NATIONAL CENTER Series 13 

For HEALTH STATISTICS I Number1 

VITALandHEALTHSTATISTICS 

DATA FROM THE HOSPITAL DISCHARGE SURVEY 

Patients Discharged From 

Short-Stay Hospitals 

United States-October-December 1964 

Statistics are presented on patients discharged from short-stay 

hospitals, based on data abstracted from a national sample of 

records of discharged patients. Hospital discharges are distributed by size, ownership,and geographic location of the hospital and by age, sex, marital status, color, and discharge status of the patient. Conditions diagnosed and operations performed are shown in broad groups. Data collected through the 

Hospital Discharge Survey. PpfJ~rn fT m 

pU;jJi;&Tr&js WNCH 

~~ITUMAL Lww\f 

Washington, D.C. October 1966 

U.S. DEPARTMENT OF 

HEALTH, EDUCATION, AND WELFARE Public Health Service 

John W . Gardner William H. Stewart 

Secretary Surgeon Genera I 

NATIONALCENTERFOR HEALTHSTATISTICS 

FORREST E. LINDER, PH.D., Directof 

THEODORE D. WOOLSEY, Deputy Director 

OSWALD K. SAGEN, PH.D., Assistant Director 

WALT R. SIMMONS, M.A., Statistical Advisor 

ALICE M. WATERHOUSE, M.D., Medical Advisor 

JAMES E. KELLY, D.D.S., Dental Advisor 

LOUIS R. STOLCIS, M.A., Executive O//icer 

DONALD GREEN, Zn/omation O//ice? 

DlVISlON OF HEALTH RECORDS STATISTICS 

Monroe G. Sirken, Ph. D., Chief 

John Monroe, Assistant Chic/ 

Peter L. Hurley., Chiej, Institutional Population Survey Branch 

Milton C. Rossoff, M.S., Chief, Hospital Discharge Survey Branch 

COOPERATION OF THE BUREAU OF THE CENSUS 

Under the legislation establishing the National Health Survey, the Public Health Service is authorized to use, insofar as 

possible, the services or facilities of other Federal, State, or 

private agencies. 

In accordance with specifications established by the National Center for Health Statistics, the Bureau of the Census, 

under a contractual arrangement, participated in planning the 

survey and collecting the data. 

Public Health Service Publication No. 1000.Series 13-No. 1 

Library o/ Congress Catalog Card Number 66-62202 
----- 

CONTENTS 

Page 

Selected Findings -_-_---_--___-_---__--------------------------------- 1 

Source and Limitations of the Data-- _____ __ __ - - - _ _ __ _ __ ____ ____ _ __ ____ __ l 4 

Hospital Utilization _________ - ______ - ____ -___-__- ______ -___- ____________ 

Discharge Status _______-____________--------------------------

Month of Discharge------------------- _________-_----___------------

Length of Stay------------------------------------------------------

Size OfHospital ___________ __ _ _- _______ _____________________ ____ _____ 

Hospital Ownership-------------------------------------------------

Geographic Region--------------------------------------------------

Characteristics of the patient _____________ ___________________________ 

Medical Conditions and Surgery- _ - - _ _ _ ___ ________ _______ - __ ____ _______ __ 8 

Conditions for Which Hospitalized--- ___ _ _______ ______________________ 11 

Surgical Treatment------------------------------------------------- 12 

References --_---_-_-__________--------------------------------------- 12 

Text Tables 

Table A. Number and percent distribution of patients discharged from 

short-stay hospitals, by discharge status: United States, OctoberDecember 1964-------------------------------------------- 4 

B. Number and percent distribution of patients discharged from 

short-stay hospitals, by month of discharge: United States, 

October-December 1964------------------------------------ 4 

C. Number and percent distribution of patients discharged from 

short-stay hospitals, by length of stay: United States, OctoberDecember 1964-------------------------------------------- 5 

D. Number and percent distribution of patients discharged from 

short-stay hospitals, by hospital size, by ownership, and by 

geographic region: United States, October-December 1964------ 6 

E. Daily discharge ratios in short-stay hospitals. by hospital size 

and by ownership: United States, October-December 1964------- 7 
CONTENTS-Con. 

Text Tables-Con. Page 

Table F. Number and percent distribution of patients discharged from 

short-stay hospitals, by sex, by age, by color, and by marital 

status: United States,October-December 1964----------------- 8 

G. Population size and annual discharge rates from short-stay 

hospitals, by sex, by age, and by geographic region: United 

States, October-December 1964 ___--___ __ ___ ____- __ -______- - 8 

H. Number, percent, rate. and rank order of diagnoses for patients 

. discharged from short-stay hospitals, by all listed and first 

listed diagnoses: United States, October-December 1964-------- 10 

J. Number. percent, rate, and rank order of surgical operations 

and procedures performed on patients discharged from shortstay hospitals, by all listed and first listed operations: United 

States, October-December 1964-- __ __ _ __ ____ _ ----_ _______ ___ 11 

K. Number and percent of patients discharged from short-stay 

hospitals. by number of coded diagnoses and operations: United 

States, October-December 1964-- _.____ _ ___ _ ___ _ _______ ____ __ 12 

Appendix 1. Technical Notes on Methods _____- ______ __-_-____ ___-___---_- 13 

Background of This Report------------------------------------------ 13 

Statistical Design of the Hospital Discharge Survey--------------------- 13 

General Qualifications ________________________________________------ 15 

Reliability of Estimates--- __________ - ____________ - ______ -___--_- ____ 15 

Appendix II. Definitionsof Certain Terms Used in This Report------------- 17 

Terms Relating to Hospitalization ____________________________________ 17 

Demographic Terms------------------------------------------------ 17 

Codes for Diagnostic Groups Shown in Table H------------------------- 18 

Codes for Operation and Procedure Groups Shown in Table J------------ 19 
IN THIS REPORT data arepresented onpatients dischargedfrom shoststay hospitals in tlte United States during the 3-month period OctoberDecember 1964. The statistics are based on information abstracted from 

the hospital records of anational sample of hospital discharges and aye 

a by-product of a pilot study for the Hospital Discharge Survey. 

The report analyzes data on inpatient hospital discharges, both with yegard to the personal characteristics of the patient (age, sex, marital 

status, color, and discharge status) and in relation to the hospital (geographic region, size, and ownership). It also reviews the Length of stay, 

the conditions diagnosed, and the operations and operative procedures 

performed. 

The diagnosed conditions and the operations and operative procedures, 

which aye classified into b,road groups, refer to thefrequency with which 

these events occurred and not to the number of persons experiencing these 

diagnoses and operations. Some of the difficu&ties involved in interpreting data on diagnoses and operations aye discussed. 

SYMBOLS 

Data not available--- _- ____ - ______________ _-_ 

Category not applicable------------------- . . . 

Quantity zero ____ _ _________________ _- __ __ _ 

Quantity more than 0 hut less than 0.05---- 0.0 

Figure does not meet standards of * reliability or precision------------------
PATIENTS DISCHARGED FROM 

SHORT-STAY HOSPITALS 

Michael J. Witkin, Division of Health Records Statistics 

This report presents some of the first statistical findings of the Hospital Discharge Survey. 

