Frequently Asked Questions

 

Learn more about participating in NHCS

• What is the National Hospital Care Survey?
• Why participate in the NHCS?
• What does participation in the NHCS entail?
• What are the benefits of participation?
• What type of information is collected?
• Who will be collecting the information and how long will it take?
• Is the information provided by my hospital kept confidential?
• Can my hospital participate and still comply with the HIPAA Privacy Rule?
• Does my hospital's Institutional Review Board need to review this research project?
• How will NHCS data be used?
• I'm ready to participate, what should I do?

 

For an expanded set of FAQs, please download our FAQ brochure

 

What is the National Hospital Care Survey?

The National Hospital Care Survey provides nationally representative data on utilization of inpatient hospital care, as well as care delivered in emergency departments, outpatient departments, hospital-based ambulatory surgery locations, and freestanding ambulatory surgery centers. For more information, please see the site About NHCS. 

 

Why participate in the NHCS?

Objective and timely data are essential to assess the health and well-being of the population and the performance and functioning of the health care system. Your participation in NHCS is important because without your involvement, your health care facility and others like yours will not be represented in the national description of care provided by hospitals and freestanding ambulatory surgery centers. Your health care facility was randomly chosen to provide representative data not only for your hospital or freestanding surgery center, but also for similar hospitals or freestanding ambulatory surgery centers of the same service type, bed size, and geographic location. For more information about your participation, please see the site Participating in NHCS.

 

What does participation in the NHCS entail?

Participation in NHCS includes the following:

• An interview to determine your hospital’s eligibility and the eligibility of your hospital’s emergency department (ED) and/or outpatient departments (OPD) and/or ambulatory surgery locations (ASL).
• Completion of a short self-administered facility questionnaire on characteristics of the hospital, EDs, OPDs, and ASLs.
• Electronic submission of Uniform Bill (UB)-04 administrative claims data on a recurring basis.
• Abstraction of medical records data from sampled visits to ambulatory units.

Each of these activities will occur on separate time tables. The submission of your  UB-04 data will be continuous while the completion of questionnaires and the abstraction of medical records will be less frequent and in some cases not start for several months following the submission of the claims data.

You may be asked to participate in special studies on occasion, but participation in these studies will be voluntary. All NHCS activities will be conducted either at your facility or by telephone. 

 

What are the benefits of participation?

• Compensation: Your facility will be paid $500 for setting up the procedures to send Uniform Bill (UB)-04 administrative claims data to NCHS and for sending a test file. Additionally your facility will receive $500 for each full year of UB-04 data submitted every year. That makes two $500 payments the first year and $500 every year thereafter. Hospitals which agree to allow NHCS project staff to abstract a sample of visits to ambulatory units will be paid an additional $500.
• CEU Credits: Health Information Management (HIM) professional staff members are eligible for free continuing education credits after completion of an on-line training about participating in NHCS.
• Data for Comparison:  Selected summaries of your inpatient data will be provided and/or comparative profiles showing statistics for inpatients from similar types of hospitals may be provided.
• National Statistics: By participating, your facility provides useful data on hospital care which will inform policies to improve the state of health care in the nation.
• Improved Patient Care: Your participation will result in more reliable statistics enabling researchers to better understand health care provided by hospitals.

 

What type of information is collected?

We will collect all information available on the UB-04.  For more information, see the listing of UB-04 variables [PDF - 55 KB].

Also, the following hospital information will be collected:

• Hospital demographics (e.g., total number of discharges for the year and hospital ownership type)
• Clinical capabilities and services (e.g., Does the hospital have an ED? What is the trauma level rating of the ED?)
• Types of revenue sources (e.g., Medicare or private insurance)
• Health information technology (HIT) (e.g., In which areas of the hospital does HIT function?)
• Electronic Medical Records (EMR) use (e.g., Are EMRs used in direct patient care settings?)

For more information, see the Facility Questionnaire.

 

Who will be collecting information and how long will it take?

NCHS has contracted with RTI and Westat for the recruitment and data collection activities of NHCS. They are agents of NCHS. Once your hospital decides to participate in the survey, you will be contacted to arrange the following:

• Induction Interview: One-time interview to determine eligibility and obtain general information about your hospital. This is estimated to take 1 hour, including answering any questions you may have.
• Facility Questionnaire: Annual, self-administered questionnaire to obtain specific information about hospital characteristics, financial information, staffing, and health information technology. This is estimated to take approximately 2 hours to complete.
• Electronic Data Submission: Transmission of UB-04/837 data to a secure site on a recurring basis. This can be an automated process, whose set up is estimated to take approximately 1 hour to complete. It is estimated to take approximately 1 hour for each manual submission of data.  

In 2013, you will be contacted to arrange the following:

• Ambulatory Induction Interview: One-time interview to identify eligible ambulatory units within your hospital and obtain general information. This is estimated to take 1 hour, including answering any questions you may have.
• Ambulatory Unit Questionnaires: Annual questionnaire to obtain more specific information about unit characteristics, patient volume, staffing, and services offered. This is estimated to take approximately 1 hour to complete.
• Medical Record Abstraction: Abstraction of a sample of medical records for selected ambulatory units. These data collection activities will be conducted by NCHS and their designated agents. All protected health information will be kept confidential and will be used only by NCHS staff, contractors, and agents when required and with necessary controls.

NHCS Secure Transfer System

Participating hospitals, are you ready to upload your UB-04/837 data? This link will take you straight to our Secure Data Transfer System maintained by Westat, an agent of the National Center for Health Statistics (NCHS).

