2010-2011 VIReC Database 

Methods Cyber Seminar Ser

RESEARCHERS’ GUIDE TO VA DATA
2010-2011 VIReC Database and Methods Cyber Sem

Improving Mortality Ascertain

Using the VHA Vital Status F

May 2, 2011

Presented by:

Noreen Arnold

RESEARCHERS’ GUIDE TO VA DATA
Session Objectives

At the conclusion of the program participants should be able to:

RESEARCHERS’ GUIDE TO VA DATA
Session Objectives

At the conclusion of the program participants should be able to:

– Identify current approaches to ascertain 

mortality using the VHA Vital Status File

RESEARCHERS’ GUIDE TO VA DATA
Session Objectives

At the conclusion of the program participants should be able to:

– Identify current approaches to ascertain 

mortality using the VHA Vital Status File

– Describe recent research and methods 

regarding mortality ascertainment using data and other sources.

RESEARCHERS’ GUIDE TO VA DATA
Session Objectives

At the conclusion of the program participants should be able to:

– Identify current approaches to ascertain 

mortality using the VHA Vital Status File

– Describe recent research and methods 

regarding mortality ascertainment using data and other sources.

– Describe limitations of using the VHA Vi

Status File to ascertain mortality.

RESEARCHERS’ GUIDE TO VA DATA
Session Objectives

At the conclusion of the program participants should be able to:

– Identify current approaches to ascertain 

mortality using the VHA Vital Status File

– Describe recent research and methods 

regarding mortality ascertainment using data and other sources.

– Describe limitations of using the VHA Vi

Status File to ascertain mortality.

Out of scope

– Cause of death

RESEARCHERS’ GUIDE TO VA DATA
Session Topics

S f t lit d t Sources

of mor

t

alit

y d

a

t

a

VHA Vital Status File (VSF) BackgrCreation/ContentsExamples of published VA studies have validated mortalit

y data

Future EnhancementsWhere to go for more help

RESEARCHERS’ GUIDE TO VA DATA
Audience Poll

Have you ever used the VHA VSF?

– 1 Yes, including the Master File– 2 Y O l th Mi i Fil 2 Yes, Only the Mini File– 3 No

RESEARCHERS’ GUIDE TO VA DATA
Audience Poll

How would you rate your overall knowledge of VHA VSF?

– 1 (Never Used)– 2– 3– 4– 5 (Used Frequently Very familiar) 5 (Used Frequently, Very familiar)

RESEARCHERS’ GUIDE TO VA DATA
Session Topics

S f t lit d t Sources

of mor

t

alit

y d

a

t

a

VHA Vital Status File (VSF) BackgrCreation/ContentsExamples of published VA studies have validated mortalit

y data or us

VHA VSFFuture EnhancementsWh f hl ere to go 

for more 

h

elp

RESEARCHERS’ GUIDE TO VA DATA
Sources of Mortality Data in t

 BIRLS Death File

 VA Death File E t t f th E

x

tract from th

e

Benefi i c ary Id tifi t

dentificat

Records 

Locator 

System (BIRLS) datab

 Produced by the Veterans Benefit 

Administration

 ~64-80% of veteran deaths de

p g endin

g 

age1,2 (veterans known to VA)

 Updated monthly

 Austin Information 

Technology Center (

RESEARCHERS’ GUIDE TO VA DATA
Sources of Mortality Data in t

 VA Medicare Vital Status File

 Veterans enrolled in Medicare R i d f C t f M di & M 

Received from Cen

ters for M

edicare & M

Services (CMS) annually

 Current through creation date

 Latest creation date: December 31, 2009 Next update: 

