NATIONAL CENTER Series 12 

For HEALTH STATISTICS, I Number 3 

VITAL and HEALTH STATISTICS 

DATA FROM THE NATIONAL HEALTH SURVEY 

Characteristics of Patients 

in Mental Hospitals 

UnitedStates- April- June1963 

Statistics on age, sex, color, length of stay, and selected health characteristics of patients in long-stay 

mental hospitals. Based on data collected in a survey of mental hospitals during April-June 1963. 

Washington, D.C. December 1965 

U.S. DEPARTMENT OF 

HEALTH, EDUCATION, AND WkLFARE Public Health Service 

John W. Gardner \E:illiam H. Stewart 

Secretary Surgeon General 
Public Health Service Publication No. 1000~Series 12-No. 8 

For ale by the Su erintmdent of Documents, U.S. Government Printing 05ca 

k aahington, D.C., 20402 - Price 85 centa 
NATIONALCENTERFORHEALTHSTATISTICS 

FORREST E. LINDER, PH. D., Director 

THEODORE D. WOOLSEY, Deputy Director 

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

WALT R. SIMMONS, M.A., Statistical Ad&or 

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

JAMES E. KELLY, D.D.S., Dental Ad&or 

LOUIS R. STOLCIS, M.A., Executive ojicer 

DIVISIONOF HEALTHRECORDSSTATISTICS 

MONROE G. SIRICEN,PH. D., Chief 

E. Earl Bryant, Chief, Instifulional Population Survey Branch 

Milton C. Rossoff, Chief, Hospital Discharge Survey Branch 

Gordon F. Sutton, Chief, Viral Records Surveys 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, 

collecting the data, and carrying out certain parts of the data 

processing. 

Public Health Service Publication No. 1000~Series 1240. 3 

Library o/ Congress Catalog Card Number 65-62787 
------ 

-- 

----------- 

CONTENTS 

Page 

1 

So~ces and Qualifications of Data-- __--__-- ______ _--_ _-______ _______c___ 2 

Distribution of Mental Hospitals and Patients----------------------------- 3 

Demographic C&-acteristics ___c____________________________________--- 4 

Age, Sex, and Color------------------------------------------------- 4 

Type ofOwnership-------------------------------------------------- 5 

Geographic Region-------------------------------------------------- 6 

Len@ of Stay of patients __-___c--__- -___________________________ 6 

Age and Sex-------------------------------------------------------- 6 

Type of Ownership-------------------------------------------------- 8 

Geographic Region----------c--------------------------------------- 8 

Heale Characteristics of patients ____~__~_~~~~~___~--_-_____---___ ___-__ 

Age, Sex, and Color-------------------------------------------------

Type ofOwnership--------------------------------------------------

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

9 

10 

10 

10 

Comparison of Health Characteristics of Mental Hospital Patients 

ad Residents in Homes for the Aged------- ________ __________________ 

Detailed Tables------------------------------------------------------- 14 

Appendix I. Technical Notes on the Survey Design and Procedures---------- 28 

General------------------------------------------------------------ 28 

Sampling Frame and Size of Sample ____ _-___ _ _--_------_- _- ----_ _- ___- 28 

Sample Design----------------------------------------------------- 28 

Survey Procedure-------------------------------------------------- 29 

Response and Imputation of Missing Data------------------------------ 29 

Estimation and Reliability of Estimates------------------------------- 29 

Appendix II. Definitions of Certain Terms Used in This Report -----___-__ 

Terms Relating to Hospital or Patient------------ -----------_-_-__-__ 

Demographic Terms------------------------------------------------

34 

34 

35 

Appendix III. Questionnaires and Letters---------------- ------------____ 36 

Communications by the Veterans Administration--- -------------__-___ 36 

Letter Mailed by the National Institute of Mental Health------ 38 

Inquiry on Ward Characteristics------------------ ------_---_-_______ 40 

Facility and Patient Questionnaire--------------- -------------_______ 41 

11 
IN THIS REPORT statistics are presented on selected characteristics 

of patients in long-stay mental hospitals. The characteristics include 

age, color, sex, length of stay, and certain indices of physical and mental disability. The data were collected during April-June 1963 from a 

probability sample of mental hospitals in the United States in which patients stay an average of 30 days OY more. On the basis of data collected 

in the survey, it is estimated that there were about 558,000 patients in 

414 long-stay mental hospitals. This estimate does not include patients 

in maximum security and children’s wards in these hospitals nor mental 

hospitals serving children only. 

The median age of the patients was 54 years. Males outnumbered females; there were 113 males per 100 females. On the average, mules 

weye younger than females and nonwhite patients younger than white. 

Nogwhite persons, constituting one-jYfih of the patients, showed almost 

twice the rate of white in number hospitalized per 1,000 population. 

Patients in the hospital at the time of the survey had a median stay of 

6.4 years, ranging from about 3 years for patients under 45 years of age 

to about 10 years for patients aged 55-64 years. Length of stay varied 

considerably by type of ownership of the hospital, from a median stay 

of less than 1 year for nongovernmental hospitals to about 7 years for 

State and county hospitals. 

The patients’ health varied mainly with age, with some sex and color 

differences present. Mental disability was far more severe than physical disability in the hospital population. For example, about half of the 

patients were un.awaYe of their surrou+adings part OY most of the time, 

while only 1 out of every 10 patients was not able to walk unassisted. 

I 1 

SYMBOLS 

lJab not available---- --___ -________-_____ --_ 

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

Quantity zero _--_ - r______________________ _ 

Quantity more than 0 but less than O.OS----- 0.0 

Figure does not meet standards of * reliability orprecision------------------
CHARACTERISTICS OF 

PATIENTS IN MENTAL HOSPITALS 

Carl A. Taube, Division of He&h Records Statistics 

INTRODUCTION 

This is the third report to be published on 

the findings of the first Resident Places Survey 

(RPS-1). This survey wasconductedduring AprilJune 1963 by the Division of Health Records 

Statistics of the National Center for Health Statistics (NCHS) in cooperation with the Bureau of 

the Census. The RPS-L was the first of a series 

of surveys designed to cover specific segments of 

the institutional population of the United States. 

These surveys are part of the U.S. National 

Health Survey program. The National Health Survey also collects health information about the 

noninstitutional population through the use of hospital records, health examinations, and household 

interviews. A description of the National Health 

Survey program has been pub1ished.l 

The RPS-1 covered various types of institutions such as nursing homes, convalescent homes, 

and other similar types of facilities that provide 

care to the aged and chronically ill. Mental hospitals were included in the survey not only because of the need for health statistics on this 

large segment of the institutional population but 

because of the apparent similarity between many 

INational Center for Health Statistics: Origin, program,, 

and operation of the U.S. National Health Survey. Vita2 and 

ileaZtiS Statistics. PHS Pub. No. lOOO-Series l-No. 1. Public 

IIealthService. Washington. U.S. GovernmentPrintingOffice, 

Aug. 1963. 

patients in mental hospitals and residents of 

nursing and personal care homes. The survey was 

designed to provide comparative statistics on 

these two parts of the institutional population. 

The two previous reports in this series deal 

with data collected from Institutions for the aged 

and chronically ill. The first report2 portrays 

characteristics of the institutions (e.g., admission 

policy, type of nurse in charge of nursing care, 

whether or not round-the-clock nursing service 

is provided, and charges for the care of residents). The second report3 deals with characteristics of the residents similar to those reported here for patients in long-stay mental 

hospitals. 

Data are presented in this report on age, 

color, and sex of patients and on their length of 

stay in the hospital. In addition, mental patients 

are described in terms of selected indices of 

physical and mental disability and a comparison 

is made of the health of these persons with that 

of residents in homes for the aged and chronically ill. 

2National C.enter for Health Statistics: Institutions for the 

aged and chronically ill. Vital and He&h Statistics. PHS 

Pub. No. 1000~Series 12-No. 1. Public Health Service. Washington. U.S. Government Printing Office, July 1965. 

3National Center for Health Statistics: Characteristics of 

residents in institutions for the aged and chronically ill. Vita2 

and Health Statistics. PHS Pub. No. 100~Series 12-No. 2. 

Public Health Service. Washington. U.S. Government Printing Office, Aug. 1965. 

1 
SOURCES AND QUALIFICATIONS 

OF PATA 

The data on which this report is based were 

obtained from a probability sample of 172 longstay mental hospitals in the United States. Excluded from the scope of the survey were longstay hospitals which served children only, as were 

children’s wards and maximum security wards 

within the sample hospitals. 

Since mental hospitals serving children only 

and children’s wards were not included in this 

survey, it is assumed that all patients within the 

scope of the survey were adults. For the purpose of relating this hospitalized population to the 

civilian population of the United States, an adult 

is considered as being any person 15 years of 

age and over. 

During April-June 1963 personal visits were 

made to the 144 sample hospitals with 300 beds 

or more by representatives of the Bureau of the 

Census who selected the sample of patients and 

assisted in conducting the survey. The survey 

was conducted by mail in the 28 sample hospitals 

with less than 300 beds. 

The universe from which the sample was 

selected was the Master Facility Inventory (MFI) 

maintained by NCHS. The MFI is a comprehensive 

list of hospitals and resident institutions in the 

United States developed to serve as a sampling 

frame from which the institutions within the scope 

of the various sample surveys are selected. 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.4 

A description of the survey design, estimation 

techniques, and general qualifications of the data 

presented in this report is given in Appendix I. 

Since estimates shown in this report are based 

on a sample of the population in long-stay mental 

4National Center for Health Statistics: Development and 

maintenance of a national inventory of hospitals and institutions. Vital and Health Statistics. PHS Pub. No. lOOO-Series 

l-No. 3. Public Health Service. Wasliington. U.S. Govemment Printing Office, Feb. 1965. 

hospitals rather than on a complete census, they 

are subject to sampling error. The sampling 

errors for most of the estimates are of relatively 

low magnitude; however, the sampling error may 

be high in cases where a percentage or an estimated number for the numerator or denominator 

of a rate is small. A standard error chart, tables 

of sampling errors, and instructions for their 

use are presented in Appendix I. 

Date of last admission, age, color, andsexof 

the patients were obtained from hospital records. 

Information on the health conditions of the patients was based on “proxy” response-i.e., on 

the personal knowledge of the nurse or other 

responsible person responding on behalf of the 

sample patient. Hence, the data ,on health conditions are only as accurate as the respondent’s 

knowledge of the patient’s health and his ability 

and willingness to answer specific questions. 

Evaluation studies conducted during the pretests 

of the survey indicated that in general most of the 

respondents gave reliable answers to the questions 

on health status. A possible exception might be 

the answers to the questions on mental status if 

the patient was receiving some form of drug treatment. The drug might have the effect of making a 

mentally alert patient confused or a confused patient alert. The proportion of respondents who 

misinterpreted this question to mean the patient’s 

mental status while receiving drugs is unknown. 

The terms used in this report are defined in 

Appendix II. The sections of the survey questionnaire that apply directly to this report are shown 

in Appendix III. Every attempt was made to make 

the questionnaire self-explanatory so that separate instructions to the respondent for completion 

of the form and explanation of terms used would 

be unnecessary. Necessary definitions and explanations were included as part of the individual 

question. In addition, for a majority of the hospitals a representative from the Bureau of the Census was available to answer any questions that 

might arise. 

The analysis which follows presents some of 

the highlights of the survey findings and points 

out the more important relationships revealed by 

the data. Detailed information about the patientsis given in tables l- 8. 
DISTRIBUTION OF 

MENTAL HOSPITALS AND PATIENTS 

There were an estimated414 long-stay mental 

hospitals in the United States at the time of the 

Survey in 1963, with an estimated resident population of 558,000 patients, excluding those in 

maximum security wards and wards serving children only. Table A shows the distribution of the 

hospitals and patients according to geographic 

region and type of ownership. 

Mental hospitals under governmental auspices were very large, having an average of almost 1,900 resident patients per hospital. The 

nongovernmental hospitals (proprietary, church, 

and voluntary nonprofit organizations) were small 

in comparison, comprising about 30 percent of 

total hospitals but only 2 percent of the patients. 

The largest hospitals were operated by State and 

county governments, averaging nearly 2,000 patients per hospital. (The term county government 

as used in this report refers to all levels of 

local government.) The federally owned hos­

?itals-composed primarily of those operated by 

the Veterans Administration-were also quite 

large, averaging about 1,500 patients per hospital.Almost two-fifths of the hospital patients 

were in the Northeast Region, a large proportion 

compared with other regions. Indeed, the Northeast had the highest rate of hospitalization relative 

to the total adult population of the region. As shown 

in table D, about 6 out of every 1,000 adults in the 

Northeast Region were in mental hospitals, compared with a rate of about4 per 1,000 adultpopulationin each of the other regions. 

