Proposed Data Collections Submitted for Public Comment and Recommendations

DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Disease Control and Prevention

[INFO-95-05]

Proposed Data Collections Submitted for Public Comment and

Recommendations

In compliance with the requirement of Section 3506(c)(2)(A) of the

Paperwork Reduction Act of 1995 for opportunity for public comment on

proposed data collection projects, the Centers for Disease Control and

Prevention (CDC) will publish periodic summaries of proposed projects.

To request more information on the proposed projects or to obtain a

copy of the data collection plans and instruments, call the CDC Reports

Clearance Officer on (404) 639-3453.

Comments are invited on: (a) Whether the proposed collection of

information is necessary for the proper performance of the functions of

the agency, including whether the information shall have practical

utility; (b) the accuracy of the agency's estimate of the burden of the

proposed collection of information; (c) ways to enhance the quality,

utility, and clarity of the information to be collected; and (d) ways

to minimize the burden of the collection of information on respondents,

including through the use of automated collection techniques for other

forms of information technology. Send comments to Wilma Johnson, CDC

Reports Clearance Officer, 1600 Clifton Road, MS-D24, Atlanta, GA

30333. Written comments should be received within 60 days of this

notice.

Proposed Projects

1. The National Ambulatory Medical Care Survey (NAMCS)--(0920-

0234)--Extension--The National Ambulatory Medical Care Survey (NAMCS)

was conducted annually from 1973 to 1981, again in 1985, and resumed as

an annual survey in 1989 by the National Center for Health Statistics,

CDC. The NAMCS samples from all office visits within the United States

made by ambulatory patients to non-Federal office-based physicians

engaged in direct patient care. More than 70 percent of all direct

ambulatory medical care visits occur in physicians' offices. To

complement these data, in 1992 NCHS initiated the separate National

Hospital Ambulatory Medical Care Survey (NHAMCS). These two surveys

constitute the ambulatory care component of the National Health Care

Survey (NHCS), and provide coverage of more than 90 percent of U.S.

ambulatory medical care. NAMCS data include patients' demographic

characteristics and medical problems, and the physicians' diagnostic

services, therapeutic prescriptions and disposition decisions. These

annual data may be used to monitor change and its effects and stimulate

further improvements to the use, organization, and delivery of

ambulatory care. Users of NAMCS data include Congress and federal

agencies (e.g. NIMH, NIAAA, NCI, HRSA), state and local governments,

medical schools, schools of public health, colleges and universities,

private businesses, nonprofits, and individual practitioners and

administrators. The total cost to respondents is estimated at

$2,570,400.

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Avg.

No. of No. of burden/ Total

Respondents respondents responses/ response burden

respondents (in hrs.) (in hrs.)

----------------------------------------------------------------------------------------------------------------

Private, Office-based Physicians Forms:

Induction..................................................... 3000 1 0.250 750

Patient Record................................................ 3000 30 0.033 2970

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Total..................................................... ........... ........... ......... 3,720

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2. The National Hospital Ambulatory Medical Care Survey (NHAMCS)--

(0920-0278)--Extension--The National Hospital Ambulatory Medical Care

Survey (NHAMCS) has been conducted annually since 1992 by the National

Center for Health Statistics, CDC. The NHAMCS is the principal source

of data on the 153 million visits to hospital emergency and outpatient

departments. It is the only source of nationally representative

estimates of outpatient demographics, diagnoses, diagnostic services,

medication therapy, and the patterns of use of care in hospitals which

differ in size, location, and ownership. NHAMCS is also the only source

of national estimates on causes of non-fatal injury for visits to

emergency and outpatient departments.

These data complement those from the National Ambulatory Medical

Care Survey (NAMCS), on visits to non-Federal physicians in office-

based practices. NHAMCS data are essential for planning health

services, improving medical education, determining health care work

force needs, and assessing health. Users of NHAMCS data include

Congress, Federal agencies such as NIH, private groups such as the

American Heart Association, universities, and state offices of public

health. The total cost to respondents is estimated at $180,000.

----------------------------------------------------------------------------------------------------------------

Avg.

No. of No. of burden/ Total

Respondents respondents responses/ response burden

respondents (in hrs.) (in hrs.)

----------------------------------------------------------------------------------------------------------------

Noninstitutional, general and short stay, hospital outpatient

and emergency departments forms:

Hospital Induction........................................... 600 1 1.0 600

[[Page 55585]]

Ambulatory Unit Induction.................................... 600 1 1.2 720

Emergency Department Patient Record.......................... 600 50 0.06 1,800

Outpatient Department Patient Record......................... 600 150 0.06 5,400

------------------------------------------------

Total.................................................... ........... ........... .......... 8,520

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3. TB Statistics and Evaluation Activity--(0920-0026)--Revision--

This is a request to revise the currently approved data collection,

which authorizes the collection of information that constitutes a

national information system for tuberculosis. These data provide

reliable and consistent information on the extent and distribution of

TB in the U.S. Two forms will be deleted from the current information

package: CDC 72.16 Tuberculosis Program Management Report, Contact

Follow-up; and CDC 72.21 Tuberculosis Program Management Report,

Completion of Preventive Therapy. The burden for those two forms is 351

hours. Performance Measurement Report, Contact Investigation and

Preventive Therapy for Contacts will replace form 72.16; Performance

measurement Report, Preventive Therapy will replace form 72.21, and the

new form Performance Measurement Report, Screening will be added. The

total burden for these three new forms is 238 hours, a decrease of 113

hours over the burden in the current package.

