From Vital and Health Statistics of the National Center for Health Statistics Number 83. October 8, 1982 

. 

RMIPE~OF Tl# 

PUBLICATIONS$RANCh 

EOJTORIM LffI~Y 

d 

Deliveries in Short-Stay Hospitals: United States, 1980 

By Barbara J. Haupt, Division 

This report concerns the use of hospitals by women 

with deliveries during 1980. Characteristics of the 

women who delivered (age, race, and marital status) 

and of the hospitals in which they delivered (region, bed 

size, and ownership) are presented by type of delivery 

(normal or complicated). Data on the types of obstet­

�

. rical complications experienced by these women and 

on the procedures they underwent are also presented. 

Hospital use measurements shown include frequencies. 

perc&ts, and average lengths of stay. - “ 

The statistics presented in this report are based on 

data collected through the National Hospital Discharge 

Survey. This is a sample survey that has been conducted 

by the National Center for Health Statistics since 

1965. In 1980, data were abstracted from the face 

sheets of medical records of approximately 224,000 

patients discharged from 420 short-stay non-Federal 

hospitals. A brief description of the sample design, data 

collection procedures, and estimation process, and 

definitions of terms presented in this report can be 

found in the section entitled “technical notes.” A detailed discussion of these items, as well as the survey 

form used to collect the data, have been published.l,z 

Diagnostic and procedure data are coded according 

to the International Classification of Diseases, 9th 

Revision, Clinical Modification. 3 Up to seven diagnoses and four procedures are coded for each discharge; 

however, the only diagnoses considered in this report 

were obstetrical diagnoses (codes 640–676) and sterilization (code V25.2). Obstetrical diagnoses are those 

diagnoses that refer to conditions arising from or affecting the mana~ement of Pregnancy, childbirth, and the 

u~rperium (&e period fioll&ing delivery). O&er diagoses were not used because they were felt to be repe­

@ titious. For example, a woman with anemia would have 

two codes for this tiagnosis-one showing it as an obof Health Care Statistics 

stetrical complication and one indicating the specflc 

type of anemia. 

In this report, obstetrical diagnoses are categorized 

into two broad types-nom-d deliveries and complicated deliveries. A normal delivery refers to a spontaneous delivery without mention of abnormality, complication, or the use of instruments or fetal manipulation. All other deliveries, including multiple births, are 

referred to as complicated. The rationale for including 

pregnancies witl multiple fetuses as complicated is 

based on the observation that such pregnancies are 

associated with increased morbidity and mortality.A 

Summary 

During 1980 3.8 million women with deliveries 

were discharged from short-stay non-Federal hospitals 

in the United States. These women made up a sizable 

portion-9.9 percent+f all the discharges (excluding 

newborn inbts) during that year. Women with deliveries remained hospitalized an average of 3.8 days and 

used 14.2 million days of inpatient hospital care. This 

was only 5.2 percent of the total days spent in hospitals 

by all patients discharged during the year. 

Most of the women who had a delivery were in their 

twenties, were white, and were married. The largest 

percent of deliveries occurred in the South Region, followed by the North Central, Northeast, and West 

Regions. The percent of women with deliveries was 

lowest in the smallest hospitals and highest in the 

largest hospitals. Most of the women with deliveries 

were discharged from nonprofit hospitals. 

About half of the women had a normal delivery and 

about half had some sort of complication. Women more 

likely to have a complicated delivery were older, were 

races other than white, had an unknown marital status, 

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES Public Health Service 
2 &t’lCwkm 

and had delivered in the South Region. These women 

also stayed in the hospital longer, on the average, than 

did women with a normal delivery. 

The most frequently occurring complications were 

forceps or vacuum extraction without mention of indication and obstetrical trauma. Episiotomy was the 

most common procedure. Other frequently performed 

procedures were low forceps or vacuum extraction with 

or @@out episiotomy,.cesarean section, repair of obstetric laceration, and bilateral destruction or occlusion 

of fallopian tubes. 

Findings 

Patient and hospital characteristics 

During 1980, 3,762,000 women with deliveries 

were discharged from short-stay non-Federal hospitals 

in the United States (table 1). Most of these women 

(over 60 percent) were in their twenties; 32.5 percent 

were 20–24 years of age and 31.6 percent were 25–29 

years of age. Almost 16 percent were in each of the age 

groups 10–1 9 years and 30–34 years, while only 4.5 percent were 35–54 years of age. This age distribution was 

the same foreachtype ofdelive~(normal or complicated). 

The majority (70.0 percent) of women with deliveries were white, and 17.6 percent were black and other 

races. These data should be viewed with some caution, 

however, because of the large percent of women (12.4 

percent) for whom race could not be identified on the 

face sheet of the medical record. As expected, most of 

the women with deliveries during 1980 were married 

(77.0 percent). However, a sizable percent–16.5 

percent-had never been married. Over 3 percent of the ~ 

women were separated, divorced, or widowed, and the 

marital status of 3.0 percent was unknown. 

Table 2 presents data on women with deliveries by 

type of delivery for the hospital characteristics region, 

bed size, and ownership. The largest percent of deliveries (34.7 percent) was in the South Region, followed 

by 27.3 percent in the North Central Region, 19.1 percent in the Northeast Region, and 18.9 percent in the 

West Region. This distribution reflects that of civilian 

noninstitutionalized women in the child-bearing ages 

(10-54 years of age for this report). Unpublished data 

from the Bureau of the Census show that during 1980, 

33.3 percent of these women lived in the South, 25.8 ~ 

percent in the North Central Region, 21.7 percent in the , 

Northeast Region, and 19.2 percent in the West. The 

pattern of deliveries was the same for each type of 

delivery (normal or complicated); that is, the largest 

percent was in the South and the second largest was in 

‘tie North Central Region. (For normal deliveries the ‘ 

difference between the South Region and the North 

Central Region was not statistically significant.) The 

percent of deliveries was approximately the same in 

each of the remaining two regions. 

