The nation's health care system has changed dramatically and the country is debating further significant changes. Comprehensive information is needed to guide policymakers in understanding and evaluating the current problems and in formulating federal health care policy. This book contains an evaluation of the plan developed by the National Center for Health Statistics for restructuring its existing provider surveys. It identifies current and future data needed by researchers and policymakers to assess the effect of changes in financing, organization, and delivery of health care on access, quality, costs, and outcomes of care and determines the extent to which the design and content of the proposed survey can meet these data needs. The book goes beyond a simple review and recommends a design framework to develop a coordinated and integrated data system to gather information about people and their illness over time and to link this information to costs and health care outcomes.

Chronic diseases are common and costly, yet they are also among the most preventable health problems. Comprehensive and accurate disease surveillance systems are needed to implement successful efforts which will reduce the burden of chronic diseases on the U.S. population. A number of sources of surveillance data-including population surveys, cohort studies, disease registries, administrative health data, and vital statistics-contribute critical information about chronic disease. But no central surveillance system provides the information needed to analyze how chronic disease impacts the U.S. population, to identify public health priorities, or to track the progress of preventive efforts. A Nationwide Framework for Surveillance of Cardiovascular and Chronic Lung Diseases outlines a conceptual framework for building a national chronic disease surveillance system focused primarily on cardiovascular and chronic lung diseases. This system should be capable of providing data on disparities in incidence and prevalence of the diseases by race, ethnicity, socioeconomic status, and geographic region, along with data on disease risk factors, clinical care delivery, and functional health outcomes. This coordinated surveillance system is needed to integrate and expand existing information across the multiple levels of decision making in order to generate actionable, timely knowledge for a range of stakeholders at the local, state or regional, and national levels. The recommendations presented in A Nationwide Framework for Surveillance of Cardiovascular and Chronic Lung Diseases focus on data collection, resource allocation, monitoring activities, and implementation. The report also recommends that systems evolve along with new knowledge about emerging risk factors, advancing technologies, and new understanding of the basis for disease. This report will inform decision-making among federal health agencies, especially the Department of Health and Human Services; public health and clinical practitioners; non-governmental organizations; and policy makers, among others.

Federal government statistics provide critical information to the country and serve a key role in a democracy. For decades, sample surveys with instruments carefully designed for particular data needs have been one of the primary methods for collecting data for federal statistics. However, the costs of conducting such surveys have been increasing while response rates have been declining, and many surveys are not able to fulfill growing demands for more timely information and for more detailed information at state and local levels. Innovations in Federal Statistics examines the opportunities and risks of using government administrative and private sector data sources to foster a paradigm shift in federal statistical programs that would combine diverse data sources in a secure manner to enhance federal statistics. This first publication of a two-part series discusses the challenges faced by the federal statistical system and the foundational elements needed for a new paradigm.

Obesity has come to the forefront of the American public health agenda. The increased attention has led to a growing interest in quantifying obesity prevalence and determining how the prevalence has changed over time. Estimates of obesity prevalence and trends are fundamental to understanding and describing the scope of issue. Policy makers, program planners, and other stakeholders at the national, state, and local levels are among those who search for estimates relevant to their population(s) of interest to inform their decision-making. The differences in the collection, analysis, and interpretation of data have given rise to a body of evidence that is inconsistent and has created barriers to interpreting and applying published reports. As such, there is a need to provide guidance to those who seek to better understand and use estimates of obesity prevalence and trends. Assessing Prevalence and Trends in Obesity examines the approaches to data collection, analysis, and interpretation that have been used in recent reports on obesity prevalence and trends at the national, state, and local level, particularly among U.S. children, adolescents, and young adults. This report offers a framework for assessing studies on trends in obesity, principally among children and young adults, for policy making and program planning purposes, and recommends ways decision makers and others can move forward in assessing and interpreting reports on obesity trends.