Summary of data sources
| Data source and description | Used to estimate/analysis | Strengths 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 database | Calculate 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 |