View Information Collection Request (ICR) Package
Skip to main content
An official website of the United States government
The .gov means it's official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you're on a federal government site.
The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.
Search:
Agenda
Reg Review
ICR
This script is used to control the display of information in this page.
Display additional information by clicking on the following:
All
Brief and OIRA conclusion
Abstract/Justification
Legal Statutes
Rulemaking
FR Notices/Comments
IC List
Burden
Misc.
Common Form Info.
Certification
View Information Collection (IC) List
View Supporting Statement and Other Documents
Please note that the OMB number and expiration date may not have been determined when this Information Collection Request and associated Information Collection forms were submitted to OMB. The approved OMB number and expiration date may be found by clicking on the Notice of Action link below.
View ICR - OIRA Conclusion
OMB Control No:
0920-0278
ICR Reference No:
201510-0920-005
Status:
Historical Active
Previous ICR Reference No:
201412-0920-013
Agency/Subagency:
HHS/CDC
Agency Tracking No:
20786
Title:
National Hospital Ambulatory Medical Care Survey
Type of Information Collection:
No material or nonsubstantive change to a currently approved collection
Common Form ICR:
No
Type of Review Request:
Regular
OIRA Conclusion Action:
Approved without change
Conclusion Date:
11/23/2015
Retrieve Notice of Action (NOA)
Date Received in OIRA:
11/02/2015
Terms of Clearance:
Inventory as of this Action
Requested
Previously Approved
Expiration Date
02/28/2018
02/28/2018
02/28/2018
Responses
105,768
0
105,768
Time Burden (Hours)
4,298
0
4,412
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). NCHS requests 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. The revisions included in this request entail making slight modifications to NHAMCS 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:
79 FR 49520
08/21/2014
30-day Notice:
Federal Register Citation:
Citation Date:
79 FR 77495
12/24/2014
Did the Agency receive public comments on this ICR?
Yes
Number of Information Collection (IC) in this ICR:
8
IC Title
Form No.
Form Name
2016 Ambulatory Surgery Center Patient Record Form
0920-0278
Attachment D - 2016 NHAMCS ASL PRF Changes
2016 Emergency Department Patient Record Form
0920-0278
Attachment B - 2016 NHAMCS ED PRF Changes
2016 Outpatient Department Patient Record Form
0920-0278
Attachment C - 2016 NHAMCS OPD PRF Changes
Ambulatory Unit Induction Interview
None
NHAMCS Ambulatory Unit Induction Form
Hospital Induction Interview
0920-0278
Attachment A - 2016 NHAMCS Hospital Induction Questionnaire - Electronic Health Record Question Changes
Reabstraction Telephone Call
Retrieve Medical Records
Retrieve Medical Records Records (Reabstraction)
ICR Summary of Burden
Total Approved
Previously Approved
Change Due to New Statute
Change Due to Agency Discretion
Change Due to Adjustment in Estimate
Change Due to Potential Violation of the PRA
Annual Number of Responses
105,768
105,768
0
0
0
0
Annual Time Burden (Hours)
4,298
4,412
0
-114
0
0
Annual Cost Burden (Dollars)
0
0
0
0
0
0
Burden increases because of Program Change due to Agency Discretion:
No
Burden Increase Due to:
Burden decreases because of Program Change due to Agency Discretion:
Yes
Burden Reduction Due to:
Miscellaneous Actions
Short Statement:
The currently approved burden for this NHAMCS package is 4,412 hours. The proposed changes to the 2016 survey, particularly the modification of the Electronic Health Records (EHR) questions captured in the Hospital Induction instrument, will reduce the burden to the respondent by 114 hours, resulting in a final burden of 4,298 hours.
Annual Cost to Federal Government:
$6,289,206
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 404 639-4775
Common Form ICR:
No
On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
(a) It is necessary for the proper performance of agency functions;
(b) It avoids unnecessary duplication;
(c) It reduces burden on small entities;
(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;
(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;
(f) It indicates the retention periods for recordkeeping requirements;
(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:
(i) Why the information is being collected;
(ii) Use of information;
(iii) Burden estimate;
(iv) Nature of response (voluntary, required for a benefit, or mandatory);
(v) Nature and extent of confidentiality; and
(vi) Need to display currently valid OMB control number;
(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.
(i) It uses effective and efficient statistical survey methodology (if applicable); and
(j) It makes appropriate use of information technology.
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
Certification Date:
11/02/2015
Something went wrong when downloading this file. If you have any questions, please send an email to risc@gsa.gov.