Below is the uncorrected machine-read text of this chapter, intended to provide our own search engines and external engines with highly rich, chapter-representative searchable text of each book. Because it is UNCORRECTED material, please consider the following text as a useful but insufficient proxy for the authoritative book pages.
Appendix C Descriptions of Data Bases Mentioned in the Panel's Recommendations The material in this appendix was derived from the Inventory of Data Sets Related to the Health of the Elderly, which was prepared as background for the pane} and published in Senate Hearings on Statistical Policy for an Aging America (U.S. Congress, Senate 1986~. More detailed information can be found in the inventory. The data base descriptions in the inventory were prepared by agency personnel responsible for the data bases. The data bases and the pages where their descriptions can be found are shown below: Continuous Work History Sample (CWHS) County and City Data Book (CCDB) Decennial Census of Population and Housing Estate/Personal Wealth File Linked Medicare Use NCHS Mortality Statistics File Longitudinal Study of Aging (I.SOA) Master Provider of Services File Medicaid Tape-to-Tape Project Medicare Annual Summary: Person Summary File Medicare Enrollment File 289 290 290 291 292 292 293 293 294 295 Medicare History Sample 1974 and Later 295 Medicare Part B (SMI) 5-Percent Sample Bill Summary Record 296 Medicare Reimbursement by State and County 296 National Ambulatory Medical Care Survey (NAMCS) 297 National Data Base on Aging National Death Index (NDI) National Health Interview Survey (NHIS): Core Questionnaire 287 297 298 299
288 AGING POPULATION IN THE TWENTY-FIRST CENTURY National Health Interview Survey (NHIS): Supplements National Health Interview Survey (NHIS): Supplement on Aging (SOA), 1984 National Health and Nutrition Examination Survey (NHANES I) NHANES ~ Epidern~ologic Follow-up Study: Initial Follow-up, 1982-84 National Master Facility Inventory (NMFI) National Medical Care Expenditures Survey (NMCES), 1977-78, and National Medical Expenditure Survey (NMES, planned for 1987) National Medical Care Utilization and Expenditure Survey (NMCUES), 1980 National Mortality Statistics File National Nursing Home Survey (NNHS) Statistics of Income: Individual Income Tax Returns Survey of Income and Program Participation (SIPP) Yearly Continuous Disability History Sample (CDHS) REFERENCE 300 300 301 302 303 304 305 307 307 309 309 312 U.S. Congress, Senate 1986 Statistical Policy for an Aging Society. Joint Hearing of the Subcommittee on Energy, Nuclear Proliferation, and Government Processes and the Subcommittee on Aging, Committee on Governmental Affairs. 99th Congress, 2nd Session. Washington, D.C.
DESCRIPTIONS OF DATA BASES TITLE: 289 Continuous Work History Sample (CWHS) Social Security Administration (SSA), Department of Health and Human Services (DHHS) YEARS OF DATA COLLECTION: Detailed annual earnings data are currently available for the period 1951-82. Some 1983 data should be available in late 1985. Files are updated annually with a 1- or 2-year lag for accounting and computer processes. PURPOSE: The CWHS evolved at SSA as the best way of collect- ing demographic, earnings, employment, and benefit datafor use in program research. The files are also used in actuarial activities, the ~ustee's Report, and Trust Fund transfers. DESIGN: The CWHS is a sample data set of administrative records, not a survey. The universe of the data set is all issued social security numbers (SSNs). The CWHS extracts data based on the serial digits of the SSN, usually at a Leo level. The CWHS currently consists of approximately 2.9 million SSNs. The data set is longitudinal in several of its data files. Annual earnings data are available starting in 1951. CONTENT: The information collected is basically that which SSA needs to administer its retirement program. Data are collected! from the: . 1040 SS-5 W-2(W-3) SS-4 Schedule C Year of birth Wages Coded Standard Self-employed Race Type of Industrial Class (FICA only) Sex employment State, county Place of birth of employer The data are supplemented from various SSA claims forms. Earn- ~ngs and claims data are collected annually.
