NYS Perinatal Data – What’s Available and Where to Get It NYSPA Presentation March 6, 2009

1. NYSPerinatal Data – What’s Available and Where to Get ItNYSPA PresentationMarch 6, 2009

2. Overview of NYS Perinatal Data • Data available to everyone through the DOH Public Website: - Perinatal Data and Statistics - Community Health Assessment Clearinghouse - Prevention Quality Indicators (PQI ) Tool - MCHBG Application • Health data only available to those authorized to use the Health Information Network (HIN) and Health Provider Network (HPN) • Data available to Birthing Hospitals – SPDS Data • Data submitted by Hospitals, but not generally available -- QI data from SPDS • Data not currently available, either because the data are not accessible or because analysis not yet finalized

3. NYSDOH Public Website • Statistics and Data • MCHBG Application • Community Health Assessment Clearinghouse • Prevention Quality Indicators

6. Partial list of Vital Stats tables: Live Births • Table 4a - Live Birth Summary by Mother's Race/Ethnicity, New York State 2007 • Table 4b - Live Births by Financial Coverage and Mother's Race/Ethnicity, New York State 2007 (Births Recorded Outside NYC) • Table 4c - Live Births by Financial Coverage and Mother's Race/Ethnicity, New York State 2007 (Births Recorded in NYC) • Table 5a - Live Birth Summary by Mother's Age, New York State 2007

8. Maternal and Child Health Services Title V Block Grant Program   Maternal and Child Health Services Title V Block Grant Program A copy of the latest Maternal and Child Health Services Title V Block Grant Program application (PDF, 2.9MB, 451pg.) is currently only available in Portable Document Format (PDF). Maternal and Child Health Title V Block Grant Program - 2009 Application / 2007 Annual Report (PDF, 2.9MB, 451pg.)

9. Types of Information Available in MCHBG: • Vital Statistics data, including trend information • Program-specific data and information • Newborn Screening data • Survey Data, including: • PRAMS • BRFSS • SLAITS • YRBS • National data, such as Current Population Survey & Census.

11. Community Health Assessment Clearinghouse • County Health Indicator Profiles • Community Health Data Set • County Health Assessment Indicator Reports

12. Community Health Assessment Data collection, analysis and interpretation of relevant data including: • Demographics of the population • Health status of the population related to the problem • Availability, accessibility and acceptability of needed resources

19. Community Health Data Set: • Also includes, under Maternal and Infant Health: • Spontaneous fetal deaths 20+ weeks • Infant, neonatal and postneonatal mortality • Low and very low birthweight • Births by gestational age at delivery • Early and late/no prenatal care • Maternal mortality • Newborn drug related discharges

20. Community Health Data Set • Under Family Planning, includes: • Pregnancy rates by age (total, and by groups for teens) • Birth rates by age (total and by groups for teens) • Teen births • Abortion rates • Out of wedlock births

21. Community Health Data Set: For all of these indicators, data available: • Rates by County and Region • Mapping of rates by County • Comparison graph of rates by County

22. PQI WebsiteFinding the Site …

23. PQI Website

24. PQI WebsiteEntry Page … Links

25. PQI WebsiteEntry Page … Links (2)

26. PQI WebsiteMain Page … Drill-Down (3)

27. PQI WebsiteMain Page … Compare

28. Useful Sources of Data on DOH Website (www.nyhealth.gov) • Statistics and Data Page (www.nyhealth.gov/statistics) • SPARCS (www.nyhealth.gov/statistics/sparcs) • Vital Statistics (www.nyhealth.gov/vital_statistics/index.htm) • MCHBG Application (particularly Needs Assessment) (http://www.nyhealth.gov/community/infants_children/maternal_and_child_health_services/)

29. Websites / Resources cont.: • Community Health Assessment Clearinghouse(www.nyhealth.gov/statistics/chac) • Community Health Data Set (www.nyhealth.gov/statistics/chac/chds.htm) • County Health Assessment Indicator Reports (www.nyhealth.gov/statistics/chac/chai/index.htm) • County Health Indicator Profiles (www.nyhealth.gov/statistics/chip/index.htm)

30. NYSDOH – HPN/HINSecure Health Provider Network for hospitals and other providers(https://commerce.health.state.ny.us/hpn/) • Data Retrieval – SPARCS • Data Tables -- Zip code-based perinatal data

37. Data Available to Birthing Hospitals: Statewide Perinatal Data System (SPDS) • The Core Module of the SPDS includes all items on the electronic birth certificate, such as: • Maternal and paternal demographic information • Information on prenatal care received • Maternal history and conditions • Method of delivery • Baby’s information, such as gender, birthweight, gestational age at delivery, Apgar Scores, feeding status at discharge, etc.

