Table A1—

Summary of data sources

Data source and descriptionUsed to estimate/analysisStrengths and limitations
National Health Interview Survey (NHIS): combined 2004–2006 surveys to increase sample size.Diabetes diagnosed prevalence by age, sex, and race/ethnicity Prevalence of insulin and oral agents use Impact of diabetes on employment/hours worked Activity limitation and restriction+Large sample size +Contains employment-related information −Diabetes status self-reported of whether ever been told by physician you have diabetes −Excludes institutionalized population where diabetes is overrepresented
National Health and Nutrition Examination Survey (NHANES): combined the three biannual surveys (1999–2000, 2001–2002, and 2003–2004) to increase sample size.Verify diagnosed prevalence Estimate undiagnosed prevalence+Contain both self-reported and lab test–identified diabetic persons −Excludes institutionalized population where diabetes is overrepresented
Medical Expenditure Panel Survey (MEPS): combined 2003–2005 surveys to increase sample size.Average cost per physician office, outpatient, and emergency visit and outpatient prescription Average annual expenditures for podiatry, home health, insulin, oral agents, diabetes-related supplies use and cost, other medical equipment and supplies+Rich source of health resource use and cost information −Relatively small sample size per year −Contains only three-digit diagnosis codes; many chronic conditions of diabetes require four-digit codes to identify −Excludes institutionalized population where diabetes is overrepresented
National Ambulatory Medical Care Survey (NAMCS): combined 2003–2005 surveys to increase sample size.National number of physician office visits by medical condition(using primary diagnosis code) Average number of scripts written per visit+Larger sample size than MEPS +Contains five-digit diagnosis codes to identify chronic conditions of diabetes −Visits are the unit of observations, with incomplete information on patients (including whether they have diabetes)
National Hospital Ambulatory Medical Care Survey (NHAMCS): combined 2003–2005 surveys to increase sample size.National number of hospital outpatient and emergency visits by medical condition (using primary diagnosis code)+Same as for NAMCS −Same as for NAMCS
Average number of scripts written per visit
Nationwide Inpatient Sample (NIS): used 2004–2005 surveys.National number of hospital inpatient days for diabetes and comorbidities of diabetes (using primary diagnosis)+Same as for NAMCS −Same as for NAMCS
Cost per inpatient day calculated using hospital-specific cost-to-charge ratios
National Home and Hospice Care Survey (NHHCS): used 2000 data.Hospice care use (also validate home health)+Same as for NAMCS −Same as for NAMCS
National Nursing Home Survey (NNHS): used 2004 data.Nursing facility use+Same as for NAMCS −Same as for NAMCS
Ingenix MCURE databaseCalculate age-sex specific relative rate ratios for each medical condition for hospital inpatient days, emergency visits, and ambulatory visits (physician office and hospital outpatient combined)+Large sample size −All medical records can be linked for the year to identify people with diabetes based on whether they have any diabetes diagnosis code during the year −Lacks detailed data on health behavior found in MEPS