Comparison of birth certificate and hospital discharge data to identify early elective deliveries
Methods: We compared the 2012 birth certificate and 2012 hospital discharge files on the number of singleton live births with any reported JC indications and used the observed hospital discharge indication rates to quantify potential overestimation when using birth certificates for EED studies.
Results: From the 2012 birth certificates, there were 36,402 singleton early term live births, and 3,682 (10.1%) had at least one of 43 JC indications available on the birth certificate. The hospital discharge data captured all JC indications, but did not have gestational age available. Of the 128,885 discharges of singleton live births at ≤40 weeks gestation, 27,047 (21.0%) had at least one of the indications available on the birth certificate. Of the remaining 101,838 births, an additional 23,972 (23.5%) had indications not available on the birth certificate. If the hospital discharge indication rates were applied to birth certificate data, 14,402 (29.4%) early term births would have had indications; therefore approximately 29% of early term births may be misclassified as having no indications for early delivery.
Conclusions: The birth certificate overestimates the EED rate because of underreporting of medical conditions and missing indications. Improvements in data systems, including linkage of discharge and birth certificates, could provide more accurate data for EED quality improvement initiatives.
Describe limitations to existing data systems in identifying early elective deliveries Identify opportunities for improvements in state MCH data systems Compare birth certificate and hospital discharge data elements
Keyword(s): MCH Epidemiology, Perinatal Health
Qualified on the content I am responsible for because: I am trained in maternal and child health epidemiology and currently serve as an epidemiologist with the Division of Patient Safety and Quality at the Illinois Department of Public Health.
Any relevant financial relationships? No
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.