior secondary to reflect the UBE policy - Administration of school-based questions for children identified as attending pre-school - Inclusion of questions on disabilities of children and parents - Additional questions on Islamic schooling - Revision to the literacy question administration to assess English literacy for children attending school - Some additional questions on delivery of UBE under the financial questions section
Upon completion of revisions to the English-language questionnaires, the instruments were translated and adapted by local translators into three languages—Hausa, Igbo, and Yoruba—and then back-translated into English to ensure accuracy of the translation. After the questionnaires were finalized, training materials used in the 2004 NDES and developed by Macro International, which included training guides, data collection manuals, and field observation materials, were reviewed. The materials were updated to reflect changes in the questionnaires. In addition, the procedures as described in the manuals and guides were carefully reviewed. Adjustments were made, where needed, based on experience on large-scale survey and lessons learned from the 2004 NDES and the 2008 NDHS, to ensure the highest quality data capture.
Data processing for the 2010 NEDS occurred concurrently with data collection. Completed questionnaires were retrieved by the field coordinators/trainers and delivered to NPC in standard envelops, labeled with the sample identification, team, and State name. The shipment also contained a written summary of any issues detected during the data collection process. The questionnaire administrators logged the receipt of the questionnaires, acknowledged the list of issues, and acted upon them if required. The editors performed an initial check on the questionnaires, performed any coding of open-ended questions (with possible assistance from the data entry operators), and left them available to be assigned to the data entry operators. The data entry operators entered the data into the system, with the support of the editors for erroneous or unclear data.
Experienced data entry personnel were recruited from those who have performed data entry activities for NPC on previous studies. The data entry teams composed a data entry coordinator, supervisor and operators. Data entry coordinators oversaw the entire data entry process from programming and training to final data cleaning, made assignments, tracked progress, and ensured the quality and timeliness of the data entry process. Data entry supervisors were on hand at all times to ensure that proper procedures were followed and to help editors resolve any uncovered inconsistencies. The supervisors controlled incoming questionnaires, assigned batches of questionnaires to the data entry operators, and managed their progress. Approximately 30 clerks were recruited and trained as data entry operators to enter all completed questionnaires and to perform the secondary entry for data verification. Editors worked with the data entry operators to review information flagged as “erroneous” or “dubious” in the data entry process and provided follow up and resolution for those anomalies.
The data entry program developed for the 2004 NDES was revised to reflect the revisions in the 2010 NEDS questionnaire. The electronic data entry and reporting system ensured internal consistency and inconsistency checks.
A very high overall response rate of 97.9 percent was achieved with interviews completed in 26,934 households out of a total of 27,512 occupied households from the original sample of 28,624 households. The response rates did not vary significantly by urban–rural (98.5 percent versus 97.6 percent, respectively). The response rates for parent/guardians and children were even higher, and the rate for independent children was slightly lower than the overall sample rate, 97.4 percent. In all these cases, the urban/rural differences were negligible.
Estimates derived from a sample survey are affected by two types of errors: (1) non-sampling errors and (2) sampling errors. Non-sampling errors are the results of mistakes made in implementing data collection and data processing, such as
This dataset provides information about the number of properties, residents, and average property values for Neds Lane cross streets in Ridgefield, CT.
The Department of Education commissioned the Human Sciences Research Council (HSRC) to conduct a national survey on the locality and other information linked to all schools in South Africa. The 2000 version was intended to update the 1996 version of the register of needs database, include 3000 institutions that were previously excluded, provide accurate data on geolocality of schools, school conditions and the availability of resources, and measure progress and trends betwee 1996 and 2000.
National coverage
Schools
All schools in South Africa
Census/enumeration data [cen]
Face-to-face [f2f]
FEMA’s Coordinated Needs Management Strategy (CNMS) uses a geospatial database to identify and track flood hazard study lifecycle and mapping needs within the flood hazard mapping program. CNMS supports community officials and FEMA personnel in analyzing and depicting the validity of flood studies to enhance the understanding of flood hazard risk and make informed decisions on community planning and flood mitigation.
CC0 1.0 Universal Public Domain Dedicationhttps://creativecommons.org/publicdomain/zero/1.0/
License information was derived automatically
The USDA Agricultural Research Service (ARS) recently established SCINet , which consists of a shared high performance computing resource, Ceres, and the dedicated high-speed Internet2 network used to access Ceres. Current and potential SCINet users are using and generating very large datasets so SCINet needs to be provisioned with adequate data storage for their active computing. It is not designed to hold data beyond active research phases. At the same time, the National Agricultural Library has been developing the Ag Data Commons, a research data catalog and repository designed for public data release and professional data curation. Ag Data Commons needs to anticipate the size and nature of data it will be tasked with handling.
