Form 0920-1175 Hospitalizations

Form Approved

OMB No. 0920-1175

Exp. Date 04/30/2020

CDC estimates the average public reporting burden for this collection of information as 80 hours per response, including the time for reviewing instructions, searching existing data/information sources, gathering and maintaining the data/information 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/ATSDR Information Collection Review Office, 1600 Clifton Road NE, MS D-74, Atlanta, Georgia 30333; ATTN: PRA (0920-0853).

Data Dictionary for Data Submission Hospitalizations National Environmental Public Health Tracking Network
Characteristic	Description
Data Source	State Hospital Discharge Data Systems
Purpose	This data set will be used to calculate measures related to asthma, acute myocardial infarction, carbon monoxide poisoning, and heat stress illness hospitalizations as described in the Part 1 package, for use on the national public portal.
Geographic Level	The smallest geographic unit to be represented in this data set is sub-county.
Restrictions	This is a restricted access data set. Data will be displayed via the national public portal only when sufficient conditions have been met to protect data privacy. Only registered users will have direct access to this data set via the national secure portal.

CDC estimates the average public reporting burden for this collection of information as xxx minutes/hours per response, including the time for reviewing instructions, searching existing data/information sources, gathering and maintaining the data/information 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/ATSDR Information Collection Review Office, 1600 Clifton Road NE, MS D-74, Atlanta, Georgia 30333; ATTN: PRA (0920-0853).

CDC estimates the average public reporting burden for this collection of information as xxx minutes/hours per response, including the time for reviewing instructions, searching existing data/information sources, gathering and maintaining the data/information 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/ATSDR Information Collection Review Office, 1600 Clifton Road NE, MS D-74, Atlanta, Georgia 30333; ATTN: PRA (0920-0853).

CDC estimates the average public reporting burden for this collection of information as xxx minutes/hours per response, including the time for reviewing instructions, searching existing data/information sources, gathering and maintaining the data/information 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/ATSDR Information Collection Review Office, 1600 Clifton Road NE, MS D-74, Atlanta, Georgia 30333; ATTN: PRA (0920-0853).

Environmental Public Health Tracking Data Dictionary for Aggregate Data Hospitalizations
Field Name	Field Description	Data Type	Code Scheme	Legal Values	Field Length	Optional
ADMISSIONDAY	Day of hospital admission	String	dd	01–31	2	Optional
ADMISSIONMONTH	Month of hospital admission	String	mm	01–12	2	Required
ADMISSIONYEAR	Year of hospital admission	Integer	yyyy	2000-2xxx	4	Required
AGEGROUP	Five-year age group of individuals hospitalized for the condition indicated by HEALTHOUTCOMEID	Integer	1= 0–4 years 2= 5–9 years 3= 10–14 years 4= 15–19 years 5= 20–24 years 6= 25–29 years 7= 30–34 years 8= 35–39 years 9= 40–44 years 10= 45–49 years 11= 50–54 years 12= 55–59 years 13= 60–64 years 14= 65–69 years 15= 70–74 years 16= 75–79 years 17= 80–84 years 18= 85+ years 19= Unknown	1–19	2	Required
CensusTract	Census tract of residence	String	FIPS U=Unknown	FIPS code, U	11	Optional
COUNTY	County of residence	String	FIPS U= Unknown	FIPS U	5	Required
ETHNICITY	Ethnicity of individuals	Text	H= Hispanic NH= Non-Hispanic U= Unknown	H, NH, U	2	Optional
GeoCodingPrecision	Describe the degree of precision achieved during the geocoding process	Text	H = High precision L = Low precision U = Unknown precision C = County only S = State only	H, L, U, C, S	1	Required for Census Tract data
HEALTHOUTCOMEID	Health outcome (asthma, acute myocardial infarction, Carbon monoxide poisoning, or Heat stress illness)	Integer	1= Asthma 2= Acute myocardial infarction 3= Carbon monoxide poisoning 4= Heat stress illness 5 = COPD 6 = Acute respiratory infections 7 = Pneumonia 8 = All other respiratory outcomes 9 = Ischemic heart disease 10 = Cardiac arrhythmias 11 = Cerebrovascular disease 12 = Peripheral vascular disease 13 = Heart failure 14 = All other circulatory outcomes 15 = Cold illness 16 = Hyperthermia 17 = Renal failure 18 = Electrolyte imbalance 19 = Diabetes 20 = Allergic rhinitis	1 – 20	2	Required
IncidentCountFire (For CO Hospitalizations ONLY)	Number of unintentional fire-related CO poisoning hospitalizations	Integer	nnnnnn -999= Count is recorded in COUNT_UNK_H	0 to 999999, -999	6	Required
IncidentCountNonFire (For CO Hospitalizations ONLY)	Number of unintentional, non-fire related CO poisoning hospitalizations	Integer	nnnnnn -999= Count is recorded in COUNT_UNK_H	0 to 999999, -999	6	Required
IncidentCountUnknown (For CO Hospitalizations ONLY)	Number of CO poisoning hospitalizations where the cause was undetermined	Integer	nnnnnn	0 to 999999	6	Required
ADMISSIONS	Number of hospitalization admission events	Integer	nnnnn	00000 –99999	5	Required
RACE	Race of individuals	Text	W= White B= Black O= Other U= Unknown	W, B, O, U	1	Optional
SEX	Sex of individuals admitted	Text	M= Male F= Female U= Unknown	M, F, U	1	Required
STATE (For Header section only; Not a data element)	State of residence	String	FIPS	Valid state FIPS	2	Required