The objective of the survey is to produce, on a 

continuing basis, national hospital patient statistics which are representative of the experience 

of the civilian population in short-stay hospitals.’ 

SELECTED FINDINGS” 

It is estimated that during the 3 months 

October-December 1964, 7,014,OOO patients w&-e 

discharged from short-stay hospitals in the 

United States. This represents an annual discharge 

rate of 148 patients per 1,000 noninstitutional 

population. Of these patients, approximately 97 

percent were discharged alive. 

One-fourth of the patients were discharged 

from hospitals having less than 100 beds; one-half 

were discharged from hospitals with less than 200 

beds. Taken as a group, the very largest hospitals 

discharged a relatively small proportion of patients. 

The annual rate of discharge per 1,000 population was highest in the South (166); it was next 

highest in the West, where the annual rate was 

163 per 1,000 population. 

Two-thirds of the patients were discharged 

from voluntary, nonprofit hospitals. One-fourth 

were discharged from governmental hospitals 1and 

nearly one-tenth from proprietary hospitals. 

Slightly over 60 percent of discharged patients were female-a ratio of 1.6 females to 

aThe data in this report relate to discharges from shortstay hospitals exclusive of military and Veterans Administration hospitals and hospital departments of long-term and custodial institutions. 

each male. Exclusive of hospitalization for deliveries the sex ratio was 1.2 to 1. 

The median age of discharged patients was 

37 years. About 15 percent of the patients were 

under 15 years of age, 44 percent were in the age 

group 15-44 years, and nearly 17 percent were 

aged 65 years and over. 

At time of discharge, 60 percent of the 

patients had but a single diagnosis, 23 percent 

of the patients had two diagnoses, and slightly 

less than 4 percent had five or more diagnoses. 

As a cause of morbidity, diseases ofthedigestive 

system ranked first among final diagnoses recorded on the face sheet of the patient’s medical 

record. 

Of all the patients discharged, 54 percent 

emerged from their hospitalization episodes without surgery having been performed. One-third of 

the patients had had one operation, and 13 percent had had two or more. 

The 7,014,000 discharges b generated 

53,908,OOO patient days of stay during the 

months. On an annual basis this represents 1,145 

patient days per 1,000 average civilian, noninstitutional population. 

About one-half of the patients were discharged 

in 4 days or less, although the average length 

of stay was 7.7 days. A stay of more than 30 

days was experienced 

b”Patients discharged” 

onymously in this report. 

corroctas used. A discharge 

it is notprecise to say that 

by 3 percent of the patients. 

and “discharges” are used synNeither term, however, is entirely 

is an action by the hospital, and 

a discharge possesses human characteristics such as age, sex, and marital status. Certain patients were discharged more than once during the S-month period: consequently, thenumberof discharges exceeds the number of patients discharged. 

1 

3 
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CONFIDENTIAL-This information is collected under authority of Public Law 652 of the 84th Congress (70 Stat, 489; 42 U.S.C.242.c.). All inform- ­

atmn which would permit identiflcatmn of an individual or an establishment will be held stnctly confidential, will be used only by persons a- = 

gaged in and for the purposes of the survey and will not be disclosed or released to other persons or used for any other purpose (22 FR 1687). -

-

HEALTH EDUCATION. AND WELFARE PHS413 2 PUBLIC HEALTHSERYICE 8 64 

ABSTRACT OF PATIENT RECORD- Hospital Discharge Survey 

rorm Loorouei ­

6”“%et B”,Pl” NO 18 R620 RI -

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1 HOSPITAL NUMBER -

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56 7 8 9= 

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- PATIENT NUMBER -

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11. FINAL DIAGNOSES: 

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- 12a. WAS AN OPERATION - YES A?. PERFORMED 7 :-::: . . -

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OPERlTlClii CODES -

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Figure I. Optical mark page reader form-Con. 
On an average day during the 3-month period, 

about 31 beds were occupied per 10,000 population. 

The percentage of occupancy (the ratio of the 

number of patient days to the number of bed 

days) was 74.3 percent. 

SOURCE AND LIMITATIONS 

OF THE DATA 

This report covers discharges during the 3 

months October through December 1964. During 

this period, a pilot study was undertaken to test 

and develop procedures for conducting the Hospital 

Discharge Survey. The substantive data reported 

here were secondary to other considerations in 

the pilot study and are a by-product of the pilot 

study. 

The principal sources of information in the 

survey are existing hospital medical records from 

which statistical information on the characteristics of the patient and his hospitalization are 

recorded on abstract forms. A copy of the abstract 

form is shown in figure 1. The data presented 

in this report are limited to items of information 

about the discharged patient that are generally 

obtainable from the summary (face) sheet of the 

patient’s medical record. The procedures used 

in sampling within a hospital and in collecting 

and processing the data are described in Appendix I. Appendix II may be consultedfor definitions 

of terms used in the survey. 

The scope of the Hospital Discharge Survey 

is limited to nonmilitary patients in short-stay 

noninstitutional hospitals having six beds or more 

and located in the 50 States and the District of 

Columbia. However, well-newborn infants are 

outside the scope of the survey. 

The universe of hospitals from which the 

sample was selected was the section of the Master 

Facility Inventory (MFI) 2 containing the names, 

addresses, and other pertinent information for 

approximately 6,900 short-stay medical and osteopathic hospitals in the United States, exclusive 

of the Veterans Administration and military 

hospitals. 

Since the estimates shown in this report 

are based on a sample of the population rather 

than on the entire population, they are subject 

to sampling error. Estimates of sampling error 

4 

Table A. Number and percent distribution 

of patients discharged from short-stay hospita Is ,r by discharge status : United 

States, October-December 1964 

Number Percent 

Discharge status distrithotiands bution 

Total --m-m- w--m 7,014 100.0 

Alive---------------- 6,767 96.5 

Dead----------------- 210 3.0 

Not St-t-d----------- 36 0.5 

‘Excludes discharges from military and 

VA hospitals. 

are presented in the section “Reliability of 

Estimates” in Appendix I. 

In addition to sampling error there are 

nonsampling errors and biases. These include, 

for example, hospital nonresponse, missing records, item nonresponse, and transcription and 

processing errors. The nonsampling errors of 

particular concern are those involved in the 

recording and coding of diagnoses andoperations. 

Table B. Number and percent distribution 

of patients discharged from short-stay hospita Is > by month of discharge : 

United States, October-December 1964 

Number 

Month of in 

discharge thousands 

OctoberDecember- 7.014 100.0 I 76.2 

October----- 2,425 34.6 78.2 

November---- 2,284 32.6 76.1 

December---- 2,305 32.9 74.3

1 

I

Excludes discharges from VA and military hospita Is. 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

23 

24 

25 

26 

27 

28 

29 

30 

31 

The nonresponse errors, together with the adjustments and imputations that were used tocompensate for them, are discussed at greater length 

in Appendix I. 

HOSPITAL UTILIZATION 

Discharge Status 

The number and percent of patients discharged alive or by death are given in table A. 

There were 3 deaths among each 100 discharges. 

Month of Discharge 

The discharges, as shown in table B, were 

almost equally distributed over the 3 months, with 

slightly more discharges occurring in October 

than in either of the other months. The average 

daily number of discharges was also higher in 

October. 