The percent of women with deliveries generally 

increased as the bed size of the hospital increased. The 

smallest hospitals (6–99 beds) had 14.9 percent of the 

deliveries while the largest hospitals (500 beds or more 

had 26.3 percent of the deliveries. When hospital@ 

ownership is examined, it can be seen that the vast 

majority (72.9 percent) of mothers were discharged 

from nonprofit hospitals, 23.8 percent were discharged 

from State and local government hospitals, and 3.2 

Table 1. Number and percent distribution of women with deliveries discharged from short-stay non-Federal hospitals by age, race, and marital status, 

according to type of delivery United States, 1980 

All Type of delivery 

Age, race, and marital status deliveries Normal Complicated 

Number in thousands 

Totall . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3,762 1,841 1,921 

Age 

10-19 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 583 291 292 

20-24 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,222 594 628 

25-29 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,190 591 599 

30–34 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 597 291 305 

35-54 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 171 74 97 

Race 

White . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2,633 1,277 1,356 

81ackand another . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 662 312 351 

Marital status 

Married . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2,898 1,434 1,464 

Never merried . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 620 299 321 

Separated, divorced, or widowed. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 131 64 68 

Unknown . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 112 44 69 

1lnclude$ dats for which race was not stated. 

All Type of delivery 

deliveries Normal Complicated 

Percent distribution 

100.0 100.0 100.0 

15.5 15.8 15.2 

32.5 32.3 32.7 

31.6 32.1 31.2 

15.9 15.8 15.9 

4.5 4.0 5.1 

70.0 69.3 70.6 

17.6 16.9 18.2 

77.0 77.9 76.2 � 

16.5 16.3 16.7 

3.5 3.5 3.5 

3.0 2.4 3.6 
tukmCMM3 

Table 2. Number and percent distribution of women with deliveries discharged from short-stay non-Federal hospitals by region, bed size, and hospital ownership, 

according to type of delive~. United States, 1980 

A,, Type of delivery AII �— Type of delivery .-!,> n,, Region,	 bed size, and ownership deliveries deliveries Normal Complicated Normal Complicated 

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

Region 

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

North Central . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

South . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

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

8ed size 

6-99 beds . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

100-199 beds . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

200-299 beds . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

300-499 beds . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

500 beda ormore . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Ownership 

Nonprofit. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

State andlocal government . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Proprietary . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

percent from proprietary hospitals. This reflects the 

distribution of all discharges by ownership of hospital; 

over 70 percent of all discharges during 1980 were from 

onprofit hospitals and about 20 percent were from 

e tate and local government hospitals. 

Table 3 gives the percent distribution of women 

with deliveries by type of delivery for the patient characteristics age, race, and marital status and the hospital 

characteristics region, bed size, and ownership. Of the 

3,762,000 women who delivered, 48.9 had a normal 

delivery and 51.1 percent had some complication or 

other condition associated with the delive~ that required 

special care or management. This distribution is similar 

for most of the characteristics examined (that is, about 

half of the deliveries were normal and about half were 

complicated). However, a significantly larger percent 

of complicated births oocurred to women 35–54 years 

of age (57.0 percent), women for whom marital status 

was unknown (61.2 percent), and women who were discharged from hospitals in the South Region (54.9 percent). Some variations also occurred by bed size of 

hospital. Only in the smallest hospitals was there a significantly larger proportion of normal deliveries than 

complicated deliveries; in hospitals of every other bed 

size, except those with 200-299 beds, the proportion of 

complicated deliveries was larger than the proportion of 

normal deliveries. Hospitals with 200-299 beds had 

about the same proportion of normal and complicated 

aleliveries. - ­

The average length of stay for all womenwithdelivries during 1980 was 3.8 days (table 4). Women with 

normal deliveries stayed an average of 3.0 days while 

those with complications were hospitalized, on the 

average, 4.5 days. 

Number in thousands Percent distribution 

3,762 1,841 1,921 100.0 100.0 100.0 

717 357 360 19.1 19.4 18.8 

1,028 528 500 27.3 28.7 26.0 

1,307 590 718 34.7 32.0 37.4 

709 367 343 18.9 20.0 17.8 

562 329 233 14.9 17.9 12.1 

679 315 363 18.0 17.1 18.9 

653 339 314 17.4 18.4 16.4 

878 416 462 23.3 22.6 24.1 

990 442 548 - 26.3 24.0 28.5 

2,744 1,315 1,429 72.9 71.4 74.4 

897 467 430 23.8 25.4 22.4 

122 60 62 3.2 3.2 

Average lengths of stay were longerfor women with 

complicated deliveries than for women with normal 

deliveries foreveryage, race, marital status, region, bed 

size, and ownership type examined. These diHerences 

were statistically significant for every characteristic 

except marital status unknown. 

Obstetrical diagnoses associated with deliveries 

Table 5 shows the number of women with deliveries 

by type of delivery and number of diagnoses. Most of 

the women (77.2 percent) had only one diagnosis regardless of the type of delivery. A much larger percent 

of women with normal deliveries had only one diagnosis compared with the percent of women with complicated deliveries (92.5 percent compared with 62.4 

percent). This is expected because women with normal 

deliveries could only have a maximum of two diagnoses: 

normal delivery and sterilization. Women with complicated deliveries, on the other hand, could have more 

than one complication as well as sterilization and, 

therefore, could have several diagnoses. 

The average length of stay was longer for women 

with more than one diagnosis than for women with only 

one diagnosis; the difference, however, was not statistically significant for women with normal deliveries. 