 Creation date October 31, 2010; In VSF J

 Mainly over 65 population  ~83% of veteran deaths

1

 Available from VIReC

RESEARCHERS’ GUIDE TO VA DATA
Sources of Mortality Data in t

 SSA Death Master File

 Received from 

Social 

Security 

Administ

M l t f 65 l ti

3



More comple

t

e for over 65 population

3

 Individuals enrolled in SSA program sin Contains deaths occurring outside Unite ~89-95% of veteran deaths depending 

group1,2

 Updated monthly Maintained b

y AITC

RESEARCHERS’ GUIDE TO VA DATA
Sources of Mortality Data in t

Inpatient Deaths

– Medical SAS Inpatient Datasets (PTF)

• D th i i VA h it l Death

s occurring i

n VA hospit

als

– Fee basis inpatient data

• Deaths occurring in non

-VA hospitals wh

inpatient care covered by VA

– ~5%-12% of veteran deaths1,2– AITC

RESEARCHERS’ GUIDE TO VA DATA
Other Sources of Mortality D

Not Available in VA

Death Certificates 

– State Vital Statistics Offices– N ti l D th I d (NDI) N

ational Death I

n

dex (NDI)

• Gold standard for death ascertainment• Maintained by the National Center for He

Statistics

• Costly

• Annual update - 18 month time lag

– 2009 deaths due to be released in June 2

– Contain cause of death

• Cause specific mortality

RESEARCHERS’ GUIDE TO VA DATA
Other Sources of Mortality D

Not Available in VA

SSA Epidemiological Search

– Provides date of death– V lid t SSN V

alid

a

tes SSN

– Provides ‘presumed living’ status

• Based on SSA administrative data includ

– Payroll deductions, railroad retirement or 

payments, death claims filed by beneficia

• Reduce loss to follow up

– Deaths occurring outside the US–

Fees

RESEARCHERS’ GUIDE TO VA DATA
Session Topics

S f t lit d t Sources of mortality dataVHA Vital Status File (VSF) BackgrCreation/ContentsExamples of published VA studies have validated mortality data or usVHA VSFFuture EnhancementsWh f hl ere to go for more help

RESEARCHERS’ GUIDE TO VA DATA
VHA VSF Background

Impetus for development of VHA V

– Mortality is a common outcome measu

research

– Conflicting results using single data set

• More deaths in Medicare VSF than BIRL

File

VIReC VA VIReC VA-NDI Mortality Data Merg

NDI Mortality Data Merg

Project (2003 SDR 03 Project (2003, SDR 03

-157)

– Recommended the creation of a new V

combined mortality data

– VIReC Technical Report 2: VA-NDI Mor

Data Merge Project (2006)

RESEARCHERS’ GUIDE TO VA DATA
VSF Available in 2006

Owner

– Built by National Data Systems (NDS)– Fi t il bl i O t b 2006 First avail

abl

e i

n O

c

t

o

ber 2006

Data access information

– A i f ti il bl NDS 

Access i

n

formation avail

abl

e on NDS we

– http://vaww4.va.gov/NDS/DataAccess/Researchers/R

Updated QuarterlyVeterans alive on or born after 10/Composed of three files

– Master, Mini, and SSN Conversion

RESEARCHERS’ GUIDE TO VA DATA
VSF – Three Files

Master

– Users of VHA or VBA– O d SSN/DOB/S bi t

One record per SSN/DOB/Sex combinat

– Over 22 million records (15.8 million SS

• 10 2 million SSNs with one record 10.2 million SSNs with one record• 5.6 million SSNs with multiple records• 1.7 million non-veteran SSNs 

– 112 variables– Sort sequence of the master file:

• SCRSSN, descending score, DOB, sex

RESEARCHERS’ GUIDE TO VA DATA
VSF – Three Files

Mini

– One record per SSN– C bi d d t Combined d

a

t

a

– Over 14 million records

– 16 variables– Sort sequence: SCRSSN

SSN Conversion 

– Scrambled to Real

RESEARCHERS’ GUIDE TO VA DATA
Matching Cohort to VSF

Decisions

– Use Mini File?– U M t Fil ? Use Mas

ter Fil

e

?

– Match on SSN, DOB, Sex?