Length of Stay 

Table C shows the patients distributed by days 

of care. The length of stay ranged from less than 

LENGTH OF STAY (IN DAYS) 

Figure 2. Cumulative percent distribution of hospital episodes,by length of stay among patients 

discharged from short-stay nonmilitary hospitals: October-December 1964. 

Table C. Number and percent distribution 

of patients discharged from short-stay hospitals,1 by length of stay: United 

States, October-December 1964 

Number Percent 

Length of stay in dis trithousands bution 

Total--------- 7,014 

Under 1 day--------- 158 

day--------------­ 582

days-------------­

days-------------­

days-------------­

days-------------­

days-------------­

days-------------­

days-------------­

days-------------­

days------------­

days------------­

days------------­

days------------­

days------------­

days------------­

days------------­

days------------­

days------------­

days------------­

days------------­

days------------­

days------------­

days------------­

days------------­

days------------­

days------------­

days------------­

days------------­

days------------­

days-------------

951 

968 

829 

618 

434 

393 

z: 

180 

149 

135 

100 

112 

:; 

64 

$4 

z: 

26 

E 

24 

f Y 

20 

21: 

days and over---- 226 

Not stated---------- 60 

'Excludes discharges from military and 

VA hospitals. 

1 day to 317 days. The modal and average (mean) 

lengths of stay were 3 and 7.7 days, respectively. 

About one-half of the patients were discharged 

in 4 days or less. 

As shown in figure 2, the cumulative percent 

distribution of discharges by length of stay rose 

sharply until about 10 days, then gradually leveled 

off until a virtual plateau was reached from 30 

days on. Approximately 11 percent of the patients 

were discharged in 1 day or less; about 70 per5 
Table D. Number and percent distribution 

of patients discharged from short-stay

hospitals, 1 by hospital size, by ownership, and by geographic region: United 

States, October-December 1964 

- -

-r 

Hospital size, Number Percent 

ownership, in distriand region thousands bution 

Total-------- 7,014 100.0 

Hospital size 

Less than 100 bedsLOO-199 beds-------

200-299 beds-------

1,737

1,795

905 

24.8 

25.6 

12.9 

300-499 beds-------

500-999 beds-------

1,593

821 

22.7 

11.7 

1,000 beds andover- 163 2.3 

Owner ship 

Voluntary---------- Church----------- 4,640 

1,767 

66.2 

25.2 

Other nonprofit-- Government---------

Proprietary--------

2,872 

1,728 

646 

41.0 

24.6 

9.2 

Region 

Northeast----------

North Central------ South--------------

West---------------

1,437

1,895

2,416

1,267 

20.5 

27.0 

34.4 

18.1 

‘Excludes discharges VA hospita 1s. from military and 

cent were discharged within a week; and 96 percent 

were discharged within 30 days. 

Size of Hospital 

The smallest hospitals, as a group, accounted 

for a greater number of discharges than did the 

largest hospitals. Hospitals with less than 100 

beds accounted for about one-quarter of the 

discharges (table D), while hospitals with 1,000 

beds or more yielded only 2.3 percent of the 

discharges. More than 85 percent of the discharges occurred in hospitals having less than 

500 beds. 

The daily number of discharges per 1,000 

beds (discharge ratio) by hospital size and by 

r 160 

148.2 

123 I 

Northeast South 

GEOGR :GION 

Figure 3. Number of patients discharged from 

short-stay nonmilitary hospitals per 1,000 population per year, by geographic region: October-December 1969. 

ownership is given in table E. The discharge 

ratio is a crude measure of the turnover of 

patients and is a reflection of the average length 

of stay as well as the percentage of beds occupied. 

As is shown in table E, the discharge ratio 

varies inversely with the hospital size group. 

Hospital Ownership 

Voluntary nonprofit hospitals accounted for an 

estimated 4,640,OOO discharges, or about twothirds of the estimated totalnumber of discharges 

during the S-month period (table D). Approximately two-thirds of the discharges from voluntary 

6 
Table E. Daily discharge ratios in short-stay hospitals? by hospital size and by 

owner ship: United States, October-December 1964 

Daily discharge

Hospital size and ownership ratio 

(per 1,000 beds)3 

Total-----------------------------

Hospita 1 size 

Less than 200 beds----------------------

200-999 beds----------------------------

1,000 beds and over---------------------

Owner ship 

Government------------------------------

Nongovernment---------------------------

782 71,924 97.5 

365 33,586 105.2 

388 35,655 93.1 

29 2,683 60.6 

190 17,519 98.7 

591 54,406 97.2 

IExcludes discharges from military and VA hospitals. 

“Number of beds multiplied by number of days in quarter. 

:<Number of discharges 

Number of bed days s 1,000 

nonprofit hospitals occurred in hospitals which 

were other than church owned or controlled. 

About one-quarter of the discharges were from 

government hospitals. 

Geographic Region 

About one-third of the patients were discharged from hospitals in the South, about onequarter from hospitals in the North Central 

Region, and about one-fifth each from the Northeast and West (table D). The annual discharge 

rates per 1,000 population in the South and West 

were virtually the same but were markedly higher 

than the rates for the other two regions (fig. 3). 

Characteristics of the Patient 

The number and percent of patients discharged are shown by age, by sex, by. marital 

status, and by color in table F. The discharge 

rates per 1,000 population per year, by age and 

by sex, are given in table G. 

Age.- Patients aged 15-24years and 65 years 

and over each accounted for nearly one-sisth of 

the total discharges. The median age of the patients 

discharged was 37 years. 

The discharge rate per 1,000 population was’ 

highest among adults 65 years and over and lowest 

among children 1-14 years (fig. 4). The rate was 

also high for infants under 1 year of age. However, 

this rate would be much higher if well-newborn 

infants in addition to nonwell-newborn infants were 

included in the survey (see definition in Appendis II). There were an estimated 871,000 wellnewborn infants as compared with approximately 

S7.000 nonwell-newborn infants. 

The rates for the 15-24 and 25-34 age groups, 

respectively, were more than 2% times the rate 

for the 1-14 age group. The high discharge rates 

among persons 15-34years of age in some measure reflect the large number of women who 

were hospitalized for deliveries and conditions 

of pregnancy, childbirth, and the puerperium. 

Sex, marital status, and color.--The ratio 

of females to males among discharges was 1.6 

to 1.0. The annual discharge rate per 1,000 

females in the population was about 1% times 

the rate for males (fig. 5). Again, the major 

reason for the proportionately larger number of 

7 
females among discharged patients was the 

numerous hospitalizations for deliveries and 

conditions of pregnancy, childbirth, andthepuerperium. 

Married patients (including separated) accounted for an estimated 4,398,00Odischarges,or 

more than three-fifths of all discharges. For 

approximately 3 percent of the patients discharged, marital status was not reported. 

