Live Birth Rates per Female Demographic

[gompertzmakeham]

Live birth rates per female demographic will provide critical insights into fertility, fecundity, and in general population dynamics (quadratic or greater terms in the male-age/female-age scattering cross-section). There are three potential sources for live birth data:

• Vital statistics
• Inpatient care
• Primary care

Vital statistics explicitly links mother and infant PHNs, but only has data after 2010. Inpatient and primary care contain pairs of records for mother and infant but the records can only be linked on secondary fields, like chart numbers, provider identifiers, location identifiers, and service dates. The strategy would then be to find all distinct pairs of mother-infant PHNs and then link that back to the derived demographic tables to assign delivery counts to the mother's age intervals, as well as filter out implausible records.

After further investigation self-referential linking within primary care is going to be involved because constraining on provider identifiers and services dates is not sufficient to narrow the possible matches. So the algorithm will be:

1. First check vital statistics for maternal-infant PHN pairs.
2. Next check inpatient care, cross linking the first new born on the reciprocally recorded chart numbers, then with all newborn chart numbers that have not been reciprocally reference back cross-reference against the successful cross-reference. Preferentially selecting the vital statistics infant data, and using inpatient only for infants not in vital statistics.
3. Finally check primary care, find the non-newborn claim immediately before the infant claim, only use this pair for infants not in the previous step.

A small nuance, there are about 2 dozen inpatient admissions that are actually transfers after live birth, so sorting on admission date needs to be accounted for.

It turns out that their has been historical heterogeneity in physician billing practices around deliveries, with various combinations of submitting claims for just the mother, just the newborn, or both. So that knocks primary care out.

[gompertzmakeham]

With Vital Statistics being pushed all the way back to 2004 there is little to be gained from incorporating inpatient data. Instead we will try to increase access to more complete Vital Statistics data.