Data from the

NATIONAL HEALTH’SURVEY

.

Utilizationof ShortSay Hospitals

by PersonsDischarged

With Alcohol=RelatedDiagnoses

UnitedStates,1976

Statistics are presented on the utilization of non-Federal short-stay

hospitals by persons dischargedwith alcohol-related diagnoses.The

alcohol-related data are shown according to age, sex, race, length of

stay, marital status, and discharge status of theinpatient, aswell as

the bed size, geographical division, and ownership of the hospital.

DHHS Publication No. (PHS) 80-1798 “

Series 13

Number 47

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

Public Health Service

Office of Health Research,Statistics, and Technology

National Centq for Health Statistics

HyattsviJie, Md. May 1980
Library of Congrass Cataloging in Publication Data

Sanchez, MarcusJ.

Utilization of short-stay hospitals by persons discharged with alcohol-related diagnoses:

United States, 1976.

(Vital and health statistics: Series 13, Data from the National Health Surve~ no. 47)

(DHHS publication; 110. (PHS) 80-1798)

Supt. of Dots. no.: HE 20.6209:13/47

1. Alcoholism-United States–Statistics. 2. Psychiatric hospitals-United StatesUtilization-Statistics. 3. United States–Statistics, Medical. I. Moien, Mary, joint author.

IL Title. III. Series: United States. National Center for Herdth Statistics. Vital and health

statistics: Series 13, Data from the National Health Survey, Data from the hospital discharge survey; no. 47. IV. Series: United States. Dept. of Health and Humsm Services.

DHHS publication, no. (PHS) 80-1798. [DNIM 1. Alcoholism-United States–Statistics.

2. Alcoholism-Complications-United States–Statistics. 3. Hospitals-Utilization-United

States–Statistics. W2 A N148vm no. 47]

RA407.3.A349 no. 47 [RC565] 362.1’1’0973s

ISBN 0-8406-0187-5 362.2’928 80-607159

For sale by the Superintendent of Documents, U.S. Government Priding Oiiice, Washington, D.C. 204)2
NATIONAL CENTER FOR HEALTH STATISTICS

DOROTHY P. RICE, Director

ROBERTA. ISRAEL,Deputy Director

JACOBJ. FELDMAN,Ph.D.,Associate Director for Analysis

GAIL F. FISHER Ph.D.,Assoctite Director for the Cooperative Health Statistics System

ROBERTA. ISRAEL,Acting Associate Director for Data Systems

ALVAN O. ZARATE,Ph.D.,ActingAssociate Director forIntemational Statistics

ROBERTC. HUBE~ Associate Director forManagement

MONROEG. SIRKEN,Ph.D., Associate Director forMathematical Statistics

PETERL. HCJRLEY,Associate Director for Operations

JAMES M. ROBEY,Ph.D.,Associate Director for program Development

GEORGE A. SCHNACK,Acting Associate Director for Research

ALICEHAYWOOD,InfomnatiorzOfficer

OFFICE OF STATISTICAL RESEARCH

GEORGEA. SCHNACK,ActingAssocfate Director for Research

DWIGHTB. BROCK,Ph.D.,Acting chie~ Statistical ResearchBranch

ROY E. HEATWOLE, Acting chief Research Technology Branch

ROSALIE A. DUNN, Ph.D., Acting chie~ Epidemiology Branch

DIVISION OF HEALTH RESOURCES UTILIZATION STATISTICS

W. EDWARD BACON, Ph.D., Acting Director

W. EDWARDBACON,Ph.D., Acting ChieJ Hospital GzreStatistics Branch

JAMESE. DeLOZIE~ Chief Ambulatory CkreStatistics Branch

MANOOCHEHRK.NOZARY,Chief TechnicalServicesBranch

JOAN F. VAN NOSTRAND, f%ie$ Long-Term ChreStatistics Branch

STEWART C. RICE, chie~ Family PlanningStatistics Branch

COOPERATION OF THE U.S. BUREAU OF THE CENSUS

Under the legislation establishingthe Nationaf Heaftb Survey, the Pubfic Heafth Service is

authorized to use, insofar aspossible, the servicesor facilitiesof other Federal, State,or private

agencies.

In accordance with specificationsestablishedby the Nationaf Center for Health Statistics,

the Bureau of tbe Census,under a contmctuaf-gemen~ participatedi. pfanningtbe survey

and collectingtbe data.

Vital and Health Statistics-Series 13-No. 47

DHHS Publication No. (PHS) 80-1798

Library of CongressC&alog CkrdNumber 80-607159
CONTENTS

Introduction...........................................................................................................................................

Background .......................................................................................................................................

Alcohof Discharge Rate .....................................................................................................................

?e,Sample ........O.................o.......o........................o.........o........................o............r...........................

Lmrttations of Data ...........................................................................................................................

Selected Fhw3ngs ...................................................................................................................................

Agc ...................................................................................................................................................

sex ....................................................................................................................................................

Dtichcrgc Stctus ................................................................................................................................

Matital Statms....................................................................................................................................

Bed Sue ............................................................................................................................................

Type of Ownership ...........................................................................................................................

HigbHghta . .. . . . . . .. . . . . . . .. . . . . . . . .. . . . . . . ..o..e . . .. . . . . . ..# . . . . . . . .. . . . . . . . .. . . . . . . .. . . . . . . .. . . . . . . . .. . . . . . . . .. . . . . . . .. . . . . . . .. . . . . . . . .................

List of Detciled Tables ...........................................................................................................................

Appendixes ............................................................................................................................................

I. Techniccl Notes on Methods .....................................................................................................

IL Definitions of Certain Terms Used in Thk Report ....................................................................

1.

2.

&

4.

6.

6.

7.

8.

9.

10.

11.

LIST OF TEXT FIGURES

Alcohol Discharge Rate “byage: United States, 1976 .....................................................................L

Alcohol Dkcharge Rate for females, excluding obstetrkalc onditions, by age: United States,’

1976 ...............................................................................................................................................

Alcohol Discharge Rate for white persons, by age: United States, 1976 .........................................

Alcohol Discharge Rate for othm than white femck, by ages United States, 1976 ........................

AIcohol Dischnrge Rate by sex and color: United States, 1976 .......................................................

Afcohol Dkcharge Rate by sex and age: United States, 1976 ..........................................................

Mcohol D~charge Rate by color and sex: United States, 1976 .. ....................................................

Alcohol Discharge Rate by color snd age: United States, 1976 .......................................................

Alcohol Discharge Rate by cencus division: United States, 1976 ....................................................

Alcohol Discharge Rate by sex and dischcrge status: United States, 1976 .......... ...........................

Alcohol Diicharge Rate by marital status: United Stctea, 1976......................................................

1

1

2

2

5

5

6

6

7

8

10

11

12

1s

27

.28

33

4

4

4

5

6

6

6

7

8

9

...

Ill
12. Acohol Dischmge %tebysexmd rntitistams: Utited States, 1976 ......."................. .............. 9

13. Mcohol Disch=& ktebysexmd bedtieofhospitd: Utited States, 1976 ................................. 10

14. Acohol Dkchm&Wte forwtitepenons bysexmdbed sizeofhospit& United States, 1976 ..... 11

15. Mcohol~stiqe Mtebysex mdhospitd om~ip:Utited S@tes, 1976 ................................. 11

16. Acohol Mch=&&tefor white pemoti-bysex mdhospitAownertip: United States, 1976 ...... 12

SYMBOLS

Datanot avzilable-——-——-—-— ----- ---

Category notapplicable——-—---- . . .

Quantity zcro—-—— ——-—..--.. .

Qoantity more than Obut 1sss than 0.05-— 0.0

Fi~e does not meet standards of

reliabrky or precM1on——— —...-—-- *

iv
UTILIZATION OF SHORT-STAY HOSPITALS

.BY PERSONS DISCHARGED WITH

ALCOHOL-RELATED DIAGNOSES

Marcus Sanchez, Office of Statistical Research, and Mary Moien, Division of Health Resources

Utilization Stati+ics

INTRODUCTION

This report presents statistics for 1976 on

the utilization of short-stay hospitals by persons

discharged with alcohol-related diagnoses. De-

. tailed tables 1-21 and figures 1-16 show numbers, rates, and standard errors of alcohol-related

discharges according to selected characteristics

of the dischyged inpatients and the attributes of

the hospitals in which patients received treatment, Patient characteristics are age, sex, race,

length of stay, marital status, and discharge status, The hospital characteristics are bed size,

census division, and ownership. Data for newborn infants are excluded from this report.

Background

The primary responsibility of the National

Center for Health Statistics is the development

and maintenance of survey mechanisms that

provide accurate and comprehensive information

on matters of health, health resources, vital

events, and related matters. To satisfy the health

community’s need for inpatient data from short:

stay hospitals, the National Center for He&h

Statistics (NCHS) conducts the National Hospital Discharge Survey,

Information from the medicrd records of inpatients discharged from a sample of hospitals in

the United States is collected for the National

Hospital Discharge Survey. Hospitals in this Survey are short-stay, special and general hospitals

having at least six beds for inpatient use and an

average length of stay of less than 30 days. Federal hospitals and hospital units of institutions

are not included in the survey. At least one, but

not more than five, ?inaJdiagn~ses are coded for

each medical record surveyed. The form used to

abstract information from medlczl records is displayed in appendix I, and the collection and

processing procedures are detailed there, too.

Alcohol Disoharge Rata

In this report, an alcoholic discharge or an

alcohol-related discharge is a discharge that has

at least one of the following diseases (and codes)

that are assigned as a final diagnosis according to

the Eighth Rerision International Classification

of Diseases, Adapted foi- Use in the United

States.a Certain modifications to these classifications are made for the National Hospital Discharge Survey.

Alcoholic psychosis

Delirium tremens, 291.0

Korsakov’s psychosis (alcoholic), 291.1

Other alcoholic hrdlucinosis, 291.2

Alcoholic paranoia, 291.3

Other and unspecified, 291.9

C“~hosis of the.liver (alcoholic), 571.0

sNationalCenterfor HeaItbStatistics:Eighth Rezds{on Intsrnati”onal Class ficatt”o?s of Diseases, A dapted for

Use in the United States. PHS Pub. No. 1693. PubIic

Health Service. Washington. U.S. Government Printing

Office, 1967.
Alcoholism

Episodic excessive drinking, 303.0

Habitual excessive drinking, 303.1

Alcoholic addiction, 303.2

Other and unspecified alcoholism, 303.9

Toxic effect of ethyl alcohol, 980.0

Acute pancreatitis, 577.0

Chronic pancreatitis, 577.1

The principal measure of alcohol morbidity

or alcoholism used in this report is the Alcohol

Discharge Rate (ADR). For a given hospit,fl subpopulation or category, the ADR is the number

of alcohol-related discharges divided by the total

number of discharges multiplied by 100,000.