The ARS Web-enabled Databases Working Group, organized under the SCINet initiative, conducted a study to establish baseline data storage needs and practices, and to make projections that could inform future infrastructure design, purchases, and policies. The SCINet Web-enabled Databases Working Group helped develop the survey which is the basis for an internal report. While the report was for internal use, the survey and resulting data may be generally useful and are being released publicly.
From October 24 to November 8, 2016 we administered a 17-question survey (Appendix A) by emailing a Survey Monkey link to all ARS Research Leaders, intending to cover data storage needs of all 1,675 SY (Category 1 and Category 4) scientists. We designed the survey to accommodate either individual researcher responses or group responses. Research Leaders could decide, based on their unit's practices or their management preferences, whether to delegate response to a data management expert in their unit, to all members of their unit, or to themselves collate responses from their unit before reporting in the survey.
Larger storage ranges cover vastly different amounts of data so the implications here could be significant depending on whether the true amount is at the lower or higher end of the range. Therefore, we requested more detail from "Big Data users," those 47 respondents who indicated they had more than 10 to 100 TB or over 100 TB total current data (Q5). All other respondents are called "Small Data users." Because not all of these follow-up requests were successful, we used actual follow-up responses to estimate likely responses for those who did not respond.
We defined active data as data that would be used within the next six months. All other data would be considered inactive, or archival.
To calculate per person storage needs we used the high end of the reported range divided by 1 for an individual response, or by G, the number of individuals in a group response. For Big Data users we used the actual reported values or estimated likely values.
Resources in this dataset:Resource Title: Appendix A: ARS data storage survey questions. File Name: Appendix A.pdfResource Description: The full list of questions asked with the possible responses. The survey was not administered using this PDF but the PDF was generated directly from the administered survey using the Print option under Design Survey. Asterisked questions were required. A list of Research Units and their associated codes was provided in a drop down not shown here. Resource Software Recommended: Adobe Acrobat,url: https://get.adobe.com/reader/ Resource Title: CSV of Responses from ARS Researcher Data Storage Survey. File Name: Machine-readable survey response data.csvResource Description: CSV file includes raw responses from the administered survey, as downloaded unfiltered from Survey Monkey, including incomplete responses. Also includes additional classification and calculations to support analysis. Individual email addresses and IP addresses have been removed. This information is that same data as in the Excel spreadsheet (also provided).Resource Title: Responses from ARS Researcher Data Storage Survey. File Name: Data Storage Survey Data for public release.xlsxResource Description: MS Excel worksheet that Includes raw responses from the administered survey, as downloaded unfiltered from Survey Monkey, including incomplete responses. Also includes additional classification and calculations to support analysis. Individual email addresses and IP addresses have been removed.Resource Software Recommended: Microsoft Excel,url: https://products.office.com/en-us/excel
SUMMARY This table contains data about women, ages 15 to 50, pregnant people, infants, children, and youths, up to age 24. It contains information about a wide range of health topics, including medical conditions, nutrition, dehydration, oral health, mental health, safety, access to health care, and basic needs, like housing. Local, county-level prevalence rates, time trends, and health disparities about national public health priorities, including preterm birth, infant death, childhood obesity, adolescent depression and substance use, and high blood pressure, diabetes, and kidney disease in young adults.
The population data is from the 2023-2024 San Francisco Maternal Child and Adolescent Health needs assessment and is published on the Open Data Portal to share with community partners, plan services, and promote health.
For more information see:
HOW THE DATASET IS CREATED The Maternal, Child, and Adolescent Health (MCAH) Needs Assessment for San Francisco included review of a wide range of citywide population data covering a ten-year span, from 2014 to 2023. Data from over 83,000 birth records, 59,000 death records, 261,000 emergency room visits, 66,000 hospital admissions, and 90,000 newborn screening discharges were gathered, along with citywide data from child welfare records, health screenings in childcare and schools, DMV records of first-time drivers, school surveys, and a state-run mailed survey of recent births (California Department of Public Health MIHA survey). The datasets provided information about approximately 700 health conditions. Each health condition was described in terms of the number of people affected or cases, and the rate affected, stratified by age, sex, race-ethnicity, insurance status, zip code, and time period.
Rates were calculated by dividing the number of people or events by the population group estimate (e.g., total births or census estimates), then multiplying by 100 or 1,000 depending on the measure. Each rate was presented with its 95% confidence interval to support users to compare any two rates, either between groups or over time. Two rates differ “significantly” if their 95% confidence intervals do not overlap.
The present dataset summarizes the group-level results for any age-, sex-, race-, insurance-, zip code-, and/or period-specific group that included at least 20 people or cases.
Causes of death, health conditions that affected over 1000 people in the time frame, problems that got worse over time, and health disparities by insurance, race-ethnicity and/or zip code were flagged for the MCAH Needs Assessment.
UPDATE PROCESS The dataset will be updated manually, bi-annually, each December and June.