Table F. Number and percent distribution 

of patients discharged from short-stay hospitals,1 by sex, by age,by color, and 

by marital status: United States, October-December 1964 

Sex, age, color, Number ?ercent 

in listri­ and marital status thousands bution 

Tot-1 ---m-e-- 7,014 100.0 

Sex 

Male---------------

Female-------------

Not stated------L--

2,694

4,289

31 

38.4 

61.2 

0.4 

Age 

Under 1 year------- 1-14 years---------

215 

857 1Z 

15-24 years-------- 25-34 years-------- 35-44 years-------- 45-54 years-------- 55-64 years-------- 65 years and over--

Not stated;--------

1,144

1,036

876 

832 

719 

1,154

180 

16:3 

14.8 

12.5 

11.9 

10.3 

16.5 

2.6 

Color 

kite----------..---

Nonwhite-----------

Not stated---------

5,895 513 

606 

84.1 

26" 

Marital status 

Married (including separated)--------

Not married-------- 4,398

2,400 

62.7 

34.2 

Single-----------

Widowed---------- 1,706 24.3 

569 8.1 Divorced--------- 125

Not stated--------- 216 i:"L 

'Excludes discharges from military and 

VA hospitals. 

Table G. Population size and annual discharge rates from short-stay hospi­ tals,l by sex, by age,and by geographic region: United States, October-December 

1964 = 

Sex, age, Population Annual 

and region in

thousands2 discharge rate3 

Total------- 188,380 148.2 

Sex 

Male-------------- 91,288 Fe~le------------ 97,092 

Age 

Under 1 year------ 1-14 years-------- 15-24 years------- 25-34 years------- 35-44 years------- 45-54 years------- 55-64 years------- 65 years and over4,084

55,374

28,129

21,399

23,929

21,592

16,582

17,294 

215.0 

63.2 

166.2 

197.7 

149.5 

157.5 

177.2 

272.6 

Region 

Northeast---------

North Central----- 46,448

52,995 

123.1 

South------------- 58,071 %*2 

West -------------- 30.866 163:3 

lExcludes discharges from military and 

VA hospitals. 

2Provisional estimates for the civilian, noninstitutional population were 

obtained by averaging U.S. estimates pro­ vided by Bureau of the Census for November 1 and December 1, 1964. 

3Expressed as annual number per 1,000

civilian, noninstitutional population. 

Of the 7,014,OOOpatients discharged, 84.1 

percent were reported as white and7.3percentas 

nonwhite. 

MEDICAL CONDITIONS ’ 

AND SURGERY 

All final diagnoses, operations, and procedures listed on the summary face sheetofthe 

discharged patient's medical record were coded 

according to the International Classification of 

Diseases, Adapted (ICDA),s which was further 

adapted for the Hospital Discharge Survey. For 

8 
176.6 

197.7 

63.2 

15-24 25-34 55-64 

IGE IN YEARS 

Figure 4. Number of patients discharged from 

short-stay nonmilitary hospitals per 1,000 population per year, by age:October-December 1969. 

discharges with mu ltiple diagnoses and mu ltiple 

operations, each diagnosis not to esceed five was 

assigned a four-digit code and each operation not 

to exceed three was assigned a three-digit code. 

All coded diagnoses and all coded operations are 

tabulated by broad groupings in tables H and J, 

respectively. Tabulations of the first listed diagnosis and the first listed operation are also 

presented in tables H and J. 

In mu ltiple-diagnosis cases the first listed 

diagnosis on the face sheet may have different 

meanings among hospitals and even among patient 

records within the same hospital. Some meanings 

that the first listed diagnosis may have are as 

follows: 

1. The diagnosis most responsible for the 

patient’s admission 

2. The diagnosis which requires most of the 

treatment 

118.0 

Male Female 

SEX 

Figure 5. Number of patients discharged from 

short-stay nonmilitary hospitals per 1,000 population Pet-Year, by sex: October-December 1964. 

3. The diagnosis which contributes most to 

the duration of stay 

4. The diagnosis that is the most serious or 

dangerous or has the poorest prognosis 

A study based on hospital records, which 

was conducted by the Bureau of Hospital Administration, University of Michigan, under contract 

with the National Center for Health Statistics, 

found that in 91.5 percent of the records studied, 

the first of the aforementioned meanings was 

attached to the first listed diagnosis.4 However, 

for records of discharges with mu ltiple diagnoses 

only, the first of these meanings was attached 

to the first listed diagnosis 80 percent of the time. 

It thus appears reasonable to assume that, 

considering diagnoses in their entirety, inpatients 

with mu ltiple diagnoses the first listed diagnosis 

is quite likely to have been the diagnosis that led 

to the hospitalization of the patient. However, the 

first listed diagnosis can have other meanings. 

9 
Table H. Number, percent, rate,2 and rank order of diagnoses for patients discharged from shortstay hospitals,1 by all listed and first listed diagnoses: United States, October-December 

1964 -

l- Number in Percent Rate per 1,000

thousands population4 

Diagnostic group3 

Total---------------------

Infective and parasitic diseases-----------------------

Malignant neoplasms, all sites 

and types----------------------

Benign and unspecified neoplasms ------------------_---

Allergic, endocrine system, metabolic, and nutritional 

diseases----------------------

Diseases of blood and bloodforming organs-----------------

Mental, psychoneurotic, and 

personality disorders----------

Diseases of nervous system and sense organs---------------

Diseases of circulatory system-­ Diseases of respiratory system-­ Diseases of digestive system----

Diseases of genitourinary 

system-------------------------

Delivery------------------------

Conditions of pregnancy and 

puerperium---------------------

Diseases of skin and cellular

tissue---------------I----------

Diseases of bones and organs of movement--------------------

Congenital malformations--------

Certain diseases of early infancy, including prematurity---

Injuries and adverse effects of 

chemical substances and other

external causes----------------

Symptoms, senility, and illdefined conditions not elsewhere classified---------------

Disease undiagnosed-------------

All First All First All First 

listed listed listed listed listed listed 

11,801 7,014 100.0 100.0 249.3 148.2 

139 83 1.2 1.2 2.9 1.8 

351 227 3.0 3.2 7.4 4.8 

368 231 3.1 3.3 7.8 4.9 

485 175 4.1 2.5 10.2 3.7 

182 49 1.5 0.7 3.9 1.0 

294 149 2.5 2.1 6.2 3.2 

517 282 4.4 4.0 10.9 6.0 

1,347

1,220

1,553 

586 

851 

1,024 

11.4 

10.3 

13.2 

1;.:

14:6 

28.5 

25.8 

32.8 

12.4 

18.0 

21.6 

1,127

1,063 

578 

1,025 

9.6 

9.0 1::: 

23.8 

22.5 

12.2 

21.7 

22.6 179 1.9 2.5 4.8 3.8 

195 109 1.7 1.6 4.1 2.3 

452 241 

86 44 i:; 2 E 29' 

106 71 0.9 1.0 2.2 1.5 

1,236 721 10.5 10.3 26.1 15.2 

501 249 4.2 10.6 

355 140 3.0 E 7.5 

Rank order 

All First 

listed listed 

. . . . . . 

18 17 

13 11 

11 10 

9 13 

17 19 

14 14 

1 : 

4 3 

1 2 

2 T 

15 12 

16 16 

:i 2: 

19 18 

3 4 

8 

12 1; 

corresponds with 

in multiple diaglExcludes discharges from military and VA hospitals. 

'The maximum number of diagnoses coded was limited to 5 per hospital episode. 