The ADR maybe expressed as:

number of alcohol-related disc-barges

ADR =

in category X 100,000

total discharges in category

An example may be useful. Suppose one has a

category of 3,825,298 other-than-white discharged patients, of whom 156,799 are discharged for alcohol-related conditions. Then, the

computation for ADR is:

ADR = 156’799 x 100’000 = 4,099

3,825,298

TheSample

The National Hospital Discharge Survey

(NHDS) utilizes a two-stage, stratified, probability sample design. In the first stage, a‘sample of

short-stay non-Federal hospitals that mainly

serve the civilkm noninstitutionzlized population

was chosen from the NCHS Master Facility Inventory, a national survey of all inpatient health

faci&ties, i.e., hospital, nursing homes, and other

facilities: The hospitals areselected from a universe stratified by geographic area, size of hospital, and ownership of hospital. For the 1976

survey, 511 hospitals formed the NHDS sample.

In the second stage, discharges are systematically sampled from the sample hospitals. Approximately 223,000 discharges were processed in

1976. A more complete description of the

NHDS sample design is contained in appendix I.

Limitationsof Data

Several limiting factors should be considered

when using the data contained in this report.

The target population does not include persons

discharged from Federal hospitals, hospital units

of institutions, hospitals with less than six beds

for inpatient use, nor hospitals with an average

length of stay in excess of 29 days. Thus, a portion of the U.S. population that may contain a

high degree of alcoholic morbidity is not represented in this report. Also, this report presents

statistics on discharges, not individual persons.

During 1976, some persons may have had more

than one hospital episode.

Another consideration is that these data are

based on a sample of the target population;

therefore, the estimates are subject to sampling

error. In this report, sampling error has been

taken into account by the use of statistical tests

of significance, as specified in appendix I.

Finally, one must exercise caution when interpreting hospital utilization data classified by

the color of the discharged patient. In this report, alcohol utilization data are grouped into

three color categories: white, all other, and not

stated. The estimated number of alcohol-related

discharges in which color was not stated represents a substantial portion of all alcohol-related

discharges, approximately 14 percent. If the

color classification for all discharges were

known, the findings by color in this report could

be materially altered.

SELECTED FINDINGS

Age

An estimated 884,600 inpatients (table 1),

excluding newborn infants, were discharged with

.an alcohol-related diagnosis from non-Federal

short-stay hospitals in 1976, Of those discharged

with an alcohol-related diagnosis, the 45-64-

year-old age group accounted for the largest proportion (approximately 44 percent); the under15-years age group accounted for the smallest

proportion (about 1 percent).

2
The Alcohol Discharge Rate (ADR) for all inpatients was 2,573 per 100,000 discharges (table

2). As measured by the ADR, alcoholism was related to age. The ADR increases with advancing

age up to age 45. The ADR for persons under 15

years of age is significantly less than that for

persons 15-24 years of age, and that for persons

aged 25-34 is materially less than that for those

35-44 years of age. However, after age 44, the

ADR decreases to the extent that pefions_45-64

.—

years of age have a significantly lower ADR than

persons in the 35-44 age group, and persons 65

years or more of age have a significantly lower

rate of alcohol-related discharges than those in

the 45-64-year age group. The relationship between age and the ADR for both sexes is graphically illustrated in figure 1.

The relationship between age and the ADR

for males was quite similar to that for persons

of both sexes. As among persons of both sexes,

the ADR increases with each successive age

group up to age 45, and thereafter, decreases.

For instance, the ADR for males under age 15

(247) is substantially less than that for males 35-

44 years of age (10,302), and the rate for males

45-64 years of age (6,934) is materially greater

than that for males aged 65 years and over

(2,428) (figure 1).

1

ALL PERSONS

e,mllp

mwr

AGE [N YE.ARS

Among females, the relationship between

age ~d the ADR varies somewhat from that for

both sexes. As among persons of both sexes, the

ADR increases with each advancing age group up

to age 45, but, unlike that for persons of both

sexes, there is no statistically significant difference between the Alcohol Dkcharge Rate for females aged 35-44 and that for femrdes aged 45-

64 years. However, the ADR’s for females aged

35-44 and 45-64 are substantially greater th&n

that for females aged 65 years or more. The relationship between age and the ADR among fe- -

males is pictorially displayed in figure 1.

If obstetrical conditions are excluded, the relationship between the ADR and age for females

does not appear to change materially (table 5).

As among females with all conditions, the ADR’s

for females, excluding obstetrical discharges

(EOD), increase with advancing age Up to age

45. The ADR-EOD for females under 15 years

of age is substantially less than that for females

15-24 years of age, and the ADR-EOD for

females 25-34 years of age is significantly less

than that for females 35-44 years of age. There

is no essential difference between the ADR-EOD

for females aged 35-44 and that for females aged

45-64. Also, the ADR-EOD for females aged 45-

64 is significantly greater than that for females

MALE

10,3G7

M

Under 1b24 2S.S4 SE-44 4SS4 65

15 and

owr

AGE m YEARS

FEMALE

.wr

AGE IN YEAR5

..

Figure 1. Alcohol Discharge Rate by agw United States, 1976
aged 65 years or more (figure 2). Thus, the exclusion of obstetrical discharges does not materially alter the relationship between age and the

ADR for femrdes.

The estimates in table 2 also show that the

relationship between age and the ADR for white

3,GO0fAGE IN YEARS

Figure 2. Alcohol Discharge Rate for females, excluding obstetrical renditions, by age: United Skates, 1976

persons is quite similar to that for persons of all

races. As among persons of all races, the ADR

for white persons increases with advancing age

up to age 45; thereafter, the ADR decreases with

advancing age (figure 3). With the exception that

there is no significant difference between the

ADR for white females aged 35-44 and that for

white females aged 45-64, the ADR’s for white

females and for white males ilso increases with

advancing ageup to age 45, decreasing thereafter.

The association between- the ADR and age

for other than white males and females is similar

to ‘that found among their whke counterparts.

The Alcohol Discharge Rate among all other

males and females generally increases with advancing age up to age 45; thereafter, the rate

tends to decrease with advancing age (figure 4

and table 2).

In summary, the relationship between age

5m

4,cm

~

.

g 3,0w

2

;

E

~ Z,am

!j

.Wm

0.

Under 1E-24 2E-34 3544 4S84

t6 2

.Lw

AGE IN YEARS

r

Figure 3. Alcohol Oischarge Rate for white persons, by agw.

United States, 1976

we r

4m

g

02

g 3,me

$

E

: 2,CQ2

z

:

l,OW

o

under 1S.24 2524 3s.44 45e4 es

15 me

W91

AGE IN YEARS

Figura 4. Alcohol Discharge Rate for other than white femelas,

by agw United Stetes, 1976

I

1

,

,

I

,

I

I

I

I

I

I

,

4
:uul the Alcohol Discharge Rate appeara to be

rcl:uively consistent. Regardless of sex and color,

the .\DR generally increases with advancing age

up to age 45, and decreases thereafter.

Sex

More males than females were discharged

from short-stay hospitals with alcohol-related

. diagnoses, an estimated 620,000 males as opposed to an estimated 264,000 females. As

measured by the Alcohol Discharge Rate (ADR),

alcoholic morbidity appears to be more prevalent among males thau females. The ADR for

males is significantly greater than that for females, 4,512 per 100,000 discharges as opposed

to 1,281 (figure 5). The same difference by sex

prevailed in each of the given age categories, except for the under-15 age group (figure 6).

White males also had a substantially higher

ADR than whke females had, 4,014 compared

with 1,156. Similarly, the ADR for other than

white males (7,842) was materially higher than

that for other than white females (1,971). The

same trend by sex prevailed within each of the

various age groups for both white and other than

white persons except for white persons under

age 15. Thus, regardless ‘of age and color, males

generally have a higher ADR than females have.

Fiaure 6. Alcohol Discharge Rate by sex and COIOK

United S~te.t, 1976

ad

we,

AGE IN YEARS

Figure 6. Alcohol Discharge Rate by sex and age:

United States, 1976

Color

As indicated in figure 7, alcohol morbidity

appears to be more prevalent among other thm

white persons than among white persons. The

Alcohol Discharge Rate (ADR) for other than

white persons (4,099) was significantly greater

than that for white persons (2,3 14). Differences

in the ADR of white persons and other than

white persons were also found among persons

of the same age group. Within the four older age

groups, other than white persons consistently

had higher ADR’s than white persons had

(figure 8).

In addition, both males and females in the

other than white category had appreciably

higher ADR’s than white persons of the same

sex had. For example, the ADR of white males

was 4,014 as compared with 7,842 for other

than white males. In general, the ADR for other

than white persons is significantly higher than

that for white persons, regardless of age or sex.

5
Figure 7. Alcohol Discharge Rata by color and aex

UnitedStates,1976

-La21~i67

o

under

15

9.077

El

2624 3544

7,?s5

4564

2

awr

AGE IN YEARa

Figure 8. Alcohol Oiacharga Rata by color and age:

UnitedStates,1976

The Direct Age-Adjusted Rate

In order to control for age, the direct sigeadjuated rate ia used. A discussion of the calculation and utility of this rate ia described in

Statistical Methods for Rates and Proportions. b

Since the previous analysis indicates that age is

related to the Alcohol Discharge Rate, a direct

age adjustment ww made in order to account for

differences in the age distribution of each of the

variables analyzed in the remainder of this report. Sampling variability for specific age

grtips was usually larger than for the total age

group because of the smaller number of sample

persons in each age group. Because the larger

sampling variability of age-specific rates frequently masks the relationships that exist with

respect to hospital subpopulation variables, the

summary comparison of age-adjusted rates was

used instead of rate age-specific comparisons.

CensusDivision

Table 7 ahowa the number and table 8 shows

the rate of alcohol-related discharges from shortstay hospitals by census division, sex, and color.

Alcoholism, as measured by the Alcohol Discharge Rate (ADR), varieaaccording to census division. Persons in the New England division have

the highest ADR (5,630); persona in East South

Central (1,140) and West South Ccntrsd divisions

(1,248) have the lowest ADR’s (figure 9). When

age is taken into consideration by comparing the

age-adjusted ADR’s among the regiona, the rela.

tionship between ADR and census division does

not change aubstsntially. That is, persons in New

England had the highest age-adjusted ADR while

persona in the East and Weat South Central divisions had the lowest age-adjusted ADR’s.