290 AGING POPULATION IN THE TWENTY-FIRST CENTURY TITLE: County and City Data Book (CCDB) SPONSOR: Bureau of Census YEARS OF DATA COLLECTION: Publication produced roughly every 5 years, though data are collected and processed continuously. CCDB 1983 is the most current edition; next edition is projected for 1987. PURPOSE: To provide statistical information for states, counties, and cities on subjects such as population, vital statistics, housing, and income. DESIGN: Data are for geographic units in the United States, com- piled from a number of sources. CONTENT: Continuous collection of county- and city-level data. Information is processed as various data series are produced. There- fore some data are annual, some periodic, and some once in a decade. PUBLIC-USE DATA TAPES: County and City Data Book 1983 (most recent), CO-STAT 1 (County Statistics 1), County and City Data Book floppy disks. TITLE: Decennial Census of Population and Housing SPONSOR: Bureau of the Census YEARS OF DATA COLLECTION: Every 10 years since 1790; the twentieth census was conducted as of April 1, 1980. PURPOSE: The Constitution mandates that a census be taken every 10 years to provide a basis for reapportioning seats in the House of Representatives. DESIGN: In the 1980 census, each household in the country re- ceived one of two versions of the census questionnaire: a short form containing a limited number of basic population and housing ques- tions or a long form containing these questions as well as a number of additional questions. Two sampling rates were used for the Tong form. For most of the country, one in every six households (about 17 percent) received the long form or sample questionnaire; in counties, incorporated places and functioning minor civil divisions estimated
DESCRIPTIONS OF DATA BASES 291 to have fewer than 2,500 inhabitants, every other household (50 per- cent) received the sample questionnaire to enhance the reliability of sample data in small areas. CONTENT: The information collected describes the basic demo- graphic and housing characteristics of the population. There are some comparability problems between censuses because of changes in definitions and procedures. A section on comparability is included in most reports. PUBLIC-USE DATA TAPES: Available for a sample for 1940, 1950, and 1960. Basic record tapes available for 1970 and 1980 censuses. TITLE: Estate/Personal Wealth File SPONSOR: Internal Revenue Service (IRS) YEARS OF DATA COLLECTION: Micro data files have been completed for estate tax returns filed in 1963, 1966, 1970, 1973, 1977, and for 1982 through 1984. Currently, the study is conducted annually. Data on personal wealth were published most recently in the winter 198~1985 Bulletin; more complete data will be released in winter 1986-1987. PURPOSE: Collection of data from federal estate tax returns for the purpose of tax administration and for use in the production of personal wealth estimates. DESIGN: Sample of estate tax returns filed each year. Sample size varies from year to year. Sample based on year of death, age at death, and size of gross estate. CONTENT: Identifying information, demographic information, as- set amounts, liabilities, deductions, net worth, estate tax computa- tion. Periodically, information on beneficiaries and amounts of bequests are collected. PUBLIC-USE DATA TAPES: Can be purchased for the years 1973, 1977,1982,1983, and 1984.
292 TITLE: AGING POPULATION IN THE TWENTY-FIRST CENTURY [inked Medicare Use NCHS Mortality Statistics File SPONSOR: Health Care Financing Administration (HCFA), De- partment of Health and Human Service (DHHS) YEARS OF DATA COLLECTION: 1979. PURPOSE: To study the relation of use of Medicare-covered ser- vices to cause of death. DESIGN: The Medicare utilization and enrollment information in the Continuous Medicare History Sample was linked to the mortality statistics file of the National Center for Health Statistics for a No random sample of Medicare enrollees who died in 1979. Of the 70,000 decedents, records were linked for Ado. CONTENT: Use and cost of Medicare-covered benefits (hospital, physician, home health, skilled nursing facility, hospital outpatient) linked to death certificate data including cause of death. D etaiT container] in descriptions of Continuous Medicare History File and Mortality Statistics file. Longitudinal Study of Aging (ISOA) SPONSOR: National Center for Health Statistics (NCHS), De- partment of Health and Human Services (DHHS) YEARS OF DATA COLLECTION: Baseline survey, 1984. First reinterview, 1986. Record linkage biannually. PURPOSE: Study changes in functional status. Develop transi- tional probability models. Study relationship between social and health factors and death. DESIGN: The Longitudinal Study on Aging is a prospective study based on respondents to the Supplement on Aging, a special set of questions added to the National Health Interview Survey in 1984. Thus the base is a national probability sample of people age 55 and older living in the community. All respondents will be followed by linkage with death records through the National Death Index.
DESCRIPTIONS OF DAT,4 BASES 293 Respondents age 65 and older will be followed by linkage with Medi- care records. Respondents age 70 and older will be reinterviewed by telephone. CONTENT: Interview will focus on changes in functioning, care giving, and living arrangements. TITLE: Master Provider of Services File Health Care Financing Administration (HCFA), De- partment of Health and Human Services (DHHS) YEARS OF DATA COLLECTION: Reflects the Medicare recerti- fication cycic from one to three years depending on type of institu- tion. Updated daily on a flow basis. PURPOSE: To automate the provider certification activity. DESIGN: All Medicare and Medicaid participating institutional providers. CONTENT: Provider characteristics: Name and address Medicare provider number Staff size Bed size Services authorized Accreditation . County, Metropolitan Statistical Area codes The file is produced from the Medicare/Medicaid Automated Certi- fication System (MMACS). Medicaid Tape-To-Tape Project Health Care Financing Administration (HCFA), De- partment of Health and Human Services (DHHS) YEARS OF DATA COLLECTION: 1980-1982 data from the five participating states have been collected and uniform files completed.
