Tackling Quality Issues in
Vit l St
Vital
Statistics
ti ti
Sam Notzon
International
I t
ti
l St
Statistics
ti ti P
Program
National Center for Health Statistics
Introduction:
ƒ
Important
p
q
quality
y issues in 4 areas:
ƒ Civil registration
ƒ Vital statistics
ƒ Certificate services
ƒ Diffusion/use of vital statistics
ƒ
Essential quality elements:
ƒ Training, retraining, and supervision
ƒ Evaluation
ƒ Communication
Improving Registration Quality:
Accuracy
y of registration
g
data:
ƒ
ƒ
Feedback to registration districts
Underreported events:
ƒ
ƒ
Put registration office in hospitals:
ƒ
ƒ
ƒ
ƒ
Facilitate reporting
p
g by
y parents,
p
, next of kin
Improve cause of death information
Capture early infant deaths
Violent deaths:
ƒ
ƒ
Improve communication with police, coroners
Amend registration laws to facilitate registration
Vital Statistics Quality:
Cause of death:
ƒ
Verbal autopsy
ƒ
ƒ
Certification of cause of death:
ƒ
ƒ
ƒ
Physician training
Query promptly
ICD coding:
ƒ
ƒ
Structured interviews
Coder training, retraining
Manual vs. automated coding
ƒ
Decision tables
Certificate Services:
Certificates required
q
for g
government
services
ƒ
ƒ
Ensures public compliance with registration
ƒ
Certificate services are the public face of the
system
ƒ
Delays in certificate production can overwhelm
registration and vital statistics efforts
ƒ
Requires management/business skills often
lacking in government
Dissemination of Vital Statistics:
ƒ
Authorize one g
government agency
g
y to
prepare and publish vital statistics
ƒ
Communicate official vital statistics to
other government agencies
ƒ
Create formal data sharing
g agreements
g
across government agencies
Useful References:
ƒ
HMN assessment framework: “Improving the
quality and use of birth, death, and causecause-of
of-death statistics generated by civil registration
systems”
systems (in draft)
ƒ
Four civil registration/vital statistics articles in
The Lancet, Oct/Nov 2007: Philip Setel, Prasanta
Mahapatra, Kenneth Hill, Carla AbouZahr.
ƒ
United Nations Statistics Division: Handbook
series on civil registration and vital statistics,
(http://unstats.un.org/unsd/demographic/sources/civilreg/
)
civilreg3.htm
Sam Notzon
International Statistics Program
National Center for Health Statistics
SNotzon@cdc.gov
301-458-4402