Addressing American Indian suicidal behavior data quality issues: Recommendations to improve the Indian Health Service Resource Patient Management System Suicide Reporting Form

background

The Indian Health Service (IHS) contracted with the Great Lakes Inter-Tribal Epidemiology Center (GLITEC) to conduct a secondary data analysis on the IHS Resource Patient Management System (RPMS) Suicide Reporting Form (SRF) aggregate database (N=12,928).  One of the goals of the national suicide project was to make recommendations to improve the SRF.  

methods

The SRF was developed to document patients’ suicidal behaviors who attended IHS, Tribal and Urban facilities that utilized the RPMS SRF.  Each facility created their own SRF data collection, entry, and exportation policies and procedures.  The SRF database included 41 standard suicide epidemiological variables.  GLITEC conducted descriptive statistics to analyze the 11,112 event-specific SRF records, which occurred between fiscal years 2003 and 2012. 

results

Although it is difficult to determine the exact causes, many data quality issues were identified including:  large variation in the number of SRFs completed at each IHS Area, and the large number of “unknown and missing” responses.  For all suicidal behaviors 23.4% of records had “unknown or missing” responses for contributing factors, while 94.2% had “unknown or missing” responses for disposition. 

conclusions

This project reiterated data quality issues others have found studying suicidal behaviors.  Therefore, some of GLITEC’s recommendations include those made by others in years past which had not been implemented.  Pertinent recommendations include examining each facility’s SRF policies and procedures, SRF training at each facility and creating universal SRF data collection, entry, and exportation policies and procedures to improve data quality.