HOW TO USE THIS DATASET Population data from the MCAH needs assessment are shared in several formats, including aggregated datasets on DataSF.gov, downloadable PDF summary reports by age group, interactive online visualizations, data tables, trend graphs, and maps. Information about each variable is available in a linked data dictionary. The definition of each numerator and denominator depends on data source, life stage, and time. Health conditions may not be directly comparable across life stage, if the numerator definition includes age- or pregnancy-specific diagnosis codes (e.g. diabetes hospitalization).
For small groups or rare conditions, consider combining time periods and/or groups. Data are suppressed if fewer than 20 cases happened in the group and period.
Group-specific rates are available if the matched group-specific census estimates (denominator) were available. Census estimates are only available for selected age-sex-race-, age-sex-zip code-, or age-sex-insurance-specific groups. Hospital records reflect what each clinician documented as relevant for the hospital encounter. No diagnosis does not rule out the presence of a condition unnoticed. Hospital and ER visit data reflect how many people had the condition vs. unknown. Rates may not be directly comparable across time and place, because data collection protocol may not be complete or standardized across data entry staff, time, and place.
Multiple statistical comparisons may lead to false positives. Some statistically significant results may be significant only by chance. Observational data do not support causal inference and are only meant to flag topics for deeper discussion and investigation. Consider alternative explanations for the data, including chance and potential sources of error.
Attribution 4.0 (CC BY 4.0)https://creativecommons.org/licenses/by/4.0/
License information was derived automatically
BackgroundDespite the incentives and provisions created for hospitals by the US Affordable Care Act related to value-based payment and community health needs assessments, concerns remain regarding the adequacy and distribution of hospital efforts to address SDOH. This scoping review of the peer-reviewed literature identifies the key characteristics of hospital/health system initiatives to address SDOH in the US, to gain insight into the progress and gaps.MethodsPRISMA-ScR criteria were used to inform a scoping review of the literature. The article search was guided by an integrated framework of Healthy People SDOH domains and industry recommended SDOH types for hospitals. Three academic databases were searched for eligible articles from 1 January 2018 to 30 June 2023. Database searches yielded 3,027 articles, of which 70 peer-reviewed articles met the eligibility criteria for the review.ResultsMost articles (73%) were published during or after 2020 and 37% were based in Northeast US. More initiatives were undertaken by academic health centers (34%) compared to safety-net facilities (16%). Most (79%) were research initiatives, including clinical trials (40%). Only 34% of all initiatives used the EHR to collect SDOH data. Most initiatives (73%) addressed two or more types of SDOH, e.g., food and housing. A majority (74%) were downstream initiatives to address individual health-related social needs (HRSNs). Only 9% were upstream efforts to address community-level structural SDOH, e.g., housing investments. Most initiatives (74%) involved hot spotting to target HRSNs of high-risk patients, while 26% relied on screening and referral. Most initiatives (60%) relied on internal capacity vs. community partnerships (4%). Health disparities received limited attention (11%). Challenges included implementation issues and limited evidence on the systemic impact and cost savings from interventions.ConclusionHospital/health system initiatives have predominantly taken the form of downstream initiatives to address HRSNs through hot-spotting or screening-and-referral. The emphasis on clinical trials coupled with lower use of EHR to collect SDOH data, limits transferability to safety-net facilities. Policymakers must create incentives for hospitals to invest in integrating SDOH data into EHR systems and harnessing community partnerships to address SDOH. Future research is needed on the systemic impact of hospital initiatives to address SDOH.
The Nationwide Emergency Department Sample (NEDS) was created to enable analyses of emergency department (ED) utilization patterns and support public health professionals, administrators, policymakers, and clinicians in their decision-making regarding this critical source of care. The NEDS can be weighted to produce national estimates. The NEDS is the largest all-payer ED database in the United States. It was constructed using records from both the HCUP State Emergency Department Databases (SEDD) and the State Inpatient Databases (SID), both also described in healthdata.gov. The SEDD capture information on ED visits that do not result in an admission (i.e., treat-and-release visits and transfers to another hospital). The SID contain information on patients initially seen in the emergency room and then admitted to the same hospital. The NEDS contains 25-30 million (unweighted) records for ED visits for over 950 hospitals and approximates a 20-percent stratified sample of U.S. hospital-based EDs. The NEDS contains information about geographic characteristics, hospital characteristics, patient characteristics, and the nature of visits (e.g., common reasons for ED visits, including injuries). The NEDS contains clinical and resource use information included in a typical discharge abstract, with safeguards to protect the privacy of individual patients, physicians, and hospitals (as required by data sources). It includes ED charge information for over 75% of patients, regardless of payer, including patients covered by Medicaid, private insurance, and the uninsured. The NEDS excludes data elements that could directly or indirectly identify individuals, hospitals, or states.