1. 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

2. 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

3. 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 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 NY C Year of Revision to 2003 Birth Certificate by State

4. 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

5. 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)

6. Unknown Rates for New Items

7. Percent of Records With Not Stated Data For Infant Breastfed: Revised states, 2003-2006 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

8. Percent of Records with Not Stated Data for Infections: Revised states, 2003-2006 Percent State B State A State J State D State G State F State I Source: NCHS/CDC/National Vital Statistics System

9. Percent of Records with Not Stated Data for Mother’s Height Revised States, 2003-2006 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

10. Percent of Records with Not Stated Data For Receipt of WIC Food, Revised states, 2004-2006 Source: NCHS/CDC/National Vital Statistics System 04 05 06 State AState BState CState DState EState FState G

11. Percent of records with not stated data for “Source of Payment:” Revised states, 2004-2006 Source: NCHS/CDC/National Vital Statistics System 04 05 06 State AState BState CState DState EState FState G

12. Timeliness and New Items

13. Average Lag in Days Between Reporting Period and Receipt of Data at NCHS by Year Revised NOTE: *range of days (150-301)* (10-192)* (25-176)* (5-51)* (12-38)*

14. THE PENNSYLVANIA DATA VINEYARD

15. *targeted= 5 facilities with highest unknown rates

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

17. *targeted= 5 facilities with highest unknown rates

18. 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.

19. 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?

20. 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 17101 (717) 783-2548 mmatthew@state.pa.us Website: www.health.state.pa.us Joyce A. Martin, M.P.H. Lead Statistician Reproductive Statistics Branch Division of Vital Statistics National Center for Health Statistics (301) 458-4362 JAMartin@cdc.gov@cdc.gov