3See Appendix II for diagnoses coded and grouped in each category. 

'Expressed as annual number per 1,000 civilian, noninstitutional population. 

Additional studies are needed before a more defin- 1. It is the major operation 

itive interpretation of the first listed diagnosis can 2. It is the operation that be made. the first listed diagnosis Among patients with multiple operations, the nosis cases meaning of the first listed operation is obscure. 

Several possible meanings are as follows: 3. It is the operation related to the most 

serious condition 

10 
---- 

Table J. Number, percent, rate, and rank order of surgical operations and procedures performed 

on patients discharged from short-stay hospitals> by all listed? and first listed operations:

United States, October-December 

-

1964 

- - -

r Number in r Percent thousands Tpopulation4

Rate per 1,000 Rank order 

Operation and procedure groups 

All First All 7irs.t All First All First 

listed listed listed listed listed listed listed listed 

Total--------------------- 4,341 3,212 100.0 100.0 91.7 67.9 -

012 nervous system--------------- 87 66 2.0 1.4 17 

on eye--------------------------

On ear, nose, and throat, not 

92 78 2.1 ::; 1.7 16 :1 

elsewhere classified----------- 116 14 18 

Tonsillectomy, adenoidectomy---- 300 62:: 62:: 61:: 5 4 

Other operations on buccal 

cavity and esophagus----------- 129 71 3.0 2.2 2.7 1.5 11 14 

On bronchi, lung, pleura, 

On breast----------------------- :A. 2 Repair of hernia -_---------- 1:; f*f i-1 ;:8' 10 8 Appendectomy-------------------- 2:5 313 

Hemorrhoidectomy---------------- Cholecystectomy----------------- ii 

75 

1.2 

2.3 ::3 

0'2 

1:6 

2: 

19 

:A 

13 

On other sites of gastrointes- tinal tract and related organs- On urinary organs---------------

322 188 

45 3.4 

5.8 6.8 

E 

4 

197 

On male genital organs---------- On female genital organs, 

1% 71 217 ::i 2: 1:5 :5 16 

chest wall, and mediastinum---- 18 0.6 0.6 0.4 

escept obstetrical------------- 586 325 13.5 10.1 12.4 6.9 3 

Obstetrical procedures---------- 702 646 16.2 20.1 14.8 13.7 

On musculoskeletal system------- 338 10.5 : 

On skin and subcutaneous tissue- ";6'; 195 24 6.1 2: i:: 6 

Endoscopy (cystoscopy, bronchoscopy, etc.)------------ 274 233 6.3 7.3 5.8 4.9 5 

Certain other nonsurgical procedures--------------------- 165 82 3.8 2.6 3.5 1.7 10 

All other operations, including ill-defined---------- 120 99 2.8 3.1 2.5 2.1 12 9 

'Excludes discharges from military and VA hospitals. 

'The maximum number of operations coded was limited to 3 per hospital episode. 

%ee Appendix II for operations and procedures coded and grouped in each category. 

'Expressed as annual number per 1,000 civilian, noninstitutional population. 

Conditions for Which Hospitalized Two or more diagnoses were coded for twofifths of the discharges (table I<). Nearly 12 

Based on the tabulations of the first listed million diagnoses were coded for the 7 million 

diagnoses in table H, delivery ranked first as the discharges during the 3-month period of the 

cause of hospitalization. Diseases of the digestive survey-an average of 1.7 diagnoses per dissystem ranked as a close second. Each of these charge. Based upon tabulation of all listed diagdiagnostic classes accounted for almost 15 percent noses, diseases of the digestive, circulatory, and 

of all discharges. Diseases of the respiratory respiratory systems ranked first, second, and 

system and injuries accounted for about 12 percent fourth, respectively, as the most prevailing condiand 10 percent, respectively. Each of the other tions; injuries ranked third. Each of these acdiagnostic classes accounted for less than 10 counted for between 10 and 13 percent of all listed 

percent of the discharges. diagnoses. 

11 
Table K. Number and percent of patients

discharged from short-stay hospitals ,r 

by number of coded diagnoses and operations: United States, October-December 

1964 

-

Number 

in Per- Diagnoses and operations thou- cent 

sands 

Total-------------- 7,014 100.0 

Number of diagnoses 

- __------_---__-------- 4,216 60.1 ~-I---------------------- 1,596 22.8 -__----------_--_ -_-_--- 668 9.5 ~------------------------ 282

5 or more---------------- 252 2 

Operations and 

procedures 

O------------------------ 3,802 54.2 l------------------------ 2,330 33.2 

2 __________-------------- 636 

3 or more---------------- 246 

*Excludes discharges from military and 

VA hospita 1s. 

Surgical Treatment 

An estimated 3.2 million patients, or 45percent of 7 million discharges during the 3-month 

period, had surgery during hospitalization. About 

one-third of the discharged patients had a single 

operation, and about 13 percent had two or 

more operations. Thus the 3.2 million patients 

receiving surgical treatment had about 4.3 million 

operations. 

Based on the tabulation of the first coded 

operation, obstetrical procedures ranked first and 

accounted for about one-fifth of all discharges with 

surgery (table J). This was true despite the 

evidence that such a common obstetrical procedure as “episiotomy without low forceps” was 

not abstracted about 10 percent of the time it 

appeared on the face sheet. 

Operations on the musculoskeletal system, 

operations on female genital organs (except 

obstetrical), and tonsillectomy-adenoidectomy 

ranked second, third, and fourth, respectively, 

each accounting for about 10 percent of the 

patients who had been treated surgically. The 

rankings of the most prevalent operations based 

on the first coded operations were quite similar 

to those based on all the coded operations. The 

four highest ranking operations according to the 

first listed operations were ranked 1, 3, 2, and 5 

when consideration was given to all listed operations. 

Certain types of operations accounted for a 

larger proportion of the first coded operations 

than of all coded operations, since they had a 

tendency not to appear in combination with other 

operations or operative procedures. Thus, obstetrical procedures accounted for 20 and 16 percent, 

respectively, of first coded and all coded diagnoses. Also, tonsillectomy and adenoidectomy 

accounted for 9 percent of first coded but less 

than 7 percent of all coded diagnoses. 

lNationa1 Center for Health Statistics: Origin, program, 

and operation of the U.S. National Health Survey. Vitd and 

Health Statistics. PHS Pub. No. lOOO-Seriesl-No. 1. Public Health Service. Washington. U.S. GovernmentPrinting 

Office, Aug. 1963. 

9National Center for Health Statistics: Developmentand 

maintenanceof a national inventory of hospitals and institutions. Vital and Health Statistics. PHS Pub. No. lOOO-Series I-No. 3.~PublicHealth Service. Washington.U.S. Government Printing Office, Feb. 1965. 

31nternational Classification of Diseases Adapted foT IndexingHospita1 Records by Diseases and Operations, 2 vols., 

rev. ed. PHS Pub. No. 719. Public Health Service. Washington. U.S. Government Printing Office, Dec. 1969. 

4Grenholm, G. G.: The 1961-1963 Changing Patterns of 

Hospital Study, Methodological Considerations. Unpublished 

report prepared by Bureau of Hospital Administration, Graduate School of Business Administration, The University of 

Michigan, under contract with the National Center for Health 

Statistics, Oct. 1965. 