Table A. Percent distribution of long-stay mental hospitals and patients in these hospitals according to type of ownership of the hospital and geographic region: United 

States, April-June 1963 

Region 

Tn= of ownership All North- North 

regions east Central South West 

Number of hospitals 

All hospitals--------------------- 414 ‘J 127 1 129 70 1 88 

Percent distribution 

All ownerships--------------------

Federal Goverrrment----------------------

State and county government------------- Nongovernmental-------------------------

All patients---------------------- 558,417 11 203,718 1152,249 137,448 ( 68,325 

Percent distribution 

All ownerships-------------------- 100 100 100 100 100 

Federal Government----------------------

State and county government-------------

Nongovernmental-------------------------

i"8 

2 

95 

2 

iz 

1 

iz 

1 

ii 

4 

3 
DEMOGRAPHIC CHARACTERISTICS 

Three major findings are highlighted concerning the age, color, and sex of mental hospital 

patients. 

1. Older persons were hospitalized at a 

higher rate than younger persons. 

2. Men were hospitalized at a higher rate 

than women. 

3. Nonwhite persons were hospitalized at 

almost twice the rate of white persons. 

The analysis in this section examines the 

findings by relating the age, color, and sex of 

patients, the type of ownership, and the geographic region in which the hospitals are located 

in an attempt to identify subgroups of the mental 

hospital population which contribute most to the 

observed differences. 

Age,. Sex, and Color 

Age. -The median age of mental hospital 

patients was 54 years. This compares with a 

median age of 41 years for the U.S. civilian population 15 years of age and over. Almost 30 percent of the hospital patients were 65 and over, 

about twice the proportion in the general population for this age group. A relatively small proU.S. CIVILIAN POPULATION 

I I I I I II II III I 

60 40 20 0 20 40 60 

PERCENT 

portion of the patients were in the younger age 

group (fig. 1); only 31 percent of the mental 

hospital patients were 15-44 years of age, compared with 58 percent of the U.S. population. 

Comparisons among age groups of the number 

of persons in mental hospitals per 1,000 population further emphasize this age difference. About 

2 out of every 1,000 persons 15-44 years of age 

were in mental hospitals as opposed to about 11 

per 1,000 persons 75 years and over. 

Sex. -There were more men than women in 

mental hospitals as shown in table 1. Although 

the difference is not very large-113 men per 100 

women-it takes on additional significance when 

compared with the sex ratio in the U.S.adult population, which was 90 men per 100women in 1963. 

Stated in terms of rates of hospitalization, there 

were 4.9 male patients and 3.9 female patients 

per 1,000 U.S. population 15 years of age and 

over (table B). This higher proportion of males 

in the ,hospital population was accounted for primarily by the large proportion of men in the age 

group 15-44 years, where there were 156 males 

per 100 females. The proportion of males and 

females was about equal for the age groups 45-

74 years. In the age group 75 years and over, 

however, females were in the majority (66 males 

per 100 females). Although the rate of hospitaliMENTAL HOSPITAL POPULATION 

FEMALE 

I 1 I I I I 1 I I I I I I 

60 40 20 0 20 40 60 

PERCENT 

Figure I. Percent distribution of the long-stay mental hospital population and the U.S. civilian population,by age and sex. 

4 
Table B. Rate of hospitalization in longstay mental hospitals per 1,000 population 15 years and over, by age, color, 

and sex: United States, April-June 1963 

Age and color Total Male Female 

II I 

Rate of hospitalization per 1,000 popu- Total lation 

All ages----- 4.4 4.9 -

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

45-54 years-------- 52:; E 

55-64 years--------

65-74 years-------- 2; 97-Y 

75+ years---------- 10:s 1012 

White 

All ages----- 4.1 4.4 3.7 

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

45-54 years--------

55-64 years--------

65-74 years-------- 75+ years----------

Nonwhite 

All ages----- 7.0 8.9 5.3 

15-44 years-------- 3.2 

45-54 years-------- 289 1E 

55-64 years-------- 10: 7 1211 z 

65-74 years-------- 12.7 14.6 11: 1

75+ years---------- 14.8 16.1 13.7 

zation for both men and women increased consistently with age, male patients were on the 

average younger than female patients. The median 

age for men was 52 years and for women 57 years. 

Color .-Nonwhite patients were hospitalized 

at almost twice the rate of white patients-a rate 

of 7.0 per 1,000 population for nonwhite and 4.1 

per 1,000 population for white (table B). This 

higher rate of hospitalization for nonwhite patients was present in all age groups and for both 

sexes; but the differences were not as marked 

for those in the age groups over 65, especially 

for females. 

Nonwhite patients were on the average younger than white patients for both sexes. Themedian 

age of nonwhite patients was 48 years and of white, 

56 years. Within each color group males were 

younger than females (table 1). 

The nonwhite segment of the hospitalpopulation had a higher proportion of males than the 

white-149 males per 100 females for the nonwhite as compared with 107 males per 100 females for the white. For the nonwhite hospital 

population, however, the predominance of males 

prevailed only in the age groups under 55 years. 

Although some excess of nonwhite males continued through age group 65-74, the differences 

for the older age groups were not statistically 

significant. Among the white population males 

were in the majority in the age groups under 55, 

the proportion of males and females 55-64 and 

65-74 years was about equal, and females were 

in the majority at ages 75 years and over. 

Type of Ownership 

Males and females were about equal in number 

in hospitals operated by State and county governments. As indicated in table 2, there were 97 

males per 100 females. In Federal hospitals, 

however, the predominance of males was overwhelming-9 males for every female. This is to 

be, expected since the majority of these hospitals 

were operated by the Veterans Administration, 

whose admissions are predominantly men. In 

nongovernmental hospitals the opposite situation 

exists-females were in the majority, with only 

54 males per 100 females. 

These differences in the proportions of males 

and females by type of ownership account for 

some of the differences in the age distribution by 

type of ownership. Mental hospitals under State 

and county control contained an older population 

than Federal hospitals (table C). This age differential is due largely to the predominance of male 

patients in Federal hospitals, males being younger 

on the average than women in the hospital population. The estimated median age of patients in 

nongovernmental hospitals was also lower than 

that for patients in State and county hospitals, but 

the difference is not statistically significant. 

5 
Table C. Median age of patients in longstay mental hospitals,by type of ownership and sex: United States, April-June

1963 

Type of ownership Both Male Female sexes 

Median age in years 

AL1 types---- 54.2 51.8 56.9 

State and local 

government--------

Federal Government54.9 49.2 

52.5 

48.2 

57.1 

56.8 

Nongovernment------ 49.9 51.9 49.0 

Geographic Region 

Most oi the relationships among the age, sex, 

and color of patients mentioned above for the 

United States as a whole were also observed for 

each of the four geographic regions (table 3). The 

rate of hospitalization increased with age in each 

region (fig. 2); males were hospitalized at a higher 

rate than females in all regions, but in the Northeast Region this difference was not statistically 

significant; nonwhite patients were hospitalized at 

a higher rate than white in all regions (table D). 

Males were younger than females; nonwhites were 

younger than whites; and males outnumbered females except in the Northeast Region. The major 

regional difference observed was the higher rate 

of ‘hospitalization for the Northeast Region (table 

D). This higher rate was true for all color-sex 

groups (fig. 2) and all age groups, especially 65 

years and over. 

LENGTH OF STAY OF PATIENTS 

Length of stay as reported in this survey 

is the time interval between the patient’s last 

admission to the hospital and the day the survey 

was conducted in the hospital. It does not, therefore, necessarily represent the total time a person has spent in mental hospitals. In this section 

length of stay is related to the age and sex of 

patients, type of ownership, andgeographic region. 

RATE PER 1,000 POPULATION 

45-64 ymrs 

Figure 2. Rate of hospitalization in long-stay 

mental hospitals perl,OOO population 15+years, 

by age and geographic region. 

A large proportion of patients in long-stay 

mental hospitals have been hospitalized for very 

long periods of time. About 40 percent of the estimated 558,000 patients had been in the hospital 

for 10 years or more, 14 percent for 5-9 years, 

23 percent for 1-4 years, and 23 percent for less 

than 1 year (table E). The average (mean) length 

of stay since the date of last admission for all 

patients was 10.6 years; the median length of 

stay was 6.4 years. 

Age and Sex 

As can be seen from table 4, length of stay 

varied considerably with age of the patient. Patients under 45 years of age had been hospitalized 

the shortest length of time-the median length of 

6 
9 

Table D. Rate of hospitalization in long-stay mental hospitals per 1,000 population iz63years and over, by color, sex, and geographic region: United States, April-June 

Region 

Color and sex 

Total 

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

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

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

White 

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

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

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

Nonwhite 

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

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

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

North- / C~~~~~, ) South 1 West eii?t 

Rate per 1,000 population 

6.4 4.3 3.6 3.6 

4.9 4.1 4.0

2:: 3.8 3.1 3.1 

6.1 4.1 2.8 3.5 

4.5 

::: 3.7 2: E 

10.8 7.1 6.9 4.9 

13.4 

8.5 

NOTE: Population aged 15 years and over used to compute ratios shown in the above 

table obtained from U.S. Bureau of the Census, U.S. Census of Population, 1960, General Population Characteristics, United States Summary, Final Report PC(l)-lB, Washington, U.S. Government Printing Office, 1961 . 

Table E. Percent distribution of patients in long-stay mental hospitals, by length of 

stay according to type of ownership: United States, April-June 1963 

-

Length of stay 

al patients-----------------------

Under 1 year-----------------------------

1-4 years--------------------------------

5-9 years-------------------------------- 10+ years-----------------------------------

Average stay-----------------------------

Median stay------------------------------

Type of ownership 

All Federal State and Nongovern­ hospitals county ment 

Percent distribution 

100 100 100 100 

I: E 2':: E 

204 iz t; 8 

10.6 8.7 10.9 3.6 

6.4 4.4 6.9 0.7 

7 
stay for this age group was 3 years. The median 

length of stay increased with age up to age group 

55-64 years, where it reached a peak of about 10 

years, and dropped off to about 6 years for age 

group 75 years and over. A similar pattern and 

similar magnitudes were observed for bothmales 

and females. 

This variation in length of stay by age can 

be attributed partly to the variation in the relative 

proportions of first admissions in each age group 

(table F); the age groups with the shortest median 

length of stay had the highest number of first 

admissions per 1,000 resident patients. The 

changing age composition of the U.S. population 

is one reason for the high rate of first admissions 

of persons 75 years and over. The number of 

persons 75 and over has increased rapidly in the 

past, and continued substantial increases in the 

population 75 years and over are indicated.5 

Placement in mental hospitals is one of the arrangements available for the care of aged persons. Alternative arrangements are placement in 

nursing care homes or homes for the aged, the 

use of home-care services, and the use of community mental health centers. The extent to which 

these alternatives are available is an important 

factor in determining the level of first admission 

rates in the older age groups. 

Type of Ownership 

As table E shows, length of stay varies considerably by type of ownership. Patients in State 

and county hospitals had been hospitalized for 

the longest period of time, with a median stay of 

about 7 years. This is a little over 1% times as 

great as the median stay for patients in Federal 

hospitals and about 10 times as great as the median 

stay for patients in nongovernmental hospitals. 

Geographic Region 

Table 5 shows the percent distribution ofpatients by length of stay according to geographic 

region, age, and sex. Median length of stay for 

6U.S. Bureau of the Census: Projections of the population 

of the United States, by age and sex, 1964 to 1985, with extensions to 2010. Current Popuhtion Reports, Series P-25, 

No. 286. Washington, July 1964. 

Table F. Number of first admissions during 1963 per 1,000 resident patients at 

the end of the year in State and county

mental hospitals by age of patient:

United States1 

Age of patient ) ~~~~, 11 Male 1 Female 

First admissions 

during 1963 per

1,000 resident 

patients 

15-44 years-------- 484 492 473 

45-54 years-------- 193 229 156 

55-64 years-------- 123 147 

65-74 years-------- 139 177 1;; 

75+ years---------- 239 308 194 

‘National Institute of Mental Health: 

Patients in Mental Institutions. 1963, 

Part II, State and County Mental HospiLtals PHS Pub. No. 1222. Public Health 

Service. Washington, D.C., 1964. 

males and females by region is shown in table 

G. As can be seen from these tables, length of 

stay varied by region and sex but not in a consistent fashion. For example, the median length 

of stay for patients in the West Region was shorter 

than the median stay for the other regions. When 

sex was considered, the median stay for males in 

the West Region was not significantly different 

from that for males in the North Central Region. 

For females, the median stay in the West was 

about the same as that in the South. Other differences between regions may be noted in tables G 

and 5. 

While no significant sex differences were 

noted in terms of length of stay when the total 

hospital population was considered, differences 

appeared when the hospital population within each 

of the four regions was considered separately. 

Males had been hospitalized for a shorter length 

of time than females in the Northeast Region. 