Women with complicated deliveries had a longer average length of stay than women with normal deliveries 

regardless of the number of diagnoses. 

Of the 3.8 million women who had a delivery in 

1980,8.3 percent were sterilized during the same hospitalization speciilcally, 7.5 percent of the women with 

normal deliveries and 9.1 percent of the women with 

complicated deliveries were sterilized. As shown in 

3.2 
� 

� 

Table 3. Percent distribution of women with deliveries discharged from 

short-stay non-Federal hospitals by type of delivery, according to selected 

characteristics: United States, 1980 

All Type of delivery 

Selected characteristics 

deliveries Normal Complicated 

Total. . . . . . . . . . . . . . . . . . . . . . . 100,0 48.9 51.1 

Age 

10–19 years . . . . . . . . . . . . . . . . . . 100.0 49.9 50.1 

20-24 years, . . . . . . . . . . . . . . . . . 100,0 48.6 51.4 

25–29 years, . . . . . . . . . . . . . . . . . 100,0 49.7 50.3 

30-34 years, . . . . . . . . . . . . . . . . . 100,0 48.9 51.1 

35 years and over ., . . . . . . . . . . . 100,0 43.0 57.0 

Race 

White . . . . . . . . . . . . . . . . . . . . . . . 100.0 48.5 51.5 

Black and another . . . . . . . . . . . . . 100.0 47.1 52.9 

Marita I status 

Married . . . . . . . . . . . . . . . . . . . . . . 100.0 49.5 50.5 

Never married..............,.. 100.0 48,3 51.7 

Separated, divorced, or 

widowed . . . . . . . . . . . . . . . . . . 100.0 48.5 51.5 

Marital status unknown. . . . . . . 100.0 38.8 61.2 

Region 

Northeast . . . . . . . . . . . . . . . . . . . . 100.0 49.8 50.2 

North Central . . . . . . . . . . . . . . . . . 100.0 51.3 48.7 

South . . . . . . . . . . . . . . . . . . . . . . . 100.0 45.1 54.9 

West . . . . . . . . . . . . . . . . . . . . . . . . 100.0 51.7 48.3 

Bed size 

6–99 beds . . . . . . . . . . . . . . . . . . . 100.0 58.6 41.4 

100-199 beds . . . . . . . . . . . . . . . . 100.0 46.5 53.5 

200-299 beds . . . . . . . . . . . . . . . . 100.0 51.9 48.1 

300-499 beds. . . . . . . . . . . . . . . . 100.0 47.4 52.6 

500 beds or more, ., . . . . . . . . . . 100.0 44.6 55.4 

Ownership 

Nonprofit . . . . . . . . . . . . . . . . . . . . 100.0 47.9 52.1 

State and local government. ., . 100.0 52.1 47.9 

Proprietary . . . . . . . . . . . . . . . . . . . 100.0 49.0 51.0 

1 ,nc,ude~ data for which rata was nOt stated 

table 6, a larger percent of the women who were sterilized had a complicated deliveW, the type of delivery did 

not differ signii3cantly among the women who were not 

sterilized. Although the average length of stay was 

longer for women who were sterilized than for those 

who were not, regardless of the type of delivery, the differences are not statistically signiilcant. Women with a 

complicated delivery had a longer length of stay, on the 

average, than women with a normal delivery for both 

sterilized and nonsterilized women. 

The number and percent distribution of first-listed 

and of all-listed obstetrical diagnoses and the average 

length of stay by first-listed diagnosis for women with 

complicated deliveries are shown in table 7. The two 

most common diagnoses were forceps or vacuum extractor delivery without mention of indication (that is, 

the reason for the use of these instruments was not 

stated on the face sheet of the medical record) and 

Table 4. Average length of stay for women with deliveries discharged from 

short-stay non-Federal hospitals by selected characteristics United States 

1980 

All Type of delivery 

Selected characteristics 

deliveries Normal 

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

Age 

10–19 years . . . . . . . . . . . . . . . . . . 

20-24 years . . . . . . . . . . . . . . . . . . 

25-29 years . . . . . . . . . . . . . . . . . . 

30–34 years . . . . . . . . . . . . . . . . . . 

35 years and over . . . . . . . . . . . . . 

Race 

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

Black and another...,.......,. 

Marital status 

Married . . . . . . . . . . . . . . . . . . . . . . 

Never married . . . . . . . . . . . . . . . . . 

Separated, divorced, or 

widowed . . . . . . . . . . . . . . . . . . . 

Marital status unknown. . . . . . . . . 

Region 

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

North Central . . . . . . . . . . . . . . . . . 

South . . . . . . . . . . . . . . . . . . . . . . . 

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

Bed size 

6–99 beds . . . . . . . . . . . . . . . . . . . 

100-199 beds . . . . . . . . . . . . . . . . 

200-299 beds . . . . . . . . . . . . . . . . 

300-499 beds, . . . . . . . . . . . . . . . 

500 beds or more . . . . . . . . . . . . . 

Ownership 

Nonprofit . . . . . . . . . . . . . . . . . . . . . 

State and local government. . . . 

Proprietary . . . . . . . . . . . . . . . . . . . 

