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Trends in Out-of-Hospital Births in the United States, 1990–2012

March 25, 2014 Comments off

Trends in Out-of-Hospital Births in the United States, 1990–2012
Source: National Center for Health Statistics

Key findings

  • The percentage of out-of-hospital births increased from 1.26% of U.S. births in 2011 to 1.36% in 2012, continuing an increase that began in 2004.
  • In 2012, out-of-hospital births comprised 2.05% of births to non-Hispanic white women, 0.49% to non-Hispanic black women, 0.46% to Hispanic women, 0.81% to American Indian women, and 0.54% to Asian or Pacific Islander women.
  • In 2012, out-of-hospital births comprised 3%–6% of births in Alaska, Idaho, Montana, Oregon, Pennsylvania, and Washington, and between 2% and 3% of births in Delaware, Indiana, Utah, Vermont, and Wisconsin. Rhode Island (0.33%), Mississippi (0.38%), and Alabama (0.39%) had the lowest percentages of out-of-hospital births.
  • In 2012, the risk profile of out-of-hospital births was lower than for hospital births, with fewer births to teen mothers, and fewer preterm, low birthweight, and multiple births.
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Routine Prenatal Care Visits by Provider Specialty in the United States, 2009–2010

March 25, 2014 Comments off

Routine Prenatal Care Visits by Provider Specialty in the United States, 2009–2010
Source: National Center for Health Statistics

Key findings
Data from the 2009 and 2010 National Ambulatory Medical Care Survey and National Hospital Ambulatory Medical Care Survey

  • At 14.1% of routine prenatal care visits in the United States in 2009–2010, women saw providers whose specialty was not obstetrics and gynecology (ob/gyn).
  • The percentage of routine prenatal care visits that were made to non-ob/gyn providers was highest (20.5%) among women aged 15–19.
  • Visits to non-ob/gyn providers accounted for a higher percentage of routine prenatal care visits among women with Medicaid (24.3%) and women with no insurance (23.1%) compared with women with private insurance (7.3%).
  • The percentage of routine prenatal care visits to non-ob/gyn providers was lower among women in large suburban areas (5.1%) compared with those in urban areas (14.4%) or in small towns or suburbs (22.4%).

Trends in Out-of-Hospital Births in the United States

March 21, 2014 Comments off

Trends in Out-of-Hospital Births in the United States
Source: National Center for Health Statistics

Key findings

  • The percentage of out-of-hospital births increased from 1.26% of U.S. births in 2011 to 1.36% in 2012, continuing an increase that began in 2004.
  • In 2012, out-of-hospital births comprised 2.05% of births to non-Hispanic white women, 0.49% to non-Hispanic black women, 0.46% to Hispanic women, 0.81% to American Indian women, and 0.54% to Asian or Pacific Islander women.
  • In 2012, out-of-hospital births comprised 3%–6% of births in Alaska, Idaho, Montana, Oregon, Pennsylvania, and Washington, and between 2% and 3% of births in Delaware, Indiana, Utah, Vermont, and Wisconsin. Rhode Island (0.33%), Mississippi (0.38%), and Alabama (0.39%) had the lowest percentages of out-of-hospital births.
  • In 2012, the risk profile of out-of-hospital births was lower than for hospital births, with fewer births to teen mothers, and fewer preterm, low birthweight, and multiple births.

Primary Cesarean Delivery Rates, by State: Results From the Revised Birth Certificate, 2006–2012

March 6, 2014 Comments off

Primary Cesarean Delivery Rates, by State: Results From the Revised Birth Certificate, 2006–2012 (PDF)
Source: National Center for Health Statistics

Objectives
This report describes state-specific trends in pri­ mary cesarean delivery rates from 2006 through 2012 for reporting areas that implemented the 2003 U.S. Standard Certificate of Live Birth by January 1, 2006, and from 2009 through 2012 for reporting areas that implemented the 2003 revision by January 1, 2009. State-specific changes by gestational age are also explored.

Methods
Data for 2006–2012 are based on 100% of singleton births to residents of the reporting areas that implemented the 2003 birth certificate revision by January 1 of each year. Results are not generalizable to the entire United States—the reporting areas do not represent a random sample of U.S. births.