294 AGING POPULATION IN THE TWENTY-FIRST CENTURY 1983-1984 data from participating states are being collected at this time. PURPOSE: This project was initiated to expand the agency's abil- ity to collect data to analyze the Medicaid program. DESIGN: The main data base consists of 100~o data from five participating states (California, Georgia, Michigan, New York, and Tennessee) in uniform codes and formats. States send their Medicaid Management Information System (MMIS) tapes, which are edited into a comparable format for analysis. CONTENT: Uniform files are produced for each participating state and year. Separate files are maintained for enrollment, claims, and provider data. Claims, provider, and reimbursements can be linked to the Medicaid enrollee who received the service, and to the provider who furnished it. TITLE: Medicare Annual Summary: Person Summary File SPONSOR: Health Care Financing Administration (HCFA), De- partment of Health and Human Services (DHHS) PURPOSE: The summary file is used to produce statistical reports by age, sex, race, and state of residence, showing number of persons receiving reimbursed Medicare services and amounts reimbursed by type of service. DESIGN: No sample of aged Medicare population based on Social Security number. 25~o sample of disabled Medicare population based on Social Security number. CONTENT: The file is based on bills for the sample population. It shows utilization, charges, and reimbursements by type of service for each person using reimbursed services.
DESCRIPTIONS OF DATA BASES TITLE: 295 Medicare Enrollment File Health Care Financing Administration (HCFA), De- partment of Health and Human Services (DHHS) YEARS OF DATA COLLECTION: Continuous file beginning with inception of Medicare program, July 1, 1966. PURPOSE: To maintain information on the demographic and en- titlement status of Medicare enrollees, used in the administration of the Medicare program. DESIGN: All Medicare enrollees. CONTENT: State and county of residence of Medicare enrollees and type of enrollment (i.e., Part A and/or Part B). Date of birth, sex, race. Medicare History Sample 1974 and Later SPONSOR: Health Care Financing Administration (HCFA), De- partment of Health and Human Services (DHHS) YEARS OF DATA COLLECTION: The file is updated annually. At present the years 1974-1981 are completed. PURPOSE: The Medicare History Sample was developed to pro- vide a longitudinal person-based data file for statistical research. DESIGN: The Medicare History File is a 5°~70 sample of all Medicare utilization records based on terminal digits of the Medicare claim number. It is a longitudinal file by person that is updated periodically to include records filed late and to maintain currency by year of medical service. CONTENT: The file contains demographic data, eligibility data, and Medicare utilization information for a 5$to sample of beneficiaries. Records for each stay in hospital or in an extended care facility are added once each year. Summary records for the year are created from physican payment records, home health bills, and outpatient bills and included annually. The utilization data include charge amounts, type of service, dates of service, and diagnoses.
296 AGING POPULATION IN THE TWENTY-FIRST CENTURY TITLE: Medicare Part B (SMI) 5-Percent Sample BiB Sn~n mary Record SPONSOR: Health Care Financing Administration (HCFA), De partment of Health and Human Services (DHHS) YEARS OF DATA COLLECTION: 1976-83 tapes completed, an- alytic studies ongoing. 1984 ongoing; budgeted and planned. PURPOSE: To obtain timely data on the amount, type, place, and cost of health care services used under the Supplementary Medical Insurance (SM! Part B) Program. DESIGN: A No sample of SM! bills is selected based on the ben- eficiary's health insurance claim number. It is linked to the Health Insurance Master File for additional beneficiary and provider infor- mation. CONTENT: Provides information identifying the beneficiary, the physician/supplier, total charges, and reimbursements, as well as data on type and place of service. Medicare Reimbursement by State and County SPONSOR: Health Care Financing Administration (HCFA), De- partment of Health and Human Services (DHHS) YEARS OF DATA COLLECTION: Annually since July 1, 1966. PURPOSE: To measure utilization of Medicare services. DESIGN: All bills reimbursed under the Medicare program are allocated to residence of the beneficiary annually. CONTENT: The file shows reimbursement for residents of each state and county enrolled in the Medicare program, as a grand total and separately for the Hospital Insurance Program (HI) and the Supplementary Medical Insurance Program (SMI).
