National Survey of Ambulatory Surgery
The National Survey of Ambulatory Surgery (NSAS)
is the only national study of ambulatory surgical care in hospital-based and
freestanding ambulatory surgery centers (ASCs). The NSAS was first conducted
from 1994 to 1996, but it was discontinued due to lack of resources. The NSAS is
being conducted again in 2006.
Who
is eligible to participate?
Why
participate?
What
are the benefits of participating?
Data from the National Hospital
Discharge Survey have been extensively used for four decades in monitoring
changes and analyzing the types of surgical treatment provided to hospital
inpatients. However, due to advances in medical technology, surgical treatment
and diagnostic procedures are increasingly provided in settings which are
outside the scope of the NHDS. The growth of freestanding ambulatory surgery
facilities and ambulatory surgery programs in hospitals has been rapid, and the
decline of these procedures on an inpatient basis has been documented by the
NHDS.
Your facility’s participation in
the NSAS will result in more reliable statistics and will enable researchers to
better measure the utilization and provision of ambulatory surgical care.
Failure to participate lessens the accuracy of the data used by researchers.
If you would like more
information on participation, please contact Karen Lees at
KCullen@cdc.gov
or (301) 458-4321, or visit our
National Hospital Discharge and
Ambulatory Surgery Data home page.
After nearly ten years of being out of the
field, the NSAS data collection instruments were updated to reflect the changing
environment in ambulatory surgery. Outside experts from the American College of
Surgeons, American Association for the Accreditation of Ambulatory Surgery
Facilities (AAAASF), American Association of Ambulatory Surgery Centers (AAASC),
the American Academy of Ophthalmology (AAO), the American Hospital Association
(AHA), the Society for Ambulatory Anesthesiologists (SAMBA), the Federation of
American Hospitals (FAH), the Joint Commission of Accreditation of Healthcare
Organizations (JCAHO), the Federated Ambulatory Surgery Association (FASA), and
the American College of Obstetrics and Gynecology (ACOG) provided input into
updating the data collection tools used for NSAS. Many of the new questions being asked in the 2006 NSAS are about the facility in which the ambulatory surgery is being conducted. Each sampled facility will be asked to complete a Facility Questionnaire and return it in the mail.
Confidentiality
of NSAS data
HIPAA
Privacy Rule and NSAS
The Privacy Rule permits your facility
to make disclosures of protected health information without patient
authorization for public health purposes or for research that has been approved
by an Institutional Review Board (IRB). This survey meets both of these
criteria. Additionally, disclosures may be made under a
data use agreement with
NCHS. If you have questions about your facility’s rights as a respondent, you
may call the IRB at 1-800-223-8118. The IRB is an independent board that
protects the interests of people who take part in studies. Click here to see the
IRB approval letter
and
IRB
continuation approval letter
for NSAS.
We have included all the information
you need to be assured that your facility is allowed to disclose protected
health information for the NSAS in our
introductory letter to facilities and
also here on our website. However, there are several things that you must do to
assure compliance with the Rule when participating in the survey. First, the
privacy notice that your facility generally provides to patients must indicate
that patient information may be disclosed for either research or public health
purposes. And, secondly, your facility may need to keep a
record of the
disclosure (which we will provide) that shows that some data from the patient’s
medical record were disclosed to CDC for the NSAS. Of course, if your facility
does not transmit health information electronically (such as claims data), then
it is not subject to the Privacy Rule or the requirements described above.
The Privacy Rule applies to data
collected for the NSAS because we are asking you to provide certain information
about patients without their authorization. For public health and research
purposes, the NSAS collects information from the patient's medical record such
as surgical visit date, birth date, and residential ZIP code. While not directly
identifiable, these data are considered protected health information as defined
by the Privacy Rule. As described above, the Rule allows you to disclose this
information for public health and research purposes.
Please be assured that we fully intend
to continue our long history of gaining the voluntary participation of
facilities like yours by upholding the highest confidentiality standards and
practices.
For additional information on the
confidentiality of NSAS data, please go to
NCHS's Privacy Protection
page.
Your
assurance of privacy
The NSAS does not collect any personally identifiable data about
patients such as patient's name or address. Sample visits are
randomly selected using the surgery schedules that the facility has as a part of its
routine recordkeeping requirements. The medical records that are included in the
sample are identified and listed on the Sample Listing Sheet. The Sample Listing
Sheet is a four part form on NCR (no carbon required) paper and the top sheet,
which contains medical record numbers and possibly other identifying
information, is retained by the facility to assure confidentiality. The top copy
is kept by facility staff for several months, in case it is necessary to
retrieve missing information or clarify recorded information.
Other information that may permit identification of an individual, or a
facility will be held confidential, will be used only by persons engaged in and
for the purpose of the survey, and will not be disclosed or released to other
persons or used for any other purpose without consent of the individual or the
establishment in accordance with section 308(d) of the Public Health Service Act
(42 USC 242m). A copy of the NSAS Medical Abstract form can be found on this page under the section, Survey Instruments.
Data Utilization and Dissemination
How
are NSAS data used?
How are
NSAS data released?
In addition to published reports on
NSAS, a public-use micro data file and supporting documentation will be prepared
for distribution at professional society meetings, health data conferences, and
through the NCHS website. NSAS data will also available on CD-ROM.
Identification of facilities and patients cannot be made from the public-use
data files.
Annual public use files containing
information collected by the NSAS were made available for the 1994-1996 NSAS and
will be made available for the 2006 NSAS. To facilitate trend analyses,
multi-year public use files of NSAS data in a standard format with standard
definitions across survey years was and will be made available. CD-ROMs for
1994-1996 in ASCII format are currently available to the public, and 2006 NSAS
data will also be available in this format.
To download the microdata for the
1994-1996 NSAS,
click here.
To download the data documentation for
the 1994-1996 NSAS,
click here.
"I can’t think of a more important way for an ASC professional to spend
[their] time. In the face of increasing legislative and regulatory challenges to
our industry, our ability to produce the kind of data this survey is collecting
is growing. When you participate in surveys such as this one, you help the whole
ASC industry as well as your own ASC." -- Jack Egnatinsky, MD, President,
Federated Ambulatory Surgery Association (FASA)
To read the article on NSAS that appeared in the January/February 2006
issue of FASA Update,
click
here. NSAS is endorsed by the following professional organizations: American Association of Ambulatory Surgery Centers 31 KB American College of Surgeons 22 KB American Health Information Management Association 29KB American Academy of Ophthalmology 34 KB Federated Ambulatory Surgery Association 17 KB
Society
for Ambulatory Anesthesia
34 KB If you have any further questions or comments related to participation, please contact Karen Cullen at:
This page last
reviewed September 10, 2008
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