Rosemarie Hirsch M.D., M.P.H.

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Presentation transcript:

Rosemarie Hirsch M.D., M.P.H. Measuring Health Care Quality from the National Health and Nutrition Examination Survey (NHANES) Rosemarie Hirsch M.D., M.P.H. U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention National Center for Health Statistics

Presentation Topics NHANES overview Health condition components and health care quality measures collected Examples of healthcare quality analyses Public data files and access

NHANES NHES I: 1960-62, ages 18-79 NHES II: 1963-65, ages 6-11 NHES III: 1966-70, ages 12-17 NHANES I: 1971-75, ages 1-74 NHANES II: 1976-80, ages 6 mos.-74 HHANES: 1982-84, ages 6 mos.-74 NHANES III: 1988-94, ages 2 mos. and older NHANES: 1999 and beyond, all ages

Current NHANES Sample Design Eligible population Continuous data collection beginning in 1999 Annual national sample of 5,000 persons Eligible population Civilian, non-institutionalized population Residents of all states and D.C. All ages

NHANES – Oversampling African Americans Mexican Americans Adolescents aged 12-19 Persons aged 60+ Pregnant women Low-income families

NHANES Household Interview Traditional CAPI interviewing with portable keyboard.

NHANES Household Interview Broad range of health conditions Environmental and occupational exposures Health behaviors Nutrition and dietary supplements Prescribed medications

NHANES Mobile Exam Center

NHANES Examination Standardized physical exam Conducted at mobile exam center Medical & dental exams Physiological measurements Laboratory test Administered by trained medical personnel

NHANES Mobile Exam Center

NHANES TOPICS Oral health Cardiovascular disease Diabetes, lower extremity disease Bone status, osteoporosis Fitness, strength and functional limitation Vision, hearing and balance Oral health

NHANES TOPICS, Continued Nutrition Anthropometry Mental health Risk behaviors Reproductive health Environmental exposures Infectious diseases and immunization status

NHANES Laboratory CBC and WBC differential Pregnancy test Blood, urine and vaginal swab processing 76 different vials of samples 26 laboratories 300 laboratory assays

Landmark findings and public health results High blood lead levels Lead out of gasoline Low folate levels Mandatory food fortification Rising levels of obesity Public health action plan Racial and ethnic disparities in Hepatitis B Universal vaccination of all infants & children

Data Analysis Examples Health Care Quality Data Analysis Examples

Source: 2004 National Healthcare Quality Report Ever Had Blood Cholesterol Checked: Percent of U.S. Adults Age 40+ years Source: 2004 National Healthcare Quality Report

Source: 2004 National Healthcare Quality Report Ever Told by Doctor Had High Blood Cholesterol: Percent of U.S. Adults Age 40+ years Source: 2004 National Healthcare Quality Report

Source: 2004 National Healthcare Quality Report Taking Cholesterol-lowering Medications: Percent of U.S. Adults Age 40+ years Ever Told by Doctor they had High Blood Cholesterol Source: 2004 National Healthcare Quality Report

Source: 2004 National Healthcare Quality Report Cholesterol and HgA1c Control: Percent of U.S. Adults Age 18+ years with Diagnosed Diabetes Source: 2004 National Healthcare Quality Report

Percent of U.S. Adults age 20-74 years with Hypertension Source: Health United States, 2003

Awareness, Treatment and Control: Percent of U. S Awareness, Treatment and Control: Percent of U.S. Adults Age 18-74 years with Hypertension Source: JNC 7 Report, 2003

Health Care Quality Data for Cholesterol and Hypertension NHES NHANES I NHANES II NHANES III NHANES 1999-2000 NHANES 2000-2001

NHANES Data Directly download from our website http://www.cdc.gov/nchs/nhanes.htm Join our LISTSERV