patricia w. potrzebowski, ph.d. executive director national association for public health statistics...
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Patricia W. Potrzebowski, Ph.D.Executive DirectorNational Association for Public Health Statistics and Information Systems
January 25, 2012
Vital Statistics 1011Types of Vital Events Live BirthsDeathsFetal DeathsInduced Terminations of PregnancyMarriagesDivorces/Annulments Responsibility for Registering Vital Events State (not federal) jurisdiction 50 states + DC + NYC + 5 territories = 57
Jurisdiction where event occurs
NOT residence of decedent or mother
How are vital statistics prepared?Data collected from new parents, hospitals, birthing centers, midwives, physicians, nursing homes, funeral homes, coroners/medical examiners, next-of-kin
Reported to local/state health departments
Records reviewed, edited, processed, registered
Causes of death coded according to international standards (ICD-10)
Data files prepared4Vital Statistics Cooperative Program (VSCP)57 jurisdictions (NAPHSIS members)Collect and report data using U.S. standard certificatesMake state and local level data available
Federal government (NCHS)Compiles dataIssues data files (individual case records, de-identified)Prepares/publishes analytical/statistical reports
5Roles of Vital StatisticsCivil registration system
6Civil Registration SystemServe as the permanent legal record of the fact of birth, death, marriage or divorce
Birth certificateProof of date of birth, age, parentage, birthplace, citizenshipUsed for school entrance, voter registration, drivers license, marriage license, passport, social security benefits
Death certificateProof of date of death, date and place of interment, cause and circumstances of deathUsed to obtain insurance benefits and pensions; transfer of property
7Roles of Vital StatisticsCivil registration system
Public health data system8Public Health Uses of Vital Statistics DataIdentifying public health problems
Identifying patterns in fertility and mortality
Monitoring trends in health and health care
Monitoring risk factors leading to poor outcomes
Planning and evaluating public health programsCritical Public Health Data SourceCertificate revisions allow data items to remain relevant
Complete reportingMandatory (not a sample or survey)
Consistent data among jurisdictionsUntil recently
10Administrative UsesPopulation estimates and projections
Enumeration at birth - SSN
School enrollment estimates
Maintenance of administrative data sets Voter registrationSSA11Roles of Vital StatisticsCivil registration system
Public health data system
National security system
12National Security SystemIntelligence Reform and Terrorism Act of 2004Minimum standardsCertification of birth certificates and use of security paperProof and verification of identity as a condition of issuance of a birth certificateProcessing of birth certificate applications to prevent fraudBirth/death matching to mark birth records of deceased persons To dateRegulations several years overdue No funds appropriated
13Recent Improvements to Vital Statistics Evolving to meet new needs
Electronic Verification of Vital Events (EVVE)State and Territorial Exchange of Vital Events (STEVE)
Electronic birth and death systems
Improve timeliness, efficiency and data qualityWill reduce need for corrections14Roles of Vital StatisticsCivil registration system
Public health data system
National security system
Public health surveillance system
15Public Health Surveillance SystemAllows for monitoring of trends as data are collected
Allows states and the federal government to identify problems in real time
Allows for the collection of additional data items
16Expanded use of data needs to begin at the state levelStates collect data from the source
States have identifiers
States have access to other data sets for linkage
States can incorporate EHR into medical portion of birth records 17Past Effects of UnderfundingElimination ofAbortion reporting systemMarriage and divorce statistics programOccupation and industry coding of death records
Delay in adoption of 2003 certificate revisions
Reduced timeliness of data
Negative impacts on data quality
18Ongoing Effects of UnderfundingScarce resources
What do states do first (or at all)?
Civil registration most critical at the state level and other functions may suffer
19What is our vision?Reengineered data collection systems based on the national model that would allow for:Immediate electronic transfer to state vital records officesImmediate transfer to other health dept. programs Timely transfer of out of state dataTimely sharing of data with federal partners
Collection of timely, complete, accurate data
Linkage with other data sets
Continued evolution from a public health data system to a surveillance system
Use of vital records as an effective tool for protecting national security
20For more informationPlease contact: Trish [email protected] go to www.naphsis.org