ED discharge overdose data

Drug Overdose Surveillance and Epidemiology (DOSE)

Att E_ED discharge_overdose_data_form_5_22_2019.xlsx

ED Discharge Overdose data - State HD

OMB: 0920-1268

Document [xlsx]
Download: xlsx | pdf

Overview

Variable_definition
Metadata_QuartED
Jurisdiction_Rpt_QuartED
County_Rpt_QuartED_unintent
County_Rpt_QuartED_selfharm
Metadata_QuartHOSP
Jurisdiction_Rpt_QuartHOSP
County_Rpt_QuartHOSP_unintent
County_Rpt_QuartHOSP_selfharm


Sheet 1: Variable_definition

Variables Definition
Jurisdiction The two-digit state abbreviation (e.g., GA)
Year The four digit calendar year (e.g., 2019)
Month The full name of the month (e.g., January)
Manner Includes "a_Unintentional" for all unintentional and undetermined overdose intent (e.g., a 1 or 4 in the 6th or 7th ICD-10-CM code character) and "b_Self-harm" for all intentional self-harm overdose intent (e.g., a 2 in the 6th or 7th ICD-10-CM code character). Please see additional case definition guidance for hospital/billing data to see all relevant ICD-9-CM and ICD-10-CM overdose codes split by manner/intent.
Sex Three categories: male, female, missing
Age_Group Eleven categories: 0-10 years, 11-14 years, 15-24 years, 24-34 years, 35-44 years, 45-54 years, 55-64 years, 65-74 years, 75-84 years, 85 years and up, missing
County_name Exact name of the County within each jurisdiction (e.g., Adams). Please exclude the word "county" after the county name (e.g., do not list "Adams County").
County_FIPS Five character FIPS code for the County within each jurisdication where the first two digits are the state code and the last three digits are the county code (e.g., 12345)
Suspected_drug_OD_n The number of ED visits/hospitalizations for each month within the required quarter related to a suspected drug overdose. For example, Q4 2019 data is due April 13, 2020 and must include data listed separately for October, November, and December.
Suspected_opioid_OD_n The number of ED visits/hospitalizations for each month within the required quarter related to a suspected opioid overdose. For example, Q4 2019 data is due April 13, 2020 and must include data listed separately for October, November, and December.
Suspected_heroin_OD_n The number of ED visits/hospitalizations for each month within the required quarter related to a suspected heroin overdose. For example, Q4 2019 data is due April 13, 2020 and must include data listed separately for October, November, and December.
Suspected_stimulant_OD_n The number of ED visits/hospitalizations for each month within the required quarter related to a suspected stimulant overdose. For example, Q4 2019 data is due April 13, 2020 and must include data listed separately for October, November, and December.
Total_ED The total number of ED visits/hospitalizations for each month within the required quarter that were included in the analysis.

Sheet 2: Metadata_QuartED

Attachment E - ED discharge overdose data form



























Form Approved
OMB NO: 0920-XXXX
Exp. Date: X/XX/XXXX
Public reporting burden of this collection of information is estimated at 3 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. An agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a currently valid OMB control number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to CDC/Information Collection Review Office, 1600 Clifton Road, NE, MS D-74, Atlanta, GA 30333; Attn: PRA (0920-XXXX).


















Describe and provide metadata on quarterly hospital discharge data tracking ED visits involving suspected drug, opioid, heroin, and stimulant overdoses
1. Approximately what percent of ED visits in your state or jurisdiction were included in your analysis? (Enter a percentage such as "75%")






































































2. How many total facilities are included in your analysis for this data submission? (Enter a number such as "22")






































































3. Over 90% of hospitals report data within (Check response):




































< 1 month

< 3 months

< 6 months

< 1 year

























< 2 year

> 2 year

Unknown


























4. What was the maximum number of diagnosis codes (e.g., ICD-10-CM) entered for a single ED visit in this data submission? (Enter a number such as "10")






































































5. What was the mean number of diagnosis codes (e.g., ICD-10-CM) that were entered for all ED visits in this data submissions? (Enter a number such as "8")






































































6. Report the percent of all ED visits in this data submission that have no diagnosis codes (e.g., ICD-10-CM). (Enter a percentage such as "5%")






































































7. Please identify and describe any major issues that impact the quality of data shared during this data submission time period.


































