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docs/api/covidcast-signals/nhsn.md

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[The National Healthcare Safety Network (NHSN)](https://www.cdc.gov/nhsn/index.html) is the nation’s most widely used healthcare-associated infection tracking system.
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This dataset represents preliminary weekly hospital respiratory data and metrics aggregated to national and state/territory levels reported to CDC’s National Health Safety Network (NHSN) beginning August 2020.
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Each signal below is derived from one of two following datasets:
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- Main: [Weekly Hospital Respiratory Data (HRD) Metrics by Jurisdiction, National Healthcare Safety Network (NHSN)](https://data.cdc.gov/Public-Health-Surveillance/Weekly-Hospital-Respiratory-Data-HRD-Metrics-by-Ju/ua7e-t2fy/about_data)
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- Preliminary: [Weekly Hospital Respiratory Data (HRD) Metrics by Jurisdiction, National Healthcare Safety Network (NHSN) (Preliminary)](https://data.cdc.gov/Public-Health-Surveillance/Weekly-Hospital-Respiratory-Data-HRD-Metrics-by-Ju/mpgq-jmmr/about_data). Signals derived from the preliminary dataset have suffix `_prelim` in their signal names.
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Both datasets started reporting data in late 2022. As of May 2024, NHSN received data from 78% of US EDs.
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State and nation-level values are pulled directly from the source; HHS-level values are aggregated up from the state level.
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| Signal | Description |
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|---------------------------------|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
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| `confirmed_admissions_covid_ew` | Total number of patients hospitalized with confirmed COVID-19 captured for the Wednesday of the reporting week **Earliest date available:** 2020-08-08 |
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{:toc}
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## Estimation
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Between the reference dates of 2024-05-01 and 2024-10-31, the total number of hospitalized patients on a subsection
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of hospitals and may not be fully represenetative. See the [missingness section](#missingness) section below for more context.
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All data is weekly such that each reported value represents a total from Sunday to Saturday of the reference week. The `output_signal_name` signal mirrors the `input signal name` field for all geographic resolutions except HHS.
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### Geographic weighting
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HHS values are computed from state-level data.
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State and nation-level values are pulled directly from the source; HHS-level values are aggregated up from the state level by summing the values of member states.
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## Missingness
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Data for reporting dates through April 30, 2024 represent data reported during a previous mandated reporting period as specified by the HHS Secretary.
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Data for reporting dates May 1, 2024 – October 31, 2024 represent voluntarily reported data in the absence of a mandate.
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Data for reporting dates beginning November 1, 2024 represent data reported during a current mandated reporting period.
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All data and metrics capturing information on respiratory syncytial virus (RSV) were voluntarily reported until November 1, 2024.
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Data for reference dates through April 30, 2024 were reported during a federally-mandated reporting period as specified by the Secretary of the Department of Health and Human Services.
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Data for reference dates May 1, 2024 – October 31, 2024 were voluntarily reported in the absence of a mandate.
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As a result, during this period the total number of hospitalized patients on a subsection of hospitals and may not be fully representative.
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Data for reference dates beginning November 1, 2024 were reported during the current mandated reporting period.
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## Lag and Backfill
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All data and metrics capturing information on respiratory syncytial virus (RSV) were voluntarily reported until November 1, 2024.
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The weekly signal is primarily reported on Friday, adding data from the prior week.
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For example, on Friday, 2024-04-19, the source added new data from the week ending 2024-04-13.
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## Limitations
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Between reference dates 2024-05-01 and 2024-10-31, the total number of hospitalized patients on a subsection
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of hospitals and may not be fully representative, since reporting was voluntary.
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See the [missingness section](#missingness) for more context.
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Standard errors and sample sizes are not applicable to these metrics.
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### Differences with HHS reports
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?
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## Lag and Backfill
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The signals are currently updated weekly, generally on Friday. Each report adds data for the week prior.
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For example, on Friday, 2024-04-19, the source added new data representing hospitalizations from the week ending 2024-04-13.
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This results in a reporting lag of 6 days from the end of the reference week.
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## Source and Licensing
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