National Hospital Discharge Survey

Forms and Documents

Document Name	Status
Form HDS-1 (DRAFT) National Hospital Discharge Survey Form	Modified
NHDS 83-C justification for the addition of 2 items.doc Justification for No Material/Nonsubstantive Change	2006-11-30

IC Document Collections

IC ID	Document Title	Status
6666	National Hospital Discharge Survey Form	Modified

ICR Details

OMB Control No: 0920-0212	ICR Reference No: 200612-0920-001
Status: Historical Active	Previous ICR Reference No: 200507-0920-002
Agency/Subagency: HHS/CDC	Agency Tracking No:
Title: National Hospital Discharge Survey
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 02/01/2007
	Date Received in OIRA: 12/12/2006
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	08/31/2008	08/31/2008	08/31/2008
Responses	47,525	0	47,525
Time Burden (Hours)	2,408	0	2,131
Cost Burden (Dollars)	0	0	0

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Abstract: The National Hospital Discharge Survey provides detailed information on characteristics, diagnoses, and surgical and other procedures for the patients discharged from short-stay non-Federal hospitals in the United States. The information collected is available in written reports, in unpubished form through special tabulations, on public use files, CD-ROMS and on-line at the NCHS website.

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Authorizing Statute(s): None

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments

Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
National Hospital Discharge Survey	HDS-1 (DRAFT)	Medical Abstraction - National Hospital Discharge Survey

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ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	47,525	47,525	0	0	0	0
Annual Time Burden (Hours)	2,408	2,131	0	277	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: The increase in burden hours (274 hours) from 2,131 to 2,405 is due to a program change with the addition of two variables to the NHDS abstract form: 1) admitting diagnosis and 2) present on admission indicators for the principal diagnosis and six secondary diagnoses.

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Annual Cost to Federal Government: $0

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? Uncollected

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? Uncollected

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? Uncollected

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 12/04/2006

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