DOCUMENT.TXT

This file contains documentation for all of the files accompanying
"Monitoring the Health Care Safety Net. Book I: A Data Book for
Metropolitan Areas."

1\. INTRODUCTION

The health care safety net---the Nation\'s system of providing health
care to low-income and other vulnerable populations---was recently
described as \"intact but endangered.\" In response, the Agency for
Healthcare Research and Quality and the Health Resources and Services
Administration are leading a joint initiative to monitor it.

The goal of this initiative is to help state and local policymakers,
planners, and analysts monitor the status of their safety nets and the
populations they serve. Strategies include providing baseline data and a
set of tools that enable monitoring of the capacity and performance of
local safety nets.

This documentation and data accompanies two books. The first book,
"Monitoring the Health Care Safety Net. Book I: A Data Book for
Metropolitan Areas," presents data on metropolitan areas from 30 states
and the District of Columbia, including 354 counties and 171 cities in
90 metropolitan areas and 94 county residuals. The second book,
"Monitoring the Health Care Safety Net. Book II: A Data Book for States
and Counties," shows data from all 1,818 counties in these states,
including both metropolitan and non-metropolitan counties. Other than
the Microsoft Excel spread sheets, the electronic data files combine the
data displayed in these two data books.

The following files are included. These files are also available at
www.ahrq.gov/data/safetynet.

2\. DOCUMENTATION FILES

2.a. DOCUMENT.DOC is the current file, which documents the contents of
this disk and describes the data involved. The same information is also
on the files DOCUMENT.TXT (plain text) and DOCUMENT.WPD (formatted for
WordPerfect®).

2.b. CODEBK.TXT (129 Kb) indicates the record layout (i.e., the start
and end position of each variable) of the file. This codebook also
includes listings of the variables in both alphabetical and positional
order, as well as the following information for each variable: 8
character name, 40 character description, format (length), type
(character or numeric), start and end positions, and unweighted and
weighted frequencies. This information is also on the files CODEBK.DOC
(formatted for Microsoft® Word) and CODEBK.WPD (formatted for
WordPerfect®).

2.c. MEASURES.PDF (118 Kb) and MEASURES.HTML (96 Kb) have identical
contents, and provide more detailed information on each measure, its
definition, the data source used to derive it and any necessary
methodologic information.

In order to access PDF files such as MEASURES.PDF, Adobe® Acrobat®
Reader™ software must be used. If you currently have this software
installed on your computer, you can use it to view or print PDF files
after you have downloaded them. Your browser may already be configured
to use the Adobe® Acrobat® Reader™ as a \"helper application,\" so that
you can automatically view a PDF file when you select it.

If you do not have the Adobe® software installed, your browser may give
you the option of downloading and saving PDF files for later viewing and
printing. In this case, you do not need to configure your browser, but
you will still need to have the Adobe® software installed in order to
access the downloaded PDF files.

It is also highly recommended that PDF files be printed on a PostScript®
printer, if one is available. Although PDF files may print legibly on
other printers, a PostScript® printer will ensure a correct rendering of
the document.

If you do not have the Adobe® software installed, you can install it by
downloading a free copy. Please note that the system requirements for
this software are: 4 MB of RAM, 5 MB of hard disk space, plus 7 MB of
additional temporary disk space available during installation. For
instructions, go to the Adobe® site at
http://www.adobe.com/prodindex/acrobat/readstep.html.

Accessibility: Online conversion tools are available from Adobe® to help
visually disabled users convert PDF documents into either HTML or ASCII
text, which can then be read by a number of common screen reader
programs. Go to: <http://access.adobe.com/onlinetools.html>.

The folder named \"images\" contains information needed to display the
file MEASURES.HTML.

3\. DATA FILES

3.a. Microsoft Excel spreadsheets

3.a.1. MSA Tables1.XLS (4,149 Kb) contains spreadsheets formatted for
use with Microsoft® Excel 97-2002 & 5.0/95. These spreadsheets contain
all of the data in "Monitoring the Health Care Safety Net. Book I: A
Data Book for Metropolitan Areas" as they appear in print.

3.a.2. State Tables1.XLS (10,126 Kb) contains spreadsheets formatted for
use with Microsoft® Excel 97-2002 & 5.0/95. These spreadsheets contain
all of the data in "Monitoring the Health Care Safety Net. Book II: A
Data Book for States and Counties" as they appear in print.

3.b. Data files and programming statements for use with statistical
software

3.b.1. SAFENET1.DAT (2,653 Kb) is a combined file containing all of the
data from both books in an ASCII format to be read into any software
package. It contains 2,183 records with 136 variables. This file has a
logical record length of 1242 with an additional 2-byte carriage
return/line feed at the end of each record.

3.b.2 SAFENET1.SD7 (2,721 Kb) is a combined file containing all of the
data from both books, formatted for use with SAS® version 8. See the
file SNSAS1.TXT for information applicable to SAS® users of the data.