DESCRIPTIONS OF DATA BASES National Ambulatory Medical Care Survey (NAMCS) SPONSOR: National Center for Health Statistics (NCHS), De- partment of Health and Human Services (DHHS) 297 ..~. . YEARS OF DATA COLLECTION: Data collected annually from 1973 through 1981. Repeated in 1985 and scheduled on a triennial basis thereafter. 1985 data will be released in fall 1986. PURPOSE: To provide general purpose statistics describing the public's use of office-based physician services, the health problems presented to physicians by ambulatory patients, and the diagnostic and therapeutic services received. DESIGN: Universe: all patient visits to office-based physicians in contiguous United States. Multistage sample design including 3,000 to 5,000 physicians in about 80 geographic areas. Probability sample, response of approximately 75~o. Sample size 3,000 physicians, 50,000 patient visits through 1981. Sample size in 1985: 5,000 physicians, 75,000 visits. CONTENT: Information includes patient age, sex, race, ethnicity, and reason for visit; physician's diagnostic and therapeutic services ordered or provided; diagnosis and disposition decision and drugs prescribed. Variations from year to year are slight. PUBLIC-USE DATA TAPES: For all years in which survey has been completed. TITLE: National Data Base on Aging Administration on Aging (AoA), Department of Health and Human Services (DHHS) YEARS OF DATA COLLECTION: Annually since 1981. PURPOSE: The National Data Base on Aging is a voluntary an- nual survey that collects information at the national level about the network of state and area agency on aging programs. DESIGN: Initial questionnaires were mailed to all 57 state units and 666 area agencies in September 1981. State units are surveyed
298 AGING POPULATION IN THE TWENTY-FIRST CENTURY annually. Updates for area agencies are made from a systematic 1/3 sample in each subsequent year, with a 65~o response rate in 1984. CONTENT: The data collection included questions on the staffing of the agencies, the types of funding used, and the characteristics of service providers, services provided, and service recipients. PUBLIC-USE DATA TAPES: Accessed through the National Data Base on Aging. TITLE: National Death Index (NDI) SPONSOR: National Center for Health Statistics (NCHS), De- partment of Health and Human Services (DHHS) YEARS OF DATA COLLECTION: The NDI file contains 10.3 million death records for 1979-1983. Deaths are added to the file annually, approximately 12-14 months after the end of a calendar year. About 2 million records are added each year. PURPOSE: The National Death Index (NDI) is a computerized central file of death record information. It is compiled from magnetic tapes submitted to the National Center for Health Statistics (NCHS) by the state vital statistics offices. These tapes contain a standard set of identifying information for each decedent, beginning with deaths occurring in 1979. Investigators conducting prospective and retrospective studies can use the NDI to determine whether persons in their studies may have died, and if so, be provided with the names of the states in which those deaths occurred, the dates of death, and the corresponding death certificate numbers. The NDI user can then arrange with the appropriate state offices to obtain copies of death certificates or specific statistical information such as cause of death. DESIGN: The NDI file contains identifying death record informa- tion for virtually all deaths in the United States, Puerto Rico, and the Virgin Islands. CONTENT: The identifying information on the ND! file is provided to NCHS on magnetic tapes submitted by the state vital statistics offices via contractual agreements. The items of information are: state of death, death certificate number, date of death, first and last
DESCRIPTIONS OF DATA BASES 299 name, middle initial, father's surname, social security number, date of birth, race, sex, marital status, state of residence, state of birth, age at death. TITLE: National Health Interview Surrey (NHIS): Core Questio:nna~re SPONSOR: National Center for Health Statistics (NCHS), De- partment of Health and Human Services (DHHS) YEARS OF DATA COLLECTION: Annually since 1957. PURPOSE: To provide data on the incidence of acute conditions, limitation of activity, persons injured, hospitalizations, disability days, dental visits, physician visits, and the prevalence of selected chronic conditions. DESIGN: The NHIS is a continuing, nationwide, household in- terview survey. A probability sample of households in the civilian noninstitutionalized population of the United States is interviewed each week by interviewers from the Bureau of the Census. The sam- ple consists of about 50,000 households representing about 130,000 persons. The NHIS "core" is not longitudinal and historically has not been linked to other files. An NHIS/National Death Index linkage capability was made possible after the 1984 NHIS survey year. In the future, beginning at the conclusion of the 1987 NHIS survey year, linkage capabilities will also exist between the NHIS, the National Medical Care Expenditure Survey, and the National Family Growth Survey. CONTENT: The NHIS provides current information on the amount, distribution, and effects of illness and disability in the United States, and the services rendered for or because of such con- ditions. The NHIS ~core" has been virtually unchanged from year to year. PUBLIC-USE DATA TAPES: Available through 1982.
300 TITLE: AGING POPULATION IN THE TWENTY-FIRST CENTURY National Health Interview Surrey (NHIS): Supple- ments SPONSOR: National Center for Health Statistics (NCHS), De- partment of Health and Human Services (DHHS) YEARS OF DATA COLLECTION: See Content. PURPOSE: To provide data, in addition to the basic NHIS data, on special topic areas pertinent to the aging population, such as living arrangements, activities of daily living (ADL), instrumental activities of daily living (IADL), retirement status, support systems, etc. DESIGN: The universe studied are those persons in the U.S. non- institutionaTized civilian population in the age categories of inter- est, as represented by persons in those age categories in the NHIS probability sample of households. CONTENT: Supplements to the NHIS have been conducted annu- ally for the past 20 years. Topics of coverage in the supplement vary from year to year and may or may not apply to the aging population. Among those that include or are designed specifically for an aging population are: Arthritis 1969, 1976. Residential mobility 1979, 1980. Hearing aid 1971, 1977, 1979. Visual and hearing impairment 1971, 1977, 1984. Edentulousness 1971. Home care-1979, 1980. Supplement on aging 1984. TITLE: 7 National Health Interview Survey (THIS): Supple- ment on Aging (SOA), 1984 National Center for Health Statistics (NCHS), De- partment of Health and Human Services (DHHS) YEARS OF DATA COLLECTION: 1984. PURPOSE: The National Health Interview Survey (NHIS) is a
DESCRIPTIONS OF DATA BASES 301 multipurpose national survey that is the principal source of infor- mation on the health of the civilian, noninstitutionaTized population of the United States. It provides current statistical information on the amount, distribution, and effects of illness and disabilities in the United States and the services rendered for or because of such conditions. The Supplement on Aging (SOA) provides data on func- tional limitations and the health and social care received by the elderly, noninstitutionalized population, to complement the National Nursing Home Survey. DESIGN: Persons ages 55 years and older in the 1984 NHIS house- hold sample, which has a response rate of Who, were selected for the SOA sample: 50~o of NHIS respondents ages 55-64 and 100~o of persons ages 65 and older were included. Response rate to the SOA was also Who. CONTENT: Health status, functional ability, health and commu- nity service utilization, employment status, social activities, family relationships and social support, housing characteristics and living arrangements, and existence of health conditions specific to the el- derly population. The information in the supplement for each person can be associated with the basic health and condition information in the NHIS core questionnaire. PUBLIC-USE DATA TAPES: Expected to be available in 1986. National Health and Nutrition I:x~mination Survey (NHANES I) SPONSOR: National Center for Health Statistics (NCHS), De- partment of Health and Human Services (DHHS) YEARS OF DATA COLLECTION: 1971 to 1975. NHANES IT was conducted from 1976 to 1980. NHANES Ill planned to start 1988. PURPOSE: Established under the National Health Survey Act of 1956 to obtain those kinds of health data optimally obtained by direct physical examinations and physiological and biochemical mea- surements. Measures and monitors health and nutritional status of the U.S. population. Permits estimation of the prevalence of certain diseases and the distributions of a broad variety of health-related measurements.
