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OMB Control No: 0920-0278	ICR Reference No: 201110-0920-011
Status: Historical Active	Previous ICR Reference No: 201106-0920-008
Agency/Subagency: HHS/CDC	Agency Tracking No:
Title: National Hospital Ambulatory Medical Care Survey
Type of Information Collection: Revision of a currently approved collection	Common Form ICR: No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 12/02/2011
	Date Received in OIRA: 10/26/2011
Terms of Clearance: The addition of new modules will be considered an ICR revision.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	12/31/2014	36 Months From Approved	08/31/2012
Responses	111,395	0	128,161
Time Burden (Hours)	9,999	0	12,194
Cost Burden (Dollars)	0	0	0

Abstract: This request is for the revision of an approved data collection (OMB No. 0920-0278), the National Hospital Ambulatory Medical Care Survey (NHAMCS), to continue the survey activities for NHAMCS for 3 years and slightly modify survey activities. NHAMCS is a national survey of patient visits to emergency departments, outpatient departments, and ambulatory surgery locations of general and short-stay hospitals, as well as freestanding ambulatory surgery centers. We propose to revise NHAMCS for the purpose of converting data collection instruments from paper to computer-based instruments, adding 167 hospitals to the NHAMCS sample to make state-based estimates on emergency department characteristics, expanding the data collection to include a lookback module, conducting a colonoscopy supplement pretest, and making slight modifications to survey questions.

Authorizing Statute(s): US Code: 42 USC 306 Name of Law: Public Health Service Act

Citations for New Statutory Requirements: None

Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	76 FR 6163	06/29/2011
30-day Notice:	Federal Register Citation:	Citation Date:
	76 FR 66070	10/25/2011
Did the Agency receive public comments on this ICR? Yes

Number of Information Collection (IC) in this ICR: 10

IC Title	Form No.	Form Name
ASC Patient Record Form	unnumbered
Ambulatory Unit Induction
Cervical Cancer Screening Supplement	unnumbered
ED Patient Record Form
Freestanding ASC Induction Form
Hospital Induction (new sample)
Hospital Induction Form
OPD Patient Record Form
Pretests	none, none, none, none, none, none, none, none, none	, , , , , , , ,
Pulling and re-filing Patient Records

ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to Agency Discretion
Annual Number of Responses	111,395	128,161	-16,766
Annual Time Burden (Hours)	9,999	12,194	-2,195
Annual Cost Burden (Dollars)	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: Yes

Burden Reduction Due to: Using Information Technology

Short Statement: Improved information technology will significantly reduce the burden for NHAMCS respondents when answering induction interview questions. Currently, completing the form requires a Census field representative (FR) to follow the flow of the form from front to back, navigating numerous skip patterns, adding information from complicated lists, and administering flash cards to the respondent. This process can be complicated and lengthy and involve numerous opportunities to enter incorrect data. Using a computer assisted interviewing instrument of the induction interview will allow FRs to skip unneeded questions, quickly populate write-in fields with drop-down menus, and eliminate the need for paper flash-cards that highlight item choices. In the end, we expect the time a respondent spends during the induction interview to be significantly reduced. Approval to collect Patient Record forms (PRFs) data through an automated instrument is also requested. Use of a computerized data entry system for PRF data will significantly simplify the data collection activities by reducing data entry errors and omissions, as well as providing on-screen look-up tables for items such as reason for visit, diagnosis, and medications. Overall, using a computerized data entry system should reduce FR and respondent burden, and ultimately improve overall data quality. In addition, collecting the data electronically will speed editing, transmission, and processing, thereby making release of the yearly statistics more timely.

Annual Cost to Federal Government: $6,032,000

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? Yes

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? Yes

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? Yes

Is this ICR related to the Pandemic Response? Uncollected

Agency Contact: Catina Conner 4046394775

View ICR - OIRA Conclusion