The relationship between census division

and ADR for males and females is similar to that

for persons of both sexes. For example, females

in the New England census division had the

highest ADR (2,620), and females in the East

South Central and West South Central divisions

have the Ioweat ADR’s (657 and 741, respectively). AISO, with only one exception, the

b~kjas,~. L.: Statzktical Methods for Rates and Proporti.ns, New York.John Wiley & Sona, 1973.

6

,

,

,

I

,

I

!

I

I
am% ALL PERSONS

2,341

ZoUth E,n Wmt

Attn. South South

Cm. Cm.

ml ml

Figure 9. Alcohol Discharge Rate by census division:

United States, 1976

ADR’s among white males and females tends to

be highest in the New England and lowest in the

East and West South Central census divisions.

The lone exception is that the ADR among

white females in New England is not substantially greater than that for white females in the

Pacific census division. When age is taken into

consideration, the relationship between census

division and the ADR for wl$te males and

females is not materially altered.

As among their white counterparts, other”

‘than white males and females with the lowest

ADR’s tend to reside in the West and East South

Central census divisions. When age is taken into

consideration, other than white mrdes and femrdes in the West South Central and East South

Central divisions continue to have the lowest

ADR’s. With the exception of the Mountain and

West North Central census divisions, other than

wklte males residing in the Middle Atlantic census division appear to have the highest ADR

regardless of age,

It is not clear which census division has the

highest ADR among other than white females.

For example, the ADR for other than white

females in the Mountain census division was not

significantly greater than that for other than

white females in the Middle Atlautic, South Atlantic, West North Central, New England, and

Pacific census divisions. When age is taken into

consideration, the picture clears to some extent;

with the exception of the Middle Atlantic,

South Atlantic, and West North Central, other

than white females in the Mountairs census division have the highest ADR.

In summary, persons residing in the East and

West South Central census divisions tend to have

the lowest ADR’s regardless of age, sex, or color.

For white mrdes and females, the highest ADR

was recorded in New England. Because of large

sampling variances, the census division with the

h@est ADR for other than white males and

females was not readily app,~ent. Nevertheless,

for other than white males, the ADR’s tend

to be highest for those residing in the Middle Atlantic census division, while that for other than

white females tend to be highest @ the Moun-”

tain census division.

.. .

DischargeStatus

As shown in table 10, approximately 97 percent of the inpatients with an alcohol-related

diagnosis (about 859,000) were discharged alive.

The Alcohol Discharge Rate (ADR) was not related to the discharge status of all inpatients; the

ADR of persons discharged alive was not essentially different from that of persons discharged

dead. However, when age was taken into consideration, the ADR of those persons discharged

dead was significantly greater than that of persons discharged alive.

After classifying the data by sex, we found

that the ADR for males was greater among those

discharged a.he than among those discharged

dead (figure 10 and table 11). But for females

the relationship between ADR and discharge

status was strikingly different. The ADR was significantly greater among females discharged

dead than among those discharged alive. When

age was taken into consideration, the relationship between ADR and discharge status for fe7
ALL PERSONS WHITE PERSONS OTHER THAN WHITE PERSONS

5,rrmr S.rce

r

Mxa

S,cm

7.UU

6PM

5.Im

4,020

?,W

2,M0

l,CQD

DI

5,am

*,WD

Fmul.

Figure 10. Alcohol Okharge Rate Izv sax and discharge status: United Ststea, 1976

males did not change, but, for males, differences

in ADR according {o discharge statusbecame insignificant. Thus, the difference in ADR according to dkcharge status for males may be attributed to difference in age.

When color differential are taken into consideration, the relationship between ADR and

discharge status does not appear to change. For

both white and other than white ~lest the

ADR of those discharged alive is materially

greater than that for those discharged dead.

Again, after the data are adjusted for age, differences in the ADR by discharge statusbecome insignificant for white and other +m white males.

On the other hand, the ADR for females in both

color categories remains substantially greater

among those discharged dead than among those

discharged alive? regardless of age (figure 10).

In summary, the ADR for femrdes is consistently greater arrksngthose discharged dead than

among those discharged alive regardless of color

or age. The difference in ADR by discharge

status among males, however, is accounted for

by age differences, regardless of color.

Marital Status

Of persons dkcharged with an alcoholreIated diagnosis, 44.8 percent were married,

21.9 percent were divorced or separated; 19.5

percent were single (never married), and 8.7 percent were widowed (table 13). As shown in table

14, significant differences in the Alcohol Discharge Rate (ADR) were found among mantrd

status groups. Divorced or separated persons

were most likely to be discharged with an

alcohol-related diagnosis; the ADR among divorced or separated persons was 8,498. The

ADR’s among married (2,102) and widowed

people (1,906) were significantly less than those

of persons in the other marital categories

(figure 11).

After the data were adjusted for age, the relationship between marital status and the ADR

changed slightly. The ADR for married persons

became substantially lower than that for all

other marital categories, but separated and divorced people continued to suffer the bigbest

ADR.

1

1

f

I

i

a

,
Z,orm

Wxl

0

Mmbd -

3,4S6

[

6in.j!e Widowed Cjw..tior

MARITAL STATUS

As among persons of both sexes, male and

female married persons had a substantially lower

ADR than their male and female counterpzn-ts

in the other marital groups had. Also, the ADR

for both male and female divorced-separated

persons was materially higher than that of males

and females in the other marital categories (figure 12). When age was taken into consideration,

the relationship between marital status and the

ADR for male and female persons was not materially altered.

The relationship between marital status and

the ADR for both male and female white persons was similar to that for all patients. Among

white males, for instance, those married had the

lowest ADR (3,311) and those divorced or separated had the highest ADR (17,483) (figure12).

After controlling for age, the relationship between marital status and the ADR for white

males and females was not materially altered.

.As among white males and females, males

and females of all other colors with the highest

ADR tend to be divorced or separated (figure 12). For example, other than white males

who are divorced or seuarated had a substanFigur.s 11. Alcohol Discharge Rat6 by mrwital status: tially higher ADR (21~226) than other than

United States, 1976 white males in each of the other marital groups.

It is not clear which marital group enjoys the

I,m

0L

~ Male

= Fond.

WJ20

17,caoJ

[

6,CQ0

4,0W

S,ml

2,2C.I

two

0

WHITE PERSONS OTItER THAN WHITE PEHSONS

17.4S3

R

MARITAL STATUS MAMITAL STATUS

2WOI1

I

12,UV2

.1

7,m

e,ow

LmO

I

3,0W

2,W0

a

21228

M

was

m Eu

II6,714

6,637

Ill IL

4,403

M@

Marl: Slnnl.” Wldw,w4Dlv-Jrcd.,

Cdpmted

MARITAL STATUS

Figure 12. Alcohol Oischarga Rate by sax and marital atatuw United Statas, 1976

9
lowest ADR among other than white males and

females because of relatively large sampIiug error. However, when the data are age adjusted,

married males and females emerge as the marital

groups with the lowest ADR among other than

white persons.

In general, we may conclude that separateddivorced persons tend to have the highest ADR

while married persons usually enjoy the lowest

ADR, regardless of age, sex, or color.

Bed Size

The number of inpatients discharged with an

alcohol-related diagnosis according to bed size

of hospital, sex, and color is shown in table 16.

The largest proportions of inpatients discharged

with an alcohol-related diagnosis were discharged from hospitals in the 6-99 and the 300-

499 bed-size categories (26.4 percent and 25.6

percent, respectively). The smallest proportion

(11.2 percent) of inpatients with an alcoholrelated diagnosis were discharged from hospitals

in the 200-299 bed-size category.

Inpatients discharged from hospitals in the

6-99 bed-size category tend to have the highest

Alcohol Discharge Rate (ADR) (3,535). The

lowest ADR (1,844) was found among inpatients discharged from hospitals in the 200-299

bed-size group (table 17 and figure 13). After age

was taken into consideration, the relationship remained essentially the same. That is, persons

discharged from hospitals in the 6-99 bed-size

group had the highest ADR while those discharged from hospitals in the 200-299 bed-size

group had the lowest ADR.

As among inpatients of both sexes, male inpatients discharged from hospitals in the 6-99

bed-size category generally have the highest

ADR (6,629), while the lowest ADR for male inpatients (3,175) was found among those dkcharged from hospitals in the 200-299 bed-size

category. After age was taken into account, the

ADR for males remained unaltered.

The lowest ADR for female inpatients was

recorded by those discharged from hospitals in

the 200-299 bed-size category (956). However,.

we are unable to determine which bed-size group

has the highest ADR among female inpatients as

the ADR of the 6-99 bed-size category is not significantly greater than that of the 100-199, 300-

6,am I“!

~ Both SW.

m mm

NUMBER OF BEDS

Figure 13. Alcohol Oischarge Rate by sex and bod size of

hospital: United States, 1976

499 or 500 and over bed-size categories. Again,

when age is taken into account, the relationship

between ADR and bed size among females is not

altered.

Among white males, inpatients discharged

from hospitals in the 6-99 bed-size group usually .

have the highest ADR (5,781). But we are unable to determine which bed-size category has

the lowest ADR among white males as there is

no essential difference among the three groups

of hospitals with the largest number of beds

(figure 14). When age is taken into consideration, the association between ADR and bed size

for white males remains the same. For white and

other than white females, the picture is less clear

as we are unable to determine which bed-size

category has the highest or lowest ADR.

For other than white males, inpatients dis-”

charged from hospitals in the 200-299 bed-size

category had the lowest ADR (4,567); however,

we are unable to determine which bed-size category had the highest ADR among other than

I

1

10
Figure 14. Alcohol Discharge Rete for white oersons bv sex and

bed size of hospkl: United Stetes; 1976

white males. After age was taken into account,

the relationship between ADR and hospital bed

size for other than white males did not change.

In summary, inpatients discharged from hospitals in the 6-99 bed-size group usually have the

highest ADR while inpatients discharged from

hospitals in the 200-299 bed-size group generally

have the lowest ADR. However, when race and

sex are taken into consideration, the relationship

between bed size and ADR becomes less clear.