• All must match• Partial match (e.g., just year and sex)

Possible Issues

– Demographics do not match– Activit

y after date of death

• 4.8% of deaths more than 31 days after last activity

Understand Construction of the File

RESEARCHERS’ GUIDE TO VA DATA
Construction of the VHA V

NDS Methodology

RESEARCHERS’ GUIDE TO VA DATA
VBA

Data

VHA

Combine Sources•One record per

Construction of the VHA VSF Construction of the VHA VSF – 

Merge on SSN/DOB/S

VHAData SSN/DOB/SEX

•Last Activity Dates by

Source•Inpatient Deaths

RESEARCHERS’ GUIDE TO VA DATA
Construction of the Master 

Combine VA Data Sources

– Data Sources for SSN/DOB/Sex key com

• M di l SAS I ti t D t t M

edical SAS Inpatient D

a

tase

t

s and C 

d Cen

• Inpatient and Outpatient Encounter (ENC• Non

-VA care or Fee Files (FEE) 

• DSS Pharmacy Files (DSS)• Enrollment (ENR)• VBA Compensation and Pension Files

– Veterans Service Network (VETSNET) Co

Master File (VETSNET File) 

– Compensation and Pension Mini Master F

File) 

RESEARCHERS’ GUIDE TO VA DATA
Construction of the Master 

Combine VA Data Sources (cont.)

– Data Contributed

• D t f l t tili ti ti it D

a

t

e

of last 

utilization or acti

vit

y

• Inpatient death dates (PTF and FEE)

RESEARCHERS’ GUIDE TO VA DATA
VBA

Data

VHA

Combine Sources•One record per

Construction of the VHA VSF Construction of the VHA VSF – 

Merge on SSN/DOB/S

VHAData SSN/DOB/SEX

•Last Activity Dates by

Source•Inpatient Deaths

Merge on SSN Only

Add Death Data•DOB, Sex, & DOD

•Select ‘best’ DOD

BIRLS

CMS

SSAD th ea s

RESEARCHERS’ GUIDE TO VA DATA
What is ‘best’?

Use of a routine to select the value demographic variable (DOB, DOD, Sassociated with an SSN when more one value for that variable is found source data Goal is to select the true value for variable in the majority of cases

RESEARCHERS’ GUIDE TO VA DATA
Construction of the Master 

Add Death Data

– CMS Medicare data

• D t f l t tili ti D

a

t

e

of last 

utilization

• Race• Submission flag by year (CMS INDYY) Submission flag by year (CMS

_INDYY) 

– SSA Death File

• Does not contain Sex

– BIRLS Death File– Matched to VA data on SSN only– Demographics (DOB and Sex) and DOD

RESEARCHERS’ GUIDE TO VA DATA
Construction of the Master 

Select ‘best’ date of death for each SSN/DOB/Sex combination

– Select inpatient DOD if present (PTF or – See Appendix A for selection routine fro

DOD sources (Inpatient, Medicare, SSA

– Put in DOD variable on the Master File r

RESEARCHERS’ GUIDE TO VA DATA
VBA

Data

VHA

Combine Sources•One record per

Construction of the VHA VSF Construction of the VHA VSF – 

Merge on SSN/DOB/S

VHAData SSN/DOB/SEX

•Last Activity Dates by

Source•Inpatient Deaths

Merge on SSN Only

Add Death Data•DOB, Sex, & DOD

•Select ‘best’ DOD

BIRLS

CMS

SSAD th

Master

Deaths

File

RESEARCHERS’ GUIDE TO VA DATA
Contents of the Master Fi

One record for each VA SSN/DOB/ScombinationDOB d SEX DOB and SEX

– One set of DOB/Sex variables for each s

VSF data

– All VA source variables have the same D– BIRLS, Medicare, and SSA matched on 

and may have different DOB and/or Sex

DOD

– From Medicare, BIRLS, Inpatient (PTF & 

and SSA

RESEARCHERS’ GUIDE TO VA DATA
Contents of the Master Fi

Last activity dates

– VA sources and Medicare– M di d t l i M

edicare d

a

t

e exclusions

• DME (durable medical equipment) and U

Carrier claims

Veteran Flags

– Based on means test variables and othe

veteran indicators

– Outpatient, Inpatient, Enrollment, and 

C i d P i Compensation and Pension

RESEARCHERS’ GUIDE TO VA DATA
Contents of the Master Fi

Medicare information

– Race– S b i i fl b (CMS INDYY) S

u

b

mission flag b

y year (CMS

_INDYY)

