Data Quality of New Birth Certificate Items: Like a Fine Wine, Does it Improve with Time? Marina O. Matthew, RHIA Pennsylvania Department of Health Bureau of Health Statistics and Research Joyce Martin, M.P.H. Division of Vital Statistics National Center for Health Statistics

Data Items Not Released Time of birth Facility – State hospital code (NPI) Mother married ever? Mother not married -- Acknowledgement signed? Father’s education Date of last live birth Date of last other outcome Date of last prenatal visit Plurality – Set order Number live born Matching certificate number Number of cigs smoked 3 months prior to pregnancy Source of payment Mother’s height WIC food during pregnancy? Infections present APGAR 10 minutes Maternal morbidity Infant transferred within 24 hrs Mother transferred Infant living at time of report Infant being breastfed Infertility 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 VA WV OH MI NY PA MD DE NJ CT RI MA ME VT NH AK HI DC or later Mid-year / rolling / partial reviser NOTE: New York State but not New York City implemented for New York City implemented in or NY C Year of Revision to 2003 Birth Certificate by State

Revision status Year # of states # of births 226, , m 2.9 m % U.S. births

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 US births (4.3 million in 2006) 30 revised states (2.9 million in 2006)

Unknown Rates for New Items

Percent of Records With Not Stated Data For Infant Breastfed: Revised states, Percent State A State B State C State D State E State F State G State H State I State J Source: NCHS/CDC/National Vital Statistics System

Percent of Records with Not Stated Data for Infections: Revised states, Percent State B State A State J State D State G State F State I Source: NCHS/CDC/National Vital Statistics System

Percent of Records with Not Stated Data for Mother’s Height Revised States, Percent State B State E State A State J State C State D State G State F State H State I Source: NCHS/CDC/National Vital Statistics System

Percent of Records with Not Stated Data For Receipt of WIC Food, Revised states, Source: NCHS/CDC/National Vital Statistics System State AState BState CState DState EState FState G

Percent of records with not stated data for “Source of Payment:” Revised states, Source: NCHS/CDC/National Vital Statistics System State AState BState CState DState EState FState G

Timeliness and New Items

Average Lag in Days Between Reporting Period and Receipt of Data at NCHS by Year Revised NOTE: *range of days ( )* (10-192)* (25-176)* (5-51)* (12-38)*

THE PENNSYLVANIA DATA VINEYARD

*targeted= 5 facilities with highest unknown rates

D PA A B C E PA W/O PA W/O is state rate without 5 targeted facilities

*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 compared with those that revised

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, RHIA Director, Division of Statistical Registries Bureau of Health Statistics and Research 555 Walnut Street, 6 th Floor Harrisburg, PA (717) Website: Joyce A. Martin, M.P.H. Lead Statistician Reproductive Statistics Branch Division of Vital Statistics National Center for Health Statistics (301)