ARF=Area Resource File
2009-2010 ARF Can Now Be Downloaded at No Cost.
The 2009-2010 ARF data files and documentation can now be downloaded. Click the link below to learn how to download ARF documentation and data.
“The basic county-specific Area Resource File (ARF) is the nucleus of the overall ARF System. It is a database containing more than 6,000 variables for each of the nation’s counties. ARF contains information on health facilities, health professions, measures of resource scarcity, health status, economic activity, health training programs, and socioeconomic and environmental characteristics. In addition, the basic file contains geographic codes and descriptors which enable it to be linked to many other files and to aggregate counties into various geographic groupings.”
“You may also choose to search the ARF to see what data variables are available in the current file.”
The table of contents below gives a sense of the county level information included.
I. DATA ELEMENT DESCRIPTIONS AND REFERENCES. 1
A. CODES AND CLASSIFICATIONS. 1
A-1) Header for ARF. 1
A-2) State and County Codes. 1
A-3) Census County Group Codes. 7
A-4) County Typology Codes. 7
A-5) Metropolitan/Micropolitan and Combined Statistical Areas. 10
A-6) Rural/Urban Continuum Codes. 11
A-7) Urban Influence Codes. 13
A-8) BEA Economic Area Codes and Names and Component Economic 14 Area Codes and Names.
A-9) Federal Region Code and Census Region and Division Codes and Names. 14
A-10) Veterans Administration Codes. 16
A-11) Contiguous Counties. 17
A-12) Health Service Area Codes. 18
A-13) Area Health Education Center (AHEC) Codes and Names. 18
A-14) HPSA Codes. 19
A-15) SSA Beneficiary State and County Codes. 21
B. HEALTH PROFESSIONS. 22
B-1) Physicians. 22
B-2) Dentists and Dental Hygienists. 31
B-3) Optometrists. 36
B-4) Pharmacists. 37
B-5) Podiatrists. 38
B-6) Veterinarians. 39
B-7) Nurses. 40
B-8) Physician Assistants. 43
B-9) Chiropractors. 45
B-10) Occupational Therapists. 46
B-11) Physical Therapists. 46
B-12) Psychology and Social Work Teachers. 47
B-13) Psychologists. 47
B-14) Sociologists. 48
B-15) Social Workers. 48
B-16) Audiologists 49
B-17) Speech Language Pathologists 49
B-18) Healthcare Practitioner Professionals. 50
B-19) Decennial Census Occupation Data. 50
C. HEALTH FACILITIES. 53
C-1) Hospital Type. 54
C-2) Hospital Services (or Facilities) 57
C-3) Hospital Employment 57
C-4) Nursing and Other Health Facilities. 58
C-5) Health Maintenance Organizations. 60
C-6) Preferred Provider Organizations (PPOs) 61
D. UTILIZATION.. 61
D-1) Utilization Rate. 62
D-2) Inpatient Days. 62
D-3) Outpatient Visits. 62
D-4) Surgical Operations and Operating Rooms. 62
E. EXPENDITURES. 63
E-1) Hospital Expenditures. 63
E-2) Medicare Advantage Adjusted Average Per Capita Cost (AAPCC) 63
F. POPULATION.. 68
F-1) Population Estimates. 68
F-2) Population Counts and Number of Families and Households. 72
F-3) Population Percents. 82
F-4) Labor Force. 84
F-5) Per Capita Incomes. 86
F-6) Income. 88
F-7) Persons and Families Below Poverty Level 90
F-8) Ratio of Income to Poverty Level 92
F-9) Median Family Income. 93
F-10) Household Income. 93
F-11) Medicaid Eligibles. 97
F-12) Medicare Enrollment Data. 99
F-13) Medicare Advantage/Managed Care Penetration. 100
F-14) Medicare Prescription Drug Plan (PDP) Penetration. 103
F-15) Health Insurance Estimates. 103
F-16) Food Stamp/SNAP Recipient Estimates. 104
F-17) Social Security Program.. 104
F-18) Supplemental Security Income Program Recipients. 105
F-19) 5‑Year Infant Mortality Rates. 107
F-20) Infant Mortality Data. 108
F-21) Mortality Data. 108
F-22) Total Deaths. 111
F-23) Natality Data. 111
F-24) Births in Hospitals. 113
F-25) Total Births. 113
F-26) Education. 114
F-27) Census Housing Data. 114
F-28) Veteran Population. 117
G. ENVIRONMENT.. 119
G-1) Land Area and Density. 119
G-2) Population Per Square Mile. 119
G-3) Elevation. 119
Window to the marketplace
FAIR Health now delivers the industry's primary source of out-of-network benchmarks with unprecedented transparency
"What was referred to as a "black box" in February 2008 today has become an open window to the healthcare marketplace. The industry's privately owned database of usual-and-customary (UC) charge information is now a transparent, public information source called FAIR Health."