302 AGING POPULATION IN THE TWENTY-FIRST CENTURY DESIGN: Probability sample of the U.S. civilian noninstitutional- ized population ages 1 through 74 years. Cross-sectional study of 31,973 persons of whom 23,808 were examined. Composed of two overlapping sets of examination components referred to as the nutri- tion examination and the detailed medical examination. Six distinct probability samples were contained within the overall survey. This study was used as the baseline for a later study called the NHANES Epidemiologic Follow-up Survey. CONTENT: Demographic information; medical histories; dietary information; electrocardiograms; body measurements; dermatolog- ical and ophthalmological examinations; general medical examina- tion; hematological, blood chemistry, and urological laboratory de- terminations. In the detailed medical examination, additional data were collected on a subsample of adults 25-74 years by supplemen- tary questionnaires concerning arthritis, respiratory conditions, and cardiovascular conditions; an extended medical examination, x-rays of the chest for heart size and pathology as well as lung volume and pathology; x-rays of the hip, sacroiliac, and knee joints for as- sessment of arthritic and related changes; spirometry and additional laboratory determinations. PUBLIC-USE DATA TAPES: Data tapes are available on virtually ah the information collected in NHANES I. Data collected in the HANES surveys can be located by means of HINDEX, available in hard copy or on a floppy diskette. HINDEX has been released in three volumes: one indexes the data items in alphabetical sort by data category; the second is an alphabetical sort by data field; and the third, a numerical sort by tape and position field. TITLE: NHANES I Epidemiologic Follow-up Study: Ihitial Follow-up, 1982-84 SPONSORS: National Center for Health Statistics (NCHS) with National Institute on Aging and other Institutes YEARS OF DATA COLLECTIONS: The NHANES ~ Epidem~o- logic Follow-up Study: initial follow-up 1982-84; continued follow-up of the elderly 1985-86; continued follow-up of total sample 1986-87; data tapes will be available in 1990.
DESCRIPTIONS OF DATA BASES 303 PURPOSE: Identify chronic disease risk factors associated with mor- bidity and mortality; ascertain changes in risk factors, morbidity, functional limitation and institutionalization between NHANES and the follow-up recontacts; and map the natural history of chronic diseases and functional impairments in an aging population. DESIGN: The baseline survey, the first National Health and Nutri- tion Examination Survey (NHANES) conducted by NCHS from 1971 to 1975 was a probability sample of the civilian noninstitutionalized coterminous U.S. population ages 1-74 years. The population of the follow-up study includes the 14,407 persons who were ages 25-74 at the time they were examined in the original NHANES ~ Survey. CONTENT: Demographic characteristics, labor force participa- tion, income, acute and chronic conditions, activity limitations, im- pairments, cognitive impairment, usual activity, changes in morbidity and self-perceived health, activities of daily living, inpatient health care utilization (hospital, nursing home, etc.~. PUBLIC-USE DATA TAPES: Initial follow-up: tapes available in 1987. Continue follow-up of elderly: tapes available in 1989. Continued follow-up of total sample: tapes available in 1990. TITLE: National Master Facility Inventory (NMFI) SPONSOR: National Center for Health Statistics (NCHS), De- partment of Health and Human Services (DHHS) YEARS OF DATA COLLECTION: Data were collected for the fol- lowing years: 1963, 1967,1969, 1971, 1973, 1976, 1978, 1980, 1982. The first report on data from the 1982 survey was published in September 1985; the second will be published during 1986. Because an evaluation of the NMFT program is under way, the inventory will not be conducted before 1988. PURPOSE: The NMFT has two basic purposes. It is an important national source of statistics on the number, type, and geographic distribution of inpatient facilities in the United States. In addition, it serves as the universe from which probability samples are selected for conducting sample surveys. DESIGN: The NMFT is a comprehensive file of all facilities in the United States with three or more beds that provide medical, nursing,
304 AGING POPULATION IN THE TWENTY-FIRST CENTURY personal, or custodial care to groups of unrelated persons on an inpatient basis. Facilities are categorized into three broad types: hospitals, nursing and related care homes, and other custodial or remedial care facilities. CONTENT: Basically, the types of data collected for the three cat- egories of facilities are: ownership; major type of service; number of beds; patient census; number of admissions, discharges, and deaths; and information about staffing, revenue, and expenses. PUBLIC-USE DATA TAPES: For all years. TITLE: National Medical Care Expenditures Survey (NMCES), 1977-78, and National Medical E~en- diture Survey (NMES, planned for 1987) SPONSORS: National Center for Health Services Research and Health Care Technology Assessment (NCHSR) and National Center for Health Statistics (NCHS) (NMCES only), Health Care Financing Adminis- tration(HCFA) (NMES only), Department of Health and Human Services (DHHS) YEARS OF DATA COLLECTION: NMCES consists of six rounds of data collection covering an 18-month period between 1977 and part of 1978. A 1987 National Medical