Form 0920-0853 STATE [Year] Hospital Discharge Data

---

Overview

STATE HD DATA
TECHNICAL NOTES

---

Sheet 1: STATE HD DATA

STATE	[Year] Hospital Discharge Data
	SM Weight		N of Hosp. Visits*	[Year] Pop.	Crude Rate
Total			0		#DIV/0!
Age groups
.Under 5 years					#DIV/0!
.5 to 9 years					#DIV/0!
.10 to 14 years					#DIV/0!
.15 to 17 years					#DIV/0!
.18 to 19 years					#DIV/0!
.20 to 24 years					#DIV/0!
.25 to 29 years					#DIV/0!
.30 to 34 years					#DIV/0!
.35 to 39 years					#DIV/0!
.40 to 44 years					#DIV/0!
.45 to 49 years					#DIV/0!
.50 to 54 years					#DIV/0!
.55 to 59 years					#DIV/0!
.60 to 64 years					#DIV/0!
.65 to 69 years					#DIV/0!
.70 to 74 years					#DIV/0!
.75 to 79 years					#DIV/0!
.80 to 84 years					#DIV/0!
.85 years or more					#DIV/0!
*First listed Dx of asthma only (ICD-10-CM code J45)					#DIV/0!
*Only provide hospitalizations that occurred among in-state residents				Age-adjusted Rate per 100,000
***CLICK HERE TO COMPLETE EXCEL SHEET LABELED 'TECHNICAL NOTES'***

---

Sheet 2: TECHNICAL NOTES

Hospitalization Data Technical Notes
1. Indicate coding scheme used for [Year] data:
	All data was coded only using ICD-10-CM
	Other; specify:
2. Types of hospitals not contained in this data (check all that apply):
	Veteran’s Administration Hospitals
	Military hospitals
	Psychiatric/mental health hospitals
	Prison hospitals
	Indian Health Service Hospital
	Other; specify:
3. Does the data include hospitalizations that occurred for in-state residents that occurred in out-of-state hospitals?
	Yes
	No
4. Location of data for an emergency department visit resulting in a hospital admission (select one only):
	Emergency department data file only
	Hospital discharge data file only
	Both the emergency department data file and the hospital discharge data file
	Unknown
	Other; specify:
	None of the above
Additional technical notes:
***CLICK HERE TO RETURN TO EXCEL SHEET LABELED 'CA HD DATA'***