• 0 = ‘Not Submitted’ • 1 = Submitted/Not Enrolled ‘Submitted/Not Enrolled’• 2 = ‘Submitted/Enrolled’ 

Quality of the date

– “Indicator” – Indicates if full or 

p p artial data 

present in 

(e.g., month, day, and year present; onpresent, etc.)

RESEARCHERS’ GUIDE TO VA DATA
VBA

Data

VHA

Combine Sources•One record per

Construction of the VHA VSF Construction of the VHA VSF – 

Merge on SSN/DOB/S

VHAData SSN/DOB/SEX

•Last Activity Dates by

Source•Inpatient Deaths

Merge on SSN Only

Add Death Data•DOB, Sex, & DOD

•Select ‘best’ DOD

BIRLS

CMS

SSAD th

Master

Deaths

File

O d SSN

Combine data into

One Record Per SSN

One record per SSN•Select veterans•Select ‘best’ DOB,

SEX, DOD for an SSN•Obtain Date of Last

Activity Activity for an SSN One Record Per SSN

RESEARCHERS’ GUIDE TO VA DATA
Construction of the Mini F

Select only Veteran recordsScenario 1: One record for an SSN M t Fil Mas

ter Fil

e

– Use DOB and Sex on record– Use best DOD on record ‘best’ DOD on record

Scenario 2: Multiple records for an on the Master File

– Multiple DOB/Sex combinations– Select best DOB/Sex from all records ‘best’ DOB/Sex from all records– Select ‘best’ DOD from all records

RESEARCHERS’ GUIDE TO VA DATA
Construction of the Mini F

Scenario 2: Multiple records for an on the Master File

– Select ‘best’ date of birth for each SSN 

the SSN/DOB/Sex combinations

• Select best utilization DOB date ‘best’ utilization DOB date

– Based on scoring method (Score range: 0 

» Priority: PTF, Encounter, DSS, FEE» Extra points if complete date sex present 

Extra points if complete date, sex presentBIRLS, SSA or Medicare

• See Appendix B for selection routine from 

sources (Utilization Medicare SSA BIRLsources (Utilization, Medicare, SSA, BIRLEnrollment, VBA C&P)

RESEARCHERS’ GUIDE TO VA DATA
Construction of the Mini F

Scenario 2: Multiple records for an on the Master File

– Select ‘best’ Sex for each SSN among th

SSN/DOB/Sex combinations

• Similar to selection of best DOB

– Select ‘best’ date of death among the 

SSN/DOB/Sex combinations

• Select inpatient DOD if present (PTF or F• See Appendix A for selection routine from 

(Inpatient Medicare SSA BIRLS) (Inpatient, Medicare, SSA, BIRLS)

RESEARCHERS’ GUIDE TO VA DATA
Construction of the Mini F

Select last activity (two dates)

– Utilization (health care)– All ti it (h lth d b fit ) All acti

vit

y (health care and benefit

s

)

– From all SSN/DOB/Sex combinations fo

Presumed living status

– ‘0’: no death date– ‘1 : death date ’: death date– ‘2’: death date and health care usage m