In the South, however, the reverse was true. ln 

the West there was no significant difference between males and females in length of stay. As 

can be seen in table 5, the relationship between 

age and length of stay prevailed within each of 

the regions. 

8 
Table G. Median length of stay of patients in long-stay mental hospitals,by geographic region and sex: United States, April-June 1963 

Sex 

Both sexes ---L------_---_---------~-----------

Male ---_----c------------~--------------------------

Female ----_-c-_----_--_---__________________c_-----~ 

HEALTH CHARACTERISTICS 

OF PATIENTS 

In this section patients are described in 

terms of their ambulation, continence, awareness 

of surroundings, hearing ability, and vision. With 

the exception of hearing ability, patients were 

classed according to extent of disability into one 

of three categories for each of these items. The 

categories correspond in general to no disability, 

partial disability, and complete disability. Definitions of the categories for each of the health items 

are given in Appendix II. The analysis in this 

section relates the health of patients to their age, 

Region 

North North 

east Central. South West 

Median length of stay in years 

7.9 5.7 6.6 4.0. 

sex, and color, the type of ownership or control 

of the hospital, andgeographic region (tables 6-8). 

Of the estimated 558,000 patients in mental 

hospitals, 90 percent were ambulatory; that is, 

they were out of bed except for ordinary rest or 

sleep and were able to walk unassisted or with a 

cane or crutch (table H). A like proportion were 

continent (i.e., they had control over their bladder 

and bowels), and about 95 percent had no trouble 

with seeing or hearing. With regard to mental 

status, however, only 47 percent of the patients 

were aware of their surroundings all of the time, 

33 percent were confused part of the time, and 

20 percent were confused alI or most of the time 

(table 6). 

Table H. Percent distribution of patients by extent of disability according to selected health items: United States, April-June 1963 

Extent of disability 

Health items 

All No Partial or 

complete patients disability disability 

Percent distribution 

Bed status--------------------------------------

W&king status----------------------------------

Continence status-------------------------------

Hearing status----------------------------------

Vision status _----------------------------------

Mental status --------------L--------------------

10 

1; 

1 

53 

9 
Age, Sex, and Color 

Table 6 shows the percent distribution ofpatients by the extent of disability in selected health 

items according to age, sex, and color. Among 

the age groups shown, both physical and mental 

disability increased with increasing age. The effect of aging on the ability to walk may be used 

as an example of this pattern. While about 96 

percent of the patients under 65 were able to walk 

unassisted, only about 72 :>ercent of those 75 

years and over could walk alone. The proportion 

of patients walking only with assistance or never 

walking increased almost sevenfold between the 

“under 65” and “75 and over” age groups. This 

relationship between age and disability existed in 

varying degrees for each of the other five health 

items, In terms of hearing and vision, the relationship between disability and age was not as 

pronounced as for the other health items. Furthermore, no differences were observed by color or 

sex for vision and hearing status. 

On the other hand, a sex difference was apparent for bed, walking, mental, and continence 

status. For each of these items males were less 

disabled in general than females. With the exception of bed status, this milder disability for males 

existed in all age groups. The sex difference for 

bed status existed only in the age groups under 

65. 

For white patients about 91 percent of the 

males were continent as opposed to 85 percent of 

the females. The proportion of males who were 

continent is greater than the corresponding proportion of females in all age groups among white 

patients. However, for nonwhite patients there 

was little difference in terms of continence between males and females of any age group (table 

6). The patterns discussed above for continence 

status were typical of the patterns which appeared 

for bed, walking, and mental status with one exception. For bed status, the sex difference among 

white patients prevailed only for those under 65 

years of age. 

There is little difference between white and 

nonwhite patients of either sex in terms of mental 

awareness. The same is true for hearing and 

seeing ability. Any differences on these measures 

shown in table 6 may be attributed to sampling 

variability. With regard to bed, walking, and 

continence status, however, nonwhite patients 

were less restricted than white. For bed status 

nonwhite patients of both sexes were less disabled than white; and for walking and continence 

status nonwhite females were less disabled than 

white females, but there was little difference in 

the extent of disability betweenwhite andnonwhite 

males. 

The proportion of patients aware of their 

surroundings all of the time decreased from 5 

out of every 10 for patients under 65 years of age 

to 3 out of every 10 for patients 75 years and 

over; and the proportion of patients confused all 

or most of the time doubled, increasing from onesixth for those under 65 years of age to one-third 

for those 75 years and over. 

Type of Ownership 

Table 7 shows the percent distribution ofpatients by the extent of disability in selected health 

items, according to type of ownership. As can be 

seen from this table, there was little variation 

in the health of the patients for the various types 

of ownership. The differences shown in the table 

are generally small, and many may be attributed 

to sampling error. 

Geographic Region 

With the exception of mental status, there was 

little variation among regions in the health ofpatients as measured by the six items reported in 

the survey (table 8). Within each of the regions 

about 9 out of every 10 patients were out of bed, 

ambulatory, and continent. In addition, about 19 

out of every 20 patients had no serious problem 

with sight or hearing. 

The relationships among age, sex, and extent of disability mentioned above were observed 

when regions were considered separately. Within 

each region, disability increased with increasing 

age for each of the six health items, and males 

were less disabled than females in terms of bed, 

walking, and continence status. 

Differences among regions were observed, 

however, in terms of mental awareness of the 

patients (fig. 3). The proportion of patients who 

were confused all or most of the time showed the 

least variation among regions. Approximately 2 

10 
PERCENT DISTRIBUTION 

0 20 40 60 60 100 

I I I 1 I I 

AeglOn 

Northeast 

North 

Central 

South 

Wl?Si 

MENTAL STATUS 

Confused Confused 

port of most of 

time time 

Figure 3. Percent distribution of patients in 

long-stay mental hospitals, by mental status 

according to geographic region. 

out of every 10 patients in each region were confused all or most of the time. The proportion of 

patients who were always aware of their surroundings was highest in the Northeast and West 

Regions, where 5 out of every 10 patients were 

always aware. Fewer patients were always aware 

of their surroundings in the South Region, aLout 

4 out of every 10 patients. When sex was considered, however, this held true only for ma les; 

and in terms of age groups, the proportion of 

patients who were always aware was lower in the 

South only for those under 65 years of age. The 

proportion of patients 65-74 years who were always aware was lower for the South than for the 

Northeast and North Central Regions but about 

the same as that in the West Region. For patients 

75 years and over there was little difference among 

the regions in the proportion of patients aware all 

or most of the time. 

Within each region the proportion of patients 

confused all or most of the time increased with 

age. More ma les than females were always aware 

of their surroundings in each region but the South, 

where there was no sex difference. However, 

more females than ma les were confused all or 

most of the time in all regions. 

COMPARISON OF HEALTH 

CHARACTERISTICS OF MENTAL 

HOSPITAL PATIENTS AND RESIDENTS 

IN HOMES FOR THE AGED 

Table J and figure 4 compare the health 

characteristics of patients 65 years and over in 

mental hospitals with those of residents or patients in homes for the aged (including such places 

as nursing homes, personal care homes, convalescent homes, and other similar facilities). 

More detailed comparisons can be made by referring to the report which has been published on 

the residents in institutions for the aged.3 In this 

section the health of the two patient populations 

is compared in terms of the six health items 

reported in the survey. 

As can be seen in table J, mental hospital 

patients 65 years of age and over were considerably less disabled physically than were patients 65 and over in homes for the aged. In terms 

of mental awareness, however, the reverse was 

true. W h ile about 4 out of every 10 patients 65 

and over in mental hospitals were always aware 

Confused port 

of time 

Figure 9. Percent distribution of patients 65+ 

years of age in mental hospitals and homes for 

the aged.by mental status. 

11 
Table J. Percent of patients in mental hospitals and in homes for the aged, by selected health characteristics: United States, April-June 1963 

I I 

Patients 65+ years Patients, all ages, in homes for 

I the aged 

Health characteristics PersonalMental Homes for Nursing care-with- Personal 

hospitals the aged, care homes nursing care homes all types homes 

Out of bed------------------

Walks unassisted------------

Continent-------------------

No serious hearing problem-- z; 

No serious vision problem--- 91 

Always aware of

surroundings--------------- 38 

of their surroundings, 5 out of every 10 patients 

65 and over in homes for the aged were always 

aware (fig. 4). A larger proportion ofmental hospital patients in this age group were confused 

most or part of the time (3 out of every 10) than 

of patients in homes for the aged (2 out of every 

(10. )

When mental hospital patients 65 years and 

over were compared separately with patients in 

the three types of homes for the aged (table J), 

several relationships appeared. Patients in homes 

providing nursing care were more disabledphysically than the mental hospital patients 65 and 

over but were quite similar in terms of the pro-

-000 

Percent of patients 

iis5 

79 

49 

portion of patients who were always aware of their 

surroundings. Patients in homes providing only 

personal care, on the other hand, were similar 

to mental hospital patients in terms of physical 

disability with the exception of continence status. 

Mental hospitals had a larger proportion of partially or totally incontinent patients than did personal care homes. In terms of the mental status 

of patients, however, personal care homes were 

most dissimilar to mental hospitals. About 

out of every 10 patients in personal care homes 

were aware of their surroundings all of the time 

as opposed to only 4 out of every 10 mental hospital patients 65 years and over. 

12 

7 
DETAILED TABLES 

Table 1. Number and percent distribution of patients in long-stay mental hospitals, by 

age according to sex and color: United States, April-June 1963------------------

2. Number and percent distribution of patients in long-stay mental hospitals, by 

age according to sex and type of ownership: United States, April-June 1963------

3. Number and percent distribution of patients in long-stay mental hospitals, by 

age according to geographic region, color, and sex: United States, April-June

1963 ----__---__-_-__------------------------------------------------------------

4. Number and percent distribution of patients in long-stay mental hospitals, by

length of stay since last admission and average and median length of stay according to sex and age: United States, April-June 1963--------------------------

5. Number and percent distribution of patients in long-stay mental hospitals, by length of stay since last admission according to geographic region,age, and sex: 

United States, April-June 1963--------------------------------------------------

6. Number and percent distribution of patients in long-stay mental hospitals, by the extent of disability in selected health characteristics according to sex, 

color, and age: United States, April-June 1963----------------------------------

7. Number and percent distribution of patients in long-stay mental hospitals, by 

extent of disability in selected health characteristics according to type of 

ownership: United States, April-June 1963---------------------------------------

8. Number and percent distribution of patients in long-stay mental hospitals, by 

extent of disability in selected health characteristics according to geographic

region, age, and sex: United States, April-June 1963----------------------------

9. Population aged 15 years and over used in obtaining rates shown in this publica­ tion, by color, age, and sex: United States, July 1, 1963-----------------------

Page 

15 

16 

17 

18 

19 

20 

22 

23 

27 

14 
Table 1. Number and percent distribution of patients in long-stay mental hospitals,by age according to sex and color: United States, April-June 1963 

Color and age Both sexes Male Female 

Total 

15-44 years------------------------------------------------ 45-54 years------------------------------------------------

55-64 years------------------------------------------------

65-74 years------------------------------------------------

75+ years--------------------------------------------------

White 

All ages---------------------------------------------

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

45-54 years------------------------------------------------

55-64 years------------------------------------------------

65-74 years------------------------------------------------

75+ years--------------------------------------------------

Nonwhite 

All ages---------------------------------------------

15-44 years------------------------------------------------ 45-54 years------------------------------------------------ 55-64 years------------------------------------------------

65-74 years------------------------------------------------ 75+ years--------------------------------------------------

Total 

15-44 years------------------------------------------------ 45-54 years------------------------------------------------ 55-64 

Number of patients 

558,417 296.334 262.083 

174,091 106,005 68,086 107,990 49,908 109,467 z; % 53,911 99,313 491887 49,426 67,556 26,804 40,752 

464,396 240,019 224,377 

132,686 53,757 89,422 x:; 42,345 93,509 46;741 46,768 88,053 43,861 44,192 60,726 23,411 37,315 

94,(321 56,315 37.706 

41,405 27,076 14,329 18,568 11,005 7,563 15,958 8,815 7,143 11,260 6,026 5,234 6,830 3,393 3,437 

Percent distribution 

100.o 100.o 100.0 

31.2 26.0

19.3 2E 19.0

19.6 18:8 20.6

16.8 18.9

z-!i. 9.1 15.5 

100.o 100.o 100.0 

28.6 32.9 24.0

19.3 19.6 18.9

20.1 19.5 20.8

19.0 18.3 19.7

13.1 9.8 16.6 

100.0 100.o 100.0 

44.0 38.0

19.7 ‘ig”G 20.1

17.0 15:7 18.9

12.0 10.7 13.9

7.3 6.0 9.1 

years------------------------------------------------

65-74 years------------------------------------------------

75+ years--------------------------------------------------

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

45-54 years------------------------------------------------

55-64 years------------------------------------------------

65-74 years------------------------------------------------

75+ years--------------------------------------------------

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

45-54 

White 

Nonwhite 

years------------------------------------------------ 55-64 years------------------------------------------------

