Mx-Plnck-Insiu fü demogfische Foschung Mx Plnck Insiue fo Demogphic Resech Kond-Zuse-Ssse 1 D-18057 Rosock GERMANY Tel +49 0 3 81 20 81-0; Fx +49 0 3 81 20 81-202; hp://www.demog.mpg.de MPIDR TECHNICAL REPORT 2011-002 FERUARY 2011 Ode-Specific Feiliy Esimes bsed on Peinl Sisics nd Sisics on Ou-Of-Hospil ihs Michel Keyenfeld keyenfeld@demog.mpg.de Fedeik Pees pees@demog.mpg.de Rembnd Scholz scholz@demog.mpg.de Ines Wlosnewski ines.wlosnewski@uniklinik-feibug.de This echnicl epo hs been ppoved fo elese by: Vldimi Shkolnikov shkolnikov@demog.mpg.de Hed of he Lbooy of Demogphic D. Copyigh is held by he uhos. Technicl epos of he Mx Plnck Insiue fo Demogphic Resech eceive only limied eview. Views o opinions expessed in echnicl epos e ibuble o he uhos nd do no necessily eflec hose of he Insiue.
Technicl ckgound Ode-Specific Feiliy Esimes bsed on Peinl Sisics nd Sisics on Ou-Of-Hospil ihs Michel Keyenfeld keyenfeld@demog.mpg.de Fedeik Pees pees@demog.mpg.de Rembnd Scholz scholz@demog.mpg.de Ines Wlosnewski ines.wlosnewski@uniklinik-feibug.de Absc Unil 2008 Gemn vil sisics hs no povided infomion on biologicl bih ode. We hve ied o close p of his gp by poviding ode-specific feiliy es geneed fom Peinl Sisics nd sisics on ou-of-hospil bihs fo he peiod 2001-2008. This invesigion hs been published in Compive Populion Sudies CPoS see Keyenfeld Scholz Pees nd Wlosnewski 2010. The CPoS-ppe descibes how d fom he Peinl Sisics nd sisics on ou-of-hospil bihs cn be used o esime ode-specific feiliy es. The min pupose of his Technicl Repo is o mke vilble he oiginl bih couns which wee used in he sudy published in CPoS. Fuhemoe we povide ddiionl bckgound infomion on he d souces in his epo. Keywods: ih ode feiliy Gemny Esen nd Wesen Gemny Peinl Sisics
1 Inoducion Unil 2008 Gemn vil sisics hs no povided infomion on biologicl bih ode. We hve ied o close p of his gp by poviding ode-specific feiliy es geneed fom Peinl Sisics nd sisics on ou-of-hospil bihs fo he peiod 2001-2008. This sudy hs been published in Compive Populion Sudies CPoS see Keyenfeld Scholz Pees nd Wlosnewski 2010. The CPoS-ppe descibes how d fom he Peinl Sisics nd sisics on ou-of-hospil bihs ws used o esime ode-specific feiliy es. The min pupose of his Technicl Repo is o mke vilble he oiginl bih couns fom he CPoS-ppe. In he following we descibe he wo d souces h he sudy ws bsed on: he Peinl Sisics nd he sisics on ou-of-hospil bihs. The le is bbevied wih QUAG Sisics s i hs been povided by he Gesellschf fü die Quliä in de ußeklinischen Gebushilfe e.v. QUAG English: Associion fo Quliy in Ou-of-Hospil ihs. In he second p of his ppe we discuss some peculiiies of he wo d ses nd he segy how we del wih uncle o missing cses. Finlly we descibe he mehod h ws pplied o esime he bih couns. This epo is lso ccompnied by Excel files h conin he bih couns h we hve geneed see Tble 1 fo n oveview on he conen of he Excel shees. Tble 1: Conen of he wo Excel files enclosed o his epo. File Wokshee Nme Conen PERINATAL.xls DEU Numbe of bihs by ge nd ode esimes bsed on Peinl Sisics Gemny DEU_EAST DEU_WEST Weighs PERINATAL_QUAG.xls DEU DEU_EAST DEU_WEST Weighs Numbe of bihs by ge nd ode esimes bsed on Peinl Sisics Esen Gemny Numbe of bihs by ge nd ode esimes bsed on Peinl Sisics Wesen Gemny Weighs mehod 1 only Peinl Sisics Numbe of bihs by ge nd ode esimes bsed on Peinl Sisics nd QUAG Sisics Gemny Numbe of bihs by ge nd ode esimes bsed on Peinl Sisics nd QUAG Sisics Esen Gemny Numbe of bihs by ge nd ode esimes bsed on Peinl Sisics nd QUAG Sisics Wesen Gemny Weighs mehod 2 only Peinl Sisics nd QUAG Sisics 2