000 

12 
APPENDIX I 

TECHNICAL NOTES ON METHODS 

Background of This Report 

This report, prepared in the Division of Health 

Records Statistics, is the first in this series of statistical reports on the Hospital Discharge Survey. It 

is based on information collected for a subsample of 

discharges occurring in the 3-month period OctoberDecember 1964 in a pilot study of the Hospital Discharge Survey. The main purpose of the pilot study 

was to test alternative procedures for collecting information from the patients’ medical records for a 

national sample of discharged patients. Knowledge 

gained from the pilot study resulted in the development 

of the procedures and forms for the survey. 

The substantive data presented in this report are 

a by-product of the pilot study. 

Statistical Design of the 

Hospital Discharge Survey 

.%x&e of the surve)r.-The scope of the Hospital 

Discharge Survey encompasses nonmilitary patients 

discharged from noninstitutional hospitals having sis 

beds or more for inpatient use, located within the 50 

States and the District of Columbia, and having an 

average length of stay of less than 30 days. 

Well-newborn infants are out of scope of the survey. Newborn infants are considered in scope only if 

at least one of the following conditions has been specified in the medical record: 

1. Immaturity or prematurity 

2. Any disease. condition, syndrome, disorder, 

injury, malformation, or birth defect 

3. Any operation or surgical procedure other than 

routine Circumcision 

4. Birth occurred under nonsterile conditions 

Sampling frame and size of sample.-The sampling 

frame for hospitals in the Hospital Discharge Survey is 

contained in the Master Facility Inventory (MFI). A 

detailed description of how the MFI was developed, its 

content, maintenance plans, and a procedure for assessing the completeness of its coverage has been published. 2 

The sampling frame for the pilot study consisted 

of 6,957 hospitals, including Veterans Administration 

(VA) hospitals. About 95 percent of these hospitals 

were classified as general hospitals. The distribution 

of short-stay hospitals in the universe (MFI) and in 

the Hospital Discharge Survey pilot study sample are 

shown in table I. The VA hospitals were originally in 

the frame from which the certainty panel, comprised 

of hospitals of 1,000 beds or more, and the first noncertainty panel, comprised of hospitals of less than 

1.000 beds, were drawn. These two panels constituted 

the pilot study sample. The VA hospitals that were 

selected in the pretest sample were dropped because 

of problems of scope. Adjustments on the data necessitated by their removal are mentioned later in this appendix. The estimates in this report do not include VA 

hospitals. 

The sample for the 

consisted of 95 hospitals; 

while 23 had 1,000 beds 

MFI. Included among the 

VA hospitals, 5 of which 

pretest as originally drawn 

72 had less than 1,000 beds, 

or more as reported in the 

95 selected hospitals were 9 

were in the bed-size class of 

1,000 or more. The latter, having been selected in 

the sample with certainty, could be dropped from the 

survey without affecting the design. 

Of the 36 non-VA hospitals, 2 were ruled out of 

scope, 2 hospitals failed to participate, and 1 hospital 

did not submit usable data for the J-month period 

covered by this report. In all, Sl of the S4 in-scope 

hospitals submitted abstracts for the months of October, 

November, and December 1964. 

Sa@Le desigm-The survey utilized a highly stratified two-stage sample design, the first stage being a 

selection of hospitals and the second stage involving a 

systematic selection of discharges within these hospitals. An abstract was prepared for each in-scope sample 

discharge, which served as the basic unit of analysis. 

All hospitals of 1,000 beds or more in the universe 

(exclusive of VA and military hospitals) were selected 

with certainty. All hospitals having less than 1,000 

beds were stratified, with the primary strata being the 

24 bed-size-by-region classes, as shown in table I. 

Within each of these 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 ownership and geographic division within each of the 24 classes. The 

sample hospitals were drawn with probabilities ranging 

from certainty for the largest hospitals to 1 in 40 for 

the smallest hospitals. 

13 
Table I. Distribution of short-stay hospitals in the universe (MFI) and in the Hospital Discharge

Survey pilot study sample,l by bed-size class and geographic region 

-

T Region

All North- North 

regions east Central South West 

Bed-size class 

All sizes 

6-49 beds 

50-99 beds 

100-199 beds 

200-299 beds 

300-499 beds 

500-999 beds 

Sarnple-------------------------------------------------

Universe-----------------------------------------------

1.000 beds and over 

l,lZ 

20; 

289” 

274 

l& 

11; 

463 

11 

11 

8182 65: 

43: 30: 

37: 16; 

16: 

4 

132 

4; 

5 

5 

‘Includes VA hospita 1s ; excludes military hospitals. 

The within-hospital sampling ratio varied inversely 

with the probability of selection of the hospital. The 

smallest fraction for sampling discharges was applied 

to the largest hospitals, and the largest sampling fraction was applied to the smallest hospitals. Each discharge in the noncertainty panel of hospitals had a 

probability of selection of approximately 1 in 1,000; 

each discharge in the certainty panel of hospitals had 

a probability of selection of 1 in 100. (It is planned that 

the overall sampling fraction will be approximately 1 

in 100 in all strata when the full sample design is in 

operation.) 

Data collection.-In nearly all hospitals, the daily 

listing of discharges was the frame from which the samples of discharges were selected. The latter were selected in a systematic manner, usually on the basis of 

the terminal digit(s) of the patient’s medical record 

number. If the sampling frame at the hospital contained 

no medical record number, the sample was selected 

by starting with a predetermined number and taking as 

specified a certain proportion of the records thereafter. 

Depending upon the study procedure agreed upon 

with the hospital, the selecting of the sample and the 

abstracting of the records were done either bythe hospital staff, by representatives of the National Center 

for Health Statistics, or by both. 

Two versions of the abstract forms were being 

tested: an optical mark page reader form (PHS 4734-2, 

fig.1) and a conventional form (PHS 4734-l). Both contained identical information, but their formats differed 

14 
and they were processed somewhat differently. The 

preparation of a punchcard was not required for the 

mark page abstract form because the coded information 

was converted directly to computer tape by an Optical 

Mark Page Reader. The coded information on the conventional abstract form was reproduced on a punchcard, 

which was then converted to computer tape. 

Data processilzg.-Shipments of completed abstract 

forms for each sample hospital were transmitted to the 

Center for processing. Every shipment of abstracts was 

reviewed; each abstract form was edited; and, as necessary, problems were referred to the hospitals for 

correction. Up to five diagnoses and up to three operations recorded on the abstract forms were codedin accordance with the 1CDA.a as modified by the Mediial 

Codiw Manzral prepared by the Hospital Discharge 

Survey. This number includes, however, virtually all 

diagnoses and operations recorded on the patient’s 

summary sheet. 

Estirnation.- Estimation, or conversion of the sample data into statistics for the Nation, is accomplished 

in four phases: (1) Inflation of sample data by the reciprocals of their probabilities of selection-separately 

for the two stages of selection; (2) a set of three adjustments identified in the following paragraph; (3) a 

within-hospital ratio control to total number of dis- l 

charges reported by the hospital; and (4) a first-stage 

ratio control to total number of beds in each of the 

primary size-class strata in the MFI frame. Thus 

final statistics are the product of two-stage ratio estimators utilizing edited data. 