Complicated 

3.8 3.0 4.5 

3.7 2.9 4.5 

3.6 2.9 4.3 

3.7 3.0 4.5 

4.0 3.2 4.7 

4.3 3.5 5.2 

3.7 3.0 4.4 

3.9 3.0 4.7 

3.7 3.0 4.4 

3.9 3.0 4,8 

3.7 2.8 4.5 

4.5 3.5 5.1 

4.5 3.6 5.4 

4.2 3.4 5.1 

3.5 2.8 4.1 

2.9 2.2 3.6 

3.0 2.6 3.7 

3.5 3.0 3.9 

3.6 3.0 4.2 

4.0 3.2 4.8 

4.3 3.2 5.1 

3.9 3.1 4.6 

3.5 2.8 4.3 

3.2 2.5 3.9 

1ln~ludes data for which race was not statsd. 

obstetrical trauma. About 18 percent of the women 

with a complicated delivery had a forceps or vacuum 

extractor delivery without mention of indication. The 

use of forceps or a vacuum extractor are two alternativemethods to assist delivery.s 

In the field of obstetrics two distinct viewpoints 

have emerged concernkg the use of forceps—those holding one viewpoint advocate their use on a routine basis 

to assist in guiding the child through the birth canal, 

whereas the other group feels that the use of forceps is 

justified only when the delivery cannot proceed spontaneously.A Undoubtedly the practice of many obstetricians is between these two extremes. Since the reas 

for the use of forceps or a vacuum extractor was 

stated for these 350,000 deliveries, one can only spec‘9 

late as to how many of the deliveries could have proceeded spontaneously-or as to how many complications were averted because of their use. 
amcedaa5 

—	 Table 5. Number, percent distribution, snd average length of stay forwomen Table 6. Number, percent distribution, and average length of stay forwomen 

with deliveries discharged from short-stay non-Federal hospitals by type with deliveries discharged from short-stay non-Federal hospitals, by type 

of delivery, according to number of diegnoses United Stetes, 1980 of delivery, according to sterilization status: United Ststes, 1980 

— 

Type of delivery All Number of diagnoses deliveries Normal Complicated 

Number in thousands 

All women with deliveries . . . . . . 3,762 1,841 1,921 

Women with one diagnosis . . . . . 2,903 1,703 1,199 

Women with more than one 

diagnosis . . . . . . . . . . . . . . . . . . 860 138 722 

Percent distribution 

All women with deliveries . . . . . . 100.0 100.0 100.0 

Women with one diagnosis . . . . . 77.2 92.5 62.4 

Women with more than one 

diagnosis . . . . . . . . . . . . . . . . . . 22.8 7.5 37.6 

Average length of stay in days 

All women with deliveries . . . . . . 3.8 3.0 4.5 

Women with one diagnosis . . . . . 3.4 2.9 4.0 

Women with more than one 

diagnosis . . . . . . . . . . . . . . . . . . 5.1 3.8 5.3 

The average length of stay for these 350,000 

. women was 3.3 davs. This lemzth is not simiilcantlv 

different from the a~erage len@-of stay of 3~0days f& 

All Type of delivery 

Sterilization status deliveries Normal Complicated 

Number in thousands 

All women with deliveries . . . . . . 3,762 1,841 1,921 

Sterilized . . . . . . . . . . . . . . . . . . . . . 312 138 174 

Not sterilized . . . . . . . . . . . . . . . . . 3,450 1,703 1,747 

Percent distribution 

All women with deliveries . . . . . . 100.0 48.9 51.1 

Sterilized . . . . . . . . . . . . . . . . . . . . . 100.0 44.2 55.8 

Not sterilized . . . . . . . . . . . . . . . . . 100.0 49.4 50.6 

Average length of stay in days 

All women with delivaries . . . . . . 3.8 3.0 4.5 

Sterilized . . . . . . . . . . ... . . . . . . . . . 4.6 3.8 5.2 

Not sterilized . . . . . . . . . . . . . . . . . 3.7 2.9 4.4 

normal deliveries. However, these women did stay a 

significantly shorter time, on the average, than did all 

women with complicated deliveries. 

Obstetrical trauma accounted for 15.4 percent of 

the first-listed and 14.8 txrcent of the all-listed obstetrical diagnoses for women with complications during 

Number, percent distribution, and average length of stay by firet-listed obstetrical diagnosis, and number and percent distribution by all-listed diagnoses 

for women discharged with complicated deliveries: United Statea, 1980 

[Discharges from short-stay non-Federal hospitals. Diagnostic groupings and code numbers from the hrtamatiorral Classification of Diseases, %h Revision, Clinical Modification] 

Women with complicated deliveries 

First-listed diagnosis AlI-listed diagnoses 

Diagnosis and ICD-9-CM code 

Number Percent Average Number Percent in in

distribution length of distribution thousands stay in days thousands 

All obstetrical diagnoses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 640-648,651-676 . 

Forceps or vacuum extractor delivery without mention of indication. . . . . . . . 669.5 

Obstetrical treuma . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 664-665 

Trauma to perineum and vulva during delive~.. . . . . . . . . . . . . . . . . . . . . . . 664 

Rmt.degree perineal laceration . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 664.0 

Second-degree perineal laceration. . . . . . . . . . . . . . . . . . . . . . . . . . . . 664.1 

Third-degree perinesl laceration. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 664.2 

Fourth-degree perineal laceration. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 664.3 

Other and unspecified trauma to perineum and vulva. . . . . . 664.4-664.9 

Laceration of cervix snd high vaginal laceration. . . . . . . . . . . . . . . 665.3-665.4 

Other obstetrical trauma. . . . . . . . . . . . . . . . . . . . . . 665.0-665.2, 665.5-665.9 

Uterine scar from previous surgery. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...654.2 

Early onset ofdelive~ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...644.2 

Fetopelvic disproportion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...653.4 

Hypertension complicating pregnancy, childbirth, and the puerperium.. . . . . . . 642 

Breech presentation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 652.1 -652.2. 669.6 

Rupture of membranes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 658.1 -658.3’ 

Cesarean delivery, without mention of indication. . . . . . . . . . . . . . . . . . . . . . . . 669.7 

Postpartum hemorrhage . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...666 

mbilical cord complications.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...663 

nemia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...648.2 

m etaldistresa . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...656.3 

Antepartum hemorrhage, abruptio placentae, and placenta previa . . . . . . . . . . . 641 