2 D The sudy dws on wo ypes of d: Fisly we use Peinl Sisics h includes hospil bihs. Secondly we hve used d on ou-of-hospil bihs which hve been povided by he Gesellschf fü die Quliä in de ußeklinischen Gebushilfe e.v. QUAG. oh d ses e descibed in he following. 2.1 The Peinl Sisics The Peinl Sisics used o be minined by he undesgeschäfsselle Quliässicheung QS English: Insiue fo Quliy nd Sfey which povided us wih he d. Howeve esponsibiliies hve ecenly shifed nd now he Aqu-Insiu is esponsible fo dminiseing his d see hp://www.qu-insiu.de. D fo he Peinl Sisics e colleced by he sff of he hospil whee he womn delives he child bsed on he pegnncy ecod Muepss of he mohe nd by sking he mohe o povide cein infomion such s smoking hbis. The chceisics of newbon such s weigh sex nd physicl condiion e ken fom he medicl ecods of he child. As esul he Peinl Sisics povides ich se of vibles fo mico-level medicl nd demogphic esech. 1 Especilly he following vibles migh be useful fo ddessing ineesing esech quesions: ge of mohe pegnncy hisoy numbes of live bihs sill bihs boions eminions of pegnncy 2 pneship sus whehe womn hs sedy pne couny of bih howeve he cuen ciizenship is no suveyed smoking hbis duing pegnncy 3 physicl mesuemens such s body mss index of mohe nd child fo mohe: weigh fis medicl exminion nd bih vious indicos eflecing esuls of medicl checkups duing pegnncy nd fe childbih 1 See Appendix fo exc fom he quesionnie 2 Unfounely infomion on he des of pevious pegnncies nd bihs e no colleced. 3 Defined s cigees pe dy mny missing cses no infomion on smoking cee. 3
deiled infomion bou complicions duing pegnncy congenil bnomliies nd infn mobidiy s well s moliy Some shocomings of he Peinl Sisics should be menioned. Mos impon he Peinl Sisics does no include deliveies h ke plce home in bih cenes o in he offices of midwives. The she of hese ou-of-hospil deliveies is only bou wo pecen see Tble 2. Howeve he fc h hese bihs e no included in he Peinl Sisics is poenil poblem becuse women who op fo n ou-of-hospil bih diffe in sevel wys fom ohe women. Ou-of-hospil bihs e moe likely o be chosen by olde women nd hose who hve ledy one o wo pio childen Loyved nd Wenzlff 2007. Anohe poblem of he Peinl Sisics is h d quliy ws incesing wih ime. Alhough i is mndoy fo ll hospils o povide infomion on ll bihs since 2001 no ll hospil bihs nd no ll Gemn fedel ses wee coveed in he ely yes. This cn be seen fom Tble 2 which displys he ol numbe of bihs in ou smple nd compes i wih complee d fom he vil sisics. The diffeences beween he vil sisics nd he Peinl Sisics e lge in 2001 nd 2002 bu hey decline ove he yes. The low covege in he ye 2001 cn minly be ibued o he fc h in his ye hee Gemn Fedel Ses Hesse Schleswig-Holsein nd Slnd did no delive hei d. Tble 2: Covege of ihs in he Peinl Sisics 2001 2002 2003 2004 2005 2006 2007 2008 ihs in Peinl Sisics ihs in Vil Sisics Peinl Sisics/ Vil Sisics 452826 608122 590293 671228 665718 655951 667016 667227 734475 719250 706721 705622 685795 672724 684862 682514 0.62 0.85 0.84 0.95 0.97 0.98 0.97 0.98 Souce: Keyenfeld Scholz Pees nd Wlosnewski 2010 2.2 The Sisics on Ou-Of-Hospil ihs The second ype of d we e using is he sisics on ou-of-hospil bihs. This sisics is monioed by he Gesellschf fü die Quliä in de ußeklinischen Gebushilfe e.v. QUAG English: Associion fo Quliy in Ou-of-Hospil ihs. We hve bbevied his sisics wih QUAG Sisics. A quesionnie simil o he one used in collecing he 4