Results
The primary cesarean delivery rate for the 2006 reporting area (19 states) increased from 21.9% in 2006 to 22.4% in 2009, and then declined to 21.9% in 2012. For the 2009 reporting area (28 states and New York City), the primary cesarean rate declined from 22.1% to 21.5% during 2009–2012. Rates for 16 of 29 areas declined during 2009–2012; the remaining states were unchanged. By gesta­ tional age, state-specific primary cesarean delivery rates at 38 weeks declined for 18 of 29 areas from 2009 to 2012; few state-specific changes were observed at other gestational ages. The primary cesarean delivery rate for the 38 states, District of Columbia, and New York City that were using the revised certificate by January 1, 2012, was 21.5%. State-specific rates ranged from 12.5% (Utah) to 26.9% (Florida and Louisiana).

Financial Burden of Medical Care: A Family Perspective

March 3, 2014 Comments off

Financial Burden of Medical Care: A Family Perspective
Source: National Center for Health Statistics

Data from the National Health Interview Survey, 2012

  • In 2012, more than one in four families experienced financial burdens of medical care.
  • Families with incomes at or below 250% of the federal poverty level (FPL) were more likely to experience financial burdens of medical care than families with incomes above 250% of the FPL.
  • Families with children aged 0–17 years were more likely than families without children to experience financial burdens of medical care.
  • The presence of a family member who was uninsured increased the likelihood that a family would experience a financial burden of medical care.

Summary Health Statistics for U.S. Adults: National Health Interview Survey, 2012

February 28, 2014 Comments off

Summary Health Statistics for U.S. Adults: National Health Interview Survey, 2012 (PDF)
Source: National Center for Health Statistics

This report presents detailed tables from the 2012 National Health Interview Survey (NHIS) for the civilian noninstitutionalized adult population, classified by sex, age, race and Hispanic origin, education, current employment status, family income, poverty status, health insurance coverage, marital status, and place and region of residence. Estimates (frequencies and percentages) are presented for selected chronic conditions and mental health characteristics, functional limitations, health status, health behaviors, health care access and utilization, and human immunodeficiency virus testing. Percentages and percent distributions are presented in both age-adjusted and unadjusted versions.

Fathers’ Involvement With Their Children: United States, 2006–2010

February 5, 2014 Comments off

Fathers’ Involvement With Their Children: United States, 2006–2010 (PDF)
Source: National Center for Health Statistics

Objective
This report measures fathers’ involvement with their children. Father involvement is measured by how often a man participated in a set of activities in the last 4 weeks with children who were living with him and with children who were living apart from him. Involvement is measured separately for children aged 0–4 years and children aged 5–18 years. Increased involvement of fathers in their children’s lives has been associated with a range of positive outcomes for the children.

Methods
The analyses presented in this report are based on a nationally representative sample of 10,403 men aged 15–44 years in the household population of the United States. The father-involvement measures are based on 2,200 fathers of children under age 5—1,790 who live with their children and 410 who live apart from their children, and on 3,166 fathers of children aged 5–18—2,091 who live with their children and 1,075 who live apart from their children.

Results
Statistics are presented on the frequency with which fathers took part in a set of age-specific activities in their children’s lives. Differences in percent distributions are found by whether the father lives with or apart from his children, and by his demographic characteristics. In general, fathers living with their children participated in their children’s lives to a greater degree than fathers who live apart from their children. Differences in fathers’ involvement with their children were also found by the father’s age, marital or cohabiting status, education, and Hispanic origin and race.

Source of Payment for the Delivery: Births in a 33-state and District of Columbia Reporting Area, 2010

January 17, 2014 Comments off

Source of Payment for the Delivery: Births in a 33-state and District of Columbia Reporting Area, 2010 (PDF)
Source: National Center for Health Statistics

Private insurance was the most frequent payment source for deliveries in the birth certificate-revised reporting area in 2010 (45.8% of births), followed closely by Medicaid (44.9%), ‘‘other’’ payment sources (5.0%), and self-pay (4.4%). Similarly, NHDS data show that private insurance was the most common payment source for deliveries nationally in 2010, followed by Medicaid. Privately insured deliveries declined over the last decade, while the use of Medicaid insurance increased. Medicaid insurance of deliveries was highest for births to teenagers and for non-Hispanic black and Hispanic mothers, according to the birth certificate data. Privately insured mothers were most likely of all payment groups to receive early prenatal care and to have cesarean deliveries.

