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Optimizing accuracy of birth certificate data through a statewide quality improvement initiative in Illinois




This study examines improvement in birth certificate accuracy during a statewide quality improvement initiative.

Study design

Participating hospitals systematically sampled 10 delivery medical records per month and compared them to corresponding birth certificates for accuracy. Accuracy was computed before implementing the initiative (Aug–Oct 2014), end of phase 1 (July 2015) and end of phase 2 (Nov–Dec 2015). Accuracy data was aggregated and compared across time points using a linear mixed model and by hospital characteristics.


105 hospitals participated. Birth certificate accuracy increased between baseline (89.59%) and end of phase 2 (97.00%, p < 0.001). Percent accuracy at baseline was lowest in hospitals serving at-risk populations (p < 0.01). These hospitals showed relatively greater increases in overall accuracy with no difference in accuracy by the end of the initiative.


A statewide QI effort contributed to improvements in birth certificate accuracy. Hospitals serving at-risk populations exhibited the greatest benefit and improvement.

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Fig. 1: Illinois accuracy over time on 4 difficult to improve birth certificate varaialbes for hospitals participating in a statewide QI initiative.

Data availability

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.


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Thank you to our collaborators who made this work possible, including ILPQC Hospital Teams, ILPQC Obstetric Advisory Work Group and Clinical Leadership, IDPH Vital Records and Regionalized Perinatal System, and the Illinois Hospital Association.


The Birth Certificate Accuracy Initiative was funded by the Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion CDC-RFA-DP14-1404, the Illinois Department of Public Health U38DP005367, and the CHIPRA Quality Demonstration Grant subcontract through Health Management Associates #3001.

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Authors and Affiliations



PLK, KF, PS, and ABorders designed and implemented the study and helped write the manuscript. EO and SL conducted statistical analysis and helped write the manuscript. ABennett contributed to study design and provided methods and epidemiology insight. PLK, KF, PS, ABorders, EO, SL, and ABennett critically reviewed the manuscript and have approved the final version of the article.

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Correspondence to Patricia A. Lee King.

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Lee King, P.A., Finnegan, K., Schneider, P. et al. Optimizing accuracy of birth certificate data through a statewide quality improvement initiative in Illinois. J Perinatol 43, 1440–1445 (2023).

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