Analysis and Use of Core Data Sets

Asthma Information Reporting System (AIRS)

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0853 can be found here:

Documents and Forms

Document Name Document Type
Form 0920-0853 Analysis and Use of Core Data Sets Form and Instruction
0920-0853 Performance Measures Reporting Tool Att5a_PMReportingTool.xlsx Form and Instruction
0920-0853 Emergency Department Visits Reporting Form Att6a_AIRS ED Visits Reporting Form.xlsx Form and Instruction
0920-0853 Hospital Discharge Reporting Form Att7a_AIRS HD Reporting Forms.xlsx Form and Instruction
Att5c_Instructions for PM Reporting Tool.docx PM Reporting tool Instructions IC Document
Att6b_AIRS ED Visits Reporting Example.xlsx ED Reporting example IC Document
Att7b_AIRS HD Reporting Example.xlsx HD reporting example IC Document
Att8_PM Comparison Table.docx PM Comparison Table IC Document

Information Collection (IC) Details

IC Title:	Analysis and Use of Core Data Sets	Agency IC Tracking Number:	0920-0853

Is this a Common Form? No		IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	0920-0853	Performance Measures Reporting Tool	Att5a_PMReportingTool.xlsx	Yes	Yes	Fillable Fileable
Form and Instruction	0920-0853	Emergency Department Visits Reporting Form	Att6a_AIRS ED Visits Reporting Form.xlsx	Yes	Yes	Fillable Fileable
Form and Instruction	0920-0853	Hospital Discharge Reporting Form	Att7a_AIRS HD Reporting Forms.xlsx	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 90	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	90	90
Annual IC Time Burden (Hours)	105	105
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
PM Reporting tool Instructions	Att5c_Instructions for PM Reporting Tool.docx	03/02/2020
ED Reporting example	Att6b_AIRS ED Visits Reporting Example.xlsx	03/02/2020
HD reporting example	Att7b_AIRS HD Reporting Example.xlsx	03/02/2020
PM Comparison Table	Att8_PM Comparison Table.docx	03/02/2020

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.