Long-Term Care Services in the United States: 2013 Overview

December 16, 2013 Comments off

Long-Term Care Services in the United States: 2013 Overview (PDF)
Source: National Center for Health Statistics

Long-term care services include a broad range of services that meet the needs of frail older people and other adults with functional limitations. Long-Term care services provided by paid, regulated providers are a significant component of personal health care spending in the United States. This report presents descriptive results from the first wave of the National Study of Long-Term Care Providers (NSLTCP), which was conducted by the Centers for Disease Control and Prevention’s National Center for Health Statistics (NCHS). Data presented in this report are drawn from five sources: NCHS surveys of adult day services centers and residential care communities, and administrative records obtained from the Centers for Medicare & Medicaid Services on home health agencies, hospices, and nursing homes. This report provides information on the supply, organizational characteristics, staffing, and services offered by providers of long-term care services; and the demographic, health, and functional composition of users of these services. Service users include residents of nursing homes and residential care communities, patients of home health agencies and hospices, and participants of adult day services centers.

Dementia Special Care Units in Residential Care Communities: United States, 2010

December 2, 2013 Comments off

Dementia Special Care Units in Residential Care Communities: United States, 2010
Source: National Center for Health Statistics

Key findings

  • In 2010, 17% of residential care communities had dementia special care units.
  • Beds in dementia special care units accounted for 13% of all residential care beds.
  • Residential care communities with dementia special care units were more likely than those without to have more beds, be chain-affiliated, and be purposely built as a residential care community, and less likely to be certified or registered to participate in Medicaid.
  • Residential care communities with dementia special care units were more likely than those without to be located in the Northeast and in a metropolitan statistical area, and less likely to be in the West.

Self-report of Diabetes and Claims-based Identification of Diabetes Among Medicare Beneficiaries

November 19, 2013 Comments off

Self-report of Diabetes and Claims-based Identification of Diabetes Among Medicare Beneficiaries (PDF)
Source: National Center for Health Statistics

Objective— This report compares self-reported diabetes in the National Health Interview Survey (NHIS) with diabetes identified using the Medicare Chronic Condition (CC) Summary file.

Background— NHIS records have been linked with Medicare data from the Centers for Medicare & Medicaid Services. The CC Summary file, one of several linked files derived from Medicare claims data, contains indicators for chronic conditions based on an established algorithm.

Methods —This analysis was limited to 2005 NHIS participants aged 65 and over whose records were linked to 2005 Medicare data. Linked NHIS participants had at least 1 month of fee-for-service Medicare coverage in 2005. Concordance between self-reported diabetes and the CC Summary indicator for diabetes is compared and described by demographics, socioeconomic status, health status indicators, and geographic characteristics.

Results— Of the Medicare beneficiaries in the 2005 NHIS, 20.0% self- reported diabetes and 27.8% had an indicator for diabetes in the CC Summary file. Of those who self-reported diabetes in NHIS, the percentage with a CC Summary indicator for diabetes was high (93.1%). Of those with a CC Summary indicator for diabetes, the percentage self-reporting diabetes was comparatively lower (67.0%). Statistically significant differences by subgroup existed in the percentage concordance between the two sources. Of those with self-reported diabetes, the percentage with a CC Summary indicator differed by sex and age. Of those with a CC Summary indicator for diabetes, the percentage with self-reported diabetes differed by age, self-rated health, number of self-reported conditions, and geographic location.

Conclusions— Among Medicare beneficiaries who self-reported diabetes in NHIS, a high concordance was observed with identification of diabetes in the CC Summary file. However, among Medicare beneficiaries with an indicator for diabetes in the CC Summary file, concordance with self-reported diabetes in NHIS is comparatively lower. Differences exist by subgroup.