Type of Ownership

Ownership refers to the organization that

controk and operates a hospital. Of those inpatients discharged with an alcohol-related diagnosis, nonprofit hospitals (operated by churches

or other nonprofit organizations) cared for approximately 570,000, or 64.4 percent; government (State or local) hospitals cared for about

203,000, or 22.9 percent; and proprietary hospitals cared for about 112,000 or 12.6 percent

(table 19),

The Alcohol Discharge Rate (ADR) varied significantly according to type of ownership (table

20). The ADR for all patients was substantially

higher among those discharged from proprietary

hospitals (4,114) thsn among those discharged

from government (2,9 15) or nonprofit hospitals

(2,308) (figure 15). When age and sex are taken

into consideration, the relationship between

ADR and type of ownership tends to remain unchanged. That is, the ADR for males and females

is usually higher for those discharged from proprietary hospitrds and lower among those discharged from nonprofit hospitals, regardless of

age.

8,000

7,WJ [

m, ‘ Fwnde

Figure 15. Alcohol Discharge Rate by sex and hospital ownership: United Ststes, 1976

The association of ADR and type of owneKshiu for white males was similar to that for all

pa~ients. As among all patients, the ADR for

white males was highest among those cared for

in propriet~y hospitals (5,6o8 ) and lowest

among those cared for in nonprofit hospitals

(3,661) regardless of age (figure 16).

On the other hand, the ADR for white females did not vary significantly according to

11
3,059

S,mtr

Male Female

Figure 16. Alcohol Oischarge Rste for white persons by sex and

hospital ownership: United States, 1976

type of ownership. Similarly, no essential differences in the ADR for other than white persons

were found among the ownership categories, regardless of age or sex.

Therefore, the ADR tends to ““be highest

among the persons cared for in proprietary hospitals and Ioweet among those cared for in nonprofit hospitals, regardless of age or sex. However, after color was taken into consideration,

the ADR of white females and other than white

persons of both sexes did not vary significantly

according to type of ownership.

HIGHLIGHTS

Alcohol morbidhy, as measured by the Alco-

_ hol Discharge Rate (ADR), is related to the age,

sex, color, marital status, and discharge status of

the discharged patient. In addition, the bed size,

census dkision, and oivnership of the nonFederal short-term hospital in which the inpatient receives treatment are also related to the

ADR.

The ADR generally increased with advancing age up to age 45; thereafter, the ADR decreased with advancing age. The ADR was higher

among males than females, and lower among

white than among other than white persons. In

general; separated or dkorced persons tend to

have the highest ADRs while married persons

usually enjoy the lowest ADRs, regardless of

age, sex, or color. The ADR for females W= cow

sistently higher among those discharged dead

than among those discharged alive, regardless of

color or age. But the difference in ADR by discharge status among male persons was accounted

for by age differences.

Inpatients discharged from hospitals in the

6-99 bed-size group usually have the highest

ADR while inpatients discharged from hospitals

in the 200-299 bed-size group generally have the

lowest ADR. When color and sex are taken into

consideration, the relationship between ADR

and bed size becomes less clear. As for ownership of hospital, the ADR tended to be highest

among the persons cared for in proprietary hospitals and lowest among those cared for in nonprofit hospitals, regardless of age or sex. After

race was taken into consideration, the ADR of

white females and other than white persons of

both sexes did not vary significantly accordkg

to type of ownership.

With regard to geographic area, persons in

hospitals in the East South Central and West

South Central census dkisions tend to have the

lowest ADR’s, regardless of age, sex, or color.

For white males and females, the highest ADR

was recorded in New England. Because of large

sampling variances, the census division with the

highest ADR for other than white males and females was not readily apparent. Nevertheless, for

other than whke males, the ADR tended to be

highest for those residing in the Middle Atlantic

census division, while that for other than white

females tended to be highest in the Mountain

census division.

i

12

1
LIST OF DETAiLED TABLES

1.

‘ 2.

3.

4.

6.

6.

7.

8.

9.

10.

Ill.

12.

13.

14.

15.

16.

17.

18.

19.

20.

21.

Number of inpatients with srlcohol.ralatad diechatges from short-stay hospitals, by color, SRX,and age: United States, 1S76 ....

Alcohol Diecharga Rata from short-stay hospitals, by color, sax, and agm United States, 1976 .................................................

Standard error of the Alcohol Discharga Rata from short-stay hospitals, by color, WX, and agw Unitad $tetas, 1976., .............

Number of female inpatients with alcohol-related dkhames from short-stay hospitals, excluding obstetrical dicanoses, W

sge end color: United States, 1976 ............................................................................................................................................

Alcohol Distharge Rate from short-stay hospitals for female inpetiants, axcluding obstetrical diegnoses, by ege and coloti

United States, 1976 .................................................................................................................................. .................... .............

Standard error of the”Alcohol Diechar@ Rate from $hort-stey hospitals for female irrfsetiense,axoluding obstetrical diagnoses,

by age and COIOCUnitad States, 1976 .......................................................................................................................................

Number of inpatients with alcohol-related cfkherges from short-stey hm.pitrds, by census division, sax, and color:

United Sm~es, 1976 .........................................................................................................i.........................................................

Alcohol Discharge Rate fmm short-stay hospimls, by aenemsdivision, sex, and color: Unimd Stares, 1976 ...............................

Stenderd error of the Alcohol Discharge Rete from short-stay hospitals, bV census region, sax, and 00I0E United States,

1976 ...................................................................................................................................................... ..:..................... ...........

Number of inpetientc with alcohol-related discharges from short-stay hospitals, by dkharge status, sex, and color:

United $tetes, 1976 ...................................................................................................................................................... .............

Alcohol Discharge Rate from short-stay hospitals, by discharge status, sex, and colon United Smtes, 1976 .............................

Standard error of the Alcohol Discharge Reta from short-stay hospitals, by dhlcharge status, se%,and color: United States,

1976 .........................................................................................................................................................................................

Number of inpatienta, aged 15 years and over, with alcohol-related discharges from short-stay hospitals, by marital status,

sex, and colon United States, 1976 ....................................................................................................................................... ....

Alcohol Disxherge Rate from short-stay hospitals for inpatients aged 16 years and over, by marital status, sex, and color:

Unltad Statas, 1976 ...................................................................................................................................................................

Standard error of the Alcohol Discharga Rate from short-emy hospitals, by marital status, sex, and color: United Smtes,

1976 ..........................................................................................................................................................................................

Numbw of inpatients with alcrshol-relatad dkharges, by bad eiza, sex, and colofi United Stat&s, f976...,..., ............................

Alcohol Discharge Rate fmm short-stay hoc@tals, by bed size, sex, and Color: Unitad Smtes, 1976 .........................................

Standard error of the Alcohol Diecharga “Ratafrom short-stay hospitals, by bed size, sax, and COIOC United Smtes, 1976 .......

Number of inpatients with alcohol-related ditahargea, by ownership of hospitcl, sex, and color: United Statas, 1976 ..............

Alcohol Discharge Rate from short-stay hospitals, by owrrarship of hospital, sax, and COIOHUnitad Stetas, 1976 ....................

Standard error of the Alcohol Disoharge Rate fm~ short-stay ho$pitela, by ownership of hospital, sex, and color:

United States, 1976 ...................................................................................................................................................................

14

15

16

1s

17

17

Is

1s

19

20

20

21

22

23

23

24

24

25

26

26

26

13
Table 1. Number of inpatients with alcohol-related dischargesf rom short-stay hospitals, by color, sax, and age: United States, 1976

Sax and age

I

25-34 yea fi ...................................................................................................................................

35-44 yeara ..........................................................................................................................c........

45-64 years ........................................................................................................................................

S5 years and owr ...............................................................................................................................

Malea

All ages...................................................................................................................................

Under 15 yeara ..................................................................................................................................

1544 years ................ .......................................................................................................................

15-24 years ...........1.......................................................................................................................

25-34 years ...................................................................................................................................

35-44 yaars ............................................................................................................................<......

45-64 years ........................................................................................................................................

65 years and over...............................................................................................................................

Females

All agas...................................................................................................................................

Under 15 years ..................................................................................................................................

15-44 years ........................................................................................................................................

15-24 years ...................................................................................................................................

25-34 years ...................................................................................................................................

3544 years ...................................................................................................................................

45-64 years ........................................................................................................................................

65 vears and over...............................................................................................................................

EllEEKz

Number in thousands

885 605

8 6

367 230

54 36

124 70

169 124

390 274

120 95

620 425

5

259

35

68

136

272

S5

264 1,760

2

I 08 6:

19 12

36 19

53 33

118 36

35 28

4

167

25

51

91

I 88

66

167

-

7

90

10

39

41

66

10

109

.

0

60

6

26

27

41

7

48 —

1

30

1:

14

15

3

1Z3

-

1

46

7

16

24

60

16

86

1

31

1:

18

43

11

36

0

15

4

4

7

77

4

NOTE: Numbers may not edd to totals due to rounding.

14 “
Table 2. Alcohol Discharge Rate from short-stay hospitals, by color, sex, and agx United States, 1976

Sex and age

,.

25-34 years..............................................................................................................................

35-44 years...................c.......................c..................................................................c...............

45-64 years...................................................................................................................................

66 years and over .........................................................................................................................

Males

All ages..............................................................................................................................

Under 16 years ..................................................................... .......................................................

15-44 years...................................................................................................................................

16-24 years..............................................................................................................................

26-34 yeers..............................................................................................................................

35.44 yeaE ..............................................................................................................................

45-64 years.........................................................................................................c.........................

65 vears and war .........................................................................................................................

W

All aWS . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .......

Under 15 years ................................................................................................................ ............

16-44 years...................................................................................................................................

15-24 yaars..............................................................................................................................

26-34 years..............................................................................................................................

35.44 years..............................................................................................................................

45-64 years...................................................................................................................................

65 wars and aver .........................................................................................................................

Total White All Nm

other stated

Rate per 100,000 discharges

T

2,573 2,314

205 214

2,573 2,229

974 931

2,353 1,820

5,467 4,807

4,619 4,087

1,513 1,489

Ir4,512 4,014

247 273

6,097 5,278

2,246 2,155

6,355 5,06f

10,302 9,069

6,934 6,034

2,428 2,381

-w=

1

162 139

1,079 860

486 422

920 657

2,478 2,086

2,615 2,402

783 803

4,089

167

4,354

1,160

5,268

9,077

7,8,95

1,807

7.642

95

11,492

3,738

13,442

17,632

12,701

2,645

1,971

259

i ,941

532

2,337

4,581

3,937

898

2,792

192

2,493

980

2,172

5,632

5,786

1,503

4.881

256

5,669

1,538

5,916

10,901

8,886

2,461

1,379

109

1,145

764

861

2,452

3,102

671

15

/
Table3. S@ndarderror of the Alcohol Discharge Rate fromshoti.smy hospitals, bycolor, ~xrand age: LInited States, 1976

Sex and age

15-24 years.......................................................................................................................