31 days after death

RESEARCHERS’ GUIDE TO VA DATA
VBA

Data

VHA

Combine Sources•One record per

Construction of the VHA VSF Construction of the VHA VSF – 

Merge on SSN/DOB/S

VHAData SSN/DOB/SEX

•Last Activity Dates by

Source•Inpatient Deaths

Merge on SSN Only

Add Death Data•DOB, Sex, & DOD

•Select ‘best’ DOD

BIRLS

CMS

SSAD th

Master

Deaths

File

O d SSN

Combine data into

One Record Per SSN

One record per SSN•Select veterans•Select ‘best’ DOB,

SEX, DOD for an SSN•Obtain Date of Last

Activity Activity for an SSN One Record Per SSN

MiniFile

RESEARCHERS’ GUIDE TO VA DATA
Contents of the VHA VSF Min

One record per SSN‘Best’ DOB, Sex, DODLast health care utilization dateLast activity datePresumed living statusSource indicators

– DOB, DOD, and utilization dates

RESEARCHERS’ GUIDE TO VA DATA
Contents of the VHA VSF Min

DOB Source

– VSF Mini created 1/24/2011

Source Number Percent

Encounter 7,631,583 54.0%Inpatient (PTF) 3 633 420 3,633,420 25 7%.Medicare Vital Status 1,358,684 9.6%

Enrollment 1,046,359 7.4%

VBA C&P Files 317 587 317,587 2 2%.SSA Death Master 88,459 0.6%

DSS Pharmacy 28,094 0.2%

Fee Basis 22,858 0.2%BIRLS Death File 2,888 0.0%

Total Records 14,129,932 100.0%

RESEARCHERS’ GUIDE TO VA DATA
Contents of the VHA VSF Min

DOB Consistency

– VSF Master created 12/12/2010

Records NumberTotal 19,869,5SSNs for Veterans 14,009,0

> 1 Gender 1.

> 1 DOB 36 

.

Conflicting DOB parts 7.

RESEARCHERS’ GUIDE TO VA DATA
Contents of the VHA VSF Min

DOD Source

– VSF Mini created 1/24/2011

Source Number Percent

Medicare Vital Status 2,474,211 2,474,211 5SSA Death Master 1,066,916 2

Patient Treatment File 643,239 1

Birls Death File 145,396 

Fee Basis 65,592 

Total Deaths 4,395,354 10

RESEARCHERS’ GUIDE TO VA DATA
Back to Possible Issues

Demographics do not matchActivity after date of deathExamples

– SCRSSN 11111 

• VSF DOB does not match patient DOB

– SCRSSN 22222 

• Last activity date is more than two years after dea

– SCRSSN 33333

• VSF DOB and sex do not match patient DOB and s

last activity date is after the death date

RESEARCHERS’ GUIDE TO VA DATA
Example 1

Master File Records

Patient demographics: Male born 7/15/1944 

SSN DOB SEX ENC DOB

ENC

SEX

ENC Last

Date PTF DOB

PTF

SEX

PTF Last

Date CMS DOB

CMS

SEX

11111 7/01/1944 M 7/01/1944 M 4/10/1992 7/01/1944 M 4/22/1992 7/15/1944 M 

11111 7/15/1944 M 7/15/1944 M 9/5/2006 7/15/1944 M 

Two records for the SSN: different DOB on Encounte

One source of death data: CMS (Medicare)

RESEARCHERS’ GUIDE TO VA DATA
Example 1

Master File Records

Patient demographics: Male born 7/15/1944 

SSN DOB SEX ENC DOB

ENC

SEX

ENC Last

Date PTF DOB

PTF

SEX

PTF Last

Date CMS DOB

CMS

SEX

11111 7/01/1944 M 7/01/1944 M 4/10/1992 7/01/1944 M 4/22/1992 7/15/1944 M 11111 7/15/1944 M 7/15/1944 M 9/5/2006 7/15/1944 M 