65-74 years------------------------------------------------

75+ years--------------------------------------------------

15 
-------------------------- 

Table 2. Number and percent distribution of patients in long-stay mental hospitals,by age according to sex and type of ownership: United States, April-June 1963 

Type of ownership 

All types Government local government government 

Number of patients 

All patients----------------- 56,504j 491,915 1 9,998 

I I 

Male------------------------------- 296,334 51,006 241,821 3,507 

Sex and age 

Federal State and NonFemale----------------------------- 262,083 I/ 5,498 250,094 6,491 

Both sexes 

All ages---------------------

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

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

65-k years 

Male 

All ages---------------------

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

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

65+ years--------------------------

Female 

All ages---------------------

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

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

65+ years ---_--__-----___----------

Percent distribution 

100.0 100 .o 100.0 100.0 

31.2 40.3 29.9 42.3 

38.9 31.6 40.0 25.7 

29.9 28.1 30.1 32.0 

100.0 100 .o 100.0 100 .o 

35.8 42.3 34.3 40.5 

38.3 29.9 40.3 28.7 

25.9 27.7 25.4 30.8 

100.0 100.0 100.0 100.0 

26.0 25.6 43.2 

39.6 39.8 24.0 

34.4 34.5 32.7 

16 
Table 3. Number and percent distribution of patients in long-stay mental hospitals, by age according to 

geographic region, color, and sex: United States, April-June 1963 

Total White I Nonwhite 

Region and age Both Male Female Both Male Female Both Male Female sexes sexes sexes 

Region 

Northeast--------------

North Central----------

South------------------

West "_"__""""_""""""""" 

Northeast 

All ages---------

15-44 year-"""""""""""" 

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

65+ years--------------

North Central 

All ages---------

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

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

65+ year---------------

South 

All ages---------

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

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

65+ years--------------

West 

All ages---------

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

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

65+ years--------------

204,660 99,947 104,713 

152,159 83,645 68,514 

133,414 74,298 59,116 

68,184 38,444 29,740 

28.4 33.3 23.7 

39.0 39.5 38.6 

32.6 27.3 37.7 

35.4 28.2 34.5 

37.9 52.9 39.8 

26.7 18.9 25.8 

34.5 37.6 

39.8 39.2 

25.8 23.2 

35.6 39.5 30.6 

35.4 34.8 36.1 

29.0 25.7 33.3 

Number of patients 

181,858 86,740 95,118 

135,994 73,108 62,886 

85,209 45,596 39,613 

61,335 34,575 26,760 

Percent distribution 

26.2 30.1 22.6 

39.8 41.0 38.6 

34.0 28.7 38.8 

30.0 35.4 28.2 

39.8 37.9 52.9 

30.2 26.7 18.9 

34.5 37.6 

39.8 39.2 

25.8 23.2 

35.6 39.5 30.6 

35.4 34.8 36.1 

29.0 25.7 33.3 

22,802 13,207 9,595 

16,165 10,537 5,628 

48,205 28,702 19,503 

6,849 3,869 2,980 

45.8 34.7 

33.0 37.8 

21.2 27.7 

54.0 28.2 

29.3 52.9 

16.7 18.9 

42.5 43.7 

38.2 39.1 

19.3 17.2 

47.0 49.5 

36.6 29.7 

16.4 20.7 
Table 4. Number and percent distribution of patients in long-stay mental hospitals, by length of 

stay since last admission and average and median length of stay according tosex and age: United 

States, April-June 1963 

Length of stay since last 

admission 

Number 

Sex and age of 

patients Total Under Lm4 5-9 lo+ 1 

year years years years 

II I I I 

Both sexes Percent distribution 

All ages------------------ 558,417 100.0 

- 22.6 23.1 10.6 6.4 

15-44 years--------------------- 174,091 100.0 36.5 25.8 15.2 22.6 5.6 3.0 

45-54 years--------------------- 107,990 100.0 20.1 19.6 13.8 46.6 10.8 8.6 

55-64 years--------------------- 109,467 100.0 12.6 19.7 13.8 53.8 14.0 10.3 

65-74 years--------------------- 99,313 100.0 14.9 21.9 14.1 49.1 14.3 9.6 

75+ years----------------------- 67,556 100.0 18.2 28.8 14.9 38.1 12.3 5.9 

All ages------------------ 296,334 100 .o 22.3 24.2 38.4 6.1 

15-44 years--------------------- 106,005 1po.o 34.1 28.2 15.8 21.9 5.6 3.2 

45-54 years--------------------- 58,082 100.0 20.0 19.4 15.1 45.6 10.8 8.4 

55-64 years--------------------- 55,556 100 .o 11.6 18.9 13.4 56.2 14.7 10.4 

65-74 years--------------------- 49,887 100.0 14.3 24.2 16.0 45.6 13.6 8.5 

75-4 years----------------------- 26,804 100.0 18.1 30.3 13.8 37.8 12.1 5.5 

Female 

All ages------------------ 262,083 100.0 22.8 21.7 41.6 6.9 

15-44 years--------------------- 68,086 100.0 40.2 22.1 14.1 23.5 5.6 2.7 

45-54 years--------------------- 49,908 100.0 20.1 19.9 12.3 47.7 10.7 9.0 

55-64 years--------------------- 53,911 100.0 13.7 20.6 14.2 51.5 13.3 10.0 

65-74 years--------------------- 49,426 100.0 15.5 19.6 12.2 52.6 15.0 10.2 

75+ years----------------------- 40,752 100.0 18.3 27.8 15.6 38.3 12.5 6.1 

18 
---- 

Table 5. Number and percent distribution of patients in long-stay mental hospitals, by length of 

stay since last admission according to geographic region, age, and sex: United States, April- June 1963 

Region and length of stay Total 

15-44 45-64 65+ 

years years years Male Female 

Region Number of patients 

Northeast------------------------------------ 204,660 58,079 79,821 66,760 99,947 104,713 

North Central-------------------------------- 152,159 45,706 60,515 45,938 83,645 68,514 

south---------------------------------------- 133,414 46,046 52,999 34,369 74,298 59,116 

west----------------------------------------- 68,184 24,260 24,122 19,802 38,444 29,740 

Northeast Percent distribution 

Total---------------------------------- 100.0 100.0 100.0 100.0 100.0 100.0 

Under 1 year--------------------------------- 19.2 33.4 14.8 12.2 19.6 18.8 

1-4 years------------------------------------ 22.2 25.6 18.4 23.7 23.5 20.9 

5-9 years ------------------_------------ 14.2 16.6 13.1 13.4 15.0 13.4 

I()+ years------------------------------------ 44.4 24.4 53.7 50.7 41.9 46.9 

North Central 

Total---------------------------------- 100 .o 100.0 100.0 100.0 100.0 100.0 

Under 1 year--------------------------------- 24.3 39.4 18.0 17.8 24.7 23.9 

1-4 years -------------_----_----------------- 23.3 27.5 20.0 23.4 25.2 20.8 

5-g years------------------------------------ 15.4 14.1 15.7 16.2 16.2 14.4 

10+ years------------------------------------ 37.0 19.1 46.3 42.6 33.9 40.8 

South 

Total---------------------------------- 100.0 100 .a 100.0 100.0 100.0 100.0 

Under 1 year--------------------------------- 21.7 32.6 14.0 18.8 19.8 24.1 

1-4 years------------------------------------ 23.4 24.1 19.6 28.1 22.0 25.2 

5-9 years------------------------------------ 14.3 15.5 12.6 15.2 15.6 12.6 

10+ years------------------------------------ 40.6 27.7 53.8 37.9 42.6 38.2 

West 

Total---------------------------------- 100 .o 100.0 100.0 100.0 100.0 100.0 

Under 1 year-.------------------------------- 30.4 45.5 22.0 22.0 29.1 32.0 

1-4 years ----------_-------__---------------- 25.0 26.6 23.0 25.3 28.2 20.8 

5-9 years ------------------_----------------- 13.3 13.0 14.4 12.4 11.8 15.2 

lO+ years ----------_-_-----__---------------- 31.3 14.8 40.6 40.3 30.8 32.1 

19 
Table 6. Number and percent distribution of patients in long-stay mental hospitals, by the extent 

of disability in selected health characteristics according to sex,color,and age: United States,

April-June 1963 

Bed status 

I Walking status 

Number 

Sex, color, and age of Total In bed In bed Walks Walks patients out 

bed 

of part of most of unasr with as- Never 

time time sisted sistance walks 

Both sexes Percent distribution 

All ages--------- 558,417 100.0 I 

6.7 

15-64 years------------ 391,548 100.0 93.6 4.7 1.7 96.0 2.6 1.5 

65-74 years------------ 99,313 100.0 86.0 9.5 4.4 86.5 7.2 6.3 

75+ years-------------- 67,556 100.0 74.9 13.8 11.3 72.4 13.3 14.3 

Males. white 

All ages--------- 240,019 100.0 91.3 5.9 2.8 93.7 3.7 2.6 

15-64 years------------ 172,747 100.0 94.4 4.1 1.5 96.6 2.2 1.2 

65-74 years------------ 43,861 100.0 86.8 9.0 4.2 89.3 6.9 3.9 

75+ years-------------- 23,411 100.0 76.9 13.2 10.0 80.5 9.1 10.3 

Males, nonwhite 

All ages--------- 56,315 100 .o 94.2 4.2 1.6 94.4 3.6 2.0 

15-64 years------------ 46,896 100.0 95.8 2.9 1.3 96.6 2.3 1.2 

65-74 years------------ 6,026 100.0 89.7 10.3 89.9 7.6 2.5 

75+ yea*s-------------- 3,393 100.0 79.7 11.1 9.3 72.4 1599 11.8 

Females, white 

All ages--------- 224,377 100.0 86.9 8.5 4.6 87.8 6.2 6.0 

15-64 years------------ 142,870 100.0 91.6 6.2 2.2 94.8 3.2 2.1 

65-74 years------------ 44,192 100.0 84.2 10.2 5.7 83.2 7.8 9.0 

75+ years-------------- 37,315 100.0 72.2 15.1 12.7 66.3 16.3 17.5 

Females, nonwhite 

All ages--------- 37,706 100.0 93.2 4.7 2.0 94.7 3.1 2.2 

15-64 years------------ 29,035 100.0 94.4 4.0 1.6 97.1 2.4 0.5 

65-74 years------------ 5,234 100.0 90.8 7.6 1.5 87.9 4.7 7.4 

75+ years-------------- 3,437 100 .o 87.1 6.4 6.. 5 84.6 6.8 8.6 

20 
Table 6. Number and percent distribution of patients in long-stay mental hospitals, by the extent 

of disability in selected health characteristics according to sex,color,and age: United States, April-June 1963-Con. 

Continence status Hearing status Vision status Mental status 

No Serious No Serious serious problem serious problem Blind

problem or deaf problem 

Percent distribution 

88.7 3.2 8.1 46.5 33.2 20.3 - -

92.6 2.7 4.6 97.2 2.7 97.3 2.1 0.6 50.3 33.0 16.6 

84.5 4.2 11.4 90.9 9.1 93.6 4.4 2.0 41.4 34.2 24.4 

71.9 4.5 23.5 85.5 14.5 87.8 9.3 2.9 31.9 32.7 35.4 

2.6 6.2 95.1 4.7 95.5 3.5 0.9 49.8 32.6 17.6 

93.8 4.1 97.6 2.4 97.2 2.4 0.4 53.1 31.6 15.2 

88.0 7.6 91.0 9.0 93.1 4.8 2.1 44.8 36.1 19.1 

78.5 18.4 85.7 14.3 88.1 9.4 2.6 34.6 33.0 32.5 

5.9 95.6 4.4 95.7 2.4 1.9 48.5 34.1 17.4 

93.5 4.4 96.2 3.8 97.2 1.6 1.2 48.6 35.3 16.1 

85.6 6.7 92.4 7.6 90.6 2.8 6.6 47.1 32.0 20.8 

67.5 24.8 93.4 6.6 83.6 13.6 2.8 48.7 21.3 29.9 

85.1 3.7 11.2 94.1 5.9 95.7 3.4 0.9 43.5 32.9 23.5 

91.0 3.6 5.5 97.4 2.6 97.5 1.9 0.6 48.8 33.3 17.8 

80.6 3.3 16.1 90.7 9.3 95.1 4.2 0.7 38.9 31.6 29.5 

67.7 4.7 27.6 85.0 15.0 89.4 8.3 2.3 28.7 33.2 38.1 

90.5 4.1 5.4 94.1 5.9 93.8 3.8 2.4 4O.L 37.5 22.1 

92.9 3.3 3.8 96.5 3.5 97.2 2.2 0.6 43.E 36.4 

86.2 4.9 a.7 89.1 10.9 88.6 4.3 7.1 27.i 43.6 

77.2 9.6 13.2 81.: 18.6 72.5 16.5 11.1 31.4 37.0 

21 
Table 7. Number and percent distribution of patients in long-stay mental hospitals, by extent of 

disability in selected health characteristics according to type of ownership: United States, 