25-34 years.......................................................................................................................

35-44 years.......................................................................................................................

4564 vears............................................................................................................................

65 vears and over ..................................................................................................................

and color: United States, 1976

Total

126.7S

_

32.45

150.79

57.70

157.55

371.95

263.40

61.22

257.07

46.67

412.56

158.86

493.52

748.01

465.02

110.21

55.16

42.24

57.09

40.78

64.16

192.61

138.35

58.64

White

102.86

34.83

129,14

66.42

131.02

319.56

196.31

69.73

201.37

55.11

346.82

172.49

431.26

634.31

333,17

122.11

54.97

39,76

51.94

44.82

52.46

196.15

140.s3

64.03

All

other

253,19

86,77

301.80

131.16

465.20

682.65

554,23

176.00

534.45

69.31

979.30

541.72

1,434.17

1,578.80

916.98

303.35

137.20

1%8.49

141.93

86,14

247.24

455.30

413.43

220,71

.——-

N.m

stated

—379,57

117.96

389.35

164,00

357.73

1,042.57

889.09

158,12

745.87

147.02

961,96

396.36

1,046.49

2,055.37

1,690,23

301,27

155.96

118.04

176.28

149,68

166.68

603,66

389.47

128.75

Tabla4. Numbarof female inpatients with a[cohol-related discharges from *on-smy hospitals, excluding obsmtrical tiagnose$, bYe9e

,

Age

All Wes..............................................................................................................................

Under 15 years ................................................... ..............................................................................

15-44 years ........................................................................................................................................

15-24 years ...................................................................................................................................

25-34 years ...................................................................................................................................

35-44 yaars ...................................................................................................................................

4M4yean ........................................................................................................................................

65 years and over...............................................................................................................................

NOTE. Numbers may not a&f to totels due to rmmdfng.

16

282

_

10:

2

53

118

35

179

_

6;

12

18

33

S6

29

46

_

2:

If

14

16

3 —

36

-

1:

4

4

7

+7

4

I

I

I

,

I
Table5. Alcohol Discharge Ratm from short-stay hospitals for female inpatients, excluding obstetrical diagnoses, bv age and COIOC

United States, 1976

Age

All ages.............................................................................................................................

Under 15 years .................................................................................................................................

15-44 years.......................................................................................................................................

15-24 years..................................................................................................................................

25-34 years..................................................................................................................................

3544 yeaB ..................................................................................................................................

45-64 yeeE .......................................................................................................................................

65 years and over .............................................................................................................................

Total Whita All I

Not

other stated .

11 I I

Rata par 100,000 discharges

III

1,579 1,401 2,717 1,742

164 140 276 110

1,759 1,413 3,400 1,957

998 826 1,393 1,533

1,534 1,136 3,588 1,650

2,757 2,302 5,321 2,731

2,619 2,406 3,955 3,110

793 803 899 671

Tabla6. Stsndard error of the Alcohol Di%harge Rate from short<tiy hospitals for female inpatien%, excluding obsmtrical tiagnows,

byageandcoloc United States, 1976

Age

All ages.......................................................................................................................

Under 15 years...........................................................................................................................

15-44 yaars.................................................................................................................................

15-24 years............................................................................................................................

25-34 years............................................................................................................................

36-44 years............................................................................................................................

45-64 yeara.................................................................................................................................

65 yaars and ovar .......................................................................................................................

Total White All Not

other stated

,

Rate per 100,000 discharges

68.62

42.73

95.25

83.15

111.72

213.65

138.46

56.64

67.16

40.03

84.60

66.93

83.11

216.28

140.s7

53.48

184.25

200.15

“258.54

223.52

417.44

527.74

414.75

220.67

196.82

118.14

300.04

303.83

316.25

556.25

390.38

126.72

17
Table 7. Number of inpatients with alcohol-related discharges from short-way hospitals, by census division, sex, and color:

United States, 1976

New Middle East Wa3t

south

Eaet West

Sex and color Total England Atlantic North North Atlantic South South Mountain Pacific

Central Cantral Central Central

Both eexes I

113[ 170 I157

71 105 110

107

77

10

20

76

54

7

14

31

22

3

6

110 I

Total ................ 22

1=

8S5 50 55 I 102

i

76 16

31 5

2 1

74 15

54 11

18 2

2 1

36 8

22 5

13 2

1 0

Whit. ..............................

All other ..........................

Not stated........................

605

157

123

39

11

0

31

23

7

0

19

15

4

0

35 77

6 16

13 9

3 51 24

39 14 23

M&

I

t

37 69

25 51

4 12

B 6

g

62 125 112

50 79

2 G 16

30 10 15

31 45 45

21 26 31

1 13 6

9 4 8

ToteI ..................... 620

whita ...............................

All other ..........................

Not stated........................

425

108

66

1- Total ..................... 264

t

16 32

11 26

2 4 d 5 3

White ...............................

NOTE Numbers may not add to totals due to rounding.

Table 8. Alcohol Oischarge Rate from short-stay hoapitala, by censusdivision, sex, and color: United States, 1976

New Middle East Weal South East west

Total England Atlantic &n:$ North Atlantic South South Mountain Pacific

Central Central Central

Sex and color

/

Both eaxes

Total ...............

white .................. .............

All other ..........................

Not stated........................

M

Total ...... ..............

White ..............................

All other ..........................

Not atated........................

Famales

Total .....................

White ...............................

All other ..........................

Not stated........................

Rate per 100,000 discharges

2,573

=

2,314

4,089

2,792

g

4,014

7,842

4,881

1,281

1,156

1,971

1.379

5,630

4,286

4,644

13,750

9,887

7.327

9,078

24,434

2,620

2,134

1,973

5.715

3,076

2,394

7,159

3,245

5,718

4,386

15,257

5,782

1,343

1,062

2,804

1.555

2,374

2,231

4.120

2,100

4,1 2s

3,844

8,336

3,427

1,156

1,071

1,676

1,23B

2,630

2,659

4981

2,077

4,655

4,715

9,314

3,612

1,275

1,289

2,300

1,023

2,341

2,121

3,760

829

3,918

3,662

5,943

1,545

1.285

T

1,140 1,248 2,956

1,158 1,193 2,580

1,411 1,629 7,436

423 3,342

2.769

2,640

4,443

1,437

4,600

4,571

8,071

2,534

1.496

1,827 T

2,142 4,943

1,990 4,583

3,114 13,24B

711 4,534

1,799

2,205

1.558

657 I 741 t 1.600

1,614

1,921

736

1,044

2,513

360

18
Table 9. Standard error of the Alcohol Discharge Rata fmm short-stay hospitals, by census ragion, sax, and COIOE Unitad States, 1976

Sex”and color

Both SEXeS

Total ......

White .....................

All other ................

Not stated..............

Malaa

Total ...........

White .....................

All other ................

Not stated..............

Famales

Total ...........

White .....................

All other ................

Not stated..............

Total England

T

126.7S 1,282.09

102.66 736.60

253.19 9m.17

379.57 4,895.67

201.37

S34.45

?45.67

i

55.16

54.97

137.20

155.98

1,349,68

1,772.95

9,136.59

484.35

368.87

596.51

1,798.95

Middla

Atlantic

479.75

406.99

1,126.99

805.45

1,000.65

S50.39

2,593.66

1,559.21

159.86

;30.87

449.00

352.12

East

North

Central

193.00

213.49

476.17

519.11

368.21

39s.04

998.99

664.S5

89.82

2%%

311.57

Wwa

North

Cantral

362.4S

445,62

1,261.62

426.71

661.77

796.70

2,270.26

736,93

237.16

31s.37

650.71

243.74

South

Atlantic

22&l;

2@

‘46S.93

310.70

406.20

408.90

756.24

657.86

127.11

105.05

358.59

130.74

Eaat

South

Cantral

$$%!$

2323?q

:297.gs’

285.44

332.98

399.m

599.57

722.47

127.14

147.37

224.53

65.71

. .

. .

Weat

south

Central

lp.,06

301;04

206.53

28S.79

277.65

400.40

534.s7

100.99

98.32

229.05

164.S4

Mountain

456.3s

*2:7X

1,S52.02-

S99.67

790.99

914,00

3,409.16

1,49V.28

‘248.40

231.51

1,246.14

562:06

Pacific

. 245.06

-

:467.42

823.44

440.72

402.86

434.35

1,529.76

777.s0

156:66

176.35

476.36

234.23

..

,. ..,.. .. .

.::, .{. :

.. ... ., J:. ,’ . ..- -,

.. ....

:,

..-

19
Table 10. Number of inpatients with alcohol-related discharges from short%tav hospitals, by diaeharge status, sax. and colon

Unitad States, 197S

Sex and color

Both saxes

wKw .........................................................................................................................a..................

All other ..................................................................................... .................................................

Not tiated ...................................................~.................................................................................

Males

white ............................................................................................................................................

All othar .......................................................................................................................................

Not tired .....................................................................................................................................

Females

Wtita ............................................................................................................................................

All other ................................................................................................... ...................................

Not mamd.....................................................................................................................................

Number in thousands

865

605

157

123

620

425

109

86

2s4

180

‘4s

36

859

=

587

162

119

603 —

413

106

84

255

175

46

35 i

23 3

17 1

6 0

2 2

i5 2

12 1

3.

1 f

8 1

5 0

2 0

1 0

NOTE Numbers may not add to totalsdue to rounding.

Table 11. Alcohol Discharge Rate from short-say ho~itals, by discharge status, sax, and color: United States, 1976

8ex and color

Both saxes

Totil ...........................................................................................................................

All other...; .................................................................................................................................

Not stated...................................................................................................................................

Males

White. ....................................................................................................................................... ..

All other .....................................................................................................................................

Femalas

Total .........~......................................................................................................................

All othtir .....................................................................................................................................

Not swed ...................................................................................................................................

Rate per 100,000 discharges

2,573

2.314

4,099

2,792

4512

-

4,014

7,s42

4,881

1,281

1,156

1,971

1,379

2y9_

2,309

4,071

2,s0s

*

4,041

7,922

4,955

1,266

1,147

1,909

1,374

y21J

2,493

6,73S

1,682

~

3,279

5,871

1,949

2,004

1,622

6,603

1,362

2Jclg

2,210

985

3,823

*

3,471

6,90S

1,482

1,186

1,354

1,s94

I

,

20 —-
Table 12. Standard error,of the Alcohol Discharga Rate fram short-may hospitals, by discharge status, sex, and COIOKUnitad States, 1976

Sex and color

Both sexes -

Totil ..................................................................................................................

wMm .................................................................................................................................

