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PubMed2004

[Regional differences in perinatal mortality rates in Japan--an investigation based on vital statistics].

OBJECTIVE: This study investigated whether regional differences in perinatal mortality rates are related to distances to medical resources for perinatal care, such as the Neonatal Intensive Care Unit (NICU). METHODS: Using the census for Japan in 2000, all municipalities in Japan were classified into four groups based on population size: municipalities of 1,000,000 people or more (Group 1), municipalities between 350,000 and 1,000,000 people (Group 2), municipalities between 10,000 and 350,000 people (Group 3), and municipalities of less than 10,000 people (Group 4). Then, using the vital statistics, perinatal mortality rates for all groups were calculated. In addition, setting the perinatal mortality rate in Group 1 as a referent, we calculated the differences in the rates to detect regional differences in perinatal mortality in Japan. Finally, we compared the distances between the municipality center and the closest NICU among the four groups by one-way ANOVA. RESULTS: The perinatal mortality rates of Groups 1, 2, 3 and 4 were 5.38, 5.58, 5.88 and 6.31, respectively. The perinatal mortality rate ratios (95%CI) were 1.04 (0.96-1.12), 1.09 (1.03-1.16), and 1.17 (1.05-1.31), respectively. The perinatal mortality rate differences (95%CI) were 0.20 (-0.24-0.64), 0.50 (0.15-0.84), and 0.93 (0.23-1.62), respectively. The distances (95%CI) between the center of the municipalities and the closest NICU for Groups 1, 2, 3 and 4 were 2.61 (1.56-3.66) km, 4.23 (2.74-5.72) km, 20.79 (17.68-23.90) km and 38.07 (31.65-44.48) km, respectively. All of the differences among the groups were significant (p < 0.001), except for the difference between Group 1 and Group 2. CONCLUSION: There are regional differences in perinatal mortality rates in Japan. This study suggests that the difference is associated with the uneven distribution of NICUs.

Health Services Accessibility↗
PubMed1995

The Philippine management information system for public health programs, vital statistics, mortality and notifiable diseases.

Strengthening the information support for decision making has been identified as an important first step toward improving the efficiency, effectiveness, and equitability of the health care system in the Philippines. A Philippine-German Cooperation is in partnership toward developing a need-responsive and cost-effective Health and Management Information System (HAMIS). Four information baskets are being strengthened specifically to address these needs in a cost-effective way: public health information systems, hospital information systems, information systems on economics and financing, information systems on good health care management. BLACKBOX is the management information system for public health programs, vital statistics, mortality and notifiable diseases of the Philippines. It handles and retrieves all data that is being collected by public health workers routinely all over the Philippines. The eventual aim of BLACKBOX is to encourage the development of an information culture in which health managers actively utilise information for rational planning and decision making for a knowledge based health care delivery.

Cost-Benefit Analysis↗
PubMed1985

The nationwide nosocomial infection rate. A new need for vital statistics.

From a random sample of patients and hospitals and extrapolation ratios derived from the best available sources of data, the authors estimate that the nationwide nosocomial infection rate among the 6,449 acute-care US hospitals in 1975-1976 was 5.7 nosocomial infections per 100 admissions and that over 2 million nosocomial infections occurred in a 12-month period in these hospitals. Nosocomial urinary tract infections constituted 42% of the infections, surgical wound infections 24%, nosocomial pneumonia 10%, nosocomial bacteremia 5%, and nosocomial infections at all other sites 19%. If adjustments are made for the accuracy of the diagnostic method, the increasing nationwide secular trend, and the number of nosocomial infections in nursing homes, however, as many as 4 million nosocomial infections per year may now be occurring. This greatly exceeds previous estimates and calls for timely and accurate vital statistics on the problem.

Adult↗
PubMed2002

Constructing vital statistics: Thomas Rowe Edmonds and William Farr, 1835-1845.

This paper describes the role of these two English statisticians in establishing mortality measurements as means of assessing the health of human populations. Key to their innovations was the uses for the law of mortality Edmonds claimed to have discovered in 1832. In reality he had merely rediscovered a relationship between aging and mortality first described mathematically by Benjamin Gompertz a decade earlier. During the 1830s Edmonds attempted to interest the medical profession in his discovery and to suggest how his discovery could be used to assess health of large communities and to study case fatality and therapy. Using the rich data of the General Register Office William Farr would develop Edmonds's suggestions to produce some of the most sophisticated uses of vital statistics in the 19th century. In understanding the motivation of these two statisticians, it is essential to recognise their reform sympathies in an age deeply troubled by the human costs of rapid industrialisation and urbanisation. The two set out to reform both their professions and society.

England↗
PubMed1990

[Estimation of vital statistics in rural areas of northern Haiti using a simplified sampling method].