After the abstracts for each hospital were inflated by their overall weights, three types of adjustments were made. The functions of these three adjustments were (1) to adjust for out-of-scope hospitals that 

were dropped from the sample, (2) to adjust for nonresponding in-scope hospitals, and (3) to correct for 

missing abstracts for in-scope sample discharges. 

In this report no imputations ware made for individual items on the abstract form for which information 

was lacking. Instead, missing individual items w:xe 

labeled “not stated . ” 

General Qualifications 

Factors affecting interpetation of rates.- The detailed tables (frequency and percent) show the extent to 

which certain characteristics were not reported. However, in computing rates per 1,000 population, these 

“not stated” cases were distributed proportionately 

among the stated categories on the assumption that the 

characteristics of discharges for which information was 

not available were distributed in the same manner as 

those for which it was available. This may not be an 

entirely valid assumption. However, it should not alter 

the rates appreciably, sincefor rates of all characteristics shown, the number of not stated cases was less 

than 3 percent of the total discharges. For color, 8.6 

percent of the cases were not stated. This was due in 

part to the fact that some hospitals did not routinely 

record this item. No rates were computed by color. 

No rates were computed for marital status either, 

since over 3 percent of the cases were not stated. 

The rates shown for the October-December 1964 

period are annual rates expressed as a number per 

year per 1,000 nonmilitary, noninstitutional population. 

In effect, this is a way of expressing rates in terms of 

a standard time period-namely, a year-irrespective 

of the period of time to which the absolute numbers 

apply. However, the absolute numbers for the 3-month 

period, e.g., 7,014,OOO discharges, should not be multiplied by 4 in order to show an absolute number for an 

entire year. 

Population figures.-The base populations used in 

computing the rates are provisional estimates for the 

civilian, noninstitutional population obtained by averaging estimates for the United States and provided by 

the Bureau of the Census for November 1 and December 

1, 1964. These estimates are solely for the purpose of 

providing denominators for rate computations and are 

not to be considered as official population estimates. 

Ramdingof rwnbevs.- The subsets of the totals in 

the tables may not add to the totals, since the subsets 

have been rounded independently of the totals. 

Reliability of Estimaies 

Since the estimates are based on a sample, they 

may differ somewhat from a complete enumeration, 

which would consist of every discharge in every shortstay hospital. As in all surveys, in additionto sampling 

Table II. Estimated frequencies and corresponding relative standard errors for selected statistics shown in this report 

Characteristic 

Length of stay:

7 days or less--------

8 days or more--------

Number of operations: No operations--------- 1 or more-------------

Number of diagnoses: 1 diagnosis----------- 2 or more -----_-_-----

Age: Under 65 years-------- 65 years and over-----

Estimated Relative 

discharges standard 

error 

Number in Percent thousands 

4,976 

2,038 

3,802 

3,212 

4,216 

2,798 

5,829 

1,185 
errors, the results are also subject to measurement 95 out of 100 that the difference would be less than 

errors. twice the standard error and about 99 out of 100 that 

The standard error is a measure of samplingvari- it would be less than 24i times the standard error. 

ability, that is, the variations that might occur by chance The relative standard error of an estimate is obbecause only a sample of the universe is surveyed. As tained by dividing the standard error of the estimate 

calculated for this report, the standard error also re- by the estimate itself and is expressed as a percentage 

flects part of the measurement error, but it does not of the estimate. The relative standard errors given in 

include any biases in the data. The chances are about table II are for selected statistics shown inthis report. 

68 out of 100 that an estimate from the sample would The relative standard errors of these statistics are 

differ from the value obtained from a complete census shown since they represent sampling errors for a wide 

by less than the standard error. The chances are about range of estimated frequencies. 

000 

16 
APPENDIX II 

DEFINITIONS OF CERTAIN TERMS USED IN THIS REPORT 

Terms Relating to Hospitalization defect was made by the physician attending 

the birth 

Hospital.-In this survey an establishment is a 3. No operation (other than a routine circumhospital if it meets all of the following conditions: cision) was performed 

1. It maintains at least sis beds for use by 4. The birth was under sterile conditions 

inpatients Final (discharges diagnosis.-Final diagnoses are 

2. It is licensed as a hospital by the State in those which take into account revisions of the working 

which it is located if the State has a hospital diagnoses and represent a final statement of opinion 

licensure law after tests and medical examinations have been performed.

3. It provides inpatient medical care under the First Listed diagnosis.-The first listed diagnosis supervision of a duly licensed doctor of medicine is the final diagnosis that is listed first on the face 

or doctor of osteopathy sheet of the patient’s record. 

4. It provides nursing service 24 hours a day Length of stay.- The length of stay is, in general, 

under the supervision of a registered nurse the number of days of hospitalization exclusive of the 

day of discharge. In the case of patients admitted and

5. It maintains medical records for each patient discharged the same day, the duration of stay is shown admitted and for newborn infants in the tables as less than 1 day. 

Average length of stay .-The average length of 

Short-stay hospital.- A short-stay hospital is one stay is the aggregate number of days of stay divided 

in which the average stay is under 30 days. by the total number of discharges. In computing the 

Bed.-A bed is one set up and staffed for contin- average length of stay, a stay of less than 1 day is 

uous (24 hour) use by inpatients. Beds in emergency counted as 1 day. 

rooms, labor rooms, postanesthesia or postoperative Surgical operation. - No formal definition was esrecovery rooms, or other such facilities, which are tablished during the pilot study period. From the hosregularly maintained and utilized for only a portion pital point of view, operations include all items that 

of the patient’s stay and are primarily for special the physician entered as such on the face sheet of the 

procedures and not for lodging, are uot termed (in- patient’s record. For coding purposes the Hospital

patient) beds. Cribs and bassinets maintained for use Discharge Survey defines operations as entries on the 

by other than newborn infants are considered beds. abstract form that are classifiable to ICDX categories Patient and inpatient.-A patient is a person 01.0-99.9. 

admitted to a hospital who occupies a hospital bed for 

observation, care, diagnosis, or treatment. “Patient” Demographic Terms 

and “inpatient” are used synonymously. 

Dis&arge.-A discharge is the formal release Age.- Age refers to the age at last birthday at 

of an inpatient by a hospital. time of admission to hospital. Whenever possible, 

well-newborn infants.- Well-newborn infants are information is obtained on date of birth. 

those who satisfy all of the following criteria: Color.-In this report, the population has been 

divided into white and nonwhite. Mesicans and Puerto 1. The birth was at term or was not other- Ricans are considered white unless specifically iden­ wise specified and there was no mention of tified as a member of a nonwhite race. The nonwhite immaturity or prematurity group includes the Negro, American Indian, Asian 

2. No diagnosis of any disease, condition, dis- Indian, Chinese, Japanese, Aleut, Eskimo, Hawaiian, 

order, syndrome, injury, malformation, or Filipino, Korean, and Malayan races. 

