Center for Studying Health System Change

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Design and Methods for the Community Tracking Study


Data Files


Design and Methods


Household Survey


Physician Survey


Site Visits


Followback Survey


Employer Survey


Status of HSC Data


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The Center for Studying Health System Change (HSC) documents changes in health care over time and tracks the effects of those changes on people. Through surveys and site visits, HSC seeks to describe and analyze how the interactions of providers, insurers, policy makers and others determine the accessibility, cost and quality of care. HSC's Community Tracking Study (CTS) and Health Tracking Surveys, a periodic set of longitudinal site visits and surveys, allow researchers to analyze information about local health care markets and the nation as a whole. Because health care delivery is primarily local, both the surveys and site visits are largely centered on U.S. communities—though later survey rounds are based on national samples only. During the first four rounds, the survey samples were concentrated in 60 communities randomly selected to provide a representative profile of change across the United States. Among 60 communities, 48 are large metropolitan areas with populations greater than 200,000, from which 12 communities were randomly selected to be studied in depth through larger sample sizes. Those 12 communities also comprise the communities used for the site visits. The community-based survey design was replaced by a national sample design for the 2007 and 2010 Household and 2008 Physician surveys, although site visits continue to be focused on the 12 communities. Because the latest samples are no longer clustered in communities, the surveys have been renamed the HSC Health Tracking Household and Physician surveys. The 2007 and 2010 Household and 2008 physician surveys support analyses at the national level only.

Finding Additional Information. Additional information about the design and methods of the HSC surveys can be found in HSC Technical Publications.



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The Center for Studying Health System Change Ceased operation on Dec. 31, 2013.