Tag Archives: databases

Institute launches global health data clearinghouse

About Andrew Van Dam

Andrew Van Dam of The Wall Street Journal previously worked at the AHCJ offices while earning his master’s degree at the Missouri School of Journalism.

Last month, the University of Washington’s Institute for Health Metrics and Evaluation (about) launched the Global Health Data Exchange (or GHDx), a sort of clearinghouse for global public health data sets. At launch, the site boasted about 1,000 data sets and promised it will index and host “information about microdata, aggregated data, and research results with a focus on health-related and demographic datasets.”

dataThe data is accompanied by visualization and GIS tools. For updates on the site, add the GHDx blog to your RSS. And, if you’re looking for a more direct connection, you can plug right into the RSS of new databases.

At present, the data is global in nature, though there are still plenty of domestic and comparative sets that will be of use to just about any U.S. reporter. Many of them will be familiar to data-heads, but it’s still handy to have it all in one place. The site will point directly to data providers when possible, and will work to provide public data for direct download. Free site registration is required before downloading.

The health highlights of two years of Guardian data

About Andrew Van Dam

Andrew Van Dam of The Wall Street Journal previously worked at the AHCJ offices while earning his master’s degree at the Missouri School of Journalism.

In two years, the Guardian’s data blog has published more than 600 data sets. I know this because, thanks to their nifty summary post, I just browsed the full list. In addition to more than a few UK analogues to the sort of stuff we see from AHRQ and NCHS, such as UK life expectancy, birth rates and aging populations and public spending, they’ve also got the sort of global health stuff that any journalist or blogger could pull out and use in a post tomorrow. I’ve collected some of my favorites and tried to strike a good balance between unique stuff and broad-spectrum, widely available global health data.

And finally, for no particular reason, here’s the outcome of every freedom of information request ever filed by the BBC. Also in the category of “data for curious journalists/insiders”? Several years of UK libel cases.

WSJ explains why Medicare data is hidden

About Andrew Van Dam

Andrew Van Dam of The Wall Street Journal previously worked at the AHCJ offices while earning his master’s degree at the Missouri School of Journalism.

In The Wall Street Journal, reporters Mark Schoofs and Maurice Tamman have pulled off an impressive feat, weaving a tale of freedom of information and databases so compelling that it’s already attracted hundreds of comments and attention from all over. At its heart, it’s the tale of why public Medicare payment data does not identify the doctors and individual providers who receive about an eighth of its annual disbursements. If the practitioners were identified, the authors argue, the public and press would be better equipped to expose and deter fraud.

The Medicare claims database, partially available for around $18,300 a year, is one of the most powerful health data resources in the world. It’s also hamstrung:

While the services and earnings of hospitals and other institutional providers can be publicly identified, such information is kept strictly confidential for doctors and other individual providers. The reason is that the American Medical Association, the doctors’ trade group, successfully sued the government more than three decades ago to keep secret how much money individual physicians receive from Medicare. The AMA has continued to defend this ruling, including in two cases in which federal appeals courts issued decisions last year.

This time around, The Wall Street Journal and the Center for Public Integrity took the AMA on. For health journalists, their description of what followed is really the crux of the story:

The Wall Street Journal, in conjunction with the nonprofit Center for Public Integrity, attempted for nearly a year to obtain the database. As part of the effort, the CPI filed a lawsuit against the Department of Health and Human Services, which houses the Medicare program. The Journal and CPI wanted the data at no cost; the government wanted $100,000 for eight years of data. In a settlement, The Journal and CPI obtained the requested data at a substantially reduced fee. They later obtained a decryption key to identify individual providers but signed a contract agreeing not to publish such identities in most cases.

The database, technically known as the Carrier Standard Analytic File, focuses on doctors and others paid on a fee-for-service basis. It contains 5% of all beneficiaries, and includes all doctor claims that Medicare paid directly in association with their care.

There’s far more to the story including information about the Consumers’ Checkbook lawsuit and the penultimate paragraphs on just how clear-cut fraud cases can be, once you know what to look for. An article on the Center for Public Integrity’s website promises more reporting, presumably based on the database, of “some of the questionable spending that occurs in the Medicare program.”


Physician Panel Prescribes the Fees Paid by Medicare

CMS failed to report disciplined providers

About Andrew Van Dam

Andrew Van Dam of The Wall Street Journal previously worked at the AHCJ offices while earning his master’s degree at the Missouri School of Journalism.

