Impact of a Hospital-Level Intervention to Reduce Heart Disease Overreporting on Leading Causes of Death

Al-Samarrai, Teeb; Madsen, Ann; Zimmerman, Regina; Maduro, Gil; Li, Wenhui; Greene, Carolyn M.

doi:10.5888/pcd10.120210

Cited by 17 publications

(15 citation statements)

References 22 publications

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“…However, the latter result may reflect differences in diagnostic and coding practices rather than real differences. An experimental intervention in eight NYC hospitals with very high death rates from “heart disease” in 2009–11 revealed that heart disease had been overrecorded on death certificates by a factor of approximately two before the intervention (Al-Samarrrai et al 2013). Many of the re-coded deaths were assigned to categories other than those included among circulatory diseases.…”

Section: Resultsmentioning

confidence: 99%

Anatomy of a Municipal Triumph: New York City's Upsurge in Life Expectancy

Preston

Elo

2014

Population & Development Rev

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Over the period 1990–2010, the increase in life expectancy for males in New York City was 6.0 years greater than for males in the United States. The female relative gain was 3.9 years. Male relative gains were larger because of extremely rapid reductions in mortality from HIV/AIDS and homicide, declines that reflect effective municipal policies and programs. Declines in drug- and alcohol-related deaths also played a significant role in New York City's advance, but every major cause of death contributed to its relative improvement. By 2010, New York City had a life expectancy that was 1.9 years greater than that of the US. This difference is attributable to the high representation of immigrants in New York's population. Immigrants to New York City, and to the United States, have life expectancies that are among the highest in the world. The fact that 38 percent of New York's population consists of immigrants, compared to only 14 percent in the United States, accounts for New York's exceptional standing in life expectancy in 2010. In fact, US-born New Yorkers have a life expectancy below that of the United States itself.

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Section: Resultsmentioning

confidence: 99%

Anatomy of a Municipal Triumph: New York City's Upsurge in Life Expectancy

Preston

Elo

2014

Population & Development Rev

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“…This intervention involved physician and hospital staff training and occurred in 8 hospitals located in Brooklyn, the Bronx, Queens, and Staten Island. 16 These hospitals accounted for only 10% of all deaths in NYC in 2008, but Al-Samarrai et al (2013) find that the intervention caused a substantial decrease in deaths attributed to heart disease. A similar intervention was performed in 12 additional hospitals across all 5 NYC counties in 2011 and 2012, yielding similar results (Madsen and Begier, 2013).…”

Section: A Empirical Modelmentioning

confidence: 99%

“…These are Kings, Bronx, Queens, and Richmond Counties, respectively. No hospital located in Manhattan or New York County was affected by the intervention conducted in 2009(Al-Samarrai et al, 2013).…”

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confidence: 99%

Trans fat and cardiovascular disease mortality: Evidence from bans in restaurants in New York

Restrepo

Rieger

2016

Journal of Health Economics

116

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This paper analyzes the impact of trans fat bans on cardiovascular disease (CVD) mortality rates. Several New York State jurisdictions have restricted the use of ingredients containing artificial trans fat in food service establishments. The resulting within-county variation over time and the differential timing of the policy's rollout is used in estimation. The results indicate that the policy caused a 4.5% reduction in CVD mortality rates, or 13 fewer CVD deaths per 100,000 persons per year. The averted deaths can be valued at about $3.9 million per 100,000 persons annually.

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“…Course materials also emphasized legal requirements for reporting and the importance of valid documentation. Heart disease deaths at these hospitals fell from 68.8% in 2008 to 32.4% in 2010; an increase in other causes was generally proportional to their burden in the population ( 16 , 18 ). Clinicians reported at DOHMH trainings that the New York City medical examiner’s policy of not allowing sepsis to stand alone as an underlying cause of death ( 14 ) had been misinterpreted by hospital staff to mean that the terms “sepsis” or “septicemia” were not accepted for use anywhere on the death certificate.…”

Section: Introductionmentioning

confidence: 99%

Effect of Cause-of-Death Training on Agreement Between Hospital Discharge Diagnoses and Cause of Death Reported, Inpatient Hospital Deaths, New York City, 2008–2010

Ong¹,

Gambatese²,

Zimmerman³

et al. 2015

Prev. Chronic Dis.

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IntroductionAccurate cause-of-death reporting is required for mortality data to validly inform public health programming and evaluation. Research demonstrates overreporting of heart disease on New York City death certificates. We describe changes in reported causes of death following a New York City health department training conducted in 2009 to improve accuracy of cause-of-death reporting at 8 hospitals. The objective of our study was to assess the degree to which death certificates citing heart disease as cause of death agreed with hospital discharge data and the degree to which training improved accuracy of reporting.MethodsWe analyzed 74,373 death certificates for 2008 through 2010 that were linked with hospital discharge records for New York City inpatient deaths and calculated the proportion of discordant deaths, that is, death certificates reporting an underlying cause of heart disease with no corresponding discharge record diagnosis. We also summarized top principal diagnoses among discordant reports and calculated the proportion of inpatient deaths reporting sepsis, a condition underreported in New York City, to assess whether documentation practices changed in response to clarifications made during the intervention.ResultsCitywide discordance between death certificates and discharge data decreased from 14.9% in 2008 to 9.6% in 2010 (P < .001), driven by a decrease in discordance at intervention hospitals (20.2% in 2008 to 8.9% in 2010; P < .001). At intervention hospitals, reporting of sepsis increased from 3.7% of inpatient deaths in 2008 to 20.6% in 2010 (P < .001).ConclusionOverreporting of heart disease as cause of death declined at intervention hospitals, driving a citywide decline, and sepsis reporting practices changed in accordance with health department training. Researchers should consider the effect of overreporting and data-quality changes when analyzing New York City heart disease mortality trends. Other vital records jurisdictions should employ similar interventions to improve cause-of-death reporting and use linked discharge data to monitor data quality.

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Impact of a Hospital-Level Intervention to Reduce Heart Disease Overreporting on Leading Causes of Death

Cited by 17 publications

References 22 publications

Anatomy of a Municipal Triumph: New York City's Upsurge in Life Expectancy

Anatomy of a Municipal Triumph: New York City's Upsurge in Life Expectancy

Trans fat and cardiovascular disease mortality: Evidence from bans in restaurants in New York

Effect of Cause-of-Death Training on Agreement Between Hospital Discharge Diagnoses and Cause of Death Reported, Inpatient Hospital Deaths, New York City, 2008–2010

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