3.b.3. SAFENET1.SSP (2,621 Kb) is a combined file containing all of the
data from both books in SAS® Transport format. This file can be used
with earlier versions of the SAS® software. See the file SNSAS1.TXT for
information applicable to SAS® users of the data.

3.b.4. SNSAS1.TXT (41 Kb) is an ASCII file that contains information for
SAS® users of the SAFENET1.DAT file. This includes information on the
SAS® Transport version of the data, as well as SAS® statements for
converting the ASCII data file into a SAS® data set (in lieu of using
the SAS® Transport file) and for creating and using SAS® formats. This
file also includes

helpful information for inexperienced SAS® users, such as sample SAS®
program code.

3.b.5 SAFENET1.SAV (2,688 Kb) is a combined file containing all of the
data from both books, formatted for use with SPSS® for Windows.

3.b.6 SAFENET1.DTA (2,380 Kb) is a combined file containing all of the
data from both books, formatted for use with Stata® version 7.

4\. VARIABLES

Detailed information on the variables included in the data files can be
found in MEASURES.PDF and MEASURES.HTML. These two files have identical
contents, and contain information on the measures, their definitions,
and their data sources. This information, along with additional details
about data sources and geographic areas, is printed in the technical
appendix at the back of "Monitoring the Health Care Safety Net. Book I:
A Data Book for Metropolitan Areas." This technical appendix is also
available electronically at www.ahrq.gov/data/safetynet.

The ASCII (SAFENET1.DAT), SAS® (SAFENET1.SD7 and SAFENET1.SSP), Stata®
(SAFENET1.DTA) and SPSS® (SAFENET1.SAV) versions of the data file merge
information from both the MSA and state Excel tables into a single file.
These files include a number of variables to help analysts link data
across geographic areas; these variables are documented in this section.

There are five types of observations in these data files, corresponding
to the five types of geographic areas included in the books: states,
Metropolitan Statistical Areas/Primary Metropolitan Statistical Areas
(MSAs/PMSAs), counties, cities, and county residuals. MSAs/PMSAs are
generally referred to throughout the products as MSAs, although the
variable containing the MSA names clearly indicates whether it is an MSA
or a PMSA. A county residual is the part of a county outside of the
city. For example, the county residual of Maricopa County, Arizona is
the part of Maricopa County that lies outside the city of Phoenix. For
additional information on geographic areas, please see "Appendix A:
Technical Information," in "Monitoring the Health Care Safety Net. Book
I: A Data Book for Metropolitan Areas." This is available in the print
version of the book or electronically at www.ahrq.gov/data/safetynet.

4.a. Variables indicating place names

4.a.1. STATE

This is the state name associated with each record. For MSAs located in
more than one state, the state listed first in the MSA name is listed in
STATE. STATE is valid for all records.

4.a.2. MSA

This is the name of the MSA/PMSA in which the MSAs, counties, cities and
county residuals are located. MSA is set to -222 for states and non-MSA
counties.

4.a.3. COUNTY

This is the name of the county in which the counties, cities and county
residuals are located. COUNTY is set to -222 for states and MSAs. 40
Virginia independent cities (18 in metropolitan areas, 22 in
non-metropolitan areas), Baltimore city and St. Louis city are treated
as counties.

4.a.4. CITY

This is the city name and is valid only for city records. CITY is -222
for states, MSAs, counties and county residuals. New York City and
Washington, DC are treated as city records. They do not contain county
information.

4.a.5. RESIDUAL

This is the county residual name, which is valid only for county
residual records. An example is 'Residual -- Maricopa County,' which is
the part of Maricopa County, Arizona that is outside the city of
Phoenix. RESIDUAL is set to -222 for state, MSA, county and city
records.

4.b. Variables describing the type of observation

4.b.1. OBSTYPE

This variable is a flag for observation type and is set to 1 for states,
2 for MSA/PMSAs, 3 for counties, 4 for cities and 5 for county
residuals.

4.b.2. METRO

This is a flag variable. METRO is set to 1 for all MSA and MSA-component
records. These include all MSA records, all counties in MSAs, all
cities, and all county residuals. There are no non-metropolitan cities
or county residuals included in the data set. METRO is set to -222 for
state records. METRO is set to 0 for all counties that are not in
MSAs/PMSAs.

4.c. FIPS codes

Federal Information Processing Standards (FIPS) codes uniquely identify
states, MSAs, counties, and cities. For analysts working with another
data set that contains FIPS codes, these variables will enable the
appropriate merging of these data onto other data sets. FIPS codes are
developed by the National Institute of Standards and Technology (NIST),
and additional information is available at
http://www.itl.nist.gov/fipspubs/.

4.c.1. UNIQFIPS

This is a unique FIPS ID, which consists of 15 fields. The fields are
state FIPS (2 bytes) + MSA FIPS (4 bytes) + county FIPS (3 bytes) + city
FIPS (5 bytes) + X or Y (1 byte, X if county residual, Y if others).

