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DiGiuseppe, David L.; Aron, David C.; Ranbom, Lorin; Harper, Dwain L.; Rosenthal, Gary E.

doi:10.1023/a:1019726112597

Cited by 255 publications

(50 citation statements)

References 17 publications

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“…39 Previous studies of birth certificate data used for hospital quality assessment studies showed that they perform as well as medical records information. 40 …”

Section: Discussionmentioning

confidence: 99%

Association Between Hospital-Level Obstetric Quality Indicators and Maternal and Neonatal Morbidity

Howell

Zeitlin

Hebert

et al. 2014

JAMA

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Importance In an effort to improve the quality of care, several obstetric-specific quality measures are now monitored and publically reported. The extent to which these measures are associated with maternal and neonatal morbidity is not known. Objective To examine whether 2 Joint Commission obstetric quality indicators are associated with maternal and neonatal morbidity. Design, Setting, and Participants Population-based observational study using linked 2010 New York City discharge and birth certificate datasets. All delivery hospitalizations were identified and two perinatal quality measures were calculated. Published algorithms were used to identify severe maternal morbidity (delivery associated with a life threatening complication or performance of a life-saving procedure) and morbidity in non-anomalous term newborns (births associated with complications such as birth trauma, hypoxia, and prolonged length of stay). Mixed-effects logistic regression models were used to examine the association between maternal morbidity, neonatal morbidity, and hospital-level quality measures while risk-adjusting for patient sociodemographic and clinical characteristics. Exposure Two Joint Commission perinatal quality measures: 1) elective (non-medically indicated) deliveries at >= 37 and < 39 weeks of gestation and 2) cesarean delivery performed in low-risk mothers. Main Outcomes and Measures Individual and hospital level maternal and neonatal morbidity. Results Severe maternal morbidity occurred among 2.4% of 115,742 deliveries and neonatal morbidity occurred among 7.8% of 103,416 non-anomalous term newborns. Rates for elective deliveries performed before 39 weeks of gestation ranged from: 15.5 to 41.9 per 100 deliveries among 41 hospitals. There were 11.7 to 39.3 cesareans per 100 deliveries performed in low-risk mothers. Overall maternal morbidity ranged from 0.9 to 5.7 mothers with complications per 100 deliveries and 3.1 to 21.3 neonates with complications per 100 deliveries. The maternal quality indicators elective delivery before 39 weeks of gestation and cesarean delivery performed in low-risk mothers were not associated with severe maternal complications (RR, 1.00; 95% CI: 0.98–1.02 and RR, 0.99, 95% CI: 0.96–1.01, respectively) or neonatal morbidity (RR, 0.99; 95% CI: 0.97–1.01 and RR, 1.01, 95% CI: 0.99–1.03, respectively). Conclusions and Relevance Rates for the quality indicators elective delivery before 39 weeks of gestation and cesarean delivery performed in low risk mothers varied widely in New York City hospitals as did maternal and neonatal complications rates. However, there were no correlations between the quality indicator rates and maternal and neonatal morbidity. Current quality indicators may not be sufficiently comprehensive for guiding quality improvement in obstetric care.

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“…39 Previous studies of birth certificate data used for hospital quality assessment studies showed that they perform as well as medical records information. 40 …”

Section: Discussionmentioning

confidence: 99%

Association Between Hospital-Level Obstetric Quality Indicators and Maternal and Neonatal Morbidity

Howell

Zeitlin

Hebert

et al. 2014

JAMA

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“…Nonetheless, the positive predictive value and specificity have generally been in the range of 70 % or greater for preeclampsia [3, 22, 23], but there are studies that suggest values as low as 54 % [21]. These tend to be much better than for birth certificate data alone, with positive predictive values as low as 54 % reported and sensitivity of only 33 % compared to medical record review [2]. However, there are no data to assess whether the quality of information differs across subgroups of women, so that the contribution of error to the observed patterns cannot be addressed.…”

Section: Discussionmentioning

confidence: 99%

“…Birth records provide comprehensive data on the population, but with limited specificity of diagnosis and substantial misclassification as compared to medical record review [2, 3]. Hospital discharge diagnoses are superior to birth certificates for this purpose [3].…”

Section: Introductionmentioning

confidence: 99%

Descriptive Epidemiology of Chronic Hypertension, Gestational Hypertension, and Preeclampsia in New York State, 1995–2004