In September 1983, we selected 30 villages in four rural counties of northern Haiti for a partial census and malaria prevalence survey. A cohort of 1,577 persons was enumerated in this census. Survey teams revisited the same houses in these villages in September 1984 and updated the previous census, inquiring about all listed family members. We administered an additional questionnaire to each household concerning the occurrence over the past year of deaths, births, pregnancies, and migration. Among the 1,218 persons who had been followed for one year, there were 21 deaths (crude mortality rate: 17 per 1,000 population; 95% confidence interval [95% CI]: 12 per 1,000, 25 per 1,000) and 35 births (birth rate: 29 per 1,000 population year; 95% CI: 19 per 1,000, 38 per 1,000). The infant mortality rate was 171 per 1,000 live births (95% CI: 81 per 1,000, 315 per 1,000), and the mortality rate for children less than 5 years old was 36 per 1,000 (95% CI: 24 per 1,000, 56 per 1,000). Although small sample surveys are subject to limitations of precision dependent on sample size, they can be a simple method by which researchers may estimate vital statistics for rural areas of less-developed countries.

Epidemiologic Methods↗
PubMed1994

Effect of air pollution on lung cancer: a Poisson regression model based on vital statistics.

This article describes a Poisson regression model for time trends of mortality to detect the long-term effects of common levels of air pollution on lung cancer, in which the adjustment for cigarette smoking is not always necessary. The main hypothesis to be tested in the model is that if the long-term and common-level air pollution had an effect on lung cancer, the death rate from lung cancer could be expected to increase gradually at a higher rate in the region with relatively high levels of air pollution than in the region with low levels, and that this trend would not be expected for other control diseases in which cigarette smoking is a risk factor. Using this approach, we analyzed the trend of mortality in females aged 40 to 79, from lung cancer and two control diseases, ischemic heart disease and cerebrovascular disease, based on vital statistics in 23 wards of the Tokyo metropolitan area for 1972 to 1988. Ward-specific mean levels per day of SO2 and NO2 from 1974 through 1976 estimated by Makino (1978) were used as the ward-specific exposure measure of air pollution. No data on tobacco consumption in each ward is available. Our analysis supported the existence of long-term effects of air pollution on lung cancer.

Adult↗
PubMed1998

Underregistration of neonatal deaths: an empirical study of the accuracy of infantile vital statistics in Taiwan.

STUDY OBJECTIVE: The accuracy of the official statistic on infant deaths in Taiwan has been questioned. This study aimed to survey infant deaths nationwide, to measure associated vital statistics, and compare them with the official statistics to assess accuracy. DESIGN AND PARTICIPANTS: A nationwide survey of all gestational outcomes occurring at > or = 20 weeks' gestation over a three day study period (15-17 May 1989) was conducted to collect data from 23 counties and cities nationwide using a two stage data collection procedure. MAIN RESULTS: The survey derived infant death rate was 9.72 per 1000 live births, which was higher than the reported official statistic of 5.71 per 1000 live births. A more detailed examination of data on infant deaths showed that the estimated neonatal death rate of 6.68 per 1000 live births (95% confidence intervals: 3.33, 11.96 per 1000 live births) was significantly higher than the published official statistic of 1.94 per 1000 live births, while the postneonatal mortality of 3.04 per 1000 live births was comparable to the reported statistic of 3.37 per 1000 live births. CONCLUSIONS: This study empirically documented the underregistration of infant deaths in Taiwan, particularly those occurring during the first 27 days of life.

Data Collection↗
PubMed2005

Correlation between suspended particles in the environmental air and causes of disease among inhabitants: cross-sectional studies using the vital statistics and air pollution data in Japan.

To identify the diseases that correlate with suspended particle concentration in the ambient air, a cross-sectional epidemiological study was conducted using the annual vital statistics and air pollution estimates of 1881 points throughout Japan. The concentration of suspended particulate matters (SPMs) 10 microm or less in diameter were hypothetically converted to PM(2.5) values (converted PM(2.5) or cPM(2.5)) by using a conversion factor obtained from 25 estimates in Japan. Among various causes of death, a significant correlation was observed between both the SPM and cPM(2.5) (SPM/cPM(2.5)) levels and the age-adjusted death rates of ischemic heart disease or hypertensive heart disease in both genders. Correlation was noted with pneumonia, asthma, chronic bronchitis/emphysema, or lung cancer only in females. Unexpectedly, breast, endometrial, and ovarian cancer also showed significant increases in mortality rates related to the SPM/cPM(2.5) level, suggesting a role for suspended particles in the ambient air with or without gaseous component as a possible endocrine-disrupting, estrogenic agent. Multivariate regression analysis of confounding factors, smoking rate, population density, and hormone-related factors revealed consistent significance of SPM/cPM(2.5) in these diseases.

Air↗