 

Is the information provided by my hospital kept confidential?

Yes.  All information collected will be the property of NCHS and kept strictly confidential.  The identity of specific health care facilities and individual patients will not be released in any manner, except to NCHS staff, contractors, and agents when required and with necessary controls.  Results of the study will be published only in an aggregated manner that will not allow identification of any individual hospital or patient.

NCHS has a long history of protecting the privacy of information we collect. NHCS is authorized by Congress in Section 306 of the Public Health Service Act (42 USC 242K), which requires NCHS to collect statistics on a variety of health indicators. Furthermore, in accordance with Section 308(d) of the Public Health Service Act (42 USC 242m), no information collected in this survey may be used for any purpose other than the purpose for which it is collected. Such information may not be published or released in any form if the individual or establishment is identifiable unless the individual or establishment has consented to such release. If any federal employee or contractor gives out confidential information not authorized by law, he or she can be fired, fined, and/or imprisoned.

The information you and your staff supply will be used solely for statistical research and reporting purposes. All information, publications, and data files will be released in such a way that no individual hospital or inpatient can be identified. For more information, please see the NCHS Confidentiality webpage or contact Eve Powell-Griner, NCHS Confidentiality Officer at 301 458-4257 or E-mail: EPowell-Griner@cdc.gov.

NCHS is required by law to keep all data regarding patients and facilities strictly confidential and to use these data only for research and statistical purposes as stated by Section 308(d) of the Public Health Service Act [42 United States Code 242m (d) and Section 513 of the Confidential Information Protection and Statistical Efficiency Act or CIPSEA (PL-107-347). All protected health information will be kept confidential and will be used only by NCHS staff, contractors, and agents when required and with necessary controls.  CIPSEA also includes provisions for a felony conviction and/or fine of up to $250,000 if NCHS staff or contractors violate the confidentiality provisions.

The national survey has been approved by the Institutional Review Board (IRB) of NCHS.  If you have questions about your rights as a participant in this research study, please call the Research Ethics Review Board at NCHS, toll-free, at 1-800-223-8118.

 

Can my hospital participate and still comply with the HIPAA Privacy Rule?

Yes. This study conforms to the Privacy Rule as mandated by HIPAA, where disclosure of patient data is permitted for public health purposes. The Privacy Rule also specifies that in providing information to public health agencies, such as CDC, your hospital may rely on our assurance that the request constitutes the minimum necessary information required. The Privacy Rule permits your hospital to make disclosures without patient authorization for public health purposes and for research that has been approved by an IRB. This survey meets both of those criteria.

NCHS' Privacy and Data Release Policies and Current Legislative Authorities [PDF - 235 KB] web sites provide information for you to verify that your hospital is allowed to disclose to NCHS the information requested by the survey. The web sites include information on the authority under which NCHS is collecting these data and that the data being collected are the minimum information necessary.

NHCS is being conducted under the auspices of CDC/NCHS (federal government).   Special provisions within HIPAA exist to permit health care facilities to provide data to public health entities such as CDC/NCHS for purposes such as NHCS. 

The HIPAA Privacy Rule recognizes 1) the legitimate need for public health authorities and others responsible for ensuring the public's health and safety to have access to protected health information to conduct their missions, and 2) the importance of public health reporting by covered entities to identify threats to the public and individuals.  The Privacy Rule permits 1) protected health information disclosures without a written patient authorization for specified public health purposes to public health authorities legally authorized to collect and receive the information for such purposes, and 2) disclosures that are required by state and local public health or other laws (HIPAA Regulations (45 CFR§164.501)).  Thus, HIPAA permits health care facilities such as yours to participate in studies of this nature for public health purposes.  Because our contractors are serving as authorized agents of NCHS, it is permissible to disclose data to them for the purposes of this project.  HIPAA also permits covered entities to obtain the documentation and rely on the approval of one Institutional Review Board (IRB) or privacy board.  In this case, the hospital may rely on the approval of the NCHS’ IRB. 

 

Does my health care facility’s Institutional Review Board need to review this research project?

No. For research projects, only one IRB must review the project and NCHS’ IRB (which has the authority to review such projects under the Regulations for the Protection of Human Subjects) has done so.  We have the IRB approval letter [PDF - 54 KB] that indicates that three waivers have been approved for this survey, and contains the documentation that is required by the Privacy Rule.  If you desire, your hospital’s IRB may review the project as well.  Your IRB can verify that the IRB approval letter we have provided adheres to the requirements of the Privacy Rule, and NHCS can send you a copy of the materials submitted to the IRB.

 

How will NHCS data be used?

NHCS data will be used by the U.S. Congress and other public health policy makers, government agencies, academic institutions, professional associations, and health services researchers, as well as the media, to describe and understand the changes that occur in health care delivery. The data are disseminated in the form of public health reports, journal articles, and microdata files.

In addition to providing a national description of health care delivery in hospital-based settings, NHCS will allow for the linkage of encounters of care both within the same facility and with outside data sources such as the National Death Index and the Medicare Provider Analysis and Review (MedPAR) and Medicaid Statistical Information System (MSIS) datasets. Linking to other government data will allow for more comprehensive analyses, such as measurement of post-discharge mortality and readmission rates.

Please see our Data Uses page for more examples of the reports that are produced with NCHS data.

 

I’m ready to participate, what should I do?

Please call Ms. Carolyn Almen, NHCS Recruitment Manager, at our toll-free number, 888-377-7161 ext. 4744, to talk about your participation in the National Hospital Care Survey.