April-June 1963 

Type of ownership 

Health characteristics 

Federal State and Non- All types Government local govern- government ment 

Number of patients 

558,417 11 56,504 ) 491,915 ) 9,998 

Percent distribution 

All patients-----------------

Bed status 

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

Out of bed-------------------------

In bed part of time----------------

In bed most of the----------------

Walking status 

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

Walks unassisted-------------------

Walks with assistance--------------

Never walks------------------------

Continence status 

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

Continent--------------------------

Partially continent----------------

Incontinent------------------------

Hearing status 

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

No serious problem-----------------

Serious problem or deaf------------

Vision status 

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

No serious problem----------------- Serious problem--------------------

Blind------------------------------

Mental status 

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

Always aware----------------------

Confused part of time--------------

Confused most of time--------------

100.0 

90.0 

4:; 

100.0 

91.4 

4.7 

3.9 

100.0 

88.7 

3.2 

8.1 

100.0 

94.7 

5.3 

100.0 

95.5 

3.4 

1.1 

100.0 

46.5 

100.0 1 100.0 1 100.0

I I 

81.2 

12.0 

6.8 

100.0 100.0 100.0 

92.9 91.4 86.6 

4.5 4.7 

2.7 3.9 iti 

100.0 100.0 100.0 

92.8 88.2 88.2 

2:: 83:: 9':: 

100.0 100.0 100.0 

96.8 94.4 98.1 

3.2 5.6 1.9 

100.0 I 100.0 I 100.0 

96.7 95.8 ‘?i 4.2 

0":; 1:2 

100.0 1 100.0 1 100.0 

51.0 46.0 48.2 

33.9 33.2 27.3 

15.1 20.8 24.4 

22 
-- 

-- 

Table 8. Number and percent distribution of patients in long-stay mental hospitals, by extent of 

disability in selected health characteristics according to geographic region, age, and sex: 

United States, April-June 1963 

Northeast 

Health characteristics 

All 

patients 

204,660 

100.0 

Age Sex 

15-64 65-74 75-k Male Female years years years 

Number of patients 

All patients----------------- 1 137,900 1 40,494 26,266 1 99,947 1 104,713 

Bed status Percent distribution 

Total------------------------ 100.0 100.0 100.0 100.0 100.0 

Out of bed------------------------- 89.4 76.0 92.3 90.8 In bed part of tie---------------- 'Z '5-i 12.1 5.7 In bed most of tie---------------- 2:9 1:o 3-i. 11.9 z-f; . 3.5

Walking status 

Total------------------------ 100.0 100.0 100.0 100.0 100.0 100.0 -

Walks unassisted------------------- 91.8 97.2 88.0 69.5 94.0 89.7 

Walks with assistance-------------- Never walks------------------------ 4.3 

3.9 208 ;:: 

13.2 

17.3 1:: 

4.9 

5.4 

Continence status 

Total------------------------ 100.0 100.0 100.0 100.0 100.0 100.0 

Continent-------------------------- 88.6 93.7 84.9 67.3 91.1 86.2 

Partially continent---------------- Incontinent------------------------ E 2; 1::: 4.7 

28.0 f:'2 

3.2 

10.5 

Mental status 

Total------------------------ -.- 100 .o 100.0 100.0 100.0 100.0 100.0 

Always aware-----------------------

Confused part of time--------------

Confused most of time--------------

E 

21:9 

E 

17:o 

42: 

28:0 

32.0 

29.7 

38.4 

54.7 

25.6 

19.7 

46.7 

29.3 

24.1 

Hearing status 

Total------------------------ 100.0 100.0 100.0 100.0 100.0 100.0 

No serious problem-----------------

Serious problem or deaf------------

94.9 

5.1 

98.1 

1.9 

90.3 

9.7 

85.2 

14.8 

94.5 

5.5 

Vision status 

Total------------------------ 100.0 100.0 100.0 100.0 100.0 100.0 

No serious problem----------------- 95.6 93.6 87.3 95.7 95.5 Serious problem-------------------- 3.5 'Z 4.5 10.0 3.6 3.3 Blind------------------------------ 1.0 0:4 1.9 2.7 0.7 1.2 

23 
Table 8. Number and percent distribution of patients in long-stay mental hospitals, by extent of 

disability in selected health characteristics according to geographic region, age, and sex:

United States, April-June 1963-Con. 

Health characteristics 

All patients-----------------

Bed status 

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

Out of bed-------------------------

In bed part of time----------------

In bed most of t-~e----------------

Walking status 

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

Walks unassisted-------------------

Walks with assistance--------------

Never walks------------------------

Continence status 

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

Continent--------------------------

Partially continent----------------

Incontinent------------------------. 

Mental status 

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

Always aware-----------------------

Confused part of time--------------

Confused most of time--------------

Hearing status 

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

No serious problem-----------------

Serious problem or deaf------------

Vision status 

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

No serious problem----------------- Serious problem-------------------- Blind------------------------------

North Central 

Age Sex 

All I I 

patients 15-64 years 1 $a$ 1 yzzs 1 Male 1 Female 

I I I I 

Number of patients 

152,159 11 106,221 1 27,542 1 18,396 1 83,645 1 68,514 

Percent distribution 

100 .c 100 .o 100.0 100.0 100.0 

87.8 

8" 

92.0 81.6 72.8 

14.6 

91.0 

315 2’3 Y.95 . 12.6 ::; 

100 .o 100.0 100.0 100.0 100.0 

91.3 95.7 86.0 73.8 94.8 

14.9 

E I:2 22 11.4 1:: 

100 .o 100 .o 100.0 100.0 100 .o 

88.6 92.0 84.1 75.3 92.3 

83:; ::; 28' 204:: Z 

100.0 100.0 100.0 100.0 100.0 

46.2 49.2 43.3 32.9 50.0 

35.1 35.2 38.0 35.3 

4z . 15.7 21.5 29.0 14.7 

100 .o 100.0 100.0 100.0 100.0 

92.0 87.2 96.1 ‘Z.-9’ g72*3 . 8.0 12.8 3.9 

100.0 100.0 100.0 100.0 100.0 

95.8 97.4 93.4 90.4 96.1 

5.1 6.8 

::o' 0':: 1.5 2.8 ::"2 

100 .o 

83.9 

10.8 

5.3 

100.0 

87.0 

75:: 

100.0 

84.0 

14:3 

100.0 

41.5 

35.7 

22.8 

100 .o 

93.8 

6.1 

100.0 

95.5 

0’:: 

24 
Table 8. Number and percent distribution of patients in long-stay mental hospitals, by extent of 

disability in selected health characteristics according to geographic region, age, and sex:

United States, April-June 1963-Con. 

south 

Health characteristics 

All 

patients 

I I I I 

Number of patients 

All patients----------------- 133,414 jj 99,045 1 21,063) 13,3061 74,298 1 59,116 

Bed status Percent distribution 

Total------------------------ 100.0 100.o 100.0 100 .o 100.o 

Out of bed------------------------- In bed part of time----------------

90.4 

6.6 

93.3 76.4 

4.7 15.8 

92.5 

4.6 8ki In bed most of tie---------------- 2.9 2.0 7.8 2.8 3:1 

Walking status 

Total------------------------ 100 .o 100.0 100.0 100 .o 100.0 

Walks unassisted------------------- 90.6 74.3 91.8 89.1 

Walks with assistance-------------- Never walks------------------------ 2: 

gfa; 14.0 

2:o 11.7 

4.8 

3.3 : :: 

Continence status 

Total------------------------ 100.0 100.0 100.0 100.0 

Continent-------------------------- 88.1 91.3 89.4 86.5 

Partially continent---------------- Incontinent------------------------ X 2:: ::; 

4.1 

9.4 

Mental status 

Total------------------------ 100.0 100 .o 100 .o 100 .o 

Always aware----------------------- 40.3 42.9 33.4 31.4 40.9 39.5 

Confused part of time--------------

Confused most of time--------------

39.3 

20.4 

38.6 35.3 

18.4 42:':. 33.3 

40.8 

18.3 

37.5 

23.0 

Hearing status 

Total----c------------------- 100 .o 100 .o 100 .o 100.0 100 .o 100.0 

No serious problem----------------- 94.2 96.1 91.7 84.1 94.8 93.4 

Serious problem or deaf------------ 5.8 3.9 5.2 6.6 

Vision status 

Total------------------------ 100.0 100 .o 100.0 100.0 

No serious problem----------------- 94.9 96.8 95.2 94.4 Serious problem-------------------- 3.3 2.0 3.9 Blind------------------------------ 1.9 1.2 2: 1.6 

25 
-- 

------------ 

----------- 

Table 8. Number and percent distribution of patients in long-stay mental hospitals, by extent of 

disability in selected health characteristics according to geographic region, age, and sex: 

United States, April-June 1963-Con. 

West 

Health characteristics Age Sex 

All 

patients 15-64 65-74 75+ 

years years years Male Female 

Number of patients 

All patients----------------- 68,1841( 48,382 1 10,214 1 9,588 1 38,444 1 29,740 

Bed status Percent distribution 

Total------------------------ 100.0 100.0 100.0 100.0 100.0 100.0 

Out of bed-------------------------

In bed part of i-~e----------------

In bed most of tie----------------

89.1 

?f 

92.9 84.9 73.9 

14.2 

1.9' l?o' 11.9 

91.3 86.1 

6.1 . 2.6 $5

Walking status 

Total.. --.. -_- _ _ -_ -__________ 100.0 100.0 100.0 100.0 100.0 100.0 

Walks unassisted-------------------

Walks with assistance--------------

Never walks------------------------

92.2 

2:: 

96.5 

1.8 

1.6 

“E 

8:9 

795-; 94.8 

14:9 32:; 

88.7 

73:; 

Continence status 

Total------------------------ 100.0 100.0 100.0 100.0 100.0 100.0 

Continent-------------------------- 90.3 93.7 81.1 82.9 92.6 

Partially continent----------------

Incontinent------------------------ 63:; 2 5: 

1.6 

15.6 Z 

8:.: 

9:o 

Mental status 

Total------------------------ 100 .o 100.0 100.0 100.0 100 .o 100 .o 

Always aware-----------------------

Confused part of time--------------

Confused most of time--------------

47.3 

33.3 

19.4 

51.6 

34.3 

14.0 

42.7 

33.7 

23.6 

30.2 52.0 

27.5 31.0 

42.3 17.0 

41.2 

36.3 

22.5 

Hearing status 

Total------------------------ 100.0 100.0 100.0 100.0 100.0 100.0 

No serious problem--- 94.3 88.4 84.9 94.3 94.3

Serious problem or d ' 5.7 g72-:: . 11.6 15.1 5.6 5.7

Vision status 

Total------------------------ 100.0 100.0 100.0 100.0 100.0 100.0 

No serious problem----------------- 95.8 97.1 96.1 88.8 94.9 96.9 Serious problem-------------------- 2.7 3.9 5.1 Blind------------------------------ 0’:: 0.1 ;:'3 2: 

26 
Table 9. Population aged 15 years and over used in obtaining rates shown in this publication, by color, age, and sex: United States, July 1, 1963l 

Color and age Both sexes 

a 

Male I Female 

Total Population in thousands 

All ages, 15+ years---------------------------------- 127,800 60,779 67.023 

15-44 years------------------------------------------------ 72,442 34,679 37,764 

45-54 years --------------------_________________L__-------- 21,403 10,435 10,968 

55-64 years-------------------------------------------------- 16,388 7,888 8,501 

65-74 years _----------------------------------------------- 11,335 5,150 6,185 

75+ years-------------------------------------------------- 6,232 2,627 3,605 

White 

114,370 54,467 59,901 

15-44 years ----------I------------------------------------- 63,946 30,721 33,223 

45-54 years -------r-----C---------------------------------- 19,301 9,431 9,870 

55-64 years------------------------------------------------ 14,901 7,160 7,741 

65-74 years------------------------------------------------ 10,451 4,739 5,712 

75+ years-------------------------------------------------- 5,771 2,416 3,355 

Nonwhite 

13,430 6,311 7,120 

15-44 years------------------------------------------------ 8,496 3,956 4,540 

45-54 years------------------------------------------------ 2,101 1,004 1,098 

55-64 years------------------------------------------------ 1,487 728 759 

65-74 years------------------------------------------------ 885 412 473 

75+ years-------------------------------------------------- 461 211 250 

k.S. Bureau of the Census: Estimates of the population of the United States, by age, color, and sex: July 1, 1963. Current Population Reports, Series P-25, No. 276. Washington, D.C., Nov. 

1963. 

