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Evaluating New York City's abortion reporting system: insights for public health data collection systems
Amita Toprani1, Ann Madsen, Tara Das
1Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia (Dr Toprani); and New York City Department of Health and Mental Hygiene, New York (Drs Toprani, Madsen, Das, Greene, and Begier and Ms Gambatese).
Context:
New York City (NYC) mandates reporting of all abortion procedures. These reports enable tracking of abortion incidence and underpin programs, policy, and research. Since January 2011, the majority of abortion facilities must report electronically.
Objectives:
We conducted an evaluation of NYC's abortion reporting system and its transition to electronic reporting. We summarize the evaluation methodology and results and draw lessons relevant to other vital statistics and public health reporting systems.
Design:
The evaluation followed Centers for Disease Control and Prevention guidelines for evaluating public health surveillance systems. We interviewed key stakeholders and conducted a data provider survey. In addition, we compared the system's abortion counts with external estimates and calculated the proportion of missing and invalid values for each variable on the report form. Finally, we assessed the process for changing the report form and estimated system costs.
Setting:
NYC Health Department's Bureau of Vital Statistics.
Main Outcome Measures:
Usefulness, simplicity, flexibility, data quality, acceptability, sensitivity, timeliness, and stability of the abortion reporting system.
Results:
Ninety-five percent of abortion data providers considered abortion reporting important; 52% requested training regarding the report form. Thirty percent reported problems with electronic biometric fingerprint certification, and 18% reported problems with the electronic system's stability. Estimated system sensitivity was 88%. Of 17 variables, education and ancestry had more than 5% missing values in 2010. Changing the electronic reporting module was costly and time-consuming. System operating costs were estimated at $80 136 to $89 057 annually.
Conclusions:
The NYC abortion reporting system is sensitive and provides high-quality data, but opportunities for improvement include facilitating biometric certification, increasing electronic platform stability, and conducting ongoing outreach and training for data providers. This evaluation will help data users determine the degree of confidence that should be placed on abortion data. In addition, the evaluation results are applicable to other vital statistics reporting and surveillance systems.
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