Mini File Record

Death data a

SSN on

SSN DOB SEX

UTL Last

Date

UTL

SRC DOD

DOD

SRC Living IND

11111 7/01/1944 7/01/1944 M 9/5/2006 9/5/2006 ENC 9/10/2006 9/10/2006 CMS 1

Most recent UTL date selected ‘best’ DOB selected Dec

RESEARCHERS’ GUIDE TO VA DATA
Example 2

Master File Records

Patient demographics: Male born 7/15/1944 

SSN DOB SEX ENC DOB

ENC

SEX

ENC Last

Date PTF DOB

PTF

SEX

PTF Last

Date CMS DOB

CMS

SEX

22222 7/15/1953 M 7/15/1943 M 9/1/2006 7/15/1943 M 4/22/1981 7/15/1944 M 

22222 8/30/1980 F 8/30/1980 F 6/12/2009 7/15/1944 M 

Two records for the SSN: different DOB and sex on Enc

One source of death data: CMS (Medicare)

RESEARCHERS’ GUIDE TO VA DATA
Example 2

Master File Records

Patient demographics: Male born 7/15/1944 

SSN DOB SEX ENC DOB

ENC

SEX

ENC Last

Date PTF DOB

PTF

SEX

PTF Last

Date CMS DOB

CMS

SEX

22222 7/15/1953 M 7/15/1943 M 9/1/2006 7/15/1943 M 4/22/1981 7/15/1944 M 22222 8/30/1980 F 8/30/1980 F 6/12/2009 7/15/1944 M 

Mini File Record

Death data 

SSN o

SSN DOB SEX

UTL Last

Date

UTL

SRC DOD

DOD

SRC Living IND

22222 7/15/1943 7/15/1943 M 6/12/2009 6/12/2009 ENC 9/10/2006 9/10/2006 CMS 2

Most recent UTL date selected Acti

RESEARCHERS’ GUIDE TO VA DATA
Example 3

Master File Records

Patient demographics: Male born 5/31/1968 

SSN DOB SEX PTF DOB

PTF

SEX

PTF Last

Date SSA DOB SSA DOD CMS DOB

CMS

SEX C

33333 8/30/1980 F 8/30/1980 F 5/9/2009 5/31/1968 11/18/2005 5/31/1968 M 

One Record for the SSN

Two sources of death data: CMS (Medicare) & SS

RESEARCHERS’ GUIDE TO VA DATA
Example 3

Master File Records

SSN DOB SEX PTF DOB

PTF

SEX

PTF Last

Date SSA DOB SSA DOD CMS DOB

CMS

SEX C

33333 8/30/1980 F 8/30/1980 F 5/9/2009 5/31/1968 11/18/2005 5/31/1968 M 

Death data ad

SSN onl

Mini File Records

SSN onl

SSN DOB SEX

UTL Last

Date

UTL

SRC DOD

DOD

SRC Living IND

33333 8/30/1980 8/30/1980 F 5/9/2009 5/9/2009 ENC 11/18/2005 11/18/2005 SSA 2

Most recent UTL date selected ‘best’ DOD selected

RESEARCHERS’ GUIDE TO VA DATA
Points to Consider

You may find inconsistencies betweVHA VSF demographics and your codemographicsTo resolve these inconsistencies thMaster file will be usefulVHA VSF should not be used for buoperations regarding individual vet

RESEARCHERS’ GUIDE TO VA DATA
Possible Strategy

Use the Mini File for the initial seardeaths

– Match on SSN

Use the Master File to investigate ucases for example: cases, for example:

– Cohort DOB/Sex do not match Mini DOB

• May be records on the Master File with m

demographics

– Activity after death

• Check DOB/Sex for DOD sources on Mas• Are all DOD on Master File the same?

