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IPODR - Definitions

Definitions used in the County Reports
Birth
California Resident
Race/Ethnicity
Medi-Cal payer
No high school degree
Mexico-born mother
Grand multiparity
Short birth interval
Late entry into prenatal care
Inadequate prenatal care
Fetal mortality rate
Neonatal mortality rate
Perinatal mortality rate
Postneonatal mortality rate
Infant mortality rate
Low birth weight
Very low birth weight
Preterm live birth
First time cesarean sections to low risk women
Repeat cesarean sections to low risk women
Non-normal newborns
Long length of stay
Birth
For IPODR, a birth is included only if it is a live birth. Fetal deaths are not included in any IPODR tables or maps, except for those in the mortality section. Note that the IPODR definition of birth (and the treatment of fetal deaths) was changed starting in May 2009. See recent changes to IPODR for more information.
California Resident
All IPODR measures include only California resident births. These are births to a mother who lists California as their current home address on the birth certificate. Note that the birth itself may have occured outside of California. A father may have a home address outside California.
Race/ethnicity
Hispanic
 All persons identifying themselves as of Hispanic ethnicity.
Non-Hispanic White
 All persons identifying themselves as White, but not as Hispanic.
Non-Hispanic Black
 All persons identifying themselves as Black, but not as Hispanic.
Non-Hispanic Asian/Pacific Islander
 All persons identifying themselves as Asian or Pacific Islander, but not as Hispanic.
Non-Hispanic Other
 All persons not identifying themselves as one of the categories above including Native American, Alaskan, Aleutian, 2 or more races, unknown and other race, but not as Hispanic.
Medi-Cal Payer
This refers to any birth record indicating that Medi-Cal or Medicare paid for labor and delivery. Note that Medi-Cal is the name of the federal Medicaid program in California.
No high school degree
Prior to 2006, the birth certificate included information on the number of years of education completed by the mother. IPODR considered a mother who completed 11 or less years of schooling as having "no high school degree." Starting in 2006, the actual degree information was captured for the birth certificate, and that information is used in IPODR from that year forward.
Mexico-born mother
Mexico-born mothers are determined from the "birthplace of mother." This refers to foreign born mothers, specifically from Mexico.
Grand multiparity
Grand multiparous mothers are women who have had six or more births (including the current birth). Note that fetal deaths are included in the count of previous births.
Short birth interval
The birth certificate collects information on the months between the current and the previous live birth. A birth interval is considered short if the number of months between the current and last birth is 23 or less. Note that this calculation leads to a conservative estimate of the percent of births occurring within 24 months of a previous birth as births occurring in the 24th month are not included.
Late entry into prenatal care
A woman is considered to enter prenatal care late if she never receives prenatal care or if her first prenatal visit occurs after the first trimester of pregnancy.
Inadequate prenatal care
The Adequacy of Prenatal Care Index (APNCU or Kotelchuck index) is based on two independent components: the initiation (timing) of prenatal care and the number of prenatal visits adjusted for the length of gestation. A woman is considered to have experienced inadequate prenatal care if the APNCU index (Kotelchuck index) indicates late or intermediate and/or too few prenatal care visits for the length of gestation. For a detailed description of and additional information on the APNCU index, click here.
Fetal mortality rate
For the Healthy People 2020 Objectives, fetal deaths occurring at 20 or more weeks of gestation are included in the fetal mortality calculations. For the California County Profile Reports, the fetal mortality rate is defined as the number of fetal deaths occurring at 20 or more weeks of gestation (including fetal deaths with missing, or unkonwn gestation) divided by the number of all live births and fetal deaths multiplied by 1,000.
Neonatal mortality rate
The neonatal mortality rate is defined as the number of deaths at less than 28 days of age divided by the number of all live births multiplied by 1,000.
Perinatal mortality rate
The Healthy People 2020 Objectives define perinatal deaths as fetal deaths at 28 weeks or more of gestation or deaths until 7 days of age. For the California County Profile Reports, the perinatal mortality rate is defined as the number of fetal or neonatal deaths at 28 weeks of gestation to seven days after birth divided by the number of all live births plus the number of fetal deaths at 28 weeks of gestation or more multiplied by 1,000.
Postneonatal mortality rate
The postneonatal mortality rate is defined as the number of deaths at age 28 days to 365 days of age divided by the number of all live births multiplied by 1,000.
Infant mortality rate
The infant mortality rate is defined as the number of deaths within 365 days of age divided by the number of all live births multiplied by 1,000. Neonatal and postneonatal deaths combined constitute infant deaths.
Low birth weight
A baby is defined as having a low birth weight if its weight is less than 2,500 grams at delivery.
Very low birth weight
A baby is defined as having very low birth weight if its weight is less than 1,500 grams at delivery. Note that very low birth weight births are by definition also low birth weight births and counted in both birth weight measures.
Preterm live birth
A baby is defined as preterm if its gestational age is less than or equal to 36 weeks at delivery. Note that any gestational age of less than 37 completed weeks (such as 36 weeks and 6 days) is said to have a gestational age of 36 weeks and is therefore preterm.
First time cesarean sections to low risk women
A live birth is said to be delivered via first time cesarean section if the mother had no previous deliveries, and the delivery is low-risk. Low-risk deliveries are for singleton (non-multiple), full-term (gestation greater than or equal to 37 weeks) babies where the fetus is in the vertex position (head facing downward). Babies delivered by cesarean who are NOT low-risk are not included in the IPODR cesarean measures. This approach is consistent with the Healthy People 2020.
Repeat cesarean sections to low risk women
A live birth is said to be delivered via repeat cesarean section if the delivery is low-risk, and the mother has previously delivered via cesarean. Low-risk deliveries are for singleton (non-multiple), full-term (gestation greater than or equal to 37 weeks) babies where the fetus is in the vertex position (head facing downward). Babies delivered by cesarean who are NOT low-risk are not included in the IPODR cesarean measures. This approach is consistent with the Healthy People 2020.
Non-normal newborns
This information is derived from the California Patient Discharge Data (PDD) published by the California Office of Statewide Planning and Development (OSHPD). Diagnosis related groups (DRG) are case mix assignments grouping hospital patients to categories based on diagnostic, therapeutic, and demographic characteristics for the purpose of reimbursement. Beginning in 2008, The PDD began reporting Medicare DRGs, known as MS-DRGs. Although MS-DRGs greatly expanded the number of diagnosis related groups, the relevant groups for newborns were essentially unchanged. Only the code identifiers changed. The groups and their definitions remained the same. Each newborn is assigned to one of seven DRG or MS-DRG codes as follows:
DRG
(prior to 2008)
MS-DRG
(2008 and later)
Description
385789Died/Transferred
386790Extreme Immaturity/Respiratory Distress Syndrome
387791Prematurity with Major Problems
388792Prematurity without Major Problems
389793Full Term Neonate with Major Problems
390794Full Term Neonate with Significant Problems
391795Normal Newborn
For the California County Profile Reports, all newborns that died/transferred, were born prematurely, or were born full term but with major or significant problems were included in the group of non-normal newborns.
Long length of stay
A long length of stay is defined as a hospital stay after birth that exceeded 5 days. Note that only infants who were discharged home are included in the reference at risk population.

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