Are MCH Directors missing a valuable data resource?

Background: Every patient discharged from a hospital has a discharge abstract record containing demographic, clinical and financial data. Most states require all hospitals to submit this data to the DPH, state Hospital Association or vendor for processing and then submission to state data departments. Forty-fourstates contribute their data sets to AHRQ National Inpatient Sample (NIS) for analysis of national estimates of health care utilization, access, charges, quality, and outcomes. Our thirty year experience analyzing these data sets has shown that many DPH/MCH directors are not familiar with this data set and are missing an extremely powerful/statewide/cost- efficient way to analyze perinatal access, regionalization and outcomes.

Method: The National Perinatal Information Center members contribute their discharge abstract data quarterly to the Perinatal Center Data Base. The presenters will share two examples of how this data set can be used to analyze the incidence and impact of two critical MCH issues- neonatal abstinence syndrome (NAS) and severe maternal morbidity (SMM).  

Results: A) An analysis conducted on 336,492 newborn discharges showed that inborns with NAS have a five times longer ALOS, six times higher average charge and 30.3% were low or very low birth weight. B) SSM, as defined in the 2012 ACOG article, showed a continuing increase when run on the latest 2013-2014 data set.

Conclusion:

Each statewide discharge data set, despite limitations, is flexible, robust and economical to analyze. It has applications that can greatly inform the work of the MCH community.   

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Learning Areas:

Program planning
Public health administration or related administration
Public health or related organizational policy, standards, or other guidelines
Public health or related public policy
Systems thinking models (conceptual and theoretical models), applications related to public health

Learning Objectives:
Identify the components of the discharge abstract data set especially those that lend themselves to the analysis of MCH issues Demonstrate how the data set can be used to analyze two current MCH issues: neonatal abstinent syndrome and severe maternal morbidity Identify other statewide applications of this data set that can support MCH initiatives such as the analysis of perinatal regionalization and matching of maternal and neonatal risk profile to the appropriate level of care

Keyword(s): Birth Outcomes, Perinatal Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am President of the National Perinatal Information Center, Inc. and worked with administrative data sets for close to 30 years. We process, analyze and report on close to 750,000 perinatal events annually. I have been the PI or key person on many public, private, state and federal contracts/subcontracts using these data sets to analyze volume, utilization, quality and outcome trends by hospital, across systems or statewide.
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.

Back to: 4244.0: Current Issues in Data & Epidemiology