Expenditure Survey (NMES) is planned jointly with NCHSR and the Health Care Financing Admin- istration. The household sample is expected to have about 14,000 households including oversamples of blacks, Hispanics, low-income people and people with functional limitations. The Institutional Population Component sample will include about 13,000 clients of nursing and personal care homes, psychiatric hospitals, and facilities for the mentally retarded. PURPOSE: The National Medical Care Expenditures Survey was designed to provide a comprehensive statistical picture of how health services are used and paid for in the United States. DESIGN: NMCES is a one-time panel sample that interviewed about 40,000 persons in 14,000 randomly selected households in the civilian, noninstitutionaTized population. The sample design is a stratified, multistage, area probability sample that allows for the
DESCRIPTIONS OF DATA BASES 305 determination of approximately unbiased estimates of health param- eters at the national level. Respondents were interviewed six times over an 18-month period during 1977 and 1978. The survey was complemented by additional surveys of physicians and health care facilities providing care to household members during 1977 and of employers and insurance companies responsible for their insurance coverage. The principal NMCES response rate was Who, defined as the proportion of eligible first-round reporting units that responded to all rounds of interviewing. CONTENT: Data collected includes but is not limited to: expen- ditures and sources of payment for all major forms of medical care; sociodemographic and economic characteristics of respondents; in- surance coverage of respondents; information from medical providers about respondents; and access to medical care. PUBLIC-USE DATA TAPES: NMCES available for person-based information and on events of medical care. Additional public-use files on insurance coverage, employer characteristics, and episodes of illness will be available in the future. TITLE: National Medical Care Utilization and Expenditure Survey (NMCUES), 1980 SPONSORS: National Center for Health Statistics (NCHS) and Health Care Financing Administration (HCFA) YEARS OF DATA COLLECTION: 1980. PURPOSE: NMCUES is designed to be directly responsive to the continuing need for statistical information on the health care expen- ditures associated with health services utilization for the entire U.S. population. Cycle 1 was designed and conducted in collaboration with the Health Care Financing Administration to provide detailed utilization and expenditure data for persons in the Medicare and Medicaid populations. NMCUES will produce estimates over time for evaluation of the impact of legislation and programs on health status, costs, utilization and illness-related behavior in the medical care delivery system. Cycle 1 was composed of several related surveys. The household
306 AGING POPULATION IN THE TWENTY-FIRST CENTURY portion of the survey consisted of a national survey of the civil- ian noninstitutionalized population and a separate survey of the Medicaid-eligible populations of the states of New York, California, Texas, and Michigan. These two surveys each consisted of five in- terviews over a period of about 15 months to obtain information on medical care utilization, expenditures, and other health-related information. A third survey, an administrative records survey, was designed to verify the eligibility status of the household survey re- spondents for the Medicare and Medicaid programs. It also checked insurance claims filed with the national Medicare program and Med- icaid programs in each of the four states for persons in the sample of Medicaid eligibles. DESIGN: The national Cycle 1 household survey comprised per- sons residing in about 6,000 households. The sample for this sur- vey was a multistage area probability sample drawn from 106 pri- mary sampling units representing the 50 states and the District of Columbia. The state Medicaid household survey sample consisted of about 1,000 families in each of the four states; these families were se- lected with a known probability of selection from the state Medicaid enrollment lists. Thus, the total sample for the survey was about 10,000 households. An overall response rate of 89.4% was achieved in the first interview for both household surveys in Cycle 1: for the national survey the response rate was 91.4%, and for the state Medicaid survey the rate was 86.7%. Attrition over the course of interviewing resulted in final response rates of 84.9~o for the national household survey and 76.1~o for the state Medicaid household survey. CONTENT: Questionnaires for the household surveys were de- signed to obtain some information on a repeated basis throughout the survey and some information only one time. The repetitive core of questions for Cycle 1 included health insurance coverage, episodes of illness, the number of bed days, restricted activity days, hospital admissions, physician and dental visits, other medical care encoun- ters, and purchases of prescribed medicines. For each contact with the medical care system, data were obtained on the nature of the health conditions, characteristics of the provider, services provided, charges, sources, and amounts of payment. Questions asked only once included data on access to medical care services, limitation of activities, occupation, income, and other sociodemographic charac- teristics.