4.c.1.a. State records have UNIQFIPS=State FIPS (2 bytes) +
YYYYYYYYYYYYY (13 bytes).

4.c.1.b. MSA records have UNIQFIPS= State FIPS (2 bytes) + MSA FIPS (4
bytes) + YYYYYYYYY (9 bytes).

4.c.1.c. MSA county records have UNIQFIPS= State FIPS (2 bytes) + MSA
FIPS (4 bytes) + county FIPS (3 bytes) + YYYYYY (6 bytes). Five counties
under New York City have special values for UNIQFIPS. These counties are
Bronx County (005), Kings County (047), New York County (061), Queens
County (081) and Richmond County (085). For example, Bronx County has
UNIQFIPS=36560000551000Y.

4.c.1.d. Non-MSA county records have UNIQFIPS=State FIPS (2 bytes) +
YYYY (4 bytes) + county FIPS (3 bytes) + YYYYYY (6 bytes).

4.c.1.e. City records have UNIQFIPS=State FIPS (2 bytes) + MSA FIPS (4
bytes) + county FIPS (3 bytes) + city FIPS (5 bytes) + Y. New York City
and Washington, DC have special UNIQFIPS because they do not have a
county FIPS. UNIQFIPS is 365600YYY5100Y for New York City and
118840YYY50000Y for Washington, DC

4.c.1.f. County residual records have UNIQFIPS=State FIPS (2 bytes) +
MSA FIPS (4 bytes) + county FIPS (3 bytes) + YYYYY (5 bytes) + X.

4.c.1.g. San Francisco County's FIPS code is used for the 'San Francisco
City and County' record. The same method is used for 'Denver City and
County,' as well as 'Philadelphia City and County.' Dade County's FIPS
is used for Miami-Dade County.

4.c.2. STFIPS

This is the state FIPS code associated with each record. For MSAs
located in more than one state, the state listed first in the MSA name
is listed in STFIPS. STFIPS is valid for all records.

4.c.3. MSAFIPS

This is the MSA FIPS code for all MSAs/PMSAs and MSA counties, a well as
all cities and county residuals. MSAFIPS is -222 for states and non-MSA
counties.

4.c.4. CONTFIPS

This is the county FIPS code for counties, cities, and county residuals.
CONTFIPS is -222 for states and MSAs.

4.c.5. CITYFIPS

This is city FIPS code, which has valid values for cities only. CITYFIPS
is -222 for states, MSAs, counties and county residuals.

4.c.6. RESFIPS

This is a constructed code, which has valid values for county residual
records only. It is set to county FIPS + X. RESFIPS is -222 for all
other records.

4.d. Variables indicating position/sequence within this data set

4.d.1 STATEID

This is a unique sequence ID based on an alphabetical sort of state
names. The range is 1-31, with all records having a value.

4.d.2. MSAID

This is a unique sequence ID for MSAs based on the order in MSA data
book. The range is 1-90 for MSAs, MSA counties, cities and county
residuals. MSAID is -222 for states and non-MSA counties.

4.d.3. COUNTYID

This is a unique sequence ID based on an alphabetical sort of
abbreviated (2 letter) state names and county names. The range is
1-1,818 for counties, cities and county residuals. COUNTYID is -222 for
state and MSA records.

4.d.4. CITYID

This is a unique sequence ID for cities based on the order in MSA data
book. The range is 1-151 for cities. CITYID is -222 for states, MSAs,
counties and county residuals. 18 Virginia independent cities,
Baltimore, St. Louis, Philadelphia, Denver, and San Francisco are all
treated as counties rather than cities.

4.d.5. RESID

This is a unique sequence ID for county residuals based on the order in
MSA data book. The range is 1-94 for county residuals. RESID is -222 for
states, MSAs, cites and counties.

5\. Missing values

The following missing values codes are used:

-111 N/A indicates that data should be available for this specific area,
but are missing.

-222 LEVEL NOT AVAILABLE indicates that data are not available at this
area level. For example, estimates of the percent of the population that
is uninsured can be made only at the state and MSA levels with our data,
so counties, cities, and county residuals are coded -222.

-333 NO DATA indicates that data were not collected or processed for
this specific area.

-444 NO HOSPITAL indicates that there is no hospital in the county.

-555 ONE HOSPITAL indicates that there is only one hospital in the
county, so there is no meaningful analysis of this measure.

-666 SUPPRESSED indicates that data have been suppressed to protect the
identity of a single facility or to protect personal privacy (cell size
less than 5 individuals).

-777 LOW POPULATION indicates that data are not presented because the
small population size of the area prevents statistically meaningful
analysis.

6\. Accuracy of data and contact information

Every effort has been made to ensure that the existing data used for
these books has been processed accurately. However, errors may still
exist, either due to an oversight in the data processing or problems
with the original data.

Questions or feedback concerning the data may be directed to
SAFENET@AHRQ.GOV.