Hypertension Among Adults in the United States: National Health and Nutrition Examination Survey, 2011–2012

November 4, 2013 Comments off

Hypertension Among Adults in the United States: National Health and Nutrition Examination Survey, 2011–2012
Source: National Center for Health Statistics

Key findings
Data from the National Health and Nutrition Examination Survey, 2011–2012

  • The age-adjusted prevalence of hypertension among U.S. adults aged 18 and over was 29.1% in 2011–2012, similar to the prevalence in 2009–2010.
  • The prevalence of hypertension was similar for men and women at nearly one-third. The prevalence increased with age and was highest among older adults; it was also highest among non-Hispanic black adults, at approximately 42%.
  • Among adults with hypertension, nearly 83% were aware, nearly 76% were taking medication to lower their blood pressure, and nearly 52% were controlled. There was no change in awareness, treatment, and control from 2009–2010 to 2011–2012.
  • Controlled hypertension was similar across race and Hispanic origin groups, but the percentage controlled was higher for women and older adults.

Total and High-density Lipoprotein Cholesterol in Adults: National Health and Nutrition Examination Survey, 2011–2012

October 29, 2013 Comments off

Total and High-density Lipoprotein Cholesterol in Adults: National Health and Nutrition Examination Survey, 2011–2012
Source: National Center for Health Statistics

Key findings
Data from the National Health and Nutrition Examination Survey, 2011–2012

  • In 2011–2012, an estimated 12.9% of U.S. adults aged 20 and over (11.1% of men and 14.4% of women) had high total cholesterol, which is unchanged since 2009–2010.
  • Approximately 17% of adults (just over one-quarter of men and less than 10% of women) had low high-density lipoprotein (HDL) cholesterol during 2011–2012. The percentage of adults with low HDL cholesterol has decreased 20% since 2009–2010.
  • Nearly 70% of adults (67% of men and nearly 72% of women) had been screened for cholesterol, which is unchanged since 2009–2010.

Prevalence of Obesity Among Adults: United States, 2011–2012

October 18, 2013 Comments off

Prevalence of Obesity Among Adults: United States, 2011–2012
Source: National Center for Health Statistics

Key findings
Data from the National Health and Nutrition Examination Survey, 2011–2012

  • More than one-third (34.9%) of adults were obese in 2011–2012.
  • In 2011–2012, the prevalence of obesity was higher among middle-aged adults (39.5%) than among younger (30.3%) or older (35.4%) adults.
  • The overall prevalence of obesity did not differ between men and women in 2011–2012. Among non-Hispanic black adults, however, 56.6% of women were obese compared with 37.1% of men.
  • In 2011–2012, the prevalence of obesity was higher among non-Hispanic black (47.8%), Hispanic (42.5%), and non-Hispanic white (32.6%) adults than among non-Hispanic Asian adults (10.8%).
  • The prevalence of obesity among adults did not change between 2009–2010 and 2011–2012.

Physician Experience With Electronic Health Record Systems That Meet Meaningful Use Criteria: NAMCS Physician Workflow Survey, 2011

September 19, 2013 Comments off

Physician Experience With Electronic Health Record Systems That Meet Meaningful Use Criteria: NAMCS Physician Workflow Survey, 2011
Source: National Center for Health Statistics

Key findings
Data from the National Ambulatory Medical Care Survey’s (NAMCS) Physician Workflow Survey, 2011

  • About three-quarters of physicians with electronic health record (EHR) systems have systems that meet meaningful use criteria.
  • Physicians with EHR systems that meet meaningful use criteria were more likely to report that their system provides time savings than physicians with systems not meeting meaningful use criteria, but only in some areas.
  • Physicians with EHR systems that meet meaningful use criteria were more likely to report enhanced confidentiality and less disruption in their interactions with patients than physicians with systems not meeting meaningful use criteria.
  • Physicians with EHR systems that meet meaningful use criteria were no more likely to report financial benefits and selected clinical benefits than those with systems not meeting meaningful use criteria.