DESCRIPTIONS OF DATA BASES PUBLIC-USE DATA TAPES: Available. 307 TITLE: National Mortality Statistics File SPONSOR: National Center for Health Statistics (NCHS), De- partment of Health and Human Services (DHHS) YEARS OF DATA COLLECTION: Data are collected annually. Data through 1983 are available and will be published in annual volumes of Vital Statistics of the United States, Vol. Il. "Mortality," Parts A and B. Summary counts of deaths by age, race, sex, and cause are available on a current basis in Monthly Vital Statistics Report, as are provisional monthly counts of deaths by cause. PURPOSE:To produce uniform national, state, and local data on numbers of deaths, causes of death, and sociodemographic charac- teristics of decedents. DESIGN: Mortality data include all deaths (approximately 2 mil- lion) occurring annually within the United States reported to state vital registration offices. In 1972, a 50~o sample of mortality data was used; generally, however, 100~o of deaths are included. Data are collected annually. Data are available for the entire U.S. annually since 1933 and for selected states since 1900. CONTENT: Demographic and medical information is coded from information reported on the death certificate including residence, age, race, sex, underlying cause of death, and multiple causes of death. PUBLIC-USE DATA TAPES: Available for data years 1963-83. TITLE: National Nursing Home Survey (NIGHS) SPONSOR: National Center for Health Statistics (NCHS), De- partment of Health and Human Services (DHHS) YEARS OF DATA COLLECTION: 1973-74, 1977, 1985, and pro- posed for 1990. PURPOSE: To collect data on nursing homes, their services, staffs,
308 AGING POPULATION IN THE TWENTY-FIRST CENTURY and financial characteristics, and on personal and health character- istics of residents and discharges. DESIGN: Data are collected from a sample of all nursing homes in the coterm~nous United States (1,200 nursing homes listed in the Master Facility Inventory). Samples in each nursing home are se- lected of current residents, persons discharged (deceased or alive in the last year), and staff members. Data on residents and discharges are collected by interviewing the nurse who obtains the needed infor- mation from the medical records and the next of kin. Estimates are produced for the United States, census regions, and DHHS regions, ant] in 1977 for five states with the largest nursing home populations. CONTENT: The survey collects data on characteristics of the fa- cility and its finances, of residents, of discharges, and of staff, as follows: Facility: size, ownership, Medicare and Medicaid certifica- tion, staffing patterns, and services offered. Financial characteristics: Total expenses and major compo- nents of operation. Residents: Demographic characteristics, living arrangements prior to admission, diagnosis and conditions, functional sta- tus, receipt of services (medical, nursing, and therapeutic), cost of care, source of payment. Discharges: A subset of items collected for current residents available from the record. Staff: Data varied with survey. In 1985 survey, characteris- tics of registered nurses- work schedule, experience, activi- ties in facility, demographic characteristics, and salary were collected. Next of kin: Information about residents' and discharges' living arrangements, health and functional status prior to nursing home admission, lifetime use of nursing home care, Medicaid spend-down. PUBLIC-USE DATA TAPES: With the exception of individual or establishment identifiers, all data collected are available on the public use data tape.
