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Birth outcomes for Texas

This is an analysis for a series of stories about birth outcomes. The data used is the Texas Hospital Inpatient Discharge Public Use Data File, [1q2016 - 4q2019]. Texas Department of State Health Services, Center for Health Statistics, Austin, Texas.

No raw data is made public through this project. The data is typically sold by the Center for Health Statistics. Details at the link above. This analysis uses files for discharges from 2016 to 2019, though a typically very small number of discharges for the fourth quarter of 2019 may not be included because of allowed reporting delays.

No patients or doctors have been revealed in the data or analysis. Suppressions have been applied for smaller aggregations to protect privacy.

This analysis is by:

CHRISTIAN MCDONALD, Assistant Professor of Practice
School of Journalism and Media, Moody College of Communication
The University of Texas at Austin

Stories

• Birth on demand: Whether a woman delivers by cesarean has less to do with her health than the hospital she goes to. Case in point: Doctors Hospital of Laredo, where rates of surgical intervention during childbirth are way above the norm. Experts say something isn’t right.
• More than ‘a little snip’: Two Texas hospitals performed episiotomies at rates four to six times the recommended level last year. But women giving birth should know: You have the final say.
• Database: C-section and episiotomy rates in Texas hospitals.

Methodology

• The methodology of the measures and calculations used in the analysis.

Notebooks

Primary Cesareans study

• 02-analysis-pcsec is an analysis of Primary Cesarean rates vs all uncomplicated births.

Vaginal Births after Cesarean study

• 02-analysis-vbac is an analysis of Vaginal births after Ceseareans by hospital.

Episiotomy study

• 02-analysis-episiotomy is an analysis of episiotomy procedures.

Deliveries study

• 02-analysis-deliveries looks at overall delivery rates at hospitals, including simple rates for Cesarean and episiotomies.

Summaries

• 03-analysis-summaries gives statewide rates and by-hospital averages by year for our key measures.

Data processing notebooks

• 00-process-lists defines various lists of codes and columns used within other notebooks.
• 0101-process-ahrq-del-loop is the method used to find all deliveries from the raw THCIC files.
• 0101-process-ahrq-del-test shows the processing logic in more detail using test data.
• 0102-process-ahrq-del-compare compares the results of the loop script to the test script when both are processed using test data.
• 0101-process-lf-epi-loop is the method used to capture vaginal births using Leapfrog's methods.
• 0101-process-lf-epi-test shows the processing logic in more detail using test data.
• 0103-process-ahrq-providers creates a list of the most recent names for hospitals in the AHRQ data to assist analysis. Can't be run until the deliveries data is generated.
• 0104-process-lf-providers creates a list of the most recent names for hospitals in the Leapfrog to assist analysis. Can't be run until the the AHRQ providers are processed.

Exports

A series of aggregated data that may prove useful. In the exports/ folder:

• Interactive Data Matrix maps specific files/data to the mockup.

From 02-analysis-pcsec

• ahrq_pcsec_rate_county_yr: (Primary cesarean rates for uncomplicated deliveries by patient county.) Grouped by PAT_COUNTY, COUNTY. Aggregations are NPCSEC_CNT (Count not primary Cesarean), PCSEC_CNT (Count primary Cesarean), TOTAL, PCRATE (Primary Cesarean rate).

From 02-analysis-episiotomy

• lf_epi_rate_county_yr: (Episiotomy rates for uncomplicated deliveries by patient county.) Grouped by YR, PAT_COUNTY, COUNTY. Aggregations are EPIF (Count Epi False), EPIT (Count Epi True), TOTAL (Count of all vaginal deliveries), EPIRATE.

From 02-analysis-deliveries

• blurbs_2019.json: Data: Hospital, birth per doc rate (weekly), Medicaid percentage, Maternal level.

From 03-analysis-summaries

• table_2019.csv: Data: Hospital, location, episiotomy and primary cesarean rates for 2019.
• chart_data.json: Data: Year, ID, Hospital, episiotomy and primary cesarean rates. There is a v2 version as well.
• chart_data_print.csv: Same as chart_data but as csv for print.
• summary_data.csv: Summary data for the major categories.

From 0102-process-providers

• providers_full: Names and addresses of all the hospitals in the analysis.
• providers_current: The most recent list of facilites, per the Center for Health Statistics.

Notes

There was a data correction sent out 2020-08-14 to replace some fields for some records in the PUDF_base1_3Q2019_tab.txt data file. The replacement file was not applied because we are not using the fields noted, TOTAL_CHARGES and TOTAL_CHARGES_ACCOMM.

Music to get you through it

A good portion of this project was made possible through Iron Maiden Radio on Pandora.