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information on treatment and payer histories,
hospitalization events, deaths, physician and supplier
services, and providers.
Coverage. The primary source of ESRD identification is the
ESRD Medical Evidence form that is used to register patients
at the onset of ESRD and that must be submitted by dialysis
or transplant providers within 45 days of initiation. The form
establishes Medicare eligibility for individuals previously not
Medicare beneficiaries, reclassifies previously eligible
beneficiaries as ESRD patients, and provides demographic
and diagnostic information on all new patients. The CMS,
USRDS, and renal research communities rely on the form to
ascertain patient demographics, primary diagnosis,
comorbidities, and biochemical test results at the time of
ESRD initiation. Since 1995, providers have been required to
complete the form for all new ESRD patients (Medicare and
non-Medicare eligible).
Methodology. Data for the USRDS database are compiled
from existing data sources, including the CMS Renal
Management Information System (REMIS), CMS claims data,
facility survey data, CDC survey data (National Health and
Nutrition Examination Survey [NHANES]), Standard
Information Management System (SIMS), Medicare Evidence
form (CMS–2728), ESRD Death Notification form (CMS–274
6), and OPTN transplant and wait-list data. The CMS data files
are supplemented by CMS with enrollment, payer history,
and other administrative data, to provide utilization and
demographic information on ESRD patients.
Coverage rates are 100% of people treated for ESRD since
May 1995 because the amended ESRD entitlement policy
requires that a Medicare Evidence form be submitted for all
ESRD patients, regardless of their insurance and eligibility
status. However, the payment data for non-Medicare ESRD
patients may be absent during the 30-month coordination
period.
Issues Affecting Interpretation. Ascertainment of incident
cases may be incomplete because the data are for persons
receiving ESRD treatment as reported to CMS and do not
include patients who die of ESRD before receiving treatment
and those who are not reported to CMS. In 2014, the
methodology was revised and all data were reestimated.
Reference
National Institutes of Health, National Institute of
Diabetes and Digestive and Kidney Diseases. United
States Renal Data System annual data report 2014: An
overview of the epidemiology of kidney disease in the
United States. Bethesda, MD: NIH; 2014. Available from:
http://www.usrds.org/adr.aspx.
For More Information. See the USRDS website at:
http://www.usrds.org.
Youth Risk Behavior Survey (YRBS)
CDC/National Center for HIV, Hepatitis, STD, and TB
Prevention (NCHHSTP)
Overview. YRBS monitors health risk behaviors among
students in grades 9–12 that contribute to morbidity and
mortality in both adolescence and adulthood. The six areas
monitored are behaviors that contribute to unintentional
injuries and violence; tobacco use; alcohol and other drug
use; sexual behaviors that contribute to unintended
pregnancy and sexually transmitted diseases (STDs),
including human immunodeficiency virus (HIV) infection;
unhealthy dietary behaviors; and physical inactivity. In
addition, YRBS monitors the prevalence of obesity, asthma,
and sleep behaviors.
Coverage. National data are representative of high school
students in public and private schools in the United States.
Methodology. The national YRBS school-based surveys have
been conducted biennially since 1991. A three-stage cluster
sample design is used to produce a nationally representative
sample of students in grades 9–12 attending public and
private schools. In 2013, the first-stage sampling frame
comprised primary sampling units (PSUs), consisting of
counties, subareas of large counties, or groups of smaller,
adjacent counties. PSUs were categorized into strata
according to their metropolitan statistical area (MSA) status
(i.e., urban city) and the percentages of black and Hispanic
students in the PSUs. PSUs were sampled with probability
proportional to overall school enrollment size for the PSU. In
the second stage of sampling, schools with any of grades
9–12 were sampled with probability proportional to school
enrollment size. The third stage of sampling consisted of
random sampling in each of grades 9–12, one or two
classrooms from either a required subject (e.g., English or
social studies) or a required period (e.g., homeroom or
second period).
All students in sampled classes were eligible to participate.
Schools, classes, and students that refused to participate
were not replaced. To enable a separate analysis of data for
black and Hispanic students, two classes per grade, rather
than one, were sampled in schools with a high enrollment of
black and Hispanic students. Prior to 2013, three strategies
were used to oversample black and Hispanic students:
(a) larger sampling rates were used to select PSUs that were
in high-black and high-Hispanic strata; (b) a modified
measure of size was used to increase the probability of
sampling schools with a disproportionately high minority
enrollment; and (c) two classes per grade, rather than one,
were sampled in schools with a high enrollment of black and
Hispanic students. A weighting factor is applied to each
student record to adjust for nonresponse and for the varying
probabilities of selection, including those resulting from the
oversampling of black and Hispanic students.
Health, United States, 2014 Appendix I. Data Sources 389