Please briefly describe the problem
























8. Who should CDC contact with questions about this data report?



































Name:




























Email:




























Sheet 3: Jurisdiction_Rpt_QuartED

Quarterly hospital discharge data on ED visits suspected to involve drug, opioid, heroin, or stimulant overdoses by sex and age group at the jurisdictional level
NOTE: Please group ED visits that have an undetermined intent with visits that have an unintentional manner (See Case Definition)
Jurisdiction Year Month Manner Sex Age_Group Suspected_drug_OD_n Suspected_opioid_OD_n Suspected_heroin_OD_n Suspected_stimulant_OD_n Total_ED_visits



a_Unintentional Female 0-10







a_Unintentional Female 11-14







a_Unintentional Female 15-24







a_Unintentional Female 25-34







a_Unintentional Female 35-44







a_Unintentional Female 45-54







a_Unintentional Female 55-64







a_Unintentional Female 65-74







a_Unintentional Female 75-84







a_Unintentional Female 85+







a_Unintentional Female Missing







a_Unintentional Male 0-10







a_Unintentional Male 11-14







a_Unintentional Male 15-24







a_Unintentional Male 25-34







a_Unintentional Male 35-44







a_Unintentional Male 45-54







a_Unintentional Male 55-64







a_Unintentional Male 65-74







a_Unintentional Male 75-84







a_Unintentional Male 85+







a_Unintentional Male Missing







a_Unintentional Missing 0-10







a_Unintentional Missing 11-14







a_Unintentional Missing 15-24







a_Unintentional Missing 25-34







a_Unintentional Missing 35-44







a_Unintentional Missing 45-54







a_Unintentional Missing 55-64







a_Unintentional Missing 65-74







a_Unintentional Missing 75-84







a_Unintentional Missing 85+







b_Self_harm Female 0-10







b_Self_harm Female 11-14







b_Self_harm Female 15-24







b_Self_harm Female 25-34







b_Self_harm Female 35-44







b_Self_harm Female 45-54







b_Self_harm Female 55-64







b_Self_harm Female 65-74







b_Self_harm Female 75-84







b_Self_harm Female 85+







b_Self_harm Female Missing







b_Self_harm Male 0-10







b_Self_harm Male 11-14







b_Self_harm Male 15-24







b_Self_harm Male 25-34







b_Self_harm Male 35-44







b_Self_harm Male 45-54







b_Self_harm Male 55-64







b_Self_harm Male 65-74







b_Self_harm Male 75-84







b_Self_harm Male 85+







b_Self_harm Male Missing







b_Self_harm Missing 0-10







b_Self_harm Missing 11-14







b_Self_harm Missing 15-24







b_Self_harm Missing 25-34







b_Self_harm Missing 35-44







b_Self_harm Missing 45-54







b_Self_harm Missing 55-64







b_Self_harm Missing 65-74







b_Self_harm Missing 75-84







b_Self_harm Missing 85+







b_Self_harm Missing Missing





Sheet 4: County_Rpt_QuartED_unintent

Quarterly hospital discharge data on ED visits suspected to involve drug, opioid, heroin, or stimulant overdoses of unintentional or undetermined intent by county
Jurisdiction County_name County_FIPS Year Month Suspected_drug_OD_n Suspected_opioid_OD_n Suspected_heroin_OD_n Suspected_stimulant_OD_n Total_ED_visits

Sheet 5: County_Rpt_QuartED_selfharm

Quarterly hospital discharge data on ED visits related to self-harm involving suspected drug, opioid, heroin, or stimulant overdoses by county
Jurisdiction County_name County_FIPS Year Month Suspected_drug_OD_n Suspected_opioid_OD_n Suspected_heroin_OD_n Suspected_stimulant_OD_n Total_ED_visits

Sheet 6: Metadata_QuartHOSP

Describe and provide metadata on quarterly hospital discharge data tracking hospitalizations involving suspected drug, opioid, heroin, and stimulant overdoses














OMB#: ??




























