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Lessons learned in using hospital discharge data for state and national public health surveillance: implications for Centers for Disease Control and prevention tracking program.

The goal of the Centers for Disease Control and Prevention Environmental Public Health Tracking (EPHT) Program is to build a nationwide network of integrated health and environmental data to measure impact of environmental factors on public health. This article describes how hospital discharge data can provide essential information for public health programs, including EPHT. The state inpatient hospital discharge data systems have properties that are highly desirable for surveillance and multistate initiatives, like EPHT, yet accessing and using the data can create challenges for the end user. This article highlights the strengths and limitations of hospital discharge data and references crash outcome data and evaluation system and Healthcare Cost and Utilization Project as models for accessing, linking, and aggregating hospital discharge data. These federal-state data partnerships have overcome many of these challenges and have the potential to serve as models for the EPHT Program. The lessons learned from these "early adopters" can shortcut the implementation period for the Centers for Disease Control and Prevention EPHT Program.