Public Health Data in Action: An Analysis of Using Louisiana Vital Statistics for Quality Improvement and Payment Reform
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METHODOLOGICAL NOTES
Public Health Data in Action: An Analysis of Using Louisiana Vital Statistics for Quality Improvement and Payment Reform Valery A. Danilack1,2,3 · Rebekah E. Gee4,5 · Danielle P. Berthelot6 · Rebecca Gurvich4 · Janet H. Muri1
© Springer Science+Business Media New York 2017
Abstract Introduction In 2012, the Louisiana (LA) Department of Health and Hospitals revised the LA birth certificate to include medical reasons for births before 39 completed weeks’ gestation. We compared the completeness and validity of these data with hospital discharge records. Methods For births occurring 4/1/2012–9/30/2012 at Woman’s Hospital of Baton Rouge, we linked maternal delivery and newborn birth data collected through the National Perinatal Information Center with LA birth certificates. Among early term births (37–38 completed weeks’ gestation), we quantified the reasons for early delivery listed on the birth certificate and compared them with ICD9-CM codes from Woman’s discharge data. Results Among 4353 birth certificates indicating delivery at Woman’s Hospital, we matched 99.8% to corresponding Woman’s administrative data. Among 1293 early term singleton births, the most common reasons for early delivery listed on the birth Electronic supplementary material The online version of this article (doi:10.1007/s10995-016-2254-z) contains supplementary material, which is available to authorized users. * Rebekah E. Gee [email protected] 1
National Perinatal Information Center, Inc., Providence, RI, USA
2
Division of Research, Women & Infants Hospital, Providence, RI, USA
3
Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA
4
Louisiana Department of Health and Hospitals, 2020 Gravier Street, New Orleans, LA 70112, USA
5
School of Public Health, Louisiana State University, New Orleans, LA, USA
6
Woman’s Hospital, Baton Rouge, LA, USA
certificate were spontaneous active labor (57.5%), gestational hypertensive disorders (15.3%), gestational diabetes (8.7%), and premature rupture of membranes (8.1%). Only 2.7% of births indicated “other reason” as the only reason for early delivery. Most reasons for early delivery had >80% correspondence with ICD-9-CM codes. Lower correspondence (35 and 72%, respectively) was observed for premature rupture of membranes and abnormal heart rate or fetal distress. Discussion There was near-perfect ability to match LA birth certificates with Woman’s Hospital records, and the agreement between reasons for early delivery on the birth certificate and ICD-9-CM codes was high. A benchmark of 2.7% can be used as an attainable frequency of “other reason” for early delivery reported by hospitals. Louisiana implemented an effective mechanism to identify and explain early deliveries using vital records. Keywords Elective delivery · Early term · Vital records · Birth certificate · Hospital discharge data
Significance Statement Primary data collection for research and quality improvement purposes is the gold standard but is costly and time consum
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