17 
Geographic retion. -The regions of the United 

States are divided as follows: 

Region States Included 

Northeast------ - Maine, New Hampshire, Vermont, 

Massachusetts, Rhode Island, 

Connecticut, New York, New Jersey, 

and Pennsylvania 

North Central--- Michigan, Ohio, Illinois, Indiana, 

Wisconsin, Minnesota, Iowa, 

Missouri, North Dakota, South 

Dakota, Nebraska, and Kansas 

South-----------Delaware, Maryland, District of 

Columbia, Virginia, West Virginia, 

North Carolina, South Carolina, 

Georgia, Florida, Kentucky, 

Tennessee, Alabama, Mississippi, 

Arkansas, Louisiana, Oklahoma, and 

Texas 

West-----------Montana, Idaho, Wyoming, Colorado, 

New Mexico, Arizona, Utah, Nevada, 

Washington, Oregon, California, 

Hawaii, and Alaska 

Codes for Diagnostic Groups Shown in Table H 

Diagnostic Group 

Infective and parasitic diseases---------------------

Malignant neoplasms, all sites and types-------------

Benign and unspecified neoplasms-------------------

Allergic, endocrine system, metabolic, and 

nutritional diseases -_______-_____-_______________ 

Diseases of blood and blood-forming organs----------

Mental, psychoneurotic, and personality disorders----

Diseases of nervous system and sense organs--------

Diseases of circulatory system---------------------

Diseases of respiratory system---------------------

Diseases of digestive system-----------------------

Diseases of genitourinary system-------------------

Delivery ________________________________________-

Conditions of pregnancy and puerperium-------------

Diseases of skin and cellular tissue-----------------

Diseases of bones and organs of movement-----------

Congenital malformations __________________________ 

Certain diseases of early infancy, including 

prematurity-------------------------------------

Injuries and adverse effects of chemical substances 

and other external causes ________-------_--------. 

Symptoms, senility, and ill-defined conditions not 

elsewhere classified ____________-_______________ 

Disease undiagnosed-------------------------------

ICDA Code Numbed 

002-138, YO3.0-Y03.2 

140-205 

210-239,YO3.3 

240-289 

290-299 

300-329 

330-398 

400-468 

470-527 

530-587 

590-637 

660-678 

640-652, 680-689, YO6-Y07 

690-716 

720-749 

750-759 

760-776, Y21, Y24, Y25, Y28, Y29 

800-999, Y10.0 

780-795.3, 795.8, YOO-Y02, Y03.9, Y04, Y05, 

Y08, Y09, YlO.l-Y18 

795.4, 795.5, 795.9 

ZDiagnoses we coded and grouped according to the International Clas’sification of Diseases, Adapted fop Indeting Hospital Records by Dis­

~QRcs and Operations with certain modifications by the Hospital Discharge Survey. 

18 
-------- 

Codes for Operation and Procedure Groups Shown in Table J 

operation arzd Procedure Group 

On nervous system --_-----__---__-____------------

On eye-------------------------------------------

On ear, nose, and throat, not elsewhere classified-----

Tonsillectomy, adenoidectomy----------------------

Other operations on buccal cavity and esophagus------

On bronchi, lung, pleura, chest wall, and mediastinumOn breast ______-______-______-------------

Repair of hernia-----------------------------------

Appendectomy-------------------------------------

Hemorrhoidectomy ____ _ _ _ ___ __ __ ___ _ __________ _ ___ 

ICDA Code Numbevsl 

01-O-06.9 

10.0-18.9 

20.0-22.9 

27.1-27.3 

24.0-27.0, 27.4-28.9 

33.0-35.9 

38.0-38.9 

40.0-40.9 

45.1 

49.3 

Cholecystectomy ____ _______________________ -_ _____ 53.5 

On other sites of gastrointestinal tract and related 

organs------------------------------------------ 41.0-45.0, 45.3-49.2, 49.4-53.4. 53.6-57.9 

On urinary organs--------------------------------- 60.0-64.9 

On male genital organs _____________________________ 66.0-69.9 

On female genital organs, except obstetrical----------

Obstetricalprocedures-----------------------------

On musculoskeletal system _________________________ 

On skin and subcutaneous tissue---------------------

Endoscopy (cystoscopy, bronchoscopy, etc.)----------

Certain other nonsurgical procedures----------------

All other operations, including ill-defined------------

70.0-75.9 

76.0-78.9 

80.0-87.9 

89.0-89.9 

90.0-90.9 

92.0-99.9 

00.0,08.0-9.7,30.0-32.1. 88.0-88.9 

loperations and procedures we coded and grouped according to the International Classification of Diseases, Adapted for Indexing Hospital 

Records 5y Diseases and Operations with certain modifications by the Hospital Discharge Survey. 

ooo-
Series 1. 

Series 2. 

Series 3. 

Series 4. 

Series 10. 

Series 11. 

Series 12. 

Sel-ies 13. 

Series 20. 

Series 21. 

Sel-ies 22. 

OUTLINE OF REPORT SERIES FOR VITAL AND HEALTH STATISTICS 

Public Health Service Publication No. 1000 

Programs amI collectiolz procedures.- Reports which describe the genera1 programs of the National 

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

and other material necessary for understanding the data. 

Data evaluation and methods research. -Studies of new statistical methodology including: esperimental tests of new survey methods, studies of vital statistics collection methods, new analytical 

techniques, objective evaluations of reliability of collected data, contributions to statistical theory. 

Analytical studies.- Reports presenting analytical or interpretive studies based on vital and health 

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

Documents and committee reports.- Final reports of major committees concerned with vital and 

health statistics, and documents such as recommended model vital registration law and revised birth 

and death certificates. 

Data from the Health Interviezu Survey.- Statistics on illness, accidental injuries, disability, use of 

hospital, medical, dental, and other services, and other health-related topics, based on data collected 

in a continuing national household interview survey. 

Data jkom the Health Examination Suruey.- Data from direct examination, testing, and measurement of national samples of the population provide the basis for tv;o 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, and psychological characteristics; and (2) 

analysis of relationships among the various measurements without reference to an esplicit finite 

universe of persons. 

Data from the hstitutiorzul Population Surveys.- Statistics relating to the health characteristics of 

persons in institutions, and on medical, nursing, and personal care received, based on national 

samples of establishments providing these services and samples of the residents or patients. 

Data from the Hospital Disckauge Survey.- Statistics relating to discharged patients in short-stay 

hospitals, based on a sample of patient records in a national sample of hospitals. 

Data orz mortality.- Various statistics on mortality other than as included in annual or monthly 

reports- special analyses by cause of death, age, andother demographic variables, also geographic 

and time series analyses. 

Data oiz natality, maw-iaqe, auddivorce. -Various statistics onnatality, marriage, and divorce other 

than as included in annual or monthly reports -special analyses by demographic variables, also 

geographic and time series analyses, studies of fertility. 

Data fvom tke National A’atality and Jlo,-tality Surveys. - Statistics on characteristics of births and 

deaths not available from the vital records, basedon sample surveys stemming from these records, 

including such topics as mortality by socioeconomic class, medical experience in the last year of 

life, characteristics of pregnancy, etc. 

For d list of titles of reports published in these series, write to: Office of Information and Publications 

h’ational Center for HeAth Statistics 

U.S. Public Health Service 

\Vashington, DC. 20201