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)

Unknown Rates for New Items

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

Timeliness and New Items

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)*

THE PENNSYLVANIA DATA VINEYARD

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