All other ............................................................................................................................

Not stated..........................................................................................................................

Males

Wh[@ .................................................................................................................................

All other ............................................................................................................................

Not stated..........................................................................................................................

Females

Wtite Total.......................................................................................................................

.................................................................................................................................

All other ............................................................................................................................

Not *ated ..........................................................................................................................

All

Statuw-s

126.7E

102.86

253.19

379.57

257.01

201.37

534.45

745.87

55.16

54.97

137.20

156.98

AKwe

129.65

_

105.59

252.21

3B5.22

265.69

20B.26

%7.65

764.63

55.47

56.27

130.69

157.2S

-

Dead

206.23

220.70

955.05

460.60

294.56

341.36

,060.79

682.40

267.67

271.77

,624.17

683.31

—

Not

statad

674.04 —

731.50

857.50

1,025.14

1,144.66

1,311.98

2,164.67

418.17

5s7.1 o

1,166.21

749.50

21
Table 13. Number of inpatients, aged 15 years and over, with a!cohol-relatad discharges from short-stay hospitals, by marftal status,

sex, and color: Unitad Statas, 1976

Sex and color

Both sexes

Whim ...............................................................................................-

All other ...........................................................................................

Not tiatid .........................................................................................

B

ToWl ......................................................................................

White ................................................................................................

Not stited .........................................................................................

M

ToWl ......................................................................................

wMm ................................................................................................

Not ~=d .........................................................................................

NOTE: Numbers may not add to totals due to rounding.

22

All D ivorcad Not

narital Married Single Widowad or

;tatuses saparatad

stated

877 393

599 290

156 45

122 58

615 279

421 204

108 30

86 45

282 114

178 .85

47 15

38 14

171

103

49

20

135

83

39

13

36

19

10

7

76

5s

11

-1

35

27

6

2

41

30

6

5

192

127

39

25

132

S9

25

18

w

3s

14

7

44

-

22

;:

33

17

9

8

11

5

2

4

I

!

I

1

I

I
Table 14. Alcohol Discharge Rate from short-etw hospitals for inpatients aged 15 years and over, by marital status, sex, and color:

United States, 1976

Sex and color

Both sexes

ToUl .................................................................................

.,

Whita ...,....., .......................................................................................

!1 1 1 I 1

Nat

stated or

separated

Rate per 100,000 discharges

T

2,863 2,102

2,560 1,941

4,704 3,160

3,116 2,478

3J19J

3,090

4,915

3,389

8,230

1,906

1,798

3,194

1,648

4,587

8,498

8,089

8,872

10,422

18,738

5,853

5,870

11,819

3,867

9.720

Not stated.........................................................................................

m

Total ......................................................................................

Whita ................................................................................................

All othar .............................................................!.............................

Not Satad .........................................................................................

m

Total ...................................................................................... T

5,281 3,844

4,651 3,311

9,866 5,897

5,723 4,667

6,235

11,883

5,170

1,318

1,122

1,493

1,999

4,508

8,714

2,827

1,269

1,188

2,105

1,367

17,483

21,226

23,262

3,836

3,575

4,400

4,408

9,654

20,184

6,097

2,650

2,533

4,646 L 2,166

1,242 976

2,143 1,678

1,491 981

All other ...........................................................................................

Not stated.........................................................................................

Tabla 15. Standard error of the Alcohol Diwharge Rate from short-s@y hospitals, bymarItal stitus, wx, andcoloc United States, 1976

Divorced

or

All

marital

Not

stated

780.55 —

716.34

1,725.34

1,316.68

1,109.95

1,227.91

2,808.60

1,726.82

400.59

516.17

1,190.64

753.78

Sex and color Married Single Widowad

..

97.30

97.69

359.94

213.86

318.40

519.53

516.63

725,89

1,796.99

1,311.39

8oth .WXeS

Total ............................................................................... 128.7Z

_

102.86

253.19

379.57

257.07

11s.12 —

94.18

190.23

371.92

245.43

114.49

_

110.44

276.88

298.14

194.88

All othar .........................................................................................

Not stated.......................................................................................

Males

Total ....................................................................................

Whita .............................................................................................. 201.37

534.45

745.87

55.16

54.97

137.20

155.88

189.09

373.24

770.32

48.85

48.60

168.56

132.07

163.95

589.67

493.25

62.61

64.81

136.27

181.02

317.82

1,089.49

641.90

86.21

90.93

324.71

203.76

1,283.73

2,018.69

3,948.97

239.14

272.19

403.17

922.08

Not stated.......................................................................................

Femalas

White ..............................................................................................

All other .........................................................................................

23
Table IS. Numkr&inpatients with alcohol.mlamd @scharges,bykdsize, wx, andcolor: United States, l976

Sex and color Total 6-99 100-199 200-299 300-499 500 beds

beds beds beds beds beds or more

Both sexes Number i“ thowands

Total ...................................................................................... 885 233 153 99 226 ‘ 173

White ..................................................................................................... 605 18s 102 80 15f f 05

All other ................................................................................................ 157 19 28 13 40 57

Not amted.............................................................................................. 123 47 24 7 35 10

Malaa

.

Tota[ ........................................................................................... 820 177 110 68 148 117

White ..................................................................................................... “425 128 73 56 99 70

All other ................................................................................................ 109 14 21 8 27 40

Not smted.............................................................................................. 88 35 15 5 23 s

Females

Total ........................................................................................... 264 m 43 31 78 56

wtiw ..................................................................................................... 180 40 28 24 52 35

All other ................................................................................................ 48 5 5 14 ~7

Not swted .............................................................................................. 36 12 : 2 12 3

NOTE: Numbers may not add to totals due to rounding.

Table 17. Alcohol Disaharge Rate from short-stay hospitals, by bed size, sax, and color: United States, 1976

SBXand color

8oth eexea

Total .................................................................................

White ................................................................................................

All other ...........................................................................................

Not sti@d .........................................................................................

M

Total ......................................................................................

White ................................................................................................

All other ...........................................................................................

Not stated .........................................................................................

Females

Total ......................................................................................

All other ...........................................................................................

Not Wted .........................................................................................

II I

2.573

=

2,314

4,099

2,792

4512

-

4,014

7,S42

4,881

1,2s1 —

1,154

1,971

1,378

3.535

3,087

3,180

S,527

6,629

5.781

5,97s

15,546

1,435

1,223

1,388

3,615

I I

Rate per 100,000 discharges

2.6S4

2,430

4,726

2,528

5,024

4,642

10,s39

3,793

1,235

1,084

1,787

1,584

1,s44

1,s14

2,695

1,306

3,175

3,123

4,567

2,416

956

923

1,615

588

2.41S

2,219

4,402

2,140

3,955

3,554

7,816

3,646

1,389

1,300

2,364

1,176

2,35S

1,982

4,543

1,367

3,914

3,108

8,879

2,579

“

1,281

1,158

2,165

6s9

24
Table 18. Standard emor of the Alcohol Discharge Rata from short-stay hospitals, by bed size, sex, and COIOC United States, 1976

Sex and color

Both sexes

Total ..........................................................................

Whim .........................................................................................

Not atatad..................................................................................

Males

White .........................................................................................

All other ....................................................................................

Not stated ..................................................................................

Whita .........................................................................................

All other ....................................................................................

Not stated ..................................................................................

qw

300-499

beds

195.30

196.9!3

713.10

497.14

367.17

379.12

1,346.29

S49.66

102.43

105.s9

428.64

290.44

500 beds

or more

158.08

126.96

479.92

474.15

257.32

209.95

980.21

931.72

115.26

t 17.05

259.85

192.72

Table 19. Number of inpatients with alcohol-related discharges, by ownership of hospital, eex, and colon United Stat&, 1976

Sex and color All Proprietary Government Voluntary

ownerships nonprofit

8oth eexes

Total ..............................................................................................

All other.. .......................................................................................................

Not stated ......................................................................................................

Total .....................................................................................................

white..............................................................................................................

All other. ........................................................................................................

Not stated ......................................................................................................

Total ....................................................................................................

I

Number in thousands

620 II 85 ] 143 I 392

whita..............................................................................................................Llu

180 16 36 127

All other ......................................................................................................... 4s 3 19 26

NQt statad ...................................................................................................... 36 7 4 25

NOTE: Numbers may not add to totals duq to rwnding.

25
:.’ :.:

Table 20. Alcohol Diwharga Rate from shtirt-stay hoqi@ls, WowneraMpof howital, wx, andcolor: UniWd SWtas,l976

Sax and color All Proprietary Government VOluntaW

ownerships nonprofh

Both eaxes

Total ..............................................................................................

White ..............................................................................................................

All other .........................................................................................................

Not stated ......................................................................................................

Ma’

To=l ........................................... ........................................................

Whita.............................................1................................................................

Allothar ..............................................................................................J.........

Not statad ......................................................................................................

Femalas -—

Whita ..............................................................................................................

All other .........................................................................................................

Not statad ......................................................................................................

I

Rate per 100,000 dischergas

Rm

Mm

IJ=-11 1’”01‘A’”! 1“9’

1,166 1,304 1,262 1,113

1,971 1,376 2,3J 1 1,s47

1,379 13,5s5 649 1,227

...

Table 21. Standard error of the Alcohol Di.seharoe Rate from short-way hospitals, by ownarahip of hospital, 5ex, and color:

United Statas, 197S

Sex and coior

Bath SX8S

Total .............................................l.........................l......................

,

White ..............................................................................................................

All other ....................................................... .................................................

Not stated .............................. ...................... ................................................

*

..

-----

Toml ...... ...= ...............Q........ L. ........ .................................................

Whita ..............................................................................................................

All othar..................................... ...................................................................

Nat atatad ......................................................................................................

Fama[as

Towl ....................................................................................................

Wtite ........I~............................................................. ......................................

All other .........................................................................................................

Not stated ............................................................. ........................................

All

>wnerships

126.76

102.66

263.19

379.57

257.07

201.37

534.45

745.67

65.16

54.97

137.20

155.98

Proprietary Government ‘“’u”tary nonprof It

w

T

244.95 115.92 64X3

, 1

.,
APPENDIXES

CONTENTS

L Technicaf Notes on Methods .......................................................................................................... 28

Sti&tid Desi~of tie National Hospital Dk&q Swq .................................................... 2S

Data Collection and Processing .................................................................................................

