The Prevalence Of Alcohol & Other Drug Abuse & Dependence In Short-term General Hospitals & The Impact Of Abuse & Dependence On Hospital Utilization, Charges & Costs-pilot

THE PREVALENCE OF ALCOHOL & OTHER DRUG ABUSE & DEPENDENCE IN SHORT-TERM GENERAL HOSPITALS & THE IMPACT OF ABUSE & DEPENDENCE ON HOSPITAL UTILIZATION, CHARGES & COSTS-PILOT

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Documents and Forms

Document Name Document Type

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Information Collection (IC) Details

IC Title:	THE PREVALENCE OF ALCOHOL & OTHER DRUG ABUSE & DEPENDENCE IN SHORT-TERM GENERAL HOSPITALS & THE IMPACT OF ABUSE & DEPENDENCE ON HOSPITAL UTILIZATION, CHARGES & COSTS-PILOT	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Migrated

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability

Line of Business:

Subfunction:

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 3,696	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	3,696	3,696
Annual IC Time Burden (Hours)	575	575
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.