Uterine inertia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 661.0-661.2 

Infections of genitourinary tract in pregnancy. . . . . . . . . . . . . . . . . . . . . . . . . . . 646.6 

Other obstetrical complication . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. Residual 

1,921 100.0 4.5 2,647 100.0 

350 18.2 3.3 350 13.2 

297 15.4 3.1 393 14.8 

241 12.6 3.0 308 11.6 

60 3.1 2.9 71 2.7 

50 2.6 2.8 62 2.3 

51 2.7 3.3 68 2.6 

46 2.4 3.4 60 2.3 

34 1.8 2.7 47 1.8 

39 2.0 3.1 59 2.2 

17 0.9 3.7 26 1.0 

169 8.8 5.9 192 7.2 

135 7.0 4.8 154 5.8 

113 5.9 5.9 153 5.8 

105 5.5 6.1 151 5.7 

88 4.6 4.9 120 4.5 

87 4.5 4.4 130 4.9 

50 2.6 6.1 50 1.9 

36 1.8 3.2 54 2.1 

35 1.8 3.6 67 2.5 

32 1.7 3.9 71 2.7 

32 1.7 4.8 64 2.4 

28 1.5 6.4 53 2.0 

24 1.3 4.5 50 1.9 

20 1.1 4.7 56 2.1 

320 16.7 4.9 639 20.4 
6 ZKklncedata 

1980. Most of the trauma involved lacerations or other 

injury to the perineum or vulva. No siguiilcant differences were found among the various degrees of perineal 

lacerations (first, second, third, or fourth degree) that 

occurred. 

Significantly longer average lengths of stay were 

found for the first-listed diagnoses of uterine scar from 

previous surgery; fetopelvic disproportion; hypertension 

complicating pregnancy, childbirth, and the puerperium; 

and cesarean delivery without mention of indication. 

All of these diagnoses are associated with or indications for cesarean delivery, which, of itself, necessitates a longer hospital stay.%T A longer average length 

of stay is also observed for the diagnosis antepartum 

hemorrhage, abruptio placenta, and placenta previa; 

however, the difference is not statistically signiilcant 

due to the relatively small number of these diagnoses. 

When comparing the number of first-listed diagnoses with the number of all-listed diagnoses for 

specific diagnostic groups, some differences can be 

seen. For example, the number of all-listed diagnoses of 

infections of the genitourinary tract is almost three 

times higher than the number of first-listed diagnoses of 

this type. The numbers of all-listed diagnoses for the 

following conditions are twice as high as the numbers of 

first-listed diagnoses: anemia; uterine inertia; fetal 

distress; umbilical cord complications; and antepartum 

hemorrhage, abruptio placenta, and placenta previa. 

This is not surprising because many of these complications are either the result of or a contributing factor to _ 

other complications. For example, abruptio placent 

may be caused by, among other things, an abnormality1 

or tumor of the uterus, a short umbilical cord, and — 

hypertension.o Uterine inertia causes prolonged labor 

and could also result in hemorrhage.a Anemia maybe 

hereditary or, if not,, has many causes such as infection, 

hemorrhage, and iron deficiency.A 

Procedures associated with deliveries 

The number and percent distribution of all-listed 

procedur& performed on women with deliveries is 

shown in table 8. About half of the procedures performed were episiotomies, making this by far the most 

common obstetrical procedure. The majority of these 

episiotomies (76.7 percent) were performed without 

forceps or other instruments to assist delivery. Of the 

women with normal deliveries, 1,146,000, or 62.2 

percent, had an episiotomy. Many physicians routinely 

perform episiotomies. because it is felt that this pro- ‘ 

cedure eliminates the risk of perineal lacerations and it 

spares the baby’s head from beating against a possible 

perineal obstruction. The straight, clean incision of an 

episiotomy is preferable to a ragged laceration, the 

procedure shortens labor, and the possibility of a thirddegree laceration is reduced. In addition, it is felt tha 

the baby’s head hitting against an obstruction for 

period of time could result in brain damage.o * 

Table 8, Number and percent distribution of all-listed procedures for women discharged with deliveries by type of procedure: United Ststes, 1980 

[Dischargesfrom short-stay non-Federal hospitals, Procaduregroupings and code numbersfrom the International Classification of Diseases, 9th Rev/simr, Clinical Modification] 

All-listed procedures 

Procedure and ICD-9-CM code 

Number in thousands Percent distribution 

All procedures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3,972 100.0 

Allobstetricsl proceduresl . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...72-75 3,526 88.8 

Low forceps operation with and without episiotomy. ., . . . . . . . . . . . . . . . . . . . . . . . . . 72.()-72.1 482 12.1 

Extraction procedures to sssist delivery. . . . . . . . . . . . . . . . . . . . . . . . . 72.2-72.5, 72.7-72.9, 73.2 127 3.2 

Midforceps operation with and without episiotomy. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 72.2 38 1.0 

Forceps rotation of fetal head..... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...72.4 31 0.8 

Breech extraction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ,. 72.5 21 0.5 

Vacuum extraction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...72.7 22 0.6 

Other extraction procedures to assist delive~ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Residual 16 0.4 

Episiotomy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 72.1, 72.21, 72.31, 72.71, 73.6 2,012 50.7 

Episiotomy only . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...73.6 1,543 38.8 

Low forceps operation with episiotomy. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...72.1 426 10.8 

Other instrumental delivey with episiotomy . . . . . . . . . . . . . . . . . . . . . . . 72.21, 72.31, 72.71 41 1.0 

Artificial rupture of membranes.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..73.o 120 3.0 

Other procedures to assist delivery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...72.6.73.1 117 2.9 

Cesarean section . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..74.0-74.2 .74.4–74.9 619 15.6 