Rcliabiity of Estimates ............................................................................................................. E

Test of Significance ................................................................................................................... 82

II. Definitions of Cmtain Tenm Used in lhis Report .......................................................................... 33

Terms Relating to Hospital and HospitaJ Characteristics ........................................................... M

Terms Relating to Hospitalization ............................................................................................. SS

Terms Relating to Diagnoses .....................................................................................................

Dcmogra@fc Terms .................................................................................................................. ::

APPENDIX FIGURE

1. Mediczd Abstract Form ................................................................................................................... 31

APPENDIx TABLE

L Distribution of short-stay hospitals in the univ$rse (Master Faciliw fnventory) and in the

National Hospital Discharge Survey sample and the number of hospftafs tit participated in the

survey, by geographic region and size of hmpitak United States, 1976 .......................................... 29

27
APPENDIX I

TECHNICAL NOTES ON METHODS

Statistical Design of the National

Hospital DischargeSurvey

Scope of the survey .-The scope of the National Hospital Discharge Survey (HDS) encompasses patients discharged from noninstitutional

hospitals exclusive of military and Veterans

Administration hffspitals, located in the 50

States and the District of Columbia. Only hospitals having six beds or more for patient use and

those in which the average length of stay for all

patients is less than 30 days are included in the

survey. Although all discharges of patients from

these hospitals are within the scope of the survey, discharges of newborn infants from all hospitals are exeluded from this report as well as

discharges of all patients from Federal hospitals.

Sampling ji-ame and size of sample.–The

sampling frame (universe) for hospitrds in the

NHDS is the Master Facility Inventory of hospitals and institutions (MFI). A detailed description of the development of MFI, its contents,

maintenance plans, and procedures for assessing

the completeness of its coverage has been

published.

The universe for the survey consisted of

6,965 short-stay hospitals contr@ed in the MFI

in 1963, 442 hospitals that were added to the

MFI in 1969, and another 223 hospitals that

were added in 1972. The distribution of the

hospitals in the MFI and in the HDS sample is

shown by bed size and geographic region in

table I.

The simple of hospitals for 1976 consisted

of 511 hospitals. Of these hospitals, 53 refused

to participate and 39 were out of scope either

because the hospital had gone out of business or

because it failed to meet the definMon of a

short-stay hospital. Thus 419 hospitals participated in the survey during 1976 and provided

approximately 223,000 abstracts of medical

records.

Sample desi~.–All hospitals with 1,000

beds or more in the universe of short-stay hospitals were selected with certainty in the sample.

All hospitals with fewer than 1,000 beds were

stratified, the primary strata being the 24 sizeby-region classes shown in table I. WMin each

of these 24 primary strata, the allocation of the

hospitals was made through a controlled selection technique so that hospitals in the sample

would be properly distributed with regard to

type of ownership and geographic division.

Sample hospitals were drawn with probabilities

ranging from certainty (for the largest hospitals)

to 1 in 40 (for the smallest hospitals).

The within-hospital sampling ratio for selecting sample discharges varied inversely with the

probability of selection of the hospital. The

smallest sampling fraction of discharged patients

was taken in the largesthospitals, and the largest

fraction was taken in the smallest hospitals. This

was done to compensate for the fact that hospitals were selected with probabilities proportionate to their size classand to assure that the overall probability of selecting a discharge would be

approximately the same in each size class.

In nearly all hospitals, the daily listing sheet

of discharges was the frame from which the subsamples of discharge were selected within the

sample hospitals. The sample dkcharges were se.

Iected by a random technique, usually on the

basis of the terminal digit(s) of the patient’s

medical record number—a number assigned

when the patient was admitted to the hospital.

If the hospital’s daily discharge listing did not

—.

show —..the medical record numbers, the sample

was selected by starting with a randomly

I

I

,

,

I

[

I

28

I

I
Table 1. Distribution of short-stay hospitals intheunivwss(MasterFacilitylnwntor~)❑nd in the National Hospital Dieaharge Survey

tsmple and the number of hospitals that participated in the surwy, by geographic region and size of hospital: United Stetes, 1976

Bed size of hospital

W

Univer* .........................................................................................................................

Total sample .................................................................................................................

Number participating .....................................................................................................

649 beds

Ufiiverw .........................................................................................................................

Total semple ..................................................................................................................

Number participating .....................................................................................................

50-99 beds

Univer* .........................................................................................................................

Totel sample ..................................................................................................................

Number participating ........................................................................i............................

100.199 beds

Total sample ..................................................................................................................

Number participating .....................................................................................................

200-29Sbeds

Unlwam.........................................................................................................................

Totalsample ..................................................................................................................

Number participating .....................................................................................................

300-486 beds

Univer* .....................i...................................................................................................

Totsl sample ..................................................................................................................

Number participating .....................................................................................................

600-999 beds

Uniuer* .........................................................................................................................

Total sempla ..................................................................................................................

Number participating .....................................................................................................

1,000 beds or more

Universe .........................................................................................................................

Total aampie ..................................................................................................................

Number participating .....................................................................................................

All

regions

7,630

511

419

3,405

66

40

1,804

76

57

1,276

106

97

592

91

72

400

94

83

135

58

52

18

18

16

Northeast

North

Central I

South

Number of hospitsls

1,157

131

116

215

7

5

296

14

11

289

26

26

192

31

25

111

25

22

46

19

16

9

9

9

2,094

148

125

879

16

15

473

19

15

398

32

28

160

26

21

133

31

27

48

19

16

3

3

3

2,966

155

120

1,608

28

13

662

29

22

393

35

28

146

20

15

103

26

25

28

- 13

12

6

5

5

west

1,413

76

6S

703

.’;

353

13

9

196

16

15

94

14

11

63

12

9

13

:

1

1

1

selected discharge and taking each M discharge of information from the hospital records to abthereafter. stract forms were ~erformed either bv the hos~ital staff or bv kmeaentatives of &e Natiorkl

Data Collection end Processing ‘Center for He&h katistics (NCHS) or by both.

In about two-thirds of the hoaoitals that DarticiData collection, –Depencling on the study pated in HDS during the ye~, this wo~k was

procedure agreed on with the hospital adminis- performed by the medical records department of

trator, the sample selection and the transeription the hospital. In the remaining hospitals, the

29
work was performed by personnel of the U.S.

Bureau of the Census acting for NCHS.

Sumey hospitals used an abstract form to

transcribe data from the hospital records. The

abstract form provides for recording demographic data, admission and discharge dates, discharge status, and information on discharge diagnoses and surgical operations or procedures (figure I). All discharge diagnoses were listed on the

abstract form in the order of principal diagnosis

or first-listed diagnosis if principrd diagnosis was

not identified, followed by the order m which

all other diagnoses were entered on the face

sheet of the medical record: AH operations were

listed in the order in which they were recorded

on the face sheet.

Shipments of completed abstract forms for

each s&nple hospitsd -were transmitted, along

with sample selection control sheets, to a Census

Regional Office. Every shipment of abstracts

was reviewed and each abstract form was

checked for completeness. Abstracts were then

sent to NCHS for processing.

Medical coding and edit.–The medical information recorded on the sample patient

abstracts was coded centrally by NCHS staff. A

maximum of five diagnostic codes was assigned

for each sample abstract; in addition, if the medical information included surgery, a maximum

of three codes for surgical operations and procedures was assigned. Following the conversion of

the data on the medical abstract form to computer tape, a tinsd medicsd edit was accomplished by computer inspection runs and a

review of rejected abstracts. If sex or age of patient was incompatible with the recorded medical information, priority was given to the medicaJ information in the editing decision.

The basic system used for coding the diagnoses on HDS sample patient abstracts is the

Eighth Revision International Classification of

Direases, Adapted for Use in the United States

(ICDA).a

Patient chai-acteristics not stated.–If age or

sex of patient was not stated on the hospital

records of sample hospitals (the face sheet of patient’s medical record), it was imputed by assigning the patient an age or sex consistent with the

age or sex of other patients with the same diagnostic code. Color was identified as “not stated.”

If the dates of admission m discharge were not

given and if they could not be obtained from the

monthly sample listing sheet transmitted by the

sample hospital, a length of stay was imputed by

assigning the patient a stay characteristic of the

stays of other patients of the same age,

Age of patient and sex of patient were not

stated for less than one-fourth of 1 percent of

the discharges. However, color was not stated

for 13 percent of all discharges and caution

should be used in drawing conclusions from the

data by color.

Rounded numbers. –Estimates of the numbers of inpatient discharges have been rounded

to the nearest thousand for tabular presentation,

For this reason, detailed figures within the tables

do not always add to tots.k. Rates and percents

were calculated on the basis of unrounded figures and will not necessarily agree with computations made from the rounded data.

Reliability of Estimates

Estimation. -Statistics produced by use of

HDS are derived by a complex estimating procedure. The basic unit of estimation is the sample

inpatient discharge abstract. The estimating

procedure used to produce essentially unbiased

national estimates in HDS has three principal

components: inflation by reciprocals of the

probabilities of sample selection, adjustment for

nonresponse, and ratio adjustment to fixed

totals. These components of estimation are

described in appendix I of two earlier pub]i:

cations .C,d

Measurement errors. -As in any survey, results are subject to nonsampling or measurement

errors, which include errors due to hospital nonresponse, missing abstracts, information incompletely or inaccurately recorded on abstract

forms, and processing errors. Some of these

cNationalCenterfor HealthStatistics:Utilization of

shor-stay hospitals,summaryof nonmedical statistics,

United States, 1965, hy Monroe G. Sirken. Vs’taland

Health Statistics. PHS Pub.. No. 1000-3eries i3-No. 2.

Public Hesltb Service. Washington. U.S. Government

printingOffice, Aug, 1967.

dNation~ Centm for He&& statistics: u~atj~n

of short-stay hospitals by characteristicsof discharged

patients, United States, 1965, by Michael J. Witldn.

Vital and Health Stat{stks.PHS Pub. No. 100tJ-Series

13-No. 3. Public Health Service.Washington.U.S. GovernmentPrintingOffice, Dee, 1967.
FORMSSDS-1

FORMERLY HSM.L3t.. I

Form Approved

11- 14-7s>

O.M.B. No. 63-R0620

CONFIDENTIAL. All inlomalion which would permit identification of a. ind,vidunl or of.. ●stablishment will be held c.. fidenti.l, will be used

only by p.rs..p emwcd i. and for ,hc purposes.1 the survey and will .OC be disclosed or released to other persons or used for .nY othe, purpose.

DEPARTMENT OP HEALTH, EOUCATION, ANO WELFARE

Public Health Service

Health Resources Adminl.tralio.