38. SPDS Reports Available to Hospitals, and to RPCs for hospitals in their networks: • Statistical summary of key indicators • 2 delivery method reports • Risk factors/Complications/Outcomes • Perinatal outcomes by birth weight • Statistical summary by insurance type • Healthy People 2010 comparisons

39. SPDS Statistical Summary of Key Indicators Report: • Month to date (MTD) and year to date (YTD) counts and percentages for key indicators such as: • multiple births • early/late prenatal care • Medicaid and no insurance • primary and repeat cesarean births • low birth weight • NICU admission • breast-feeding

40. Delivery Method Reports: • Delivery Method Statistics, PartA • MTD, quarterly, and YTD counts and percentages detailing delivery route and method • Delivery Method Statistics, Part B • MTD and YTD counts and percentages of dominant indications for cesarean and operative vaginal births, and anesthesia used for vaginal and C-section births

41. Risk Factors/Complications & Procedures among Deliveries and Outcomes among Live Births Report: MTD and YTD counts and percentages for select Indicators such as: • diabetes • hypertension • fetal genetic testing • medicinal induction and augmentation of labor • births occurring prematurely • births with serious congenital anomalies

42. Other SPDS Reports: • Perinatal Outcomes by Birth Weight -- MTD and YTD counts and percentages of live births and infant deaths by birth weight category • Statistical Summary by Type of Insurance-- YTD counts and percentages for indicators, broken out by Medicaid (HMO/Other), private (HMO/Other) or other insurance • Healthy People 2010 -- Comparison of hospital or RPC performance to year 2010 goals for select indicators, such as maternal complications, adequacy of prenatal care, first birth c-section rate among low risk women, alcohol, cigarette, and illicit drug abstinence during pregnancy

43. Data submitted by Hospitals, but not generally available in a dataset: • “Quality Improvement” or “QI” items (summaries under development) • Content of prenatal care • Maternal depression • Exercise during pregnancy • Oral health during pregnancy • Pregnancy planned/or not • Genetic testing • Infertility treatments • Indications for vacuum/forceps delivery • Other items not officially part of the Birth Certificate • These data are not protected by law, and can be summarized and provided to interested parties.

44. Data not currently available: • Medicaid Client Identification Numbers (CINs) While this information is collected, it is not available to other than the Office of Health Insurance Programs • NYC Vital Statistics – NYC Vital Statistics data are collected as part of a separate vital statistics registration area, and are therefore only available with special permission from the NYCDOHMH Office of Vital Statistics or in summary form through DOH.

45. Data not currently available: • Fetal Death information: Fetal death certificates, and therefore information, are protected by special public health law (PHL Title 10. Section 35.3 Fetal death; confidential information.(a) The information contained on a fetal death certificate shall be disclosed by the State Commissioner of Health only to the mother, her lawful representative, and to authorized personnel of the Department.(b) The confidential information for medical and health use only furnished with a fetal death certificate shall not be copied and shall not be detached except as herein provided.

46. Data not currently available, but analyses proceeding: Analyses are proceeding on a number of topics, and data will be presented at the annual NYSPA meeting in June: • Very low birthweight analysis • C-section analysis • SPDS data and information on updates to system • NICU data and information on updates to system • QI indicators • Etc.

47. Other Sources of NYS Data: • Examples include: • March of Dimes • National Center for Health Statistics • Annie E. Casey Foundation

48. March of Dimes: • State-specific information on perinatal health, including: • Perinatal overview • Births • Preterm births • Birthweight • Prenatal care • Infant mortality • Singleton vs Multiple births • Delivery method

49. March of Dimes (cont.) • Smoking/alcohol/drugs • Obesity • Infections • Health Insurance • Newborn screening • Folic acid • Population • MCH programs • Birth defects

50. March of Dimes (cont.): • Some trend information • Cross tabs – e.g., low birthweight by maternal age • Data posted up through 2005 so far • See: http://www.marchofdimes.com/peristats/