Diagnostic amniocentesis and fetal monitoring . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 75. I, 75.34 119 3.0 

Manual removal of retained placenta. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...75.4 29 0.7 

Repair occurrent obstetric laceration. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...75.5-75.6 350 8.8 

Manual exploration of uterine cavity, postpartum . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...75.7 17 0.4 

Other obstetrical procedures. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. Residual *2 *O. 1 

Bilateral destruction or occlusion of fallopian tubes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 66.2–66.3 

Dilation sndcurettage of uterus.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..69.02-69.Og 

313 

17 

7.9 

0.4 � 

Other procedures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ,., .,. ,., .,. ,.. ,,, .,. ,Residual 117 2.9 

Incidental appendectomy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..47. I 20 0.5 

Insertion ofindwelling urinary catheter. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...57.94 10 0.3 

1 Numbers ~i]l not add to tOtai because episiotomies are listed in more than One cate90v 
ackmedata 7 

7


Others question the routine performance of episiotomies: they feel that if the delivery was allowed to 

proceed normally and in an unrushed manner, many 

episiotomies would be unnecessary. Moreover, since 

the site of the incision can often be bothersome and 

even painful during healing, they feel that episiotomies 

should be done only when necessary.g 

Of all the procedures performed on women with 

deliveries, 12.1 percent were low forceps or vacuum 

extraction with or without episiotomy. As stated previously, some physicians feel that this type of procedure 

should be done routinely to forestall possible complications, while others feel it should be done only to assist 

a delivery that cannot proceed spontaneously.a 

The number of cesarean sections performed in 

1980 was 619,000, or 15.6 percent of the total number 

of procedures. This surgery was performed on 16.5 

percent of all mothers and 32.2 percent of the women 

with complicated deliveries. 

The incidence of cesarean sections has been increasing since the late sixties, sparking much debate and 

discussion about the necessity for this procedure. 

During 1965 only about 5 percent, or 174,000, of the 

women with deliveries had a cesarean section. In 1980, 

619,000 women, about 16 percent of all women who 

delivered, underwent a cesarean section. Many explanations have been given for this trend-for example, 

the increased use of fetal monitoring (and the subsequent identification of potential complications that 

would otherwise be unanticipated); the policy of “once 

a cesarean always a cesarean” (that is, once a woman 

has this procedure, all subsequent deliveries should be 

by cesarean section); and the feeling that a cesarean 

section is preferable to a vaginal delivery for dif13cult 

deliveries, as a response to indications of fetal distress, 

or for breech presentations .a+b~T, 10 

Repair of current obstetric laceration was one of the 

more frequently performed obstetrical procedures; the 

350,000 performed made up 8.8 percent of all procedures. Other obstetrical procedures of interest that 

were performed relatively frequently were art~lcial 

rupture of membranes (120,000) and diagnostic amniocentesis and fetal monitoring (11 9,000). Each of these 

categories made up 3 percent of the total procedures 

performed. 

There were 446,000 nonobstetrical procedures 

performed on women who delivered in 1980. These 

nonobstetrical procedures made up 11.2 percent of all 

the procedures performed. Most of these (313,000) 

were bilateral destruction or occlusion of fallopian 

tubes (sterilization). 
8 

References 

lNational Center for Health Statistics, W. R Simmons: Develop 

ment of the design of the NCHS Hospital Discharge Survey. Vital 

andHeaWzStatistics.PHS Pub. No. 1000-Series 2-No. 39. Public 

Health Service. Washington. U.S. Government Printing Office, 

Sept. 1970. 

2National center for Health Statistics, B. J. Haupti Utilization of 

shofi-stay hospitals, annual summary for the United States, 1980. 

Vital and Health Statistics. Series 13-No. 64. DHHS Pub. No. 

(PHS) 82-1725. Public Health Service. Washington. U.S. GovernmentPrinting Office, Mar. 1982. 

3U. S. Public Health Service and Health Care Financing Administration: International Classl&ation of Diseases, 9th Revision, 

ClinicalModification. DHHS Pub. No. (PHS) 80–1260. Public 

Health Service. Washington. U.S. Government Printing OITice, 

Sept. 1980. 

4J. A, Pritchard and p. c+ MacDonald: Williams obste~”cs, 1Sth 

ed. New York. Appleton-Century-Crofts, 1976. 

51nstmctions for the Silastic Obstetn”cal Vacuum Cup in the 

Second Stage of Labor. Midland, Mlch. Dow Corning Corp., 

1980. 

60fice of the Assistant Secretary for Planning and Evaluation/ 

Health, H. I. Marieskind: An Evaluation of Caesarean Section in 

the United States. U.S. Department of Health, Education, and 

Welfare. Washington. June 1979. 

7P.J.placek andS.M. Taffek
 Trend in Complications Associated 

With Cesarean and Non-Cesarean Deliveries, United States, 1970 

and 1978. Paper presented to the Annual Meeting of the American 

Public Health Association. Los Angeles, Nov. 1981. 

SE.c.Hughes: Obstem.c-Gynecologic Terminology. P~ladelphia. 

F. A. Davis Co., 1972. 

9Boston Women’s He~fi Book collective: OurBodies, ourselves: 

A Book by andfor Women. New York. Simon and Schuster, 1973, 

pp. 185–192. 

1OP- J- Placek and s- M. T~e~ Trends ~ Cesaem section rates for 

the United States, 1970-78. Pub. Health Rep. 95(6):540-548, 

Nov.-Dee. 1980. 

I lNatio~ Cenkr for He~th Statistics, M. G. Sirken Ufliation 

of short-stay hospitals, summary of nonmedlcal statistics, United 

States, 1965. Vital and Health Statistics. PHS Pub. No. 1000-

Series 13-No. 2. Public Health Service. Washington. U.S. Government Printing Office, Aug. 1967. 