Nwian.1 Center far Ha. hh Statistics

MEDICAL ABSTRACT - HOSPITAL DISCHARGE SURVEY

L Patient Identification

1. Hospital number........ ..... 4. Date of admiaaion _ _ _.

2. HDS number .... ... ... ... .....

Monah Daq Year

5. Date of discharge

3. Medical record number..... Month Day Year

II. Patient Characteristics

1. Dete of birth: — — — 2.. Age (comp(ete ONLY

Month

{

1 ❑yeara

Ow Year if date of binh not given~

Units 2 ❑ mmths

3 ❑ days

3. Sex: 1 IJ Male 2 ❑ Female

4. Race or COIOC 1 IJ White 2 ❑ Negro 3 ❑ Other nonwhita 4 ❑ ““Nonwhite”” 5 ❑ Not stated

5. Marital atatUa: 1 ~Marriad 2 ❑ Single 3 ❑ Widowed 4 ❑ Oivorced 5 ❑ aeparamd 6 (_JNot stat%

6. Di icharge etatua: 1 ❑ Alive 2 ❑ Dmd

Ill. Diaghoaee and Operations

1. Final diagnoaes

a. Principal diagno ais:

b. Other diagnoses:

❑ see raverse side

—

2. Operations

❑ saa revw%eside

—

Cempletad by Date

FDR NCHS USE ONLY

Dlagnoaea — .. .—

CS@rations

Figurel. Madical Abstract fortha Hospitil Diwharg@Su~ay

31
I

errors were discussed under a previous section

“Patient characteristics not stated.”

Sampling errom.–The standard error is primarily a measure of the variability that is attributed }0 using a value obtained from a sample as

an estunate of a population value. In this report

it also reflects part of the measurement error.

The value that would have been obtained had a

complete enumeration of the population been

made will bk: contained in an interval represented by the sample estimate plus or minus 1

standard error about 68 out of 100 times and

plus or minus 2 standard errors about 95 out of

100 times.

Test of Signifieanee

To determine if one statistic is significantly

greater than another, the following procedure

kw used. Firk determine if

tween two statistics is equrd

32

the di~f&ence beto or greater than

1.7 times the standard error of the difference, If

so, it may be concluded that the larger statistic

is significantly greater than the smaller. Thk procedure assumes that there are 10 chances in 100

that the difference between the two statistics is

due to chance. h approximation of the standard error of the difference (d = x - y) of two

statistics x and y given by the formula

S& = (S$. + Sj?-)~, where Sx and SY are the

standard errors of x and y, respectively.

The following example illustrates the abovementioned procedure. Table 2 shows that the

Alcohol Discharge Rate (ADR) for all males is

4,512 and 1,281 for all females; table 3 indicates

that the standard error for all males is 257.07

and for females is 55.16. The formula yields a

standard error of the difference (d = 3,231) of

Sd = 262.90. Hence, as the observed difference

is more than 1.7 times its standard error, it can

be concluded that the ADR of males is significantly greater than that for females.

ooo —

I

,

t

I

I

I

I
APPENDIX II

DEFINITIONS OF CERTAIN TERMS USED IN THIS REPORT

Terms Relating to Hospital and

Hospital Characteristiee

Hospitals. –Short-stay special and general

hospitals having six beds or more for inpatient

use and an average length of stay of less than 30

days. Federal hospitals and hospital units of institutions are not included.

Bed ske of hospital. –Measured by the number of beds, cribs, and pediatric bassinets regularly maintained (set up and staffed for use)

for patients; bassinets for newborn infants are

not included. In this report the classification of

hospitals by bed size is based on the number of

beds at or near midyear as reported by the

hospitals.

Type of ownership of hospital.– The type of

organization that controls and operates the hospital. Hospitals are grouped as follows:

Voluntary nonprofit: Hospitals operated by

a church or another nonprofit organization.

Government: Hospitals operated by State or

local governments.

Proprkta~: Hospitals operated by individuals, partnerships, or corporations for profit.

Terms Relating to Hospitalization

Patient.– A person who is formally admitted

to the inpatients service of a short-stay hospital

for observation, care, diagnosis, or treatment. In

thk report the number of patients refers to the

number of discharges during the year inchdng

any multiple discharges of the same individual

from one short.stay hospital or more. Infants admitted on the day of birth, directly or by trahsfer from another medical facility, with or without mention of a disease, disorder, or immaturity me included. All newborn infants, defined

as those admitted by birth to the hospital, are

excluded. In this report, “patient,” “inpatient,”

and “p&son” are used synonymously.

Discharge.–The formal release of a patient

by a hospital; that is, the termination of a period

of hospitrdization by death or by disposition to

place of residence, nursing home, or another

hospitaL “Discharges” and “patients discharged”

are used synonymously.

Alcohol Discharge Rate. –The number of

hospital discharges with an alcohol-related diagnosis times 100,000 divided by the total number of discharges during the year.

Terms Relating to Diagnoses’ ~.

Discharge diagnossk-The classification of

one or more diseases or iojuries (or special conditions and examinations without sickness or

tests with negative findings) that the attendksg

physician assigns to the medical record of patients. In HDS ZU discharge (final) diagnoses

listed on the face sheet (summarj sheet) of the

medicrd record for patients dkcharged from the

inpatient service of short-stay hospitals are transcribed in the order listed. Each sample discharge

is assigned a maximum of five 3- or 4-digit

codes according to the Eighth Revision International Ck.+%ation of Dkeases, Adapted for

Use in the United States (ICDA) .a

Demographic Terms

Age.–Patient’s age refers to age at birthday

prior to admission to the hospital inpatient

service.

Color. –Patients are

groups, “white” and “all

classified into two

other.” The all other

33
classification includes all categories other than ing to the nine geographic divisions of the 1

white. Mexican and Puerto Rican are included in United States, which correspond to those used

the white category unless specifically identified by the U.S. Bureau of the Census. For the conas all other. venience of the reader, the following table shows

Geographic region and division. -In thk re- region and division groups for the 50 States and ‘.

port, hospitals are classified by location accord- the District of Columbia.

Region

Northeast ...........

North Central ....

south .................

West ...................

Division

. New England .............

Middle Atlantic ..........

East North Central.....

West North Central ....

South Atlantic ...........

East South Central.....

West South Central ....

Mountain ...................

Pacific; .......................

34

States included

Maine, New Hampshire, Vermont, Massachusetts, Rhode ~

Island, Connecticut

New York, New Jersey, Pennsylvania

Michigan, Ohio, Illinois, Indiana, Wisconsin I

,

Minnesota, Iowa, Missouri, North Dakota, South Da- ~

kota, Nebraska, Kansas

Delaware, Maryland, District of Columbia, Virginia, ~

West Virginia, North Carolina, South Carolina, Georgia, ‘

Florida

Kentucky, Tennessee, Alabama, Mississippi

I

Arkansas, Louisiana, Oklahoma, Texas

I

Montana, Idaho, Wyoming, Colorado, New Mexico, Ari.

zona, Utah, Nevada I

Washington, Oregon, California, Hawaii, Alaska

-000 .

I

MIS. GOVERNMENT PRINTING OFFICC 19S0 311-240/lB 1-3 ;

I
VITAL AND HEALTH STATISTICSSeries

Series 1. Programs and Collection Procedures. -Reports which describe the general programs of the National

Center for Health Statistics and its offices and divisions and data collection methods used and include

deftiltions and other materisf necessary for understanding the data.

Series 2. Data Errahsation and Methods Reseerrclc.-Studies of new statistical methodology including experimental tests of new survey methods, studies of vitrd statistics collection methods, new analytical”

techniques, objective evsfuations of relisbifity of collected data, and contributions to statistics theory.

Series 3. Analytical Studies. –Reports presenting arrsfytical or interpretive studies based on vital and health

statistics, carrying the analysis further than the expository types of reports in the other series.

Series 4. Documents and Commsltee Refmrts. –Fmrd reports of major committees concerned with vitaf and

heafth statistics and documcnta such as recommended model vital registration laws and revised birth

aud death certificates.

Series 10. Data From the Health Interview Survey. –Statistics on illness, accidental injuries, dkability, use of

hospitsl, medicaf, dental, and other services, and other heafth-related topics, afl based on data collected

in a continuing nationaf household interview survey.

Series 11. Data From the Health Examination Survey and the Health and Nutrition Examination Survey .-Data

from duect examination, testing, and measurement of national samples of the civifian noninstitutionafized population provide the basis for two types of reports: (1) estimates of the medically defined

prevalence of specific diseases in the United States and the distributions of the population with respect

to physical, physiological, snd psychological characteristics and (2).wdysisOf reIatiOnships amOng the

various measurcm&rts without reference to an expficit finite ~versa of persons.

Series 12, Data From the Imtitutio?ealized Population Surveys. –Discontinued effective 1975. Future reports from

these surveys wilf be in Series 13.

Saries 13. Data on Health Resources Utilizati”on.-Statistics on the utilization of heaftb manpower and facilities

providing long-term care, ambulatory csre, hospital care, and fa@y planning services.

Series 14. Data on Health Resources: Manpower and Facilities. -Statistics on the numbers, geographic distribution, and characteristics of health resources including physicians, dentists, nurses, other health

occupations, hospitals, nursiug homes, and outpatient facilities.

Series 20. Data on Mortality. –Various statistics on mortafity other than as included in regukw srmual or monthly

rep orts. Special smdyses by cause of death, age, and other demographic variables; geographic and time

series snrdyscs; and 5tatistics on characteristics of deaths not availakde from the vital records baaed cm

ssrcrple surveys of those records.

Series 21. Data on Nat$ity, Marrs”age,and Diuorce.–Vsxious statistics on natality, msrriage, and divorce other

than aa included in regulsr annual or monthly reports. Speciaf analyses by demographic variables;

geographic and time series anslyses; studies of fertility; and statistics on characteristics of births not

available from the vital records based on sample surveys of those records.

Sen”es 22. Data From the National Mortality and Natality Surveys. –Discontinued effective 1975. Future reports

from these sample surveys based on vital records will be included in Series 20 and 21, respectively.

Series 23. Data From the National Survey ofFamily Gro cuth.-Statistics on fertility, family formation and dissolution, fsrrdly planning, and related maternal rmd infrmt health topics derived from a bienni d survey

of a nationwide probabilky sample of ever-msrried women 15-44 years of age.

For a fist of titles of reports published in these series, write to: Scientific and Technical Information Branch

National Center for Health Statistics

Public Health Service

Hyattaville, Md. 20782