Post on 02-Jan-2016
Data Quality of New Birth Certificate Items: Like a Fine Wine, Does it
Improve with Time?
Marina O. Matthew, RHIAPennsylvania Department of HealthBureau of Health Statistics and Research
Joyce Martin, M.P.H.Division of Vital StatisticsNational Center for Health Statistics
Data Items Not Released
Time of birthFacility – State hospital code (NPI)Mother married ever?Mother not married -- Acknowledgement signed?Father’s educationDate of last live birthDate of last other outcomeDate of last prenatal visitPlurality – Set order Number live born Matching certificate numberNumber of cigs smoked 3 months prior to pregnancy
Source of paymentMother’s heightWIC food during pregnancy?Infections presentAPGAR 10 minutesMaternal morbidityInfant transferred within 24 hrsMother transferredInfant living at time of reportInfant being breastfedInfertility treatment
MT
WY
ID
WA
OR
NV
UT
CA
AZ
ND
SD
NE
CO
NM
TX
OK
KS
AR
LA
MO
IA
MN
WI
IL IN
KY
TN
MS AL GA
FL
SC
NC
VAWV
OH
MI
NY
PA
MD
DE
NJ
CT RI
MA
ME
VTNH
AK
HI
DC
2005
2006
2009 or later
Mid-year / rolling / partial reviser
NOTE: New York State but not New York City implemented for 2004. New York City implemented in 2008.
2003 or 2004
2007
2008
NYC
Year of Revision to 2003 Birth Certificate by State
Revision status
Year 2003 2004 2005 2006
# of states 2 7 12 19
# of births 226,448 571,858 1.3 m 2.9 m
% U.S. births 6 14 31 49
Non-Hispanic white Non-Hispanic black
Hispanic API/AIAN
Distribution of births by race/Hispanic origin
NOTE: Distributions based on 2006 preliminary birth data. Revised states have implemented the 2003 revision of the U.S. Standard Certificate of Live birth as of 2008.
US births (4.3 million in 2006)30 revised states (2.9 million in 2006)
Percent of Records With Not Stated Data For Infant Breastfed:Revised states, 2003-2006
0
2
4
6
8
10
12
14
16
2003 2004 2005 2006
Per
cen
t
State A
State BState C
State DState E
State F
State GState H
State IState J
Source: NCHS/CDC/National Vital Statistics System
Percent of Records with Not Stated Data for Infections: Revised states, 2003-2006
0
2
4
6
8
2003 2004 2005 2006
Per
cen
t
State B
State A
State J
State D
State GState F
State I
Source: NCHS/CDC/National Vital Statistics System
Percent of Records with Not Stated Data for Mother’s Height Revised States, 2003-2006
0
2
4
6
8
10
12
14
16
2003 2004 2005 2006
Per
cen
t
State B
State E
State A
State J
State CState D
State GState F
State HState I
Source: NCHS/CDC/National Vital Statistics System
Percent of Records with Not Stated Data For Receipt of WIC Food, Revised states, 2004-2006
0
2
4
6
8
10
12
14
16
18
Perc
en
t
Source: NCHS/CDC/National Vital Statistics System
04 05 06
04 05 06 04 05 06 04 05 06 04 05 06 04 05 06 04 05 06
State A State B State C State D State E State F State G
Percent of records with not stated data for “Source of Payment:” Revised states, 2004-2006
0
2
4
6
8
10
12
14
16
18
Perc
en
t
Source: NCHS/CDC/National Vital Statistics System
04 05 06
04 05 06 04 05 06 04 05 06 04 05 06 04 05 06 04 05 06
State A State B State C State D State E State F State G
Average Lag in Days Between Reporting Period and Receipt of Data at NCHS by Year Revised
020406080
100120140160180200220240
2003 2004 2005 2006 2007
# o
f d
ays
NOTE: *range of days
(150-301)*
(10-192)* (25-176)*
(5-51)* (12-38)*
Reporting of Unknown Payment SourcePennsylvania Occurrences by Year
0.00%
10.00%
20.00%
30.00%
40.00%
50.00%
60.00%
70.00%
80.00%
90.00%
100.00%
2003 2004 2005 2006 2007
Year of Birth
Perc
en
t U
nkn
ow
n
Remainderof Facilities
TargetedFacilities*targeted= 5 facilities with highest unknown rates
Reporting of Unknown Payment Source by Targeted Hospitals
Pennsylvania Occurrences by Year
0%
20%
40%
60%
80%
100%
2003 2004 2005 2006 2007
Year of Birth
Per
cen
t U
nkn
ow
n D
PA
A
BCE
PA W/O
PA W/O is state rate without 5 targeted facilities
Reporting of Unknown Payment SourcePennsylvania Occurrences
by Year
-
2,000
4,000
6,000
8,000
10,000
12,000
14,000
16,000
18,000
20,000
2003 2004 2005 2006 2007
Year of Birth
Nu
mb
er
of O
ccu
ren
ces
Remainderof Facilities
TargetedFacilities
*targeted= 5 facilities with highest unknown rates
Wine or Vinegar?
Overall levels of unknowns for most areas are acceptable, but
– They can vary widely by state AND, more importantly…– Unknowns generally decline for all areas following the first
year of implementation
Timeliness also tends to improve quite dramatically following the first year of revision
– Timeliness was much improved for states which revised in 2006-2007 compared with those that revised 2003-2005.
Improving the Vintage
Look at individual facilities to see if there are any major outliers and work with those facilities to improve the unknown rates.
Does it appear all facilities are having high unknowns in certain items? If so,
– Can the birth clerk/registrar find the information in the records?
– Is there a problem with the wording of the item?
– Do you need to do more education on the item?
Do facilities and parents understand the importance of the data?
– Is there a problem with the software if using an electronic birth certificate system?
For More Information:
Marina O. Matthew, RHIADirector, Division of Statistical
RegistriesBureau of Health Statistics and
Research555 Walnut Street, 6th FloorHarrisburg, PA 17101(717) 783-2548mmatthew@state.pa.us
Website: www.health.state.pa.us
Joyce A. Martin, M.P.H.Lead StatisticianReproductive Statistics BranchDivision of Vital StatisticsNational Center for Health
Statistics(301) 458-4362JAMartin@cdc.gov