27 
APPENDIX I 

TECHNICAL NOTES ON THE SURVEY DESIGN AND PROCEDURES 

General 

This is one of a series of statistical reports prepared by the National Center for Health Statistics on the 

health of the institutional population in the UnitedStates. 

It is based on information collected in a nationwide 

sample of long-stay mental hospitals, excluding those 

serving children only. This survey of mental hospitals 

was one part of the Resident Places Survey-I (RPS-I) 

conducted during April-June 1963. In addition tomental 

hospitals, the RPS-I included all types of institutions 

such as nursing homes, convalescent homes, geriatric 

and, chronic disease hospitals, and other related types 

of facilities that provided care for the aged. 

The survey was conducted by mail for all establishments with less than 300 beds. Personal visits were 

made to all places with 300 beds or more to select a 

sample of patients and to aid in the completion of 

questionnaires. The questionnaire elicited primarily 

information about the patients in the hospital rather 

than information about the hospital itself. Information 

was requested about the age, sex, color, and length of 

stay of patients in the hospital, and about the health of 

the patients in terms of their general physical and 

mental condition. The source of the information was 

records and/or the personal knowledge of the respondent, usually a nurse or person in charge of a ward 

in which a patient was confined. 

Sampling Frame and Size of Sample 

The universe from which the sample of hospitals was 

selected consisted of 468 long-stay mental hospitals 

included in the Master Facility Inventory of the National 

Center for Health Statistics. The MFI was developedby 

collating a large number of hospital and institution lists 

of varied degrees of comprehensiveness and surveying 

the places on the list to collect data needed to classify 

them by type of business, size, and type of ownership. 

A description of the Master Facility Inventory program 

has been published. 4 The universe from which the 

sample of patients was selected consisted of resident 

patients (see definition, Appendix II) on the registers 

of the sample hospitals on the day the questionnaire was 

completed. This excluded patients in children’s or 

maximum security wards as mentioned above. The 

28 

national sample included 172 hospitals and 7,075 

patients. For hospitals the sampling rates ranged from 

1 in 10 for the smallest hospitals to unity for the largest 

hospitals. The sampling rates for residents ranged 

from 1 in 8 for the smallest hospitals to 1 in 80 for the 

largest hospitals. This produced an overall sampling 

rate of 1 in 80 patients. 

Sample Design 

The sampling for this surveywas basedona stratified probability design selected in two stages. In the 

first stage a sample of hospitals was selected from 

within five primary strata. The primary strata consisted of five bed-size groups (table I). Sampling of 

hospitals was systematic within each of these primary 

strata. Within each primary stratum the sequence of the 

listing of hospitals was by geographic region, ownership or type of control, and State and county. 

In the second stage, a sample of patients was selected from each hospital selected in the first stage. The 

sample of patients for hospitals with less than 300 beds 

was completed by a systematic selection scheme built 

into the questionnaire. The respondent was asked to list 

on the questionnaire all the patients on the register of 

the hospital on the day of the survey and to complete the 

health information for those patients who fell on the predetermined sample lines. This scheme is illustratedon 

the questionnaire reproduced in Appendix III. 

The sampling of patients in hospitals with 300 beds 

or more was completed using an intermediate stage of 

selection, namely the selection of a sample of wards 

within the sample hospital. A questionnaire eliciting 

information on the number and characteristics of the 

wards was secured for each sample hospital (see 

Appendix III). The list of wards within each hospital was 

then put in sequence by type of service provided in the 

ward. Maximum security and children’s wards were 

deleted because the patients found in these wards were 

not within the scope of the survey. Medical-surgical 

wards and infirmaries were deleted from the list if the 

patients names were retained in the other ward files. 

A sample of wards was then selected with probability 

of selection proportional to the size of the ward. Within 

each sample ward, the interviewer selecteda systematic 

sample of patients: 
loo-299 beds------- 67 

Table I. Distribution of long-stay mental hospitals in the Master Facility Inventory (MFI) and 

the sample of long-stay mental hospitals, by response status and primary size strata: Resident 

Places Survey I 

I 

Hospitals Total Total 

Primary size in the hospitals 

out of Nonresponding r~$~~~~~g sample patients scope hospitals hospitals strata universe in responding in sample hospitals (Mm hospitals

All hospitals-- 468 180 

Under 30 beds------ 7'; 4 

30-99 beds--------- 9 

300-4,999 beds-----

5,000t beds--------

270 

14 

1:: 

14 

Survey Procedure 

Data for this survey were collected by the Bureau of 

the Census, which acted as collecting agent for NCHS. 

Personal visits were made to alI hospitals with 300 beds 

or more by the Census interviewers. An initial contact 

letter introducing and explaining the survey was sent 

by the central office of the Veterans Administration to 

the hospitals in the sample. The questionnaire on ward 

characteristics was included with this letter. A similar 

letter was mailed by the National Institute of Mental 

Health to the sample hospitals which were not under the 

control of the Veterans Administration. The questionnaire on ward characteristics was also included with 

this letter. 

Followup procedures for hospitals with less than 

300 beds consisted of a regular mailing 3 weeks after 

the initial mailing and a second certified mailing 3 weeks 

after the first followup letter. Hospitals still not responding were then contacted by telephone if they had 

less than 100 beds and by personal visit if’they had 

between 100 and 299 beds. 

The Bureau of the Census edited and coded the 

completed questionnaires in accordance with specifications established by NCHS. If data were not reported 

or reported inadequately for certain items, further mail 

inquiries were made specifically for these items. 

After the edited and coded data were converted to 

punch cards, the staff of the National Center for Health 

Statistics processed the data on an electronic computer. 

This processing included assignment of weights, ratio 

adjustments, and other related procedures necessary to 

produce national estimates from the sample data. It 

also included matching with basic identifying information 

contained in the MFI as welI as carrying out internal 

edits and consistency checks to eliminate “impossible” 

responses and erors in editing, coding, or processing. 

Number in sample 

8 2 170 7,075 

2 : 8' 2 

1:: 

6 140' 5,858

14 1,060 

Response and Imputation of Missing Data 

The survey was conducted in 170 sample hospitals, 

or about 94 percent of the hospitals selected for the 

sample. Only two hospitals, or about 1 percent, in the 

sample refused to cooperate in the survey. Bothof these 

hospitals maintained less than 100 beds. Eight hospitals 

selected in the original sample were found to be hospitals 

for the mentally retarded or some other’type of hospital 

not within the scope of the survey (see table I). The 

response rate for the in scope sample was 98.8 percent. 

Statistics presented in this report were adjusted 

for the failure of a hospital to respond by the use of a 

separate nonresponse adjustment factor for each size 

stratum further stratified by three major ownership 

groups. This factor was the ratio of all in scope sample 

hospitals to the responding in scope sample hospitals. 

Data were also adjusted for nonresponse of patients 

within a hospital by a procedure which imputed to 

patients for whom no data were obtained the characteristics of responding patients within the same hospital. 

Adjustment for nonresponse in patient data was minimal; 

the imputation of unknown data (e.g., age, sex, and 

bed status)was less than 3 percent for any single item. 

Estimation and Reliability of Estimates 

Statistics reported in this publication are essentially the result of two stages of ratio adjustment, one 

at each stage of selection. The purpose of ratio estimation is to take into account all relevant information 

in the estimation process, thereby reducing the variability of the estimate. The first stageratioadjustment 

was included in the estimation of hospital and resident 

data for all primary size strata from which a sample 

of hospitals was drawn. This factor was a ratio calculated for each stratum. The numerator was the total 

29 
number of beds according to the MFI for all hospitals 

in the stratum. The denominator was the estimate of 

the total beds obtained through a simple inflation of the 

MFI data for sample hospitals in the stratum. The 

effect of this first ratio adjustment was to bring the 

sample in closer agreement with the known universe 

of beds. 

The second stage ratio adjustment was included in 

the estimation of patient data for all primary size 

strata. This second stage ratio adjustment factor was 

the product of two fractions: The first was the ratio of 

the total number of patients in the hospital to the number 

of patients designated as sample residents by the systematic selection scheme; the second was the sampling 

fraction for patients upon which the systematic selection 

was based. This second stage adjustment corrected the 

sample for over- or under-representation of patients 

in the particular sample selected within each sample 

hospital. The basic types of statistics presented in this 

report are aggregates and proportions of patients with 

specified personal or health characteristics. 

Since statistics presented in this report are estimates based on a sample, they will differ from the 

figures that wouid have been obtained from a complete 

enumeration of all mental hospitals and patients in the 

universe, using the same schedule and survey procedures. As in any survey, inaddition tosampling errors, 

the results are also subject to measurement errors. 

any systematic biases in the data. The chances are 

about 68 out of 100 that an estimate from the sample 

differs from the value obtained from a complete census 

by less than the standard error. The chances are about 

95 out of 100 that the difference fs less than twice the 

standard error and about 99 out of 100 that it is less, 

than 2% times as large. 

Relative standard errors of the estimated number 

of patients shown in this report can be determined from 

the standard error chart of this appendix. The relative 

stan:ard error of an estimate is obtained by dividing 

the standard error of the estimate by the estimate itself 

and is expressed as a percentage of the estimate. Stand-’ 

ard errors of estimated percentages and averages can 

be determined from tables II-IV of this appendix. In 

order to obtain measures of sampling errors which 

would be applicable to a wide variety of statistics and 

which could be prepared at a moderate cost, a number 

of approximations were required. As a result, the chart 

and tables provide estimates of approximate errors 

rather than precise errors for specific statistics. 

Rules for determining the approximate relative 

standard errors or standard errors for estimates presented in this report are as follows: 

Rule 1. Estimates ofnumber ofpatients: Approximate relative standarderrors of estimates 

of numbers of patients, suchas the number 

of patients in an age-sex group or the 

number of patients with a given health 

characteristic, are obtained from the 

appropriate curves shown in the standard 

error chart. 

The standard error 

variability that occurs 

rather than the entire 

culated for this report, 

part of the measurement 

Table II. Approximate 

is primarily a measure of the 

by chance because only a sample 

universe is surveyed. As calthe standard error alsoreflects 

error, but itdoesnot measure 

standard errors of percentages of patients shown in this report for the 

United States and the South and West Regions 

Estimated percent 

Base of percent 5 10 15 20 25 30 35 40 45 

9"; ;"o E 8": 2 or 50 

70 6"; 6"; E 

Number of patients Standard error (expressed in percentage points) 

Illustration of use of table II. Table 6 shows that 75 percent of the 67,556 mental ha kspital patients 75 years of age and over were out of bed all or most of the time. As shown in ta ble II 

the standard error of 75 percent based on 67,556 patients lies between 1.7 and 2.1 percentage

points. Thus, by interpolatioqthe desired standard error is approximately 1.8 percentage points. 

30 
0:6 

Table III. Approximate standard errors of percentages Northeast and North Central 

of patients shown in this report for the

Regions 

Estimated percent 

Base of percent 5 10 15 20 25 30 35 40 45 

or or or 50 

;; 2 8": 8"; 75 70 E 2 55 

vumber of patients , Standard error (expressed in percentage points) 

2.0 2.8 3.3 I 3.71 4.11 4.3 4.7

1.4 2;o 2.4 2~9 3~0 

1.2 ?2:"2 213 2'5 z-:

1.5 ;:z 1'9 2:1

E 0:9 ::: ::"3 1:4 1.5 

:-z 2: i-i o'*; 2; O'G 1.2 

0:3 0:4 0.5 0:5 0:6 0:6 E 

Illustration of use of table III. Table 3 shows that 30 percent of the 152,159 patients in

mental hospitals in the North Central Region were between 15 and 44 years of age. As shown in 

table III the standard error of 30 percent based on 152,159 patients is approximately 0.8 per­ centage points. 

,Table IV. Approximate standard errors of average length of stay shown in this report 

Average length of stay (in years) 

Base of average 

2 4 6 8 10 12 14 16 

Number of patients Standard erl :0 r in years 

2.9 Z 

2: 

E 

i:: 

0’:; 

z

0:5 ao*: 

0.4 0:5 I I 

Illustration of use of table IV. Table 4 shows that the average length of stay of the 107,990

patients between 45 and 64 years of age tn mental hospitals was 10.8 years. As shown in table IV 

the standard error of the average based on 107,990 patients is approximately 0.7 years. 

Rule 2. Estimates of ~erc&tages in a percent to the relative standard error of the 

distribution: Approximatestandsrderrors numerator whichcan be obtained directly 

of percentages in a percent distribution from thechart.Forexample,tableBshows 

of a total are obtained from table IIor III. that there are 4.4 persons per1,000popu- / lation in mental hospitals. The numerator 

Rule 3. Estimates of rates: When the denominator of this rate is 558,417, the estimated 

is the total U.S. population or when it number of patients in long-stay mental 

includes all persons in one or more sub- hospitals (table I), and its relative standgroups of the U.S.population, the relative ard error is 1.57 percent (see standard 

standard error of the rate is equivalent error chart). Therefore, one standard 

31 
error of the rate 4.3 persons per 1,000 

population is 0.07 (1.57 percent of 4.3). 

