Public Health Data in Action: An Analysis of Using Louisiana Vital Statistics for Quality Improvement and Payment Reform.
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 ICD-9-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 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.
National Perinatal Information Center, Inc., Providence, RI, USA.|Division of Research, Women & Infants Hospital, Providence, RI, USA.|Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA.
Valery A
VA
Danilack
Louisiana Department of Health and Hospitals, 2020 Gravier Street, New Orleans, LA, 70112, USA. rgee@lsuhsc.edu.|School of Public Health, Louisiana State University, New Orleans, LA, USA. rgee@lsuhsc.edu.
Rebekah E
RE
Gee
Woman's Hospital, Baton Rouge, LA, USA.
Danielle P
DP
Berthelot
Louisiana Department of Health and Hospitals, 2020 Gravier Street, New Orleans, LA, 70112, USA.
Rebecca
R
Gurvich
National Perinatal Information Center, Inc., Providence, RI, USA.
Janet H
JH
Muri
D017281:Cost of Illness; D005260:Female; D018166:Health Care Reform / Q000191:economics / Q000379:methods*; D006753:Hospital Records / Q000706:statistics & numerical data; D006801:Humans; D038801:International Classification of Diseases / Q000706:statistics & numerical data; D008145:Louisiana / Q000453:epidemiology; D009321:Natural Childbirth / Q000191:economics / Q000706:statistics & numerical data; D011159:Population Surveillance / Q000379:methods; D011247:Pregnancy; D047928:Premature Birth / Q000453:epidemiology; D011634:Public Health / Q000191:economics* / Q000379:methods / Q000706:statistics & numerical data; D058996:Quality Improvement / Q000706:statistics & numerical data*; D013223:Statistics as Topic / Q000379:methods; D014798:Vital Statistics
Birth certificate; Early term; Elective delivery; Hospital discharge data; Vital records