12Natio~ Center for He~th Statistics, M. J. with: utilization 

of short-stay hospitals by characteristics of discharged patients, 

United States, 1965. Vital and Health Statistics. PHS Pub. No. 

1000-Series 13-No. 3. Public Health Service. Washington. U.S. 

Government Printing OfIice, Dec. 1967. 

c 
aCkmCMw 9 

— 

* 

6 

Technical notes 

Source of data 

The NationalHospitalDischarge Survey(NHDS) 

encompasses patientsdischargedfrom short-stayhospitals, exclusive of militaryandVeteransAdministrationhospitals,Iocatedinthe50 StatesartdtheDistrictof 

Columbia. Onlyhospitalswithsixbeds or more andan 

average length of stay of less than 30 days for all 

patients are included in the survey. Discharges of 

newborn infantsare excluded from this report. 

Theuniverseofthesurveyconsistedof 6,965 shortstay hospitals contained in the 1963 Master Facility 

Inventoryof Hospitals and Institutions.New hospitals 

weresampledfor inclusioninthesurveyin 1972,1975, 

and 1977. In all, 544 hospitalswere sampledin 1980. 

Of these hospitals, 72 refused to participate, and 52 

were out of scope. The 420 participatinghospitals 

provided approximately224,000 abstractsof medical 

records. 

Sample design 

All hospitals with 1,000 beds or more in the 

verse of shoti-stay hospitals were selected with 

certaintyin the sample. All hospitalswith fewer than 

1,000 beds were st.ratiiled,the primarystratabeing 24 

size-by-regionclasses.Withineachofthese 24 primary 

strata,theallocationof thehospitalswasmadethrough 

a controlledselectiontechniqueso thathospitalsin the 

sample would be properly distributedwith regard to 

type of ownership and geographic division. Sample 

hospitals were drawn with probabilitiesranginghorn 

certaintyfor the largest hospitals to 1 in 40 for the 

smallesthospitals. 

Sample discharges were selected within the hospitalsusingthe daily listingsheetof dischargesas the 

samplingframe. These dischargeswere selected by a 

randomtechnique,usuallyon thebasis of thetermimd 

digitor digitsof thepatient’smedical recordnumber,a 

numberassignedwhenthepatientwas admittedto the 

hospital.The within-hospitalsamplingratiofor selecting sampledischargesvariedinverselywiththeprobability of selection of the hospital. 

Data collection and estimation 

The sample selection and the transcription of 

@ormationfrom thehospitalrecordsforabstractforms 

<wereperformedby the hospital staffor by representatives of the National Centerfor Health Statisticsor by 

both. The datawere abstractedfrom theface sheetsof 

the medical records. All discharge diagnoses and 

procedureswerelistedon theabstractintheorderofthe 

principalone, or thefirst-listedone iftheprincipalone 

was not identified,followed by the order in which all 

otherdiagnosesor procedureswereenteredon theface 

sheet of the medical record. 

Statisticsproduced by the NHDS arederivedby a 

complex estimatingprocedure. The basic m-t of estimationis the sampleinpatientdischargeabstract.The 

estimatingprocedure used to produce essentiallyunbiased national estimates in the NHDS has three 

principal components: inflationby reciprocals of the 

probabilities of sample selection, adjustmentfor nonresponse, and ratio adjustmentto freed totals. These 

components of estimationare described in appendixI 

of two earlierpublications.11Jz 

Sampling errors and rounding of numbers 

The standarderror is a measure of the sampling 

variability that occurs by chance because only a 

sample,ratherthananentireuniverse,is surveyed.The 

relative standarderror of the estimateis obtained by 

dividingthe standarderrorby the estimateitselfandis 

expressed as a percent of the estimate.Table I shows 

relativestandarderrorsfor discharges,fwst-listeddiagnosis, andall-listeddisgnoses.Relativestandarderrors 

for all-listedprocedures are as follows: 

Size of 

estimate 

1,000...................................... 2,500 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

5,000 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

10,000 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

25,000 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

50,000 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

100,000 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

500,000 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

1,000,000 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

4,000,000 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Relative 

standard 

error 

35.5 

26.7 

21.9 

18.3


14.6


12.6 

10.9


8.2 

7.4 

6.1 

The standard errors for average lengths of stay are 

shown in table II. 

Estimateshave been roundedto the nearestthousand. For this reason detailedfigureswithintables do 

not always add to the totals. Percents and average 

lengths of stay were calculated from original, unroundedfiguresandwillnotnecessarilyagreeprecisely 

withpercentsor averagelengthsof staycalculatedfrom 

rounded data. 

NOTE A list of references follows the text. 
------

10 admncedata 

Table 1. Approximate relative standard errors of estimated number of 

discharges, first-listed diagnosis, and all-listed diagnoses, by selected 

patient and hospital characteristics 

Ownership of hospital 

Size of Proprietary Bed size Ail other 

estimate or State less than characteristics 

and local Nonprofit 100 

government 

Relative standard error 

....... 35.7 19.9 20.7 16.3 

50,000 . . . . . . . 27.9 15.2 13.1 10.2 

100,000 . . . . . . 25.5 13.7 11.0 8.5 

300,000. ... . 22.4 11.9 8.6 6,6 

500.000 . . . . . . 21.2 11.2 7.8 5.9 

1,000,000 . . . . 19.9 10.4 6.8 5.1 

10,000


4,000,000, . . . 17.7 9.2 5.4 4.0 

— 

Table 11, Approximate standard errors of average lengths of stay 

Average length of stay 

Number of discharges in days 

or first-listed diagnosis 

2 6 10 

Standard error in days 

10,000 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0.7 1.2 1.7 

50,000 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0.3 0.7 1.0 

100,000 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0.3 0.6 0.9 

500,000 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0.2 0.5 0.8 

1,000,000 . . . . . . . . . . . . . . . . . . . . . . . . . 0.2 0,5 0.8 

5,000,000 . . . . . . . . . . . . . . . . . . . . . . . . . . . 0.2 0.5 0.8 

Tests of significance 

In this report, the determination of statistical inference is based on the two-tailed Bonfen-oni test for 

multiple comparisons. Terms relating to differences 

such as “higher” and “less” indicate that the differences are statistically significant. Terms such as “similar” or “no difference” mean that no statistically 

significant difference exists between the estimates 

being compared. A lack of comment on the difference 

between any two estimates does not mean that the 

difference was tested and found to be not significant. 

