Chiao-Wen Lan1,2, Sujata Joshi3,4, Jenine Dankovchik3,4, Candice Jimenez3,4, Elizabeth Needham Waddell5, Tam Lutz3,4, Jodi Lapidus5. 1. Northwest Portland Area Indian Health Board, 2121 SW Broadway Suite 300, Portland, OR, 97201, USA. chiaowenlan@npaihb.org. 2. Northwest Tribal Epidemiology Center, 2121 SW Broadway Suite 300, Portland, OR, 97201, USA. chiaowenlan@npaihb.org. 3. Northwest Portland Area Indian Health Board, 2121 SW Broadway Suite 300, Portland, OR, 97201, USA. 4. Northwest Tribal Epidemiology Center, 2121 SW Broadway Suite 300, Portland, OR, 97201, USA. 5. OHSU-PSU School of Public Health, 1805 SW 4th Ave - Mailcode VPT, Portland, OR, 97201, USA.
Abstract
OBJECTIVES: Maternal substance misuse can result in neonatal abstinence syndrome (NAS), a drug withdrawal process in newborns exposed in utero to drugs. This study aimed to examine the effect of racial misclassification of American Indians and Alaska Natives (AI/AN) on rates of NAS in two hospital discharge datasets in the Pacific Northwest. METHODS: We conducted probabilistic record linkages between the Northwest Tribal Registry and Oregon and Washington hospital discharge datasets to correct racial misclassification of AI/AN people. We assessed outcomes using International Classification of Disease, Ninth Revision/Tenth Revision, Clinical Modification (ICD-9-CM or ICD-10-CM) diagnosis codes. RESULTS: Linkage increased ascertainment of NAS cases among AI/AN by 8.8% in Oregon and by 18.1% in Washington. AI/AN newborns were 1.5 and 3.9 times more likely to be diagnosed with NAS than NHW newborns in Oregon and Washington, respectively. The results showed that newborns residing in rural Washington were 1.4 times more likely to be diagnosed with NAS than those living in urban areas. CONCLUSIONS: Correct racial classification is an important factor in improving data quality for AI/AN populations and establishing accurate surveillance to help address the disproportionate burden of neonatal abstinence syndrome among AI/AN. The results highlight the need for programing efforts tailored by insurance status and rurality for pregnant women using substances.
OBJECTIVES: Maternal substance misuse can result in neonatal abstinence syndrome (NAS), a drug withdrawal process in newborns exposed in utero to drugs. This study aimed to examine the effect of racial misclassification of American Indians and Alaska Natives (AI/AN) on rates of NAS in two hospital discharge datasets in the Pacific Northwest. METHODS: We conducted probabilistic record linkages between the Northwest Tribal Registry and Oregon and Washington hospital discharge datasets to correct racial misclassification of AI/AN people. We assessed outcomes using International Classification of Disease, Ninth Revision/Tenth Revision, Clinical Modification (ICD-9-CM or ICD-10-CM) diagnosis codes. RESULTS: Linkage increased ascertainment of NAS cases among AI/AN by 8.8% in Oregon and by 18.1% in Washington. AI/AN newborns were 1.5 and 3.9 times more likely to be diagnosed with NAS than NHW newborns in Oregon and Washington, respectively. The results showed that newborns residing in rural Washington were 1.4 times more likely to be diagnosed with NAS than those living in urban areas. CONCLUSIONS: Correct racial classification is an important factor in improving data quality for AI/AN populations and establishing accurate surveillance to help address the disproportionate burden of neonatal abstinence syndrome among AI/AN. The results highlight the need for programing efforts tailored by insurance status and rurality for pregnant women using substances.
Authors: Jean Y Ko; Stephen W Patrick; Van T Tong; Roshni Patel; Jennifer N Lind; Wanda D Barfield Journal: MMWR Morb Mortal Wkly Rep Date: 2016-08-12 Impact factor: 17.586
Authors: Sarah C Haight; Jean Y Ko; Van T Tong; Michele K Bohm; William M Callaghan Journal: MMWR Morb Mortal Wkly Rep Date: 2018-08-10 Impact factor: 17.586