Rule 4. Estimates of average length of stay: Approximate standard errors for average 

length of stay are obtained from table IV. 

Rule 5. Estimates of medians: The medians shown 

in this report,were calculatedfrom grouped 

data. Approximate standard errors for 

these estimated medians can be computed 

as follows: 

(a) Determine the standard error of a50-

percent characteristic whose denominator is equal to the estimated number 

of persons in the frequency distribution 

on which the median is based. For example, the median length of stay in 

mental hospitals for male patients 65-

74 years of age is 8.5 years. The 

estimated number of males 65-74 is 

49,887. The standard error bf a 50-

percent characteristic whose base is 

49,887 is shown in table II to be 2.4 

percentage points. 

(b) Apply this standard error to the cumulative frequency distribution to obtain 

the confidence interval around the 

median. For the above example, using 

the 95-percent level of confidence, 

determine the points on the cumulative 

frequency distribution corresponding 

to 54.8 percent (50 percent plus ‘two 

standard errors) and 45.2 percent 

(50 percent minus 2 standard errors). 

These points are 27,338 and 22,549. 

Determine the length of stay corresponding to these two points. This 

gives a lower limit of 7.0 years and 

an upper limit of 9.9 years. Therefore, the confidence limit for the estimated median stay of 8.5 years is 

7.0-9.9 years at the 95-percent level 

of confidence. 

Rule 6. Diffe’erence between two sample estimates: 

The standard error of a difference is approximately the square root of the sum 

of the squares of each standard error 

considered separately. This formula will 

represent the actual standard error quite 

accurately for the difference between separate and uncorrelated characteristics, 

although it is only a rough approximation 

in most other cases. 

32 
Approximate relative standard errors of estimated numbers of patients ahoun in this report. 

Size of Estimate 

Illustration of use of chart: There are an estimated 558,417 patients in mental hospitals 

in the United States as shown in table 1. The relative standard error of this estimate is 

approximately 1.6 percent (read f rom scale at left side of chart); the standard error of 

558,417 is 8,935 (1.6 percent of 558,417). 

33 
APPENDIX II 

DEFINITIONS OF CERTAIN TERMS USED IN THIS REPORT 

Terms Relating to Hospital or Patient 

Long-stay mental hospital: A long-stay mental hospital 

Phtient: 

Length of stay: 

is a hospital with an average patient stay of 30 days 

or more which specializes 

in the care of psychiatric 

patients or which provides 

psychiatric care to a majority ofits patients. Hospitals serving children only 

are excluded from the survey. 

A patient is defined as a 

resident patient. Aresident 

patient is one either physically present in the hospital 

or on temporary leave from 

the hospital for 7 days or 

less. Patients on leave for 

more than 7 days or receiving extramural care 

were excluded from the 

survey as were patients in 

children’s wards andmaximum security wards. 

The date of last admission 

was reported on the questionnaire for each sample 

person. The length of stay 

shown in this report is the 

length of time between the 

date the survey was conducted in the hospital and 

the date that the person 

was last admitted to the 

hospital. Length of stay as 

reported in this publication 

does not represent total 

length of stay in mental 

hospitals or the hospital 

the patient was in at the 

time of the survey unless 

this was the patient’s first 

admission to a mentalhospital. 

Health characteristics: For each of the six health 

items except hearing status, patients were classified according to extent of 

disability into one of three 

categories for each of these 

items. The categories correspond to “no disability,” 

“partial disability,” and 

“complete disability.” For 

hearing status only two categories were used, corresponding to “no disability” 

and “partial or complete 

disability.” 

Bed status: 

1. Out of bed is defined as being out of 

bed except for ordinary rest or sleep. 

2. In bed part of the time is defined as 

being in bed part of the time except 

for ordinary rest or sleep. 

3. In bed is defined as being in bed all 

or most of the time. 

Walking status: 

1. Walks unassisted is defined as walking unassisted or with a cane or 

crutch. 

2. Walks with assistance is defined as 

walking with a walker, attendants’ 

help, or by own efforts in a wheelchair. 

3. Never walks is defined as inability 

to walk or get about at all, or complete dependence on others to get 

about. 

Continence status: 

1. Continent means that a person normally can control feces and urine. 

2. Partially continent means that a 

person normally can control either 

urine or feces but not both. 

3. Incontinent means that a person 

normally cannot control either feces 

or urine. 

34 
------------------- 

Mental status: 

1. Always aware means that a person is 

not confused, i.e., he is aware ofhis 

surroundings. 

2. Conficsed part of time means that a 

person is unaware of his surroundings part of the time. 

3. Confused means that a person isunaware of his surroundings all or 

most of the time. 

Hearing status: 

1. No serious problem with hearing. 

2. Serious problem with hearing or 

deaf. 

Vision status: 

1. No serious problem means that a 

person has no problem seeing either 

with or without glasses. If a person 

is reported to be blind in one eye, 

he is also included in this category. 

2. Serious problem means that a person 

has a serious problem with seeing 

even with glasses but is not blind. 

3. Blind means that a person is blind 

in both eyes. 

Demographic Terms 

Age: The date of birth was reported for each 

sample resident. The year of birthwas 

recoded in single years of age and 

grouped in various distributions depending on the purpose of the table. 

Color: Color was reported in the survey as 

white or nonwhite. No attempt was made 

to define the two groups. 

Region: Classification of establishments by 

geographic area is provided by grouping the States into regions. These 

regions correspond to those used by 

the Bureau of the Census and are as 

follows: 

Region States Included 

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

Vermont, Massachusetts, 

Rhode Island. Connecticut, 

New York, New Jersey, 

Pennsylvania 

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

Indiana, Wisconsin, 

Minnesota, Iowa, Missouri, 

North Dakota, South Dakota, 

Nebraska, Kansas 

South------------------- Delaware, Maryland, 

District of Columbia, 

Virginia, West Virginia, 

North Carolina, South 

Carolina, Georgia, Florida, 

Kentucky, Tennessee, 

Alabama, Mississippi, 

Arkansas, Louisiana, 

Oklahoma, Texas 

West Montana, Idaho, Wyoming, 

Colorado, New Mexico, 

Arizona, Utah, Nevada, 

Washington, Oregon, 

California, Hawaii, Alaska 

000 

35 
APPENDIX III 

QUESTIONNAIRES AND LETTERS 

First Communication by the Veterans Administration 

VETERANSADMINISTRATION ROUTINE APRIL 26, 1963

CENTRALOFFICE 

AREAMEDICALDIRECTORS,AREAMEDICALOFFICES, DIRECTORSOF 

SELECTEDVA STATIONS(35 STATIONS) 

THIS IS DM&SCIRCULAR10-63-102 

1. UNCIAS/ THE DEPARTMENT OF MEDICINE AND SURGERY HAS BEENAPPRISEDOF A NATION-WIDE

SAMPLESURVEYTO BE CONDUCTEDBY THE PUBLIC HEALTHSERVICEUNDERTHE GENERALTITLE 

"RESIDENT PLACESSURVEY"DESIGNEDTO OBTAIN INSTITUTIONAL DATA ON CAREPROVIDEDTO THE 

AGED, THE INFIRM AND THE CHRONICALLYILL. THE COOPERATIONOF THIS AGENCYAND ITS 

HOSPITALSHAS BEENREQUESTED. 

2. THE PUBLIC HEALTHSERVICEADVISES US THAT YOURFACILITY IS ONE OF THE THIRTY-FIVE 

VA FACILITIES INCLUDEDIN THEIR SAMPLE. THEY ALSO ADVISE US THAT THE BUREAUOF THE 

CENSUS,ACTING AS THE COLLECTIONAGENTFOR THE PUBLIC HEALTHSERVICE, WILL HAVE A 

REPRESENTATIVE CALL YOURHOSPITALTO ARRANGEA CONVENIENTIME TO VISIT THE HOSPITAL 

AND COMPLETETHE REQUIREDSURVEYFORMS. 

3. IN NEUROPSYCHIATRIC HOSPITALSFALLING INTO THE SAMPLECOMPLETION OF PUBLIC HEALTH

SERVICEFORMT-183, "INQUIRY ON WARDCHARACTERISTICS - SCHEDULEI, "WILL BE REQUIRED 

PRIOR TO THE BUREAUOF THE CENSUSREPRESENTATIVE'SCALL AND VISIT. THIS FORMTOGETHER 

WITH FORMHRS 2d(m) AND A LETTERUSED BY THE NATIONALINSTITUTE OF MENTALHEALTH, IS 

BEING MAILED TO THE SELECTEDVA NEUROPSYCHIATRICHOSPITALSBY CENTRALOFFICE. FORM 

PHS T-183 WILL BE COMPLETED AND RETURNED TO THE DEPARTMENT OF MEDICINE AND SURGERY IN

ACCORDWITH THE INSTRUCTIONSCONTAINEDIN THE CIRCULARTRANSMITTINGTHE AFOREMENTIONED 

DOCUMENTS. 

4. APPROPRIATEOFFICES IN CENTRALOFFICE HAVEREVIEWEDTHE PROTOCOLOF THIS SURVEYAND 

EXAMINEDTHE QUESTIONNAIRE FORMS. THE OBJECTIVEOF THIS SURVEYIS CONSONANT WITH THE

BEST INTERESTSOF THE VA MEDICAL PROGRAM.VA FACILITIES SHOULDTHEREFORECOOPERATE 

WITH THE PUBLIC HEALTHSERVICEAND THE BUREAUOF THE CENSUSIN SUPPLYINGDATA NEEDED 

FOR THE SURVEY. 144Bl/lOA 

SIGNED& DISPATCHED 

APRIL 26, 8:13 AM' 63 

COMMUNICATIONSSCRECORDS 

DMSCS 

36 
Second Communication by the Veterans Administration 

Veterans Administration CIRCULAR 10-63-105 

Department of Medicine and Surgery 

Washington 25, D. C. April 29, 1963 

Subject: PUBLIC HEALTH SERVICE STUDY - RESIDENT PLACES SURVEY 

To : To 16 Selected VA Neuropsychiatric Hospitals 

1. Reference is made to teletype CM&S Circular 10-63-102 dated April 26, 

1963 inforllling you of the inclusion of your hospital in the forthco&ng 

Resident Places Survey to be conducted by the National Health Survey 

Division of the United States Public Health Service and requesting your 

cooperation in this r,ntter. 

2. Enclosed is forI, PHS r-183, "Inquiry on Ward Characteristics -

Schedule 1" of the Resident Places Survey. Please complete this form 

and forward it to reach Central Office no later than May 15, 1963 

addressed as follows: 

Department of Medicine and Surgery (l@+Bl) 

Veterans Administration Central Office 

Washington 25, D. C. 

3* Enclosed also for INFORMATIONALPURPOSESONLY is a copy of PHS Form 

HRS-2d(m). This is the form the Bureau of the Census representative, 

acting as collection agent for the Public Health Service, will bring to 

your station for coi!;pletion. The Bureau of the Census agent from one 

of its regional offices will telephone your station to arrange for a 

convenient time to visit your station for this purpose. 

4. There is also enclosed for INFORMATIONALPURPOSESONLY a copy of the 

letter sent by the National Institute of Mental Health to non-VA mental 

hospitals included in the survey. It contains background and procedural 

information relative to the study which inlay be of interest to you. 

5. The request for coLlpletion of form PHS r-183 has been assigned

RCS lo- 33 -63s. 

Chief Medical Director 

Encl. (3) 
Letter Mailed by the National Institute of Mental Health 

DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE 

PUBLIC HEALTH SERVICE BETHESDA I,,’ MD. 

NATIONAL INSTITUTES OF HEALTH REFER TO: NI H-M-B-H 

Area Code 301 Tclr 6564000 

Dear Doctor: 

The U. S. National Health Survey of the Public Health Service is conducting a 

nationwide survey of mental hospitals, nursing homes, boarding care homes and 

other establishments whose primary function is to provide medical, nursing or 

personal care to aged and chronically ill persons. 

The National Health Survey was authorized by Congress in 1956 to collect, analyze and publish statistical data on the health of the U. S. population. Since 

that time they have initiated several nationwide surveys of the general population, but for various reasons have not been collecting data on the institutionalized population. There is a very great need for data on the health 

characteristics of patients in these establishments. Such data will be used 

to assess the health of these persons and to provide the basis for future 

planning in caring for their needs. 

We at the National Insti’tute of Mental Health have been assisting the National 

t-lealth Survey in the planning of the mental hospital phase of this survey because of our continuing work with mental hospitals and our great’interest in 

the data to be collected in this survey. Your hospital is one of th-e approximately 250 hospitals selected in a scientific nationwide sample whi&h is representing all mental hospitals in the U. S. 