RESEARCHERS’ GUIDE TO VA DATA
Possible Strategy

Consider additional validation step

– Compare the DOB and Sex for the DOD 

on the Master File to cohort DOB and Sedeaths 

– Use the NDI or State Vital Statistics Off

cases lost to follow up

• No death date• No VHA or VBA activity after end of follo• Remember NDI has 18-month lag

Use NDI or State Vital Statistics Offor cause of death

RESEARCHERS’ GUIDE TO VA DATA
Session Topics

S f t lit d t Sources

of mor

t

alit

y d

a

t

a

VHA Vital Status File (VSF) BackgrCreation/ContentsExamples of published VA studies have validated mortalit

y data or us

VHA VSFFuture EnhancementsWh f hl ere to go 

for more 

h

elp

RESEARCHERS’ GUIDE TO VA DATA
VA Validation Studies

S ho

h

n, t l “A d l t f 

et 

al “Accuracy ccuracy and comple

teness

of mo

data in the Department of Veterans Affairs”

– Sample of 3,000 Veterans alive on 1/1/1999, 4.8% fem– 292 deaths from 1999-2002– Gold standard: NDI– BIRLS, PTF, Medicare, SSA

Savas, et al “Mortality Ascertainment of Wome

, et al “Mortality Ascertainment of Wome

Veterans: A Comparison of sources of Vital StaInformation, 1979 Information, 1979-2002”

– 6,297 deceased women Veterans 

• Texas death certificate record 1979-2002• US National Registry of Women Veterans

– Gold standard: Texas mortality database– BIRLS, PTF, SSA

RESEARCHERS’ GUIDE TO VA DATA
VA Validation Studies

Sensitivity by age

– % gold standard’s deaths found in sour– S ho

h

n

Age BIRLS SSA Combine

< 65 67 6 91 5 95 

– Savas

< 65 67.6 91.5 95

65 or older 80.5 92.3 99

– Savas

Age BIRLS SSA Combine

25-44 64.0 88.7 93

45-64 76.7 93.2 97

65 or older 81.5 95.6 98

RESEARCHERS’ GUIDE TO VA DATA
VA Validation Studies

Sensitivity by data source

Study SSA Medicare BIRLS PTF So

Savas 93.8 N/A 77.2 5.2 

Sohn 92 1 83 2 77 4 12 0 

Conclusions

Sohn 92.1 83.2 77.4 12.0 

– BIRLS should not be used alone– All sources provide unique cases– Sensitivity decreases with age

RESEARCHERS’ GUIDE TO VA DATA
Session Topics

S f t lit d t Sources

of mor

t

alit

y d

a

t

a

VHA Vital Status File (VSF) BackgrCreation/ContentsExamples of published VA studies have validated mortalit

y data

Future EnhancementsWhere to go for more help

RESEARCHERS’ GUIDE TO VA DATA
Future Enhancements

VIReC Data Quality Review

– Quantifying missing and conflicting 

demographics (DOB Sex DOD) demographics (DOB, Sex, DOD)

– Evaluating best DOB selection methodo– Investigating cases of activity after dea– Technical report

Medicaid Data

– Under 65 deaths

RESEARCHERS’ GUIDE TO VA DATA
Session Topics

S f t lit d t Sources

of mor

t

alit

y d

a

t

a

VHA Vital Status File (VSF) BackgrCreation/ContentsExamples of published VA studies have validated mortalit

y data or us

VHA VSFFuture EnhancementsWh f hl ere to go 

for more 

h

elp

RESEARCHERS’ GUIDE TO VA DATA
Help

N ti l D t S t National Data Systems

– Dorothea Garrett– Larry Hughes– http://vaww4.va.gov/NDS/DataAccess/Rese

ESViStat.asp

VIReC Webpage

http://www.virec.research.va.gov

– Information on VA data sources and how 

access data

– Documentation on some VA datasets, i.

RESEARCHERS’ GUIDE TO VA DATA
Help (cont’d)

HSRData Listserv

– Join at the VIReC Web site– Discussion among 

 >500 data stewards

managers, and users

– Past messages in archive (on intranet)

VIReC Help Desk

– VIR C t ff ill ti 

VIReC staff will answer your question adirect you to available resources on to

– VIReC@va gov VIReC@va.gov

– (708) 202-2413

RESEARCHERS’ GUIDE TO VA DATA
Questions?

