Data Linkage

The opioid overdose crisis has rapidly expanded in North Carolina (NC), paralleling the epidemic across the United States. The number of opioid overdose deaths in NC has increased by nearly 40% each year since 2015.1 Critical to preventing overdose deaths is increasing access to the life-saving drug naloxone, which can reverse overdose symptoms and progression. Over 700 EMS agencies across NC respond to over 1,000,000 calls each year; naloxone administration was documented in over 15,000 calls in 2017.2 Linking EMS encounters with naloxone administration to the corresponding ED visit assists in understanding the health outcomes of these patients. However, less than 66% of NC EMS records with naloxone administration in 2017 were successfully linked to an ED visit record. This study explored methods to improve EMS and ED data linkage, using a multistage process to maximize the number of correctly linked records while avoiding false linkages.

Objective: To improve linkage between North Carolina's Emergency Medical Services (EMS) and Emergency Department (ED) data using an iterative, deterministic approach.

In 2017, 951 Missouri residents died from an opioid overdose, a record number for the state.1 This continues the trend from 2016, which saw an increase of over 30% in opioid overdose deaths compared to 2015. The Missouri Department of Health and Senior Services (MDHSS) manages several public health surveillance data sources that can be used to inform about the opioid epidemic. Opioid overdose deaths are identified through death certificates which are collected through the vital records system. MDHSS also manages the Patient Abstract System (PAS), which contains ED and inpatient hospitalization data from approximately 132 non-federal Missouri hospitals. PAS contains about 130 variables, which include demographic data, diagnoses codes, procedures codes, and other visit information. Records can have up to 23 diagnosis fields, which are coded using ICD-10-CM (International Classification of Diseases, Clinically Modified). The first diagnosis field is the primary reason for a visit.

Objective: Link emergency department (ED) with death certificate mortality data in order to examine the prior medical history of opioid overdose victims leading up to their death.

Many studies have shown relationships between race/ethnicity and some birth defects. For example, white teenagers have higher rates of gastroschisis than African-American teenagers 1 , and transposition of great arteries is more prevalent in white than non-white children 2 .The Louisiana Birth Defects Monitoring Network (LBDMN) is a population-based surveillance system created in 2005. LBDMN actively collects information from multiple sources to track babies born with birth defects up to three years old in the state. Racial disparity in birth defects has never been evaluated using birth defects surveillance data in Louisiana. Findings from this study are expected to help LBDMN and Louisiana Children and Youth with Special Health Needs Program better understand variations in the prevalence of some birth defects among certain racial/ethnic groups in the state.

Objective

This study aimed to evaluate relationships between race/ethnicity and selected major birth defects using 2006-2008 Louisiana birth defects surveillance data.

Newborns who fail initial hearing screening are encouraged to follow up to get further tests to confirm diagnosis of hearing loss. Loss to follow-up of hearing screening is defined as a newborn who fails the initial hearing test before hospital discharge but does not follow up with further hearing tests to confirm diagnosis of hearing loss. Although rates of loss to follow-up are considered high in Louisiana, with great efforts by Louisiana Early Hearing Detection and Intervention Program (EHDI), loss to follow-up has significantly improved in the last several years. A trend analysis of loss to follow-up was helpful in evaluating accomplishments to reduce loss to follow-up and refining plans and strategies to enhance the quality of newborn hearing detection and intervention in the state.

Objective

The study aimed to analyze the trend in loss to follow-up of hearing screening among newborns who failed initial hearing screening tests prior to hospital discharge, and evaluate accomplishments in improving loss to follow-up from 2004 to 2011 in Louisiana.