Occupational Science & Occupational Therapy

• Public health statistics are used to understand risk factors, track and monitor trends and diseases, allocate health care resources, evaluate the effectiveness of public health interventions, assess the quality and safety of health care, and see the impact of policy changes.
• Health statistics measure four types of information: correlates, conditions, care, and cost - and can be collected at the nation, state, or local levels.
• The main sources of health statistics are surveys, administrative and medical records, claims data, vital records, surveillance, disease registries, and peer-reviewed literature.
• Statistics are derived from data sets, which can be broken out into two broad categories:
  • counts of individual health-related events or services
  • population data sets gathered through sampling techniques

• Identify the type of data you need to answer your research question. Do you need:
  • A numerical statistic or fact, such as prevalence rates, mortality rates, or other health indicators?
  • A complete data set for independent analysis?
  • A chart or figure?

• What is the geographic scope of your data needs?
  • Are you looking for county, state, nationwide, or global health data?

• Identify one or more organizations/agencies that are likely to collect or share the information you are interested in. (ex: The National Center for Health Statistics compiles statistics on virtually all aspects of health and health care, from chronic conditions and risk factors, to insurance and utilization. This is often a good place to start for U.S. health statistics.)
  • Look for a tab or link that says “Data”, “Statistics”, “Research”, etc. on the organization’s homepage.

Adapted from: https://www.nlm.nih.gov/nichsr/stats_tutorial/section4/index.html

If this topic is new to you you can use this self-paced tutorial, created by the National Library of Medicine, to learn more about health statistics and data and the major organizations and government agencies that collect and provide them. 

In addition to the resources listed in the tutorial, you will find other resources in the two guides listed below:

• USC Libraries Health Statistics Guide - includes links to data resources by type, location, population groups, health topics and more.
• USC Libraries Statistics & Data: Datasets  - includes links to databases and other resources containing datasets.

The National Library of Medicine recently launched the Dataset Catalog (in beta) to improve the discoverability and reuse of research data. This resource has been designed to connect users with multiple repositories through a single, user-friendly, “all-in-one” resource to search, find, and retrieve datasets. Please note, the beta version of the Dataset Catalog indexes datasets from a limited collection of repositories and features minimal functionality initially. 

Data resources focused on the Social Determinants of Health (SDOH):

• CDC Sources for Data on Social Determinants of Health
• CDC resources for SDOH data, research, tools for action, programs, and policy. 
• AHRQ SDOH Data and Analytics
• Healthy People 2030 - Social Determinants of Health

Below are some resources that can help you get started with identifying specific datasets used by occupational therapy/science researchers.

• Freburger JK, Konrad TR. The use of federal and state databases to conduct health services research related to physical and occupational therapy. Archives of physical medicine and rehabilitation. 2002;83(6):837-845. doi:10.1053/apmr.2002.32661
  • Although dated, this article provides insight into federal and state databases identified as having the potential to answer questions related to the use of, access to, and effectiveness of occupational therapy. Links to the current/updated versions of the databases referred to in the article are listed below.

Databases maintained by the National Center for Health Statistics (NCHS):

The NCHS maintains a number of public use databases that can be used by health services researchers to gain a better understanding of the health and health care of the US population.

• The National Ambulatory Medical Care Survey (NAMCS) and The National Hospital Ambulatory Medical Care Survey (NHAMCS) The NAMCS, that began in 1973, is a nationally representative, cross-sectional survey on ambulatory medical care services provided by office-based physicians. The NHAMCS was inaugurated in 1992 to expand the scope of data collection to include ambulatory care provided by hospital outpatient and emergency departments.
• The National Health Interview Survey (NHIS) is a cross-sectional, in-person, household interview survey of the civilian, noninstitutionalized population of the United States living at the time of the survey. The main objective of the NHIS is to monitor the health of the US population through the collection and analysis of data on a broad range of health topics. The survey has been conducted continuously since 1957.
• The National Nursing Home Survey (NNHS) was a continuing series of surveys on a national sample of nursing homes, their residents, and their staff. This website contains information on the National Nursing Home Survey (NNHS), which was last fielded by NCHS in 2004. In 2012, NCHS initiated the National Study of Long-Term Care Providers (NSLTCP)—see link to this resource below.
• The National Home and Hospice Care Survey (NHHCS) was a continuing series of surveys of home and hospice care agencies in the United States. This website contains information on the National Home and Hospice Care Survey (NHHCS), which was last fielded by NCHS in 2007. In 2012, NCHS initiated the National Study of Long-Term Care Providers (NSLTCP)— see link to this resource below.

Databases maintained by the Agency for Health-care Research and Quality:

• The Medical Expenditure Panel Survey (MEPS) is a nationally representative survey of health care use, expenditures, sources of payment, and insurance coverage for the US civilian noninstitutionalized population, as well as a national survey of nursing homes and their residents.
• The State Inpatient Databases (SIDs) are part of a family of databases developed as part of the Healthcare Cost and Utilization Project (HCUP), a federal-state-industry partnership sponsored by the AHRQ. Participating states submit annual data on inpatient discharges from hospitals in their state.
• The Nationwide Inpatient Sample (NIS), a second database developed as a part of the HCUP, is a stratified probability sample of nonfederal, short-term general and specialty hospitals drawn from the SIDs. In addition, the NIS includes information on hospital characteristics (ie, location, number of beds, teaching status, ownership).

Databases maintained by the Centers for Medicare and Medicaid Services:

The CMS maintains a number databases that have been used by health services researchers to examine issues related to the use of rehabilitation services, including PT and OT. Unlike the public use databases maintained by the NCHS and the AHRQ, the databases managed by the CMS are less accessible because of more complex data-use agreements and cost. For example, Medicare administrative files, available at both the person and claims level, are classified as Restricted Public Use Files or Beneficiary Encrypted Data Files and require the completion of a data use agreement.

• The Medicare Current Beneficiary Survey (MCBS) overcomes some of the limitations of administrative files by combining administrative data with data obtained from in-person surveys. The survey, which began in 1991, is conducted on a nationally representative sample.
• In 2012, NCHS initiated the National Study of Long-Term Care Providers (NSLTCP). In January 2020, the NSLTCP was renamed the National Post-acute and Long-term Care Study (NPALS). This new name reflects the addition of more post-acute sectors (i.e. inpatient rehabilitation facilities and long-term care hospitals), while keeping the same sectors that have been in the study since it launched in 2012 (adult day services centers, assisted living and similar residential care communities, home health agencies, hospices, and nursing homes).

The resources below focus on physical therapy, but may contain relevant resources for occupational therapy as well:

• Resnik L, Freburger J. Health services research: Physical therapy has arrived. Physical therapy. 2015;95(12):1605-1607. doi:10.2522/ptj.2015.95.12.1605 
  • This article provides insight regarding the evolution of health services research within the physical therapy profession. It also highlights 6 research reports using large secondary data sources.
• The Center on Health Services Training and Research (CoHSTAR) was created with a mission to train rehabilitation professionals in health services research that informs rehabilitation practice, care delivery, and policy.
  • On the Pilot Studies page many researchers name the datasets that they are using to conduct their research.