1. Approximately what percent of hospitalizations in your state or jurisdiction were included in your analysis? (Enter a percentage such as "75%")






































































2. How many total facilities are included in your analysis for this data submission? (Enter a number such as "22")






































































3. Over 90% of hospitals report data within (Check response):




































< 1 month

< 3 months

< 6 months

< 1 year

























< 2 year

> 2 year

Unknown


























4. What was the maximum number of diagnosis codes (e.g., ICD-10-CM) entered for a single hospitalization in this data submission? (Enter a number such as "10")






































































5. What was the mean number of diagnosis codes (e.g., ICD-10-CM) that were entered for all hospitalizations in this data submissions? (Enter a number such as "8")






































































6. Report the percent of all hospitalizations in this data submission that have no diagnosis codes (e.g., ICD-10-CM). (Enter a percent such as "5%")






































































7. Please identify and describe any major issues that impact the quality of data shared during this data submission time period.


































Please briefly describe the problem
























8. Who should CDC contact with questions about this data report?



































Name:




























Email:




























Sheet 7: Jurisdiction_Rpt_QuartHOSP

Quarterly hospital discharge data on hospitalizations suspected to involve drug, opioid, heroin, or stimulant overdoses by sex and age group at the jurisdictional level
NOTE: Please group ED visits that have an undetermined intent with visits that have an unintentional manner (See Case Definition)
Jurisdiction Year Month Manner Sex Age_Group Suspected_drug_OD_n Suspected_opioid_OD_n Suspected_heroin_OD_n Suspected_stimulant_OD_n Total_ED_visits



a_Unintentional Female 0-10







a_Unintentional Female 11-14







a_Unintentional Female 15-24







a_Unintentional Female 25-34







a_Unintentional Female 35-44







a_Unintentional Female 45-54







a_Unintentional Female 55-64







a_Unintentional Female 65-74







a_Unintentional Female 75-84







a_Unintentional Female 85+







a_Unintentional Female Missing







a_Unintentional Male 0-10







a_Unintentional Male 11-14







a_Unintentional Male 15-24







a_Unintentional Male 25-34







a_Unintentional Male 35-44







a_Unintentional Male 45-54







a_Unintentional Male 55-64







a_Unintentional Male 65-74







a_Unintentional Male 75-84







a_Unintentional Male 85+







a_Unintentional Male Missing







a_Unintentional Missing 0-10







a_Unintentional Missing 11-14







a_Unintentional Missing 15-24







a_Unintentional Missing 25-34







a_Unintentional Missing 35-44







a_Unintentional Missing 45-54







a_Unintentional Missing 55-64







a_Unintentional Missing 65-74







a_Unintentional Missing 75-84







a_Unintentional Missing 85+







b_Self_harm Female 0-10







b_Self_harm Female 11-14







b_Self_harm Female 15-24







b_Self_harm Female 25-34







b_Self_harm Female 35-44







b_Self_harm Female 45-54







b_Self_harm Female 55-64







b_Self_harm Female 65-74







b_Self_harm Female 75-84







b_Self_harm Female 85+







b_Self_harm Female Missing







b_Self_harm Male 0-10







b_Self_harm Male 11-14







b_Self_harm Male 15-24







b_Self_harm Male 25-34







b_Self_harm Male 35-44







b_Self_harm Male 45-54







b_Self_harm Male 55-64







b_Self_harm Male 65-74







b_Self_harm Male 75-84







b_Self_harm Male 85+







b_Self_harm Male Missing







b_Self_harm Missing 0-10







b_Self_harm Missing 11-14







b_Self_harm Missing 15-24







b_Self_harm Missing 25-34







b_Self_harm Missing 35-44







b_Self_harm Missing 45-54







b_Self_harm Missing 55-64







b_Self_harm Missing 65-74







b_Self_harm Missing 75-84







b_Self_harm Missing 85+







b_Self_harm Missing Missing





Sheet 8: County_Rpt_QuartHOSP_unintent

Quarterly hospital discharge data on hospitalizations suspected to involve drug, opioid, heroin, or stimulant overdoses of unintentional or undetermined intent by county
Jurisdiction County_name County_FIPS Year Month Suspected_drug_OD_n Suspected_opioid_OD_n Suspected_heroin_OD_n Suspected_stimulant_OD_n Total_ED_visits

Sheet 9: County_Rpt_QuartHOSP_selfharm

Quarterly hospital discharge data on hospitalizations related to self-harm involving suspected drug, opioid, heroin, or stimulant overdoses by county
Jurisdiction County_name County_FIPS Year Month Suspected_drug_OD_n Suspected_opioid_OD_n Suspected_heroin_OD_n Suspected_stimulant_OD_n Total_ED_visits
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