ProPublica’s Marian Wang reports that the Centers for Medicare & Medicaid Services “essentially undermined” HHS efforts to create a national database of disciplined health care providers by failing to report disciplinary actions. The news comes from a report by the HHS Office of Inspector General (23-page PDF).

According to Wang, the investigation “found that CMS, which oversees health care programs serving about 45 million Medicare beneficiaries and 59 million Medicaid beneficiaries, took disciplinary action against numerous bad medical providers but did not report those actions to the Healthcare Integrity and Protection Data Bank.” As anyone who’s been following ProPublica’s award-winning “When Caregivers Harm” series knows, the database is chronically deficient, and – despite federal requirements – CMS isn’t helping.

CMS is required by law to report the following types of disciplinary action to the database: revocations and suspensions of laboratory certifications; terminations of providers from participation in Medicare; civil monetary penalties against all types of providers, managed care plans, and prescription drug plans.

Some of the data that should’ve been reported includes 148 sanctions imposed against laboratories in 2007 and 30 sanctions taken against managed care and prescription drug plans between January 2006 and July 31, 2009. From 2004 to 2008, the agency banned 45 nursing homes from participating in Medicare, and those actions were not reported until fall 2009, long after the required reporting timeframe, the inspector general’s office said.

According to officials, it was all just a big misunderstanding.

Data: Calif. for-profits order more C-sections

About Andrew Van Dam

Andrew Van Dam of The Wall Street Journal previously worked at the AHCJ offices while earning his master’s degree at the Missouri School of Journalism.

Writing for California Watch, Nathanael Johnson leads with the numbers on his story about for-profit hospitals and C-sections. Appropriately for a story based on a hand-built database, classic health anecdotes don’t even surface until after the 20th paragraph. Instead, readers are immediately hit with this:

A database compiled from state birthing records revealed that, all factors considered, women are at least 17 percent more likely to have a cesarean section at a for-profit hospital than at one that operates as a non-profit. A surgical birth can bring in twice the revenue of a vaginal delivery.

It’s a powerful and nuanced – if not unexpected – finding. Johnson digs deep in the numbers, and hits on a litany of confounding factors and caveats. In the end, some of his most surprising findings were that patients at for-profit hospitals in poorer areas of Los Angeles were the most likely to receive C-sections, and that variation in these surgeries can be attributed to everything from cultural differences, patient preferences and even a desire to avoid malpractice suits.

How Johnson put it all together

For health journalists, the most exciting part of the entire package is likely Johnson’s detailed “how I did it” sidebar. He talks about how he chose which data to pursue, how he created the database behind the story, and even which specific Excel functions he used to find meaning within the numbers. Of particular interest are the sections in which he lists the sources he used to help him understand what he was seeing within the numbers, and to guide him toward his subsequent conclusions.

Forum offers stats on well-being of elderly

About Andrew Van Dam

Andrew Van Dam of The Wall Street Journal previously worked at the AHCJ offices while earning his master’s degree at the Missouri School of Journalism.

AgingStats.gov is an often-overlooked federal clearinghouse of aging-related data from the Federal Interagency Forum on Age-Related Statistics. It focuses on summary reports.

Its latest effort, Older Americans 2010: Key Indicators of Well-Being (174-page PDF), summarizes 37 key indicators it believes are broadly relevant and easy to understand. By my count, 24 of those are explicitly health-related.

Everything is illustrated with an abundance of charts and maps, and an emphasis on bulleted summary and analysis helps keep things accessible. Those looking for a deeper dive into the summary numbers will want to head to the appendix.

As part of its health sections, the report contains seven “Health Status” indicators, including chronic health conditions, depressive symptoms, sensory impairments and oral health, and functional limitations.

One example:


It also includes eight “Health Risks and Behaviors” – things like diet, air quality, mammography and vaccinations – and nine “Health Care” indicators, including expenditures, prescription drugs and residential services.

The forum, which nobody seems to refer to by the acronym FIFARS, has been around since 1986. Participants include the Census Bureau, a number of Health and Human Services departments (AHRQ, CMS, NCHS and others), HUD, the Bureau of Labor Statistics, the Department of Veterans Affairs, the EPA, the Office of Management and Budget, and the Social Security Administration.

Thanks to AHCJ member Eileen Beal for suggesting this as a tool other members might find helpful.