Perinatal and Medicaid Data Methodology
The MMD Perinatal Care Project collected Medicaid delivery data from 22 states, representing over 830,000 singleton births. All Medicaid singleton births in a given calendar-year (for most states, 2011) as well as trend data were reported by individual states.
The 22 states which reported aggregated data for this study include:
|
State
|
Reporting Year
|
Birth Certificate Data Linked to Medicaid Data
|
Birth Certificate Standard Used
|
|
Alaska
|
2011
|
Yes
|
1989
|
|
Alabama
|
2011
|
No
|
1989
|
|
California
|
2011
|
No
|
2003
|
|
Colorado
|
2011
|
No
|
2003
|
|
Connecticut
|
2010
|
Yes
|
1989
|
|
Florida
|
2012
|
No
|
2003
|
|
Iowa
|
2011
|
Yes
|
2003
|
|
Idaho
|
2011
|
No
|
2003
|
|
Louisiana
|
2011
|
Yes
|
2003
|
|
Massachusetts
|
2010
|
No
|
1989
|
|
Minnesota
|
2010
|
Yes
|
1989
|
|
North Carolina
|
2011
|
Yes
|
2003
|
|
Ohio
|
2010
|
Yes
|
2003
|
|
Oregon
|
2011
|
Yes
|
2003
|
|
Pennsylvania
|
2010
|
No
|
2003
|
|
South Dakota
|
2011
|
No
|
2003
|
|
Tennessee
|
2011
|
Yes
|
2003
|
|
Utah
|
2011
|
No
|
2003
|
|
Vermont
|
2011
|
Yes
|
2003
|
|
Washington
|
2011
|
Yes
|
2003
|
|
Wisconsin
|
2010
|
Yes
|
2003
|
|
West Virginia
|
2011
|
No
|
1989
|
Data Collection Tools
Methods using birth certificates, by themselves or linked to Medicaid administrative data, were found to be appropriate for examining the problem of elective deliveries across the Medicaid population and when looking at other comparators (i.e. gestational ages, all planned births). The collection of this measure can be linked to mechanisms for rapid feedback to states and providers, making it an appropriate measure for use quality improvement purposes in the Medicaid populations.
For the purposes of the project, an elective delivery was defined as any labor induction or cesarean delivery without justification of a maternal or fetal medical condition, as indicated on the 1989 or 2003 version of the birth certificate. This calculated rate of elective deliveries is based on the measure used in the Health Resources and Services Administration Collaborative Improvement & Innovation Network (CoIN).