Using Infant Mortality Data to Improve Maternal and Child Health Programs: An Application of Statistical Process Control Techniques for Rare Events
Using Infant Mortality Data to Improve Maternal and Child Health Programs: An Application of Statistical Process Control Techniques for Rare Events
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DOI：
10.1007/s10995-018-02710-3
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发表时间：
2019-06-01
影响因子：
2.3
通讯作者：
Berns, Scott
中科院分区：
文献类型：
--
作者：
Finnerty, Patricia;Provost, Lloyd;Berns, Scott
简介 美国的婴儿死亡率 (IMR) 仍然高于大多数发达国家。为了了解这一公共卫生问题并支持州公共卫生部门以支持学习的方式显示和分析数据，参与降低婴儿死亡率的协作改进和创新网络 (IM CoIIN) 的各州创建了罕见事件的统计过程控制 (SPC) 图表。方法 使用有关活产和婴儿死亡的州生命记录数据为堪萨斯州和阿拉斯加创建 U、T 和 G 图，这两个州参与了 IM CoIIN，他们寻求更有效地分析死亡人数较少的人口子集的 IMR 的方法。分别绘制了 2013-2016 年和 2011-2016 年期间堪萨斯州非西班牙裔黑人人口和阿拉斯加六个地区的 IMR 以及婴儿死亡之间的天数和出生人数。已建立的经验模式表明了特殊原因变异的点。结果 堪萨斯州的 T 和 G 控制图以及阿拉斯加的 G 控制图描绘了控制上限之外的点。这些点表明特殊原因变异以及这些时间段内死亡之间的天数和/或出生数增加。讨论 T 和 G 图在检查罕见事件方面具有价值，并指示 U 图或其他更传统的分析方法无法检测到的特殊原因。当数量较少使得传统分析具有挑战性时，SPC 在 MCH 领域具有潜力，可以更好地了解罕见结果改善的潜在驱动因素、为决策提供信息并扩大干预措施。
Introduction The infant mortality rate (IMR) in the United States remains higher than most developed countries. To understand this public health issue and support state public health departments in displaying and analyzing data in ways that support learning, states participating in the Collaborative Improvement and Innovation Network to Reduce Infant Mortality (IM CoIIN) created statistical process control (SPC) charts for rare events. Methods State vital records data on live births and infant deaths was used to create U, T and G charts for Kansas and Alaska, two states participating in the IM CoIIN who sought methods to more effectively analyze IMR for subsets of their populations with infrequent number of deaths. The IMR and the number of days and number of births between infant deaths was charted for Kansas Non-Hispanic black population and six Alaska regions for the time periods 2013-2016 and 2011-2016, respectively. Established empirical patterns indicated points of special cause variation. Results The T and G charts for Kansas and G charts for Alaska depict points outside the upper control limit. These points indicate special cause variation and an increased number of days and/or births between deaths at these time periods. Discussion T and G charts offer value in examining rare events, and indicate special causes not detectable by U charts or other more traditional analytic methods. When small numbers make traditional analysis challenging, SPC has potential in the MCH field to better understand potential drivers of improvements in rare outcomes, inform decision making and take interventions to scale.