— -. 

Recent Issues of Advance Data 

No. 82. Contraceptive Use Patterns, Prior Source, and Pregnancy 

History of Female Family Planning Patients: United States, 1980 

(Issued: June 16, 1982) 

No. 81. Drug Utilization in Office Practice by Age and Sex of the 

Patienti National Ambulatory Medical Care Survey, United 

States, 1980 (Issued July 26, 1982) 

676 of the International Classl~cation of Diseases, _ 

9th Revision, Clinical i140d@ation (ICD-9-CM).3 

Normal delivery. —Delivery without abnormality ( 

or complication of pregnancy, childbirth, or the puerperium, and with spontaneous cephalic delivery (that 

is, presentation of the child headfirst and delivery of the 

child without external aid). No mention of fetal manipulation or instrumentation is made. ICD-9-CM code 

650 is assigned. 

Complicated delivery. —All deliveries not considerd normal, including deliveries of multiple gestation. ICD-9-CM code numbers 640-648 and 65 1–676 

are assigned. 

First-listed diagnosis. —The coded diagnosis 

identified as the principal diagnosis or listed first on the 

face sheet of the medical record. The number of firstIisted diagnoses is equivalent to the number of discharges. 

All-1isted diagnoses. —The estimated number of 

discharge (or final) diagnoses, up to a maximum of 

seven, that are listed on the face sheet of the medical 

record for inpatients discharged from non-Federal 

short-stay hospitals during the. year. 

Procedure. —One or more surgical or nonsurgical 

operations, procedures, or special treatments assigned 

by the physician to the medical record of patients 

discharged from the inpatient service of short-sta 

hospitals. In the NHDS all terms listed on the fac 

sheet (summary sheet) of the medical record under them 

captions “operation,” “operative procedures,” “operations and/or special treatments,” and the like are 

transcribed in the order listed. A maximum of four 

procedures are coded. 

Average length of stay. —The total number of 

patient days accumulated at time of discharge by 

patients discharged during the year divided by the 

number of patients discharged. 

Race. —A term used to classify patients into one of 

two groups: “white” and “all other.” The “all other” 

classification includes all categories other than white. 

Mexican and Puerto Rican patients are included in the 

white category unless speciilcally identified as “all 

other.” 

Type ofownership of hospital. —The type of organization that controls and operates the hospital. Hospitals are ~ogped as foll~.. ___ 

,-.-

From Vital and Health Statistics 

e 

National Ambulatory Medical Care Survey, United States, 1980 

(Issued July 22, 1982) 

No. 79. Blood Lead Levels for Persons 6 Months-74 Years of Age: 

United States, 1976-80 (Issued May 12, 1982) 

No. 78. Drugs Most Frequently Used in OffIce-Based Practice: 

National Ambulatory Medical Care Survey, 1980 (Issued May 
admcedm 11 

Region—Con. States included—Con. — ., Geographic region. —One of the four geographic 

regions of the United States corresponding to those North Dakota, South Dakota, Nebraska, 

and Kanaas 

/ used by the U.S. Bureau of the Census: South . . . . . . . . . . . . . Delaware, Maryland, District of Columbia, 

Wrainia, West Vlrginla, North Carolina, 

Region States included South Carolina, Georgia, Florida, Kentuckv. 

Northeast . . . . . . . . . Maina, New Hampshire, Vermont, Mass- slppi, Arkansas, Louisiana, Oklahoma, 

achusetta, Rhode Island, Connecticut, and Texas 

New York, New Jersey, and Pennsyl- West . . . . . . . . . . . . . Montana, Idaho, Wyoming, Colorado, 

vania New Mexico, Arizons, Utah, Nevada, 

.––,. Tennessee, Alabama, MissisNorth Central . . Michigan, Ohio, Illinois, Indiana, Wis- Washington, Oregon, California, Haconsm, Minnesota, lowa, Missouri, waii, and Alaska 

.f- ..- Data not available 

. . . Category not applicable 

Quantity zero 

0.0 Quantity more than zero but less than 

0.05 

z	 Quantity more than zero but less than 

500 where numbers are rounded to 

thousands 

* Figure does not meet standards of 

reliability or precision (more than 30-

percent relative standard error) 

#	 Figure suppressed to comply with 

confidentiality requirements 
12


Recent Issues of Advance Data 

No. 82. Contraceptive Use Patterns, Prior Source, and Pregnancy 

History of Female Family Planning Patients: United States, 1980 

(Issued: June 16, 1982) 

No. 81. Drug Utilization in Ofice Practice by Age and Sex of the 

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No. 80. Medication Therapy in OffIce Visits for Hypertension 

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Deliveries In short-stay hospitals. Advance Data From


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No. 79. Blood Lead Levels for Persons 6 Months-74 Years of Age: 

United States, 1976-80 (Issued: May 12, 1982) 

No. 78. Drugs Most Frequently Used in OffIce-Based Practice: 

National Ambulatory Medical Care Survey, 1980 (Issued: May 

12, 1982) 

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