See also: Use of Electronic Health Records in Residential Care Communities

Births: Preliminary Data for 2012

September 6, 2013 Comments off

Births: Preliminary Data for 2012 (PDF)
Source: National Center for Health Statistics

The preliminary number of births for the United States in 2012 was 3,952,937, essentially unchanged (not statistically significant) from 2011; the general fertility rate was 63.0 births per 1,000 women age 15-44 years, down only slightly from 2011, after declining nearly 3 percent a year from 2007 through 2010. The number of births and fertility rate either declined or were unchanged for most race and Hispanic origin groups from 2011 to 2012; however, both the number of births and the fertility rate for Asian or Pacific Islander women rose in 2012 (7 percent and 4 percent, respectively). • The birth rate for teenagers 15-19 years was down 6 percent in 2012 (29.4 births per 1,000 teenagers 15-19 years), yet another historic low for the nation, with rates declining for younger and older teenagers and for nearly all race and Hispanic origin groups. • The birth rate for women in their early twenties also declined in 2012, to a new record low of 83.1 births per 1,000 women. • Birth rates for women in their thirties rose in 2012, as did the birth rate for women in their early forties. • The birth rate for women in their late forties was unchanged. • The nonmarital birth rate declined in 2012 (to 45.3 birth per 1,000 unmarried women aged 15-44), whereas the number of births to unmarried women rose 1 percent and the percentage of births to unmarried women was unchanged (at 40.7 percent). • The cesarean delivery rate for the United States was unchanged in 2012 at 32.8 percent. • The preterm birth rate fell for the sixth straight year in 2012 to 11.54 percent. • The low birthweight rate also declined in 2012, to 7.99 percent.

Prescription Sleep Aid Use Among Adults: United States, 2005–2010

September 4, 2013 Comments off

Prescription Sleep Aid Use Among Adults: United States, 2005–2010
Source: National Center for Health Statistics

Key findings
Data from the National Health and Nutrition Examination Survey, 2005–2010

  • About 4% of U.S. adults aged 20 and over used prescription sleep aids in the past month.
  • The percentage of adults using a prescription sleep aid increased with age and education. More adult women (5.0%) used prescription sleep aids than adult men (3.1%).
  • Non-Hispanic white adults were more likely to use sleep aids (4.7%) than non-Hispanic black (2.5%) and Mexican-American (2.0%) adults.
  • Prescription sleep aid use varied by sleep duration and was highest among adults who sleep less than 5 hours (6.0%) or sleep 9 or more hours (5.3%).
  • One in six adults with a diagnosed sleep disorder and one in eight adults with trouble sleeping reported using sleep aids.

Trends in Circumcision for Male Newborns in U.S. Hospitals: 1979–2010

August 23, 2013 Comments off

Trends in Circumcision for Male Newborns in U.S. Hospitals: 1979–2010
Source: National Center for Health Statistics

This report provides estimates of male newborn circumcisions performed during the birth hospitalization. Using data from the National Hospital Discharge Survey (NHDS), annual rates of newborn circumcision are presented for 1979–2010. National and regional rates are shown in both tabular and graphical form, and trends across the 32-year period are discussed. Note that these estimates do not include circumcisions performed outside the hospital setting (e.g., ritual circumcisions) or those performed at any age following discharge from the birth hospitalization. Thus, these rates cannot be used as prevalence estimates for all male circumcisions in the United States.

National trends

Across the 32-year period from 1979 through 2010, the national rate of newborn circumcision declined 10% overall, from 64.5% to 58.3% (Table and Figure 1). During this time, the overall percentage of newborns circumcised during their birth hospitalization was highest in 1981 at 64.9%, and lowest in 2007 at 55.4%.

However, rates fluctuated during this period, generally declining during the 1980s, rising in the 1990s, and declining again in the early years of the 21st century. These changes occurred during a period of changing guidance on routine newborn circumcision. For example, American Academy of Pediatrics’ (AAP) task force reports during the 1970s (1,2) stated there was no medical indication for routine circumcision of the newborn; AAP revised its position in 1989 (3), stating there were potential medical benefits to newborn circumcision; and then in 1999 (4), an AAP policy statement said that, despite potential medical benefits of newborn male circumcision, there was insufficient evidence to recommend routine circumcision of newborns.

