Barriers in Accurate and Complete Birth Registration in New York State.

Birth records have important legal, administrative and public health uses. However, invalid and incomplete birth reporting is a significant problem in New York State (NYS) and nationwide. We aimed to identify current practices and potential barriers in data collection by birth registrars (BRs) in NYS facilities. Using a 28-question survey regarding birth data collection, we surveyed 127 BRs in August 2013. The response rate was 88.2% (n = 112), with 31.2% from New York City (NYC) and 68.8% from the Rest of State (ROS). NYC facilities were dedicating significantly fewer staff hours (0.98 h) per birth to electronic birth registration on average compared to facilities in the ROS (1.54 h/birth). ROS BRs reported significantly less support in continuing education/training for data quality, and supervisor or manager review, and significantly greater use of electronic reports to monitor data quality compared to NYC BRs. Fewer than half the BRs statewide reported being able to accurately report previous low-birthweight birth, previous preterm delivery, and date of last menses. In addition, NYC BRs reported being significantly less able to accurately report previous C-section, method of delivery, and birthweight compared to ROS BRs. Furthermore, NYC BRs had more problems with fetal presentation coding compared to ROS BRs. The implementation of good practices identified in this report and the elimination of barriers suggested by the results are being used to guide the development of statewide efforts to improve birth data accuracy and completeness.