USING SPSS
    
  There are two ways to read the 2022 NHAMCS Emergency Department (ED) public use data file using SPSS:

  Option 1 - Use the zipped file ed2022-spss.zip in the SPSS folder on 
  the FTP server to open a complete pre-made SPSS dataset of the 2022 NHAMCS ED public use file.

  The steps for this option are as follows:

  1) Create a new folder on your local workstation, for example, C:\MYFILES\ED2022

  2) Download to the new folder the file ed2022-spss.zip from the FTP server: 
     https://ftp.cdc.gov/pub/Health_Statistics/NCHS/dataset_documentation/nhamcs/spss

  3) ed2022-spss.zip is a compressed file which you must unzip prior to use. 
     In order to do this, double click on the file name in your directory screen; 
     an option to unzip the file should appear. A new folder, ed2022-spss, will probably 
     be created, depending on the software your system uses. The unzipped file ed2022-spss.sav 
     will be within that folder. This is the SPSS dataset. You can then move the file to 
     your preferred location.

     Alternately, you can right-click on the name of the compressed file from your directory screen. 
     On the pop-up menu, there should be an option to extract the file to a location of your choosing.

  4) To use the SPSS dataset, simply open SPSS on your computer and click on "Open Other Files" at the
     initial screen prompt.  Point to the location you have saved your .sav file and it should
     populate the Data Editor screen.  From there, you can select the steps for your analysis.

   Option 2 - The SPSS syntax file ed2022.sps will read in the NHAMCS ED public use 
   data file, create an SPSS dataset and assign variable and value labels. All that the
   user needs to do is to change the path name at the beginning of the program to point to
   the location of the dataset that has already been downloaded, and at the end of the program, to assign 
   a location for the resulting SPSS dataset.  This is described in the comments at the 
   beginning of the program.

   The following provides an example of how to begin:  
    
    1) Create a new folder on your local workstation, for example, C:\MYFILES\ED2022

    2) Download to the new folder the 2022 NHAMCS ED ASCII dataset (ed2022.zip) from the FTP server: 
       https://ftp.cdc.gov/pub/Health_Statistics/NCHS/datasets/nhamcs
 
    3) ed2022.zip is a compressed file which must be unzipped prior to use.
       In order to do this, double click on the file name in your directory screen; 
       an option to unzip the file should appear. A new folder, ed2022, will probably 
       be created, depending on the software your system uses. The unzipped file ed2022 
       with no extension will be within that folder. This is the NHAMCS ED ASCII dataset. 
       You can then move the file to your preferred location. 

    4) Download to the new folder the ed2022.sps file from the FTP server:
       https://ftp.cdc.gov/pub/Health_Statistics/NCHS/dataset_documentation/nhamcs/spss

    5) From your directory, click on the ed2022.sps file; it should open automatically in the
       SPSS syntax editor.  If not, you can start SPSS and either point to the file on your workstation
       or copy and paste the entire ed2022.sps file into the syntax editor window.  Follow the directions
       in the comments at the top of the program to point your program to the location of your dataset.
       Run the file in SPSS; your SPSS dataset should be created and ready for analysis.

       SPSS documentation files are being provided as a convenience to data users 
       and may be considered as "beta" versions for the time being. Although we conduct 
       our own testing, we are not primarily SPSS users, and are grateful for the assistance 
       of SPSS users who might wish to offer feedback.  

       NOTE: When creating the SPSS file, you may see a warning in your SPSS log that a numeric field contains 
       no digits, and the result has been set to the system-missing value. This can be disregarded.  The reason
       for the warning is that the dataset contains a facility-level weight called EDWT on the first record for
       each ED only, in addition to the visit-level weight called PATWT that is on every record. The facility-level 
       weight only occurs on the first record for the ED so that data users can obtain an unduplicated weighted estimate 
       at the facility level. The remaining records for that ED have a blank field for the EDWT variable, which SPSS sets 
       to the system-missing value. Those missing values appear to be what is causing the warning message, but they should
       not affect your results.  

       A similar message may appear when data users use the EDWT to weight cases.  This warning states that, on at least one case, 
       the value of the weight variable was zero, negative, or missing. This is correct, for the reason stated above. Results
       should not be affected and the message may be disregarded.

       CAUTION - Because NHAMCS is a sample survey, the application of 
       weights to the sample data is REQUIRED to produce national estimates
       of office visits, as well as to accurately assess the sampling error of
       statistics based on the survey data.  Please refer to the appropriate
       sections of the documentation file for information on how to apply the 
       weights and to obtain relative standard errors of national estimates.
                                                                                                
       For questions, suggestions, or comments concerning NHAMCS data, please
       contact the Data Analytics and Production Branch (formerly the Ambulatory Care
       Statistics Branch) at (301) 458-4600 or by email at ambcare@cdc.gov. 

       For additional information on NCHS data products, please call CDC-INFO at 
       800-CDC-INFO (800-232-4636), TTY (888-232-6348), Monday-Friday 8am-8pm EST, 
       or use the CDC-INFO online request form at https://www.cdc.gov/info.