The American Hospital Association’s Annual Survey of Hospitals: a critical appraisal

Data from the American Hospital Association’s Annual Survey of Hospitals, which are used to produce the AHA Guide, Hospital Statistics, and other data products, are widely used by hospital administrators, academic researchers, and healthcare marketers. Although they are widely used, many who use data from the survey are unaware of their limitations and problems. Such problems include: inaccuracies and inconsistencies in reporting; low response rates to certain data items; biases in reporting; and a lack of publicly available technical documentation concerning the statistical methodology of the survey, particularly its estimation and imputation procedures for missing data. Failure to be sophisticated consumers of data products can misdirect the outcome of important planning and marketing efforts.