0920-0853 HD Reporting Form MAY2023

[NCEH] Asthma Information Reporting System (AIRS)

Att7a_AIRS HD Reporting Forms.xlsx

OMB: 0920-0853

Document [xlsx]
Download: xlsx | pdf

Overview

STATE HD DATA
TECHNICAL NOTES


Sheet 1: STATE HD DATA

STATE [Year] Hospital Discharge Data




SM Weight
N of Hosp. Visits* [Year] Pop. Crude Rate
Total

0
#DIV/0!
Age groups





.Under 5 years



#DIV/0!
.5 to 9 years



#DIV/0!
.10 to 14 years



#DIV/0!
.15 to 17 years



#DIV/0!
.18 to 19 years



#DIV/0!
.20 to 24 years



#DIV/0!
.25 to 29 years



#DIV/0!
.30 to 34 years



#DIV/0!
.35 to 39 years



#DIV/0!
.40 to 44 years



#DIV/0!
.45 to 49 years



#DIV/0!
.50 to 54 years



#DIV/0!
.55 to 59 years



#DIV/0!
.60 to 64 years



#DIV/0!
.65 to 69 years



#DIV/0!
.70 to 74 years



#DIV/0!
.75 to 79 years



#DIV/0!
.80 to 84 years



#DIV/0!
.85 years or more



#DIV/0!
*First listed Dx of asthma only (ICD-10-CM code J45)
#DIV/0!
*Only provide hospitalizations that occurred among in-state residents Age-adjusted Rate per 100,000
***CLICK HERE TO COMPLETE EXCEL SHEET LABELED 'TECHNICAL NOTES'***


Sheet 2: TECHNICAL NOTES

Hospitalization Data Technical Notes
1. Indicate coding scheme used for [Year] data:

All data was coded only using ICD-10-CM

Other; specify:
2. Types of hospitals not contained in this data (check all that apply):

Veteran’s Administration Hospitals

Military hospitals

Psychiatric/mental health hospitals

Prison hospitals

Indian Health Service Hospital

Other; specify:
3. Does the data include hospitalizations that occurred for in-state residents that occurred in out-of-state hospitals?

Yes

No
4. Location of data for an emergency department visit resulting in a hospital admission (select one only):

Emergency department data file only

Hospital discharge data file only

Both the emergency department data file and the hospital discharge data file

Unknown

Other; specify:

None of the above
Additional technical notes:

***CLICK HERE TO RETURN TO EXCEL SHEET LABELED 'CA HD DATA'***
File Typeapplication/vnd.openxmlformats-officedocument.spreadsheetml.sheet
File Modified0000-00-00
File Created0000-00-00

© 2024 OMB.report | Privacy Policy