B'FRIEND Data Request Form
The Baltimore Fall Reduction Initiative Engaging Neighborhoods and Data (B'FRIEND) is a public-private partnership to prevent falls among older adults in Baltimore City. The goals of B’FRIEND are to decrease the rate of falls leading to an emergency department visit or hospital admission among older adults in Baltimore City, and to keep older adults independent and at home.

B'FRIEND is a partnership among the Baltimore City Health Department (BCHD), CRISP (Maryland’s regional health information exchange), non-profit organizations, academic institutions, and hospitals. BCHD and CRISP work together to conduct falls surveillance to identify neighborhoods in Baltimore that are at high risk for falls. Non-identifiable aggregate information is then shared with community partners to inform falls prevention efforts in Baltimore City.

This data request form can be used to request non-identifiable aggregate information about emergency department visits and/or hospitalizations related to falls among older adults in Baltimore City.  The data source is the Maryland Health Services Cost Review Commission (HSCRC) Inpatient and Outpatient Case Mix Data with CRISP EID since October 2015.  Please note the HSCRC requires suppression of counts between 1 and 10 in order to protect patient privacy.  

For specific questions regarding this form, email BFRIEND.Data@gmail.com or call 410-361-9580.  Thank you.
Sign in to Google to save your progress. Learn more
To request data on emergency department visits and/or hospitalizations related to falls among older adults (65+ years) in Baltimore City, please fill out and submit the below form.
First and last name *
Organization
Role at organization
Phone number
Email address *
What is the purpose of your data request?
How do you intend to use this information?
What is the time frame of interest for your data request? *
Presently, the earliest data are available starting October 2015.  For "Other", please specify the time frame by month and year (e.g., January 2017 - December 2017).
What is your geographic area of interest in Baltimore City? *
Required
What kind(s) of data are you seeking on emergency department (ED) visits and/or hospitalizations related to falls in older adults (65+ years) in Baltimore City? *
Required
Do you want your data selection categorized by demographics?  
Does your organization offer any programs or services that may affect falls among older adults in Baltimore City?  If so, please briefly describe.
Examples include exercise classes, education sessions, medication review, vision screenings, home repairs, clinical interventions, etc.
If you have comments or questions regarding your data request, please list them here.
Data limitations
There are limitations to data available through B'FRIEND:

1.   BCHD is only able to share non-identifiable aggregate information about emergency department (ED) visits and hospitalizations related to falls in older adults (65+ years) in Baltimore City;

2.  The data are ED visits and hospitalizations related to falls rather than actual falls.  People who fall may not access treatment or they may be treated in different settings (e.g., primary care);

3.   The data do not contain information on where or how a fall occurred (this is because the primary purpose of the data is billing);  

4.   A given patient may have more than one visit during the time frame.  When possible, BCHD will share data on the number of unique patients;

5.   Presently, data are only available since October 2015;

6.   Location is based on a given patient’s most recent residence;

7.   The Maryland Health Services Cost Review Commission is the custodian of these data, and it requires suppression of counts between 1 and 10 in order to protect patient privacy;  

8.   Preliminary data may change.
Please indicate your acknowledgement of the above data limitations.
Clear selection
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. - Terms of Service - Privacy Policy

Does this form look suspicious? Report