DESCRIPTIONS OF DATA BASES 309 TITLE: Statistics of Income: Individual Income Tax Returns SPONSOR: Internal Revenue Service (IRS) YEARS OF DATA COLLECTION: Data are collected for each tax year. Individual income tax data are currently available for tax years 1913 through 1983. These data will continue to be collected, processed, and published in future years. PURPOSE: The production of individual income tax statistics was authorized by the Revenue Act of 1916. Statistics of income data are used by a variety of agencies for tax system and economic analyses. DESIGN: Statistics of income data are estimated from a stratified probability sample of income tax returns and supporting schedules filed with the Internal Revenue Service. The sample is based on such criteria as: principal business activity; presence or absence of a schedule; state from which filed; size of adjusted gross income (or deficit) or largest of specific income (or loss) items; total assets or size of business and farm receipts. The sample size alternates from 80,000 to 120,000 returns each year, selected from a population of approximately 96 million returns. Special searches are conducted for returns selected so that any bias from nonresponse is minimal. A large proportion of the sample is longitudinal and research on the longitudinal design of the sample is being conducted. The individual income tax returns sample does not make use of data linked to other files, however, certain other statistics of income studies do use linked data files. CONTENT: Data relative to taxpayers' income, exemptions, de- ductions, credits, and tax are collected. Due to changes in tax laws, items collected vary from tax year to tax year. PUBLIC-USE DATA TAPES: Available on a reimbursable basis. TITLE: Survey of Income and Program Participation (SIPP) SPONSOR: Bureau of the Census YEARS OF DATA COLLECTION: The initial interviews for the 1984 panel began in October 1983. Seven of nine proposed waves of the 1984 panel have been completed. In February 1985 a new panel began and three waves of interviewing have been completed. A new
310 AGING POPULATION IN THE TWENTY-FIRST CENTURY pane! will be implemented each February. The first five quarterly reports third quarter 1983, fourth quarter 1983, first quarter 1984, second quarter 1984, and third quarter 1985 have been released. PURPOSE: The objectives of SIPP include the collection of data on cash and noncash income for the purpose of studying the efficiency of transfer and service programs, the estimation of future program costs and coverage, and the assessment of the effects of proposed policy changes. SIPP will also satisfy the need for improved data on the economic situation of persons and families in the United States to produce improved est~rnates of the distribution of income, poverty, and wealth. DESIGN: SIPP started in October 1983 as an ongoing nationally representative survey of the Bureau of the Census with one sample pane! of approximately 21,000 households in 174 primary sample units selected to represent the noninstitutional population of the United States. The sample design is self-weighting. Each household is interviewed once every 4 months for 2 2/3 years to produce sufficient data for longitudinal analyses while providing a relatively short recall period for reporting monthly income and labor force activity. The reference period for the principal survey items is the four months preceding the interview. Each February a new pane! goes into the field with a sample size of about 15,000 households. Members of each pane! go through eight interviews or waves. In order to spread! the workload for the field staff, members of each pane! are divided into four groups of equal size called rotation groups. Each month in turn one rotation group receives its interview. Thus the four month relevance period is different for each rotation group. At this time, cross-sectional unit noninterview rates are available for the first two waves of SIPP. Unit noninterview rates provide a mea- sure of the success/failure of the SIPP field work. While refusals are the largest part of the type A rate, it also includes "no one home" and "temporarily absent" households. In Wave 1 (all rotation groups), the mean type A rate was 4.~%; in Wave 2, 3.7%, in Wave 3, 5 Who. The cumulative Type A rate after 3 interviews is approximately 12~o. A study has been implemented to validate electronically reported social security numbers (SSN), to manually search for SSNs not
DESCRIPTIONS OF DATA BASES 311 reported correctly, and to use the pane! aspect of the SIPP to cor- rect and verify a respondent's SSN. Having established the link for matching activities, work is now proceeding on identifying content and availability of administrative record systems for use in: (a) data augmentation for research and estimates and (b) survey data evalu- ation. Another aspect of this work is the development of a demonstration and feasibility study to evaluate SIPP data from Waves 1 and 2 using several federal administrative record systems such as the Master Beneficiary Record (SSA), and the Supplemental Security Record (SSA). CONTENT: The content of SIPP was developed around a "core" of labor force and income questions designed to measure the econorn~c situation of persons ages 15 and over in the United States. These questions expand the data currently available on the distribution of cash and noncash income and are repeated at each interviewing wave. Specific questions are asked about the types of income received, including transfer payments and noncash benefits from various pro- grams, disability, assets and liabilities, pension coverage, taxes, and many other items, for each month of the reference period, as well as labor force status, which is collected on a weekly basis. A few questions on private health insurance coverage are also included in the core. The SIPP has been designed to provide a broader context for analysis by adding questions on a variety of topics not covered in the core section. These questions are labeled "fixed topical modules" and are assigned to particular interviewing waves of the survey. For example, questions are asked about health and disability in the third interview of the 1984 panel, and questions are asked about the value of assets and liabilities in the fourth interview of the 1984 panel. If more than one observation is needed, questions on one wave may be repeated on a later wave. In response to program plannir g and policy analysis data require- ments, the final component of the SIPP content consists of modules of questions designed in consultation with other federal agencies. These variable topical modules are designed to be flexible and to meet im- mediate policy analysis needs. For example, Wave 4 includes data on pension plan coverage and retirement plans and expectations.
312 AGING POPULATION IN THE TWENTY-FIRST CENTURY PUBLIC-USE DATA TAPES: SIPP micro data files for Waves 1-4 of the 1984 panel have been released. TITLE: Yearly Continuous Disability History Sample (CDHS) SPONSOR: Social Security Administration (SSA), Department of Health and Human Services (DHHS) YEARS OF DATA COLLECTION: Annually since 1975. The latest available file is for 1983. PURPOSE: To furnish statistics on the operations of the social se- curity disability program and the characteristics of the claimant population. DESIGN: The CDHS is a yearly 20~o simple random sample of initial disability claims processed by the Social Security Adminis- tration. The 1983 sample contained approximately 300,000 records. The sample is linked to the Master Beneficiary Record (MBR) and the Summary Earnings Record (SER). CONTENT: The basic data set comprises: personal characteris- tics sex, race, date of birth, occupation; agency decision allowance/ denial, legal basis, medical diagnosis, onset date; payment history- worker and family payments; annual earnings. See Division of Disability Studies, Users' Manual for the 1976 Con- tinuous Disability History Sample (CDHS) Restricted Use Data File.