"Currently, FAIR has approximately 80 different data sources nationwide, collectively contributing claims data for 125 million covered lives. Data is deidentified as to the payer source and the individual member's identity. By aggregating claims in this way, FAIR can meet HIPAA requirements and discourage the use of information for competitive advantages among participating payers.
Gelburd says the required fields that FAIR collects from the claims data supplied by contributors include CPT codes, standard charges, date and location of service. Additional fields include ICD-9 and ICD-10 codes, provider identifiers and negotiated, in-network charges. The optional fields are particularly useful from a research perspective."
I would welcome comments from anyone who has used this data.
This is an excellent short NEJM article summarizing why the federal government does have the authority to mandate that people buy health insurance. Written by a Harvard Law School professor.
Einer Elhauge, J.D.
N Engl J Med 2012; 366:e1January 5, 2012
"Others argue that the Constitution's framers could not possibly have envisioned a congressional power to force purchases. However, in 1790, the first Congress, which was packed with framers, required all ship owners to provide medical insurance for seamen; in 1798, Congress also required seamen to buy hospital insurance for themselves. In 1792, Congress enacted a law mandating that all able-bodied citizens obtain a firearm. This history negates any claim that forcing the purchase of insurance or other products is unprecedented or contrary to any possible intention of the framers."
How Doctors Die
It’s Not Like the Rest of Us, But It Should Be
by Ken Murray
Years ago, Charlie, a highly respected orthopedist and a mentor of mine, found a lump in his stomach. He had a surgeon explore the area, and the diagnosis was pancreatic cancer. This surgeon was one of the best in the country. He had even invented a new procedure for this exact cancer that could triple a patient’s five-year-survival odds—from 5 percent to 15 percent—albeit with a poor quality of life. Charlie was uninterested. He went home the next day, closed his practice, and never set foot in a hospital again. He focused on spending time with family and feeling as good as possible. Several months later, he died at home. He got no chemotherapy, radiation, or surgical treatment. Medicare didn’t spend much on him.
It’s not a frequent topic of discussion, but doctors die, too. And they don’t die like the rest of us. What’s unusual about them is not how much treatment they get compared to most Americans, but how little. For all the time they spend fending off the deaths of others, they tend to be fairly serene when faced with death themselves. They know exactly what is going to happen, they know the choices, and they generally have access to any sort of medical care they could want. But they go gently.
The book I am just finishing that is chock full of new ideas, (actually mostly old ideas, but ones that had not been systematically presented) is Daniel Kahneman's "Thinking, Fast and Slow." I see it has climbed to the top ten bestsellers among nonfiction. I am loving it. It will be a terrific read for you, or someone you know who is open to new ideas about how real people (but not academic economists) actually make choices.
Under $20 on Amazon.com
High Fees Seen as Main Cause of Higher Overall Spending on Physician Services in U.S.
A new study comparing fees for physician services in the United States with those in five other nations finds that U.S. physicians are paid more per service than doctors in other countriesas much as double in some cases. According to the Commonwealth Fund–supported study, which appears in the new issue of Health Affairs, U.S. primary care physicians were paid an average of 27 percent more by public payers for an office visit, and 70 percent more by private payers for an office visit, compared with the average amount paid across the other countries, which include Australia, Canada, France, Germany, and the United Kingdom. For hip replacements, the gap was even larger: U.S. physicians received 70 percent more from public payers, and 120 percent more from private payers, than the average fees paid to physicians in the other nations studied.