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Redesign of the National Hospital Discharge Survey

Conceptual Framework and Feasibility Study: Final Report

by Robin Meili, Sandra H. Berry, Marc N. Elliott, Carol P. Roth, Anne Reid Griffin, Kristin J. Leuschner, Denise D. Quigley, Megan K. Beckett, Yimin Lou, Chau Pham, et al.

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Since its inception more than 40 years ago, the National Hospital Discharge Survey (NHDS) has been a principal source of information on inpatient utilization in short-stay, nonfederal hospitals in the United States. However, it is based on concepts of the health care delivery system and hospital and patient universe of previous decades. For the NHDS to remain relevant, it must reflect the types of care and services now offered in American hospitals. The National Center for Health Statistics, Centers for Disease Control and Prevention, asked RAND Health to assist in the first phase of the redesign effort by developing an approach for redesigning the survey and identifying, through a feasibility study, specific data elements to be included and field procedures to be used in that survey. New data elements recommended add clinical and financial depth and breadth, and the ability to link facility structure to process and outcomes of care. The survey also provides a structure for incorporating modules that can focus in detail on selected issues.

This report documents the findings from this study and includes appendixes containing the names of people and institutions involved in the study and the forms and surveys used in the study and revised in light of the findings.

Table of Contents

  • Chapter One

    Introduction

  • Part One: Development Of a Conceptual Framework for the NHDS

  • Chapter Two

    Methods Used in Developing a Conceptual Framework for the Redesign

  • Chapter Three

    Findings: Critical Information Needs for the Conceptual Framework

  • Chapter Four

    Findings: Selection of Variables to Be Tested in the Feasibility Study

  • Chapter Five

    Discussion and Summary: Research Questions That Might Be Addressed Through a Redesigned Survey

  • Part Two: Feasibility Study

  • Chapter Six

    Methods Used to Conduct the Feasibility Study

  • Chapter Seven

    Findings: Procedures Used to Recruit, Induct, and Train Hospitals for Participation in the Feasibility Study

  • Chapter Eight

    Findings: Facility Questionnaire, Sampling, and Abstraction

  • Chapter Nine

    Discussion and Recommendations: Feasibility Study

  • Part Three: Statistical Analysis

  • Chapter Ten

    Design and Statistical Considerations

  • Part Four: Conclusions

  • Chapter Eleven

    Conclusions

  • Appendix A

    Revised Forms and Documents

  • Appendix B

    National Hospital Discharge Survey Interviewees

  • Appendix C

    National Hospital Discharge Survey Workgroup Panel Members

  • Appendix D

    Description of Policy Issues and Sample Research Questions

  • Appendix E

    A Menu of Non-Mutually Exclusive Options for Redesigning the NHDS

  • Appendix F

    Mapping Research Questions to Variable Categories

  • Appendix G

    Patient Abstract Form – Feasibility Study 2006

  • Appendix H

    Pilot Site Recruitment Contact Tracking Sheet

  • Appendix I

    Facility Induction Form – Feasibility Study 2006

  • Appendix J

    Key Contacts List

  • Appendix K

    Feasibility Study On-Site Debrief Questions

  • Appendix L

    Statistical Tables

The research described in this report was prepared for the Centers for Disease Control and Prevention, National Center for Health Statistics and conducted within RAND Health, a division of the RAND Corporation.

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