Because of the unusual size of many mental hospitals, we have devised the 

following procedure for selecting the sample of patients and for collection 

of data. 

1. Selection of sample wards within the hospital 

To simplify the collection of data about patients, it is necessary 

to confine the sample to certain wards of the hospital. The information requested in the enclosed questionnaire on resident 

patients’ files and number of patients by ward will enable us to 

select a random sample of wards within the hospital. 

2. Selection of the sample of patients 

The U. S. Bureau of the Census is acting as the collection agent 

for the National Health Survey. A person from the Census Bureau’s 

field staff will contact you to arrange a convenient time for him 

to visit the hospital and conduct the survey. ‘When he arrives, he 

will be prepared to draw a sample of patients from each ward included in the sample. 

38 
-2-

5. Collection of patient data 

The Census Bureau representative will then proceed to fill out 

Form HRS-2D(M), a three part questionnaire. Part I contains 

questions about the characteristics of the hospital, while 

Parts II and III focus on patient characteristics. Part II of 

this form will be completed by the Census representative as he 

identifies the sample. The questions in Part I I I would need to 

be completed by some person, possibly a different person for each 

ward, who is acquainted with the patients’ health. A typical

questionnaire for a ward can be filled out in a few minutes. I 

have enclosed a sample copy of Form HRS-ZD(M) for your inspection. 

This method has been designed to provide a standardized sampling procedure and 

to minimize the amount of time required by hospital personnel to complete the 

questionnaire. All sample selection wi 11 be done by the Census Bureau 

sentative. The only work required

quired questions for the sample of 

time of one person in each selected 

Since plans call for this survey to 

ou would fill out and return the enclosed

f Schedule I) within two weeks. We then can take the initial steps for determining which wards of your hospital will be in the sample. 

Sincerely yours, 

R. H. Felix, M.D. 

Director 

National Institute of Mental Health 

Enclosure 

repreof hospital personnel is to answer the repatients. This requ i res a small amount of 

ward. 

begin in May, we would appreciate it if 

Inquiry on Ward Characteristics 

39 
Inquiry on Ward Characteristics 

I PHS-TlB3 Budget Bureau No. 6843620.Rl 

3-63 Approval Expires 12-31-63 

U. S. DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE NAME OF HOSPITAL: 

PUBLIC HEALTH SERVICE 

NATIONAL INSTITUTES OF HEALTH 

ADDRESS: 

INQUIRY ON WARD CHARACTERISTICS - SCHEDULE l 

RESIDENT PLACES SURVEY 

1. DO YOU MAINTAIN A FILE LOCATED IN THE WARD OR 

NEAR IT CONTAINING THE NAMES OF RESIDENT UYes INo 

PATIENTS BY WARD? 

a. Does this file include the names of 

patients absent an leaves of 7 days q Yes UNo orless? b. Does this file include the names of 

patients who have been transferred to 

a medical-surgical ward? 

2. DO YOU MAINTAIN A CENTRAL FILE THAT CONTAINS 

THE NAMES OF ALL RESIDENT PATIENTS IN THE q Yes ~NO HDSPITAL ARRANGED BY WARD? 

a. Does this file include the names of 

patients absent on leaves of 7 days j-+es nNo 

or less? 

3. PLEASE LIST ALL YOUR WARDS BY NAME OR NUMBER AND INDICATE THE FOLLUtIlNG: 

a. TYPE OF SERVICE: (such as geriatrics, b. NUMBER OF PATIENTS: Use a recent census 

medical-surgical, receiving wards, etc.). count OF a recent average daily figure. 

If exact numbers are not available, 

If a ward includes only patients 17 years please estimate the numbers. 

old or less, please indicate by writing 

“CHILDREN” for type of service. If a ward NOTE: If you have a ward listing already 

includes only patients under security available, a copy of this would suffice, 

regulations, please indicate by writing provided it contains all the information 

“MiXlMUM SE’klR’lTY” for tY 'pe of-service; indicated below. 

Ward Name Type of Number of Ward Name Type of Number of 

or- number Service Patients or number Service Patients 

Continue on reverse slae 

40 
-- 

Facility and Patient Questionnaire 

111~ ful~~)\vin~ ilc.:!:\ SIKW the c.\i~ct cc)ntcllt ;IIIJ ?vc,l-cling of the 

clu~~-;ri~)l~nitirc uscJ in the i<l'S-1. ?'hc actual qut?stionnuii-cw3s Jc+nt'cl 

fut- an illstitutir)n as 3 unit and incluctcs acfJitiona1 space fix reports un 

all ~c~siJc1~t.sof tin institution. Such ~-cpctitivcspncesilre urnittcd in this 

iilu~Irntir)n. 

Budget Bureau No. 6&R620-RI; Approvd Expires December 31, 1963 

CONFIDENTIAL - This information is collected under authority of Public Law 652of the 84th Congress (70 Sac. 489; 

42 U.S.C. 305). All information which would permit identification of an individual or of an establishment will be held 

strictly confidential, will be used only by persons engaged in and for the purposes of the survey and will not be disclosed or released to other persons or used for any otber purpose (22 FR 1687). 

;o;,Me~jRS-2c(m) fff nscsm.ery pfeam change to Lhow correct nane md addrem) . . 

U.S. DEPARTMENT OF COMMERCE BUR!aU OF THE CENSUS 

ACTING AI COLLECTING *GENT FOR THE 

U. S. NATIONAL HEALTH SURVEY 

Gentlemen: 

The U.S. National Health Survey of the Public Health Service, authorized 

by Public Law 652, 84th Congress, is conducting a survey of nursing homes, 

convalescent or rest homes, homes for the aged, chronic disease and 

mental hospitals, and other establishments in the United States which 

provide medical, nursing, personal or domiciliary care to the aged, infirm, 

or chronically ill. This is one of a series of surveys mentioned in a 

recent inquiry to your establishment by the Bureau of the Census which is 

acting as the collecting agent for the U.S. National Health Survey. 

The purpose of the survey is to obtain much needed information on the 

health of residents in these establishments and facts related to their 

care. Please answer the questions on the inside of this form and return 

it as soon as possible preferably within the week. A self-addressed 

envelope which requires no postage has been provided for your convenience. 

The information will be given confidential treatment by the U.S. National 

Health Survey and the Bureau of the Census, and will be used for statistical purposes only. It will not be used for any regulatory, licensing 

or accreditation purposes; any published summary will be presented in 

such a manner that no individual establishment or person can be identified. 

Thank you for your cooperation. 

Sincerely yours, 

(2hG-w 

Richard M. Scammon 

Director 

Bureau of the Census 

41 
-- 

-- 

-- 

-- 

-- 

GENERAL INSTRUCTIONS FOR COMPLETING THE QUESTIONNAIRE 

Bose your answers on records, OS appropriate, 

when records ore ovoiloble 

Step 1 Complete Port I, FACILITY INFORMATION 

These questions should be self-explanatory. The words “resident or patient” 

are used interchangeably in this questionnaire. The people being cared for 

are usually referred to as “residents.” However, they are referred to as 

“patients” when this term seems more appropriate. 

Step 2 Complete Port II, CENSUS OF RESIDENTS OR PATIENTS 

List in Column (b) the nome of each resident who is currently on your register 

as a formal admission. (The number listed should be the same as shown for 

Part I, Question 1). List the names in any order that is most convenient to 

you. If the names are not listed in alphabetical order or in sequence by some 

assigned number, such as admission number, please explain the order of the 

listing in the “Comments” section on Page 4. 

For each person listed, record his admission number, the date he was last 

admitted to your establishment, his daee of birth, sex, and race. You may 

wish to make these entries as you record the persons’ names in Column (b). 

If the date of admission or date of birth for a resident is not known, record 

your best estimate of the date. 

Step 3 Complete Port Ill, HEALTH OF RESIDENTS OR PATIENTS 

Some of the lines in Part III are blocked out, while others are not. For the 

lines not blocked out (identified by a circled line number), make the appropriate entries in the columns in Part III for the person whose name appears 

on that line in Part II, Column (b). This information should be provided by 

the person most acquainted with the health of residents in this establishment. 

Step 4 The names of persons entered on Part II are needed only as a means of identification in case there should be a question about an entry on the questionnaire 

when it is reviewed. If you prefer, you may tear off the strip on Part II which 

contains the names of patients. If you do teor off this port of the form, pleose 

keep it in your files for at leost 6 months. 

Step 5 For convenience of contact in the event that questions concerning an encry do 

arise, the person completing the questionnaire should enter his name and give 

his title or position, telephone number, and the date the form is completed on 

the bottom of Part I. 

Step 6 -- Af ter y ou h ave completed the questionnaire, return it in the enclosed postagefree envelope. If ehe self-addressed envelope gets misplaced before the questionnaire can be completed, return the completed questionnaire to the Bureau 

of the Census, Jeffersonville, Indiana. 

42 
Part I- FACILITY INFORMATION 

(NOTE: When the term“RESIDENT” is used in the qucstionrmire, ie refers to resident or patient.) 

NUUlber 

1. How many patients are currenrly residents of this facility? 

(Include patients out on leave for 8cven days or less as we11 as 

patientsphysically present in the facility.). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

2. How many beds are regularly maintained for residents? 

(Include any beda uet up for use whether or not they me in u8e at the 

present time. Exclude beds used by staff or any beda used excZusively 

for emergency service.). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

3. How many persons are employed in this establishment? 

(In&de all paid anployeea, membera of rdigioue ordera, sod omers, L&J 

usually work 15 hours or more a week in this eetabliahmeot.). . . . . . . . . . . . . . . . . . . . 

Comments (Record any coonmat ts about the facility or about individuala.) 

Name of person comp!ering this form Telephone No. and Ext. Dare complered 

I Title or posirion 

COMPLETE PARTS II AND III 

OF THE QUESTIONNAIRE 

‘. 

Establishmenr No-------c 

43 
Part II - CENSUSOF 

RESIDENTS OR PATIENTS F‘art II -CENSUS OF RESIDENTS OR PATIENTS 

I 

If ,wu wish you may detach md keep 

this stub of Port II for your records. 

IF YOU DO TEAR OFF THK’STRIP, ?*d- Enter Date Enter resiPLEASE RETAIN IT IN YOUR FILES Imt’r of Last dent’s Date 

FOR AT LEAST 6 MONTHS. Llllm Admission of Birth 

khm- [month. day, :month, day. 

ber year) for Ye4 

each 

&dent 

eri­

:nt’s List the names of all residents 

in this esrablisbment M=M& U = White ine l F = Fe- NW=Non-, i 

male white: 

04 (4 k) (h) : -

1 

-

2 

3 

3 

4 4 

5 5 

Part Ill - HEALTH OF RESIDENTS OR PATIENTS 

IMPORTANT: Complete one llnc of Part 111far each persun flsred on those lines of Part /I that ma fdmtffled by D ClRCLED NUMBER. 

BED STATUS MENTAL STATUS 

(Except in bed for (Awareness of 

ordinary rest or sleep) WALKING STATUS %zsG VISION STATUS CONTINENCE I surroundings) 

b-9 I h-2) (m-3) 1 (m-4) 1 (n-1) 1 (n-2) 

44 
Series 1. 

Series 2. 

Series 3. 

Series 4. 

Series 10. 

Series 11. 

Series 12. 

Series 20. 

Series 21. 

c 

Series 22. 

OUTLINE OF REPORT SERIES FOR VITAL AND HEALTH STATISTICS 

Public Health Service Publication No. 1000 

Programs and collection procedures. -Reports which describe the general 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. 

Reports number l-4 

Rata evaluation and methods research .-Studies of new statistical methodology including: experimental 

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. 

Reports number l-12 

AnaZyticaE 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. 

Reports number 1-4 

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

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

death certificates. 

Reports number 1 and 2 

Data From the Health Interview 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. 

Reports number l-25 

Data From the Health Examination Survey.- Statistics based on the direct examination, testing, and 

measurement of national samples of the population, including the medically defined prevalence of specific diseases, and distributions of the population with respect to various physical and physiological 

measurements. 

Reports number 1-12 

Data From the Health Records Survey. -Statistics from records of hospital discharges and statistics 

relating to the health characteristics of persons in institutions, and on hospital, medical, nursing, and 

personal care received, based on national samples of establishments providing these services and 

samples of the residents or patients. 

Reports number 1-3 

Data on mortality. -Various statistics on mortality other than as included in annual or monthly reportsspecial analyses by cause of death, age, and other demographic variables, also geographic and time 

series analyses. 

Reports number 1 

Data on natality, marriage, and divorce. -Various statistics on natality, 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. 

Reports number l-7 

Data From the National Natality and Mortality Surveys.- Statistics on characteristics of births and 

deaths not available from the vital records, based on 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. 

Reports number 1 

For a list of titles of reports published in these series, write to: National Center for Health Statistics 

U.S. Public Health Service 

Washington, D.C. 20201