Regional trends
Newborn circumcision rates for the four U.S. census regions showed distinctly different patterns (Table and Figure 2). For newborns in the Northeast, the overall trend was flat across the 32 years, and no discernible patterns were evident, although annual rates varied between 60.7% (in 2007) and 69.6% (in 1994). In the Midwest, fluctuations in newborn circumcision rates generally mirrored trends in the national rate: declining until the mid-1980s, increasing until 1998, and then declining again through 2010. Rates ranged between 82.9% in 1998 and 68.8% in 2009. In the South, rates of newborn circumcision generally increased from 1979 until 1998, after which they declined. These rates ranged between 53.8% (in 1988) and 66.1% (in 1995). In marked contrast was the trend for the West. Over the 32-year period, the percentage of newborns receiving circumcision at birth decreased 37%, from 63.9% in 1979 to 40.2% in 2010. Most of this decrease occurred in the 1980s, with the rate dropping to 41.0% in 1989. Rates continued to decrease through 2010, with a low of 31.4% in 2003.

Total Body Bone Area, Bone Mineral Content, and Bone Mineral Density for Individuals Aged 8 Years and Over: United States, 1999–2006

August 20, 2013 Comments off

Total Body Bone Area, Bone Mineral Content, and Bone Mineral Density for Individuals Aged 8 Years and Over: United States, 1999–2006 (PDF)
Source: National Center for Health Statistics

Objectives
This report presents bone measurement data from total body dual energy x-ray absorptiometry scans for 28,454 persons aged 8 years and over who participated in the 1999–2006 National Health and Nutrition Examination Survey. The sample consisted of 22,667 respondents with valid data, and 5,787 with missing data that were successfully multiply imputed (i.e., not highly variable). Bone area, bone mineral content, and bone mineral density (BMD) are presented for the total body, the total body minus the head (e.g., subtotal), and 10 subregions of the body.

Methods
Means, standard deviations, and selected percentiles were calculated for the total body, total body minus head (subtotal), and 10 body subregions by sex, race and ethnicity, and age. Smoothed mean total body BMD was plotted by age, sex, and race and ethnicity. Multiple regression was used to evaluate differences in mean total body BMD by age, sex, and race and ethnicity

Results
After adjusting for race and ethnicity, total body BMD among those under age 20 was significantly higher in respondents aged 12–19 than in those aged 8–11 in both sexes.Among adults of both sexes, total body BMD in persons aged 20–49 was significantly higher than in those aged 50–79, and significantly lower in persons aged 80 and over than in those aged 50–79, after adjusting for race and ethnicity.After adjusting for age, total body BMD was significantly higher in non-Hispanic black persons than in non-Hispanic white persons, regardless of age or sex. However, the pattern differed by age when Mexican-American persons were compared with non-Hispanic white persons:Age-adjusted total body BMD was significantly lower among MexicanAmerican males aged 8–19, was similar in Mexican-American females aged 8–19, and was significantly lower in MexicanAmerican men and women aged 20 and over.

Infertility and Impaired Fecundity in the United States, 1982–2010: Data From the National Survey of Family Growth

August 14, 2013 Comments off

Infertility and Impaired Fecundity in the United States, 1982–2010: Data From the National Survey of Family Growth (PDF)
Source: National Center for Health Statistics

Objectives
This report presents nationally representative estimates and trends for infertility and impaired fecundity—two measures of fertility problems—among women aged 15–44 in the United States. Data are also presented on a measure of infertility among men aged 15–44.

Methods
Data for this report come primarily from the 2006–2010 National Survey of Family Growth (NSFG), which consisted of 22,682 interviews with men and women aged 15–44, conducted from June 2006 through June 2010. The response rate for women in the 2006–2010 NSFG was 78%, and for men was 75%. Selected trends are shown based on prior NSFG years.

Results
The percentage of married women aged 15–44 who were infertile fell from 8.5% in 1982 (2.4 million women) to 6.0% (1.5 million) in 2006–2010. Impaired fecundity among married women aged 15–44 increased from 11% in 1982 to 15% in 2002, but decreased to 12% in 2006–2010. Among all women, 11% had impaired fecundity in 2006–2010. Both infertility and impaired fecundity remain closely associated with age for nulliparous women. Among married, nulliparous women aged 35–44, the percentage infertile declined from 44% in 1982 to 27% in 2006–2010, reflecting greater delays in childbearing over this period. Among married women in 2006–2010, non-Hispanic black women were more likely to be infertile than non-Hispanic white women. Some form of infertility (either subfertility or nonsurgical sterility) was reported by 9.4% of men aged 15–44 and 12% of men aged 25–44 in 2006–2010, similar to levels seen in 2002.

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