This is the program for the 2010 Joint Statistical Meetings in Vancouver, British Columbia.

Abstract Details

Activity Number: 292
Type: Topic Contributed
Date/Time: Tuesday, August 3, 2010 : 8:30 AM to 10:20 AM
Sponsor: Health Policy Statistics Section
Abstract - #308030
Title: Application of Small-Area Estimation Methods to Emergency Department Data from the National Hospital Ambulatory Medical Care Survey
Author(s): Vladislav M. Beresovsky*+ and Cathy Burt and Van Parsons and Nathaniel Schenker
Companies: National Center for Health Statistics and National Center for Health Statistics and National Center for Health Statistics and National Center for Health Statistics
Address: 3311 Toledo Rd, Hyattsville, MD, 20782 ,
Keywords: health care utilization ; logistic regression ; random effects ; cluster sampling ; small area estimation
Abstract:

The National Hospital Ambulatory Medical Care Survey (NHAMCS) is designed to produce national-level estimates, but sample sizes are inadequate for direct county- and state-level estimation. To expand upon estimation capabilities, data from a sample of emergency departments (ED) from the NHAMCS were combined with universe county and hospital-level covariates to create small-area prediction models for estimating county- and state-level attributes of emergency department visits (rates of ambulance arrival and visits with asthma or injury). Effects of data clustering at the hospital, county or state levels were modeled by introducing random effects into a generalized linear model. Point estimates were calculated and compared when random effects were applied at different levels. A bootstrap approach to estimating mean squared errors was illustrated as well.


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