The existing form for contact follow-up (72.16) is being replaced

because it does not stratify the contacts by the sputum smear status of

the index case. Sputum smear cases are most likely to be highly

infectious and their contacts should receive the highest priority for

identification, evaluation, and preventive therapy. Furthermore, it

does not reflect whether or not the contacts to a specific cohort of TB

cases who were started on preventive therapy actually complete a

recommended course of medication. Recently infected contacts are one of

the highest risk groups for developing active TB and therefore should

receive high priority for completing preventive therapy. The existing

form on completion of preventive therapy (72.21) is being replaced

because it does not stratify persons starting and completing preventive

therapy by HIV status, the highest risk factor ever identified for

developing active TB. Furthermore, it does not separate those who are

at high risk because they are more likely to be infected with TB or

because they are more likely to develop TB disease once infected.

Finally, it does not specify the activity or group (e.g., correctional

facility or drug treatment center) in which the preventive therapy is

being carried out. The new screening form is being added because there

is currently no mechanism for systematically collecting information

from TB grant recipients on TB screening activities in various risk

groups (e.g., persons with HIV infection) or in various settings (e.g.,

correctional facilities, drug treatment centers). The new form also

collects data that determines of those screened, the number and percent

found to have TB infection and who were subsequently placed on

preventive therapy. CDC cannot currently determine whether grant

recipients are appropriately carrying out these activities.

----------------------------------------------------------------------------------------------------------------

Avg.

No. of No. of burden/ Total

Respondents respondents responses/ response burden

respondent (in hrs.) (in hrs.)

----------------------------------------------------------------------------------------------------------------

Performance Measurement Report, Contact Investigation and

Preventive Therapy for Contacts................................ 68 2 0.5 68

Performance Measurement Report, Preventive Therapy.............. 68 2 1.0 136

Performance Measurement Report, Screening....................... 68 2 0.25 34

-----------------------------------------------

Total..................................................... ........... .......... .......... 238

----------------------------------------------------------------------------------------------------------------

4. Hanford Environmental Dose Reconstruction (HEDR) Project Milk

Producers Survey--New--OMB approved the information collections for the

``Hanford Thyroid Disease Full Epidemiology Study'' under OMB No. 0920-

0296 to determine the health effects to the public from radioactive

releases from the Hanford Nuclear Site Operations during the 1940's and

1950's. A primary component of these releases was radioactive iodine.

Consumption of fresh milk from cows that have eaten contaminated

vegetation and fresh leafy vegetables and eggs from chickens with

access to outdoor vegetation are important pathways of radioactive

iodine to the human body which adversely affects the thyroid gland. To

estimate the doses to the thyroid that individuals and populations

could have received, historical milk cow and chicken feeding and

distribution practices must be reconstructed for the downwind area.

This information is particularly important for use in this ongoing

study and its relation to radiation exposures. Researchers from LTG

Associates will collect information from a representative sample of

individuals who farmed in 7 counties within the study area during the

periods of 1945 and 1951. There are no costs to the respondents.

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Avg.

No. of No. of burden/ Total

Respondents respondents responses/ response burden

respondents (in hrs.) (in hrs.)

----------------------------------------------------------------------------------------------------------------

Contact Potential Sources of Names of farmers.................. 50 1 0.16 8

[[Page 55586]]

Initial Contact of Potential Candidates........................ 1,600 1 0.16 267

Scheduling Interview........................................... 400 1 0.08 33

Telephone Interview............................................ 400 1 2 800

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Total.................................................... ........... ........... .......... 1,108

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5. State-Based Evaluation of Trends and Risk Factors in Morbidity

and Mortality from Sickle Cell Disease after Newborn Screening--New--

Children with sickle cell disease are at increased risk for mortality

and morbidity, especially in the first three years of life. The need

for early diagnosis and preventive medical intervention is the

rationale for newborn hemoglobinopathy screening programs, now

operating in more than 40 states. Although clinical trials have clearly

demonstrated the efficacy of early medical intervention, more

information is needed regarding the actual utilization of available

therapies and preventive measures in large populations, health statuses

of children identified by newborn screening programs, and risk factors

for adverse health outcomes. Potential risk factors include extent of

medical care follow-up, location of treatment, the use of penicillin

prophylaxis, immunization patterns, as well as parental social,

demographic and educational factors. In FY 1995, CDC awarded $150,000

to three state health departments to assist in their efforts to

ascertain health status and risk factors for young children with sickle

cell disease. States will be using these funds to obtain information

about individual children through structured questionnaires directed

toward their parents and physicians. There are no costs to the

respondents.

----------------------------------------------------------------------------------------------------------------

Avg.

No. of No. of burden/ Total

Respondents respondents responses/ response burden

respondent (in hrs.) (in hrs.)

----------------------------------------------------------------------------------------------------------------

Parents........................................................ 3,000 1 1.5 4.5

Physicians..................................................... 4,500 1 1 4.5

------------------------------------------------

Total.................................................... ........... .......... .......... 9

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Dated: October 26, 1995.

Joseph R. Carter,

Acting Associate Director for Management and Operations, Centers for

Disease Control and Prevention (CDC).

[FR Doc. 95-27056 Filed 10-31-95; 8:45 am]

BILLING CODE 4163-18-P