Savitz

Danilack

Engel

et al. 2013

Matern Child Health J

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We examined social, demographic, and behavioral predictors of specific forms of hypertensive disorders in pregnancy in New York State. Administrative data on 2.3 million births over the period 1995–2004 were available for New York State, USA, with linkage to birth certificate data for New York City (964,071 births). ICD-9 hospital discharge diagnosis codes were used to assign hypertensive disorders hierarchically as chronic hypertension, chronic hypertension with superimposed preeclampsia, preeclampsia (eclampsia/severe or mild), or gestational hypertension. Sociodemographic and behavioral predictors of these outcomes were examined separately for upstate New York and New York City by calculating adjusted odds ratios. The most commonly diagnosed conditions were preeclampsia (2.57 % of upstate New York births, 3.68 % of New York City births) and gestational hypertension (2.46 % of upstate births, 1.42 % of New York City births). Chronic hypertension was much rarer. Relative to non-Hispanic Whites, Hispanics in New York City and Black women in all regions had markedly increased risks for all hypertensive disorders, whereas Asian women were at consistently decreased risk. Pregnancy-associated conditions decreased markedly with parity and modestly among smokers. A strong positive association was found between pre-pregnancy weight and risk of hypertensive disorders, with slightly weaker associations among Blacks and stronger associations among Asians. While patterns of chronic and pregnancy-induced hypertensive disorders differed, the predictors of gestational hypertension and both mild and severe preeclampsia were similar to one another. The increased risk for Black and some Hispanic women warrants clinical consideration, and the markedly increased risk with greater pre-pregnancy weight suggests an opportunity for primary prevention among all ethnic groups.

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“…Birth certificate and hospital data quality could not be verified. Birth certificate data on maternal race/ethnicity, birth weight, and gestational age have been shown to have good reliability (DiGiuseppe, Aron, Ranbom, Harper, & Rosenthal, 2002; Zollinger, Przybylski, & Gamache, 2006). Mother’s health insurance at delivery was measured using both birth certificate and hospital data to identify those with private insurance only.…”

Section: Discussionmentioning

confidence: 99%

Racial/ethnic differences in hospital use and cost among a statewide population of children with Down syndrome

Derrington¹,

Kotelchuck²,

Plummer³

et al. 2013

Research in Developmental Disabilities

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Children with Down syndrome (DS) use hospital services more often than children without DS, but data on racial/ethnic variations are limited. This study generated population-based estimates of hospital use and cost to 3 years of age by race/ethnicity among children with DS in Massachusetts using birth certificates linked to birth defects registry and hospital discharge data from 1999 to 2004. Hospital use (≥1 post-birth hospitalization and median days hospitalized birth and post-birth) and reasons for hospitalization were compared across maternal race/ethnicity using relative risk (RR) and Wilcoxon rank sums tests, as appropriate. Costs were calculated in 2011 United States dollars. Greater hospital use was observed among children with DS with Hispanic vs. Non-Hispanic White (NHW) mothers (post-birth hospitalization: RR 1.4; median days hospitalized: 20.0 vs. 11.0, respectively). Children with DS and congenital heart defects of Non-Hispanic Black (NHB) mothers had significantly greater median days hospitalized than their NHW counterparts (24.0 vs. 16.0, respectively). Respiratory diagnoses were listed more often among children with Hispanic vs. NHW mothers (50.0% vs. 29.1%, respectively), and NHBs had more cardiac diagnoses (34.1% vs. 21.5%, respectively). The mean total hospital cost was nine times higher among children with DS ($40,075) than among children without DS ($4053), and total costs attributable to DS were almost $18 million. Median costs were $22,781 for Hispanics, $18,495 for NHBs, and $13,947 for NHWs. Public health interventions should address the higher rates of hospital use and hospitalizations for respiratory and cardiac diseases among racial/ethnic minority children with DS in Massachusetts.

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Abstract: Our findings indicate that the reliability of birth certificate data vary for specific elements. Researchers and health policymakers need to be cognizant of the potential limitations of specific data elements.

Cited by 255 publications

References 17 publications

Association Between Hospital-Level Obstetric Quality Indicators and Maternal and Neonatal Morbidity

Association Between Hospital-Level Obstetric Quality Indicators and Maternal and Neonatal Morbidity

Descriptive Epidemiology of Chronic Hypertension, Gestational Hypertension, and Preeclampsia in New York State, 1995–2004

Racial/ethnic differences in hospital use and cost among a statewide population of children with Down syndrome

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