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National Mortality Data Set

National Mortality Data Set Kenneth D. Kochanek Mortality Statistics Branch Division of Vital Statistics National Center for Health Statistics Data Users Conference July 12-14, 2004 Presentation Outline National Vital Statistics System Nature of the System – Decentralized

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National Mortality Data Set

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  1. National Mortality Data Set Kenneth D. Kochanek Mortality Statistics Branch Division of Vital Statistics National Center for Health Statistics Data Users Conference July 12-14, 2004

  2. Presentation Outline • National Vital Statistics System • Nature of the System – Decentralized • Role of the States • Role of NCHS • Role of the World Health Organization (WHO) • Mortality Data • Underlying Cause-of-Death Data • Advantages of Underlying Cause-of-Death Data • Limitations of Underlying Cause-of-Death Data • Multiple Cause-of-Death Data • Entity Axis Applications • Record Axis Applications • Electronic Death Certificate • Data Dissemination

  3. The National Vital Statistics System is decentralized There are no laws at the national level requiring the collection of vital statistics data Statistics that are produced by NCHS are based on information obtained from certificates filed in the States where events occur Cooperation between NCHS and the States is governed by contracts of agreement Nature of the National Vital Statistics System SOURCE: CDC/NCHS

  4. State laws govern filing of certificates and reports States produce their own certificates and reports States code the information Vital Statistics Cooperative Program (VSCP) Availability of certificates and reports Role of States SOURCE: CDC/NCHS

  5. To compile and publish national and sub-national vital statistics To promote coherence and uniformity of the data collected through the VSCP Role of NCHS SOURCE: CDC/NCHS

  6. Model law Handbooks Training and instruction manuals Various publications Standard certificates and reports Quality control Promote Data Quality SOURCE: CDC/NCHS

  7. Mortality Data • Mortality statistics are based on information from the approximately 2.3 million death certificates filed each year in the 50 States and the District of Columbia • The Death Certificate serves two very different purposes

  8. A legal document regarding the facts and circumstances of a death A statistical resource providing information on characteristics of the decedent Death Certificate SOURCE: CDC/NCHS

  9. Promoting standardization of mortality statistics through the International Classification of Diseases (ICD) Compiling international mortality statistics Role of World Health Organization SOURCE: CDC/NCHS

  10. Provides standard definitions Prescribes the format for cause-of-death information on the death certificate Describes how death certificate should be completed Provides rules for selecting the underlying cause of death Role of ICD SOURCE: CDC/NCHS

  11. “The disease or injury which initiated the chain of morbid events leading directly to death, or The circumstances of the accident or violence that produced the fatal injury.” Underlying Cause of Death SOURCE: CDC/NCHS

  12. ACME: Automated Classification of Medical Entities TRANSAX: Translation of Axes MICAR: Mortality Medical Indexing, Classification and Retrieval SuperMICAR Computer Software SOURCE: CDC/NCHS

  13. Simple and one dimensional Conceptually easy to understand Well-accepted measure of mortality Useful to public health officials Advantages of Underlying Cause of Death SOURCE: CDC/NCHS

  14. Only one disease selected Arbitrary selection Excludes information Certifier mistakes Only as good as the information on the death certificate Limitations of Underlying Cause of Death SOURCE: CDC/NCHS

  15. Portrays the number of deaths in which a given condition is a significant factor contributing to death, if reported Portrays the Interaction of diseases Contains two fields: Record Axis Entity Axis Multiple Cause of Death SOURCE: CDC/NCHS

  16. Relationships among conditions Accuracy of certification reporting Testing traditional assumptions of underlying cause selection Entity Axis Applications SOURCE: CDC/NCHS

  17. Classifiable in manner like the underlying cause of death Best representation of ICD codes Record Axis Applications SOURCE: CDC/NCHS

  18. Certifier and funeral director data entry in electronic form, including prompts tutorials querying for incomplete or uninformative terms querying for implausible cause of death sequences Electronic Death Certificate (EDC) SOURCE: CDC/NCHS

  19. Preliminary Report Final Report Monthly National Vital Statistics Reports Special reports Public use micro data – CD-ROM Confidentiality Data Dissemination SOURCE: CDC/NCHS

  20. CD-ROM’s • Mortality Public Use Data Sets • ASCII Dump CD-ROM’s 1968-2001 • SETS CD-ROM’s 1991-98 • Compressed Mortality File (CMF)

  21. Mortality Data from the National Vital Statistics System website:http://www.cdc.gov/nchs/about/major/dvs/mortdata.htm

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