RESEARCHERS’ GUIDE TO VA DATA
Next Seminar

6/6/2011 6/6/2011 1:00pm

Overview of VA Data, Information Systems, National Databases and Research Uses VIReC Database and Methods Seminar 

Presented by: 

Denise M Denise M Hynes PhD MPH RN Denise M. Hynes, PhD, MPH, RN

RESEARCHERS’ GUIDE TO VA DATA
References

1. Savas LS d l J DJ B ti LA V SW LS, del Junco DJ, Bastian LA, Vernon SW

Mortality ascertainment of women veterans: a comparison of sources of vital status informa1979-2002 . Med Care Med Care 2009 47 125 2009;47:125-128.

2. Sohn MW, Arnold N, Maynard C, Hynes DM. Ac

MW, Arnold N, Maynard C, Hynes DM. Ac

and completeness of mortality data in the Dep

of V t Aff i f Veterans Affairs. P l opu H lthea M t e r 2006 4 

2006;4

3. Hill ME, Hill ME, Rosenwaike Rosenwaike I. The Social Security I. The Social Security 

Administration's Death Master File: the compl

of d h i ld f death reporting at o ng at older ages. er ages. Soc Secur Bu2001;64:45 2001;64:45-51.

4. Doody MM, Chimes K. The Social Security MM, Chimes K. The Social Security 

Administration "presumed living" search. Am Health 2000;90:1948 2000;90:1948-1949.

RESEARCHERS’ GUIDE TO VA DATA
Appendix A

Best Date of Death for VHA Vital Status File 1. If all sources (Inpatient, BIRLS, Medicare, SSA) have a different date: 

– If complete inpatient death date present use inpatient death date ; otherwi– If Medicare death date present and the day was not equal to 28, 30, and 31

Medicare date; otherwise 

– If SSA death date p y q ,, , 

resent and the day is not equal to 00, 01, and 15, use t

otherwise 

– If BIRLS death date present use the BIRLS date; otherwise – If Medicare death date present and the day equals 28, 30, or 31 use the M

otherwise 

– If SSA death date present, use the SSA date. 

2 If all sources have a date and the extern 2. If all sources have a date and the external dates (SSA and Medicare) matched 

internal dates (Inpatient and BIRLS) matched but the external dates did internal dates, use the inpatient death date. 

3. If the external sources only had matching dates:

– If an inpatient death date is present, use the inpatient death date; otherwis

– Use the external date. 

4. If the internal sources only had matching dates use the internal source. 5. If an external source matches an internal source: 

– Use the inpatient death date if the external source matches the inpatient de

otherwise 

6. If BIRLS date is present, use the BIRLS date; otherwise 

7 If th FEE d t i t th FEE d t 7. If the FEE date is present, use the FEE date.

RESEARCHERS’ GUIDE TO VA DATA
Appendix B

Best Date of Birth for VHA Vital Status File1. If all sources had a different date: 

– If a complete Utilization birth date present, use the Utilization date (highe

Utilization birth date); otherwise

– If Medicare birth date present, use the Medicare date; otherwise 

– If SSA b h d h SS d h birth date present , use the SSA date; otherwise

– If Enrollment birth date present, use the Enrollment Date 

– If BIRLS birth date present, use the BIRLS date; otherwise – If VBA (C&P Mini) birth date present, use the VBA date; otherwise 

– Use incomplete Utilization birth date.

2. If all sources have a date and the external dates (SSA and Medicare) matched 

internal dates (Utilization, BIRLS, VBS and Enrollment) matched but the did not match the internal dates, use the internal birth date. 

3. If the external sources only had matching dates:

– If a comp p, ; lete Utilization birth date present, use the Utilization date; otherw

external date. 

4. If the internal sources only had matching dates use the internal date. 5. If an external source matches an internal source: 

– Use the Utilization birth date if the external source date matches the Utiliza

otherwise 

6. If BIRLS birth date present, use the BIRLS date; otherwise7. If VBA (C&P Mini) birth date present, use the VBA date; otherwise 8. Use incomplete Utilization birth date.

RESEARCHERS’ GUIDE TO VA DATA