Peinl Sisics is used. 4 Alhough picipion of midwives is voluny bou 80 pecen of ll ou-of-hospil bihs e coveed in his d souce Loyved 2009: 6. ecuse he sucue of he vibles in he QUAG Sisics is lmos he sme s in he Peinl Sisics he wo souces cn be combined in sighfowd mnne. An essenil mesue of quliy fo he QUAG Sisics is how mny of ll ou-of-hospil bihs e included in he d se. Tble 3 compes he numbe of bihs in he QUAG Sisics wih he clculed ol numbe of ou-of-hospil bihs in Gemny. 5 As cn be seen fom his ble covege of he ou-of-hospil bihs in he QUAG Sisics nges fom 68 o 91 pecen. This is lowe hn he covege of he Peinl Sisics. Howeve we ssume h non-esponse is disibued ndomly so h his sisics will povide us wih esonble esimes of he ge nd piy disibuion of ou-of-hospil bihs. Tble 3: Covege of ihs in QUAG Sisics 2001 2002 2003 2004 2005 2006 2007 2008 Numbe of bihs in QUAG Sisics Ou-of-hospil bihs in Gemny Numbe of bihs in Gemny Covege of ou-of-hospil bihs in QUAG Sisics She of ou-of-hospil bihs ou of ll bihs in Gemny 8245 8219 8561 8686 8305 8315 8188 8280 9841 11236 9415 12130 12260 10859 10997 9799 734475 719250 706721 705622 685795 672724 684862 682514 84% 73% 91% 72% 68% 77% 74% 84% 1% 2% 1% 2% 2% 2% 2% 1% Noes: * The numbe of ou-of-hospil bihs ws geneed s he diffeence beween he numbe of bihs in he vil sisics nd he numbe of hospil bihs ken fom he Gesundheisbeichesung des undes Sisisches undesm 2009b. Souce: Keyenfeld Scholz Pees nd Wlosnewski 2010 4 Unfounely infomion on he des of pevious pegnncies nd bihs e no colleced. 5 Unfounely hee e no officil ecods on he ol numbe of ou-of-hospil bihs in Gemny. They cn neihe be geneed fom he Peinl Sisics s his sisics is no complee duing he fis yes fe he cenl egise hd been esblished. The d in Tble 2 comes fom he Gesundheisbeichesung des undes Sisisches undesm 2009. We should noe howeve h his is pobbly he uppe benchmk fo he cul moun of ou-of-hospil bihs Loyved 2009: 6. 5
3 Vibles nd Cses 3.1 Definiion of Vibles Since he QUAG nd he Peinl Sisics e he simil ll vibles h we equie fo ou invesigion e vilble in boh d ses. The following vibles hve been used: Age bih ws defined s he diffeence beween ye of bih of mohe nd ye of bih of he child lso known s ge eched duing he ye. Regionl specs wee ken ino ccoun by disinguishing Esen Gemny nd Wesen Gemny. Esen Gemny is hee defined s Esen Gemny including he enie ciy of elin. Wesen Gemny does no include elin. 6 The ode of bih ws consuced by dding one o he numbe of pio live bihs. One spec h equied specil enion concens he muliple bihs. Fo singleons he bih ode cn be geneed by simply dding one o he numbe of peviously live-bon childen. This segy needed o be modified fo muliple bihs becuse he numbes of peviously bon childen do no ke ino ccoun he cuen bih. In ohe wods if womn gives bih o wins nd does no hve ny pio childen he numbe of pevious live bihs is zeo in he Peinl Sisics. If we would pply he sme segy s fo singleons we would ssign eoneously boh childen he bih ode one. We coeced his bis by ssigning one of he wins o bih ode one while he ohe one coesponds o bih ode wo. 7 3.2 Excluded bihs Only smll numbe of bihs hd o be omied fom he w d in boh d ses see Tble 4. This peins o bihs wih missing infomion on he ye of bih of he child. We lso deleed cses whee he mohe s ge childbih ws below ge 11 o bove ge 50 s we ssumed h hese cses wee mosly miscoding. Fuhemoe in he QUAG Sisics hee wee lso some cses wih missing infomion eihe on he numbe of pio live-bon childen o on he ge of he mohe which wee omied oo. 8 In ol we deleed 0.09 6 7 We do no povide ny esimes by fedel lnd. The eson is h we equie he numbe of bihs fom he vil sisics o genee he weighing fco. Howeve hee is disgeemen beween he vil nd he Peinl Sisics in epoing bihs by egion. In he vil sisics he bihs e ssigned ccoding o he plce of esidence of he mohe. In he Peinl Sisics bihs e ssigned ccoding o he plce of bih of he child. Thee e some women who migh no give bih in he sme fedel se s hey e living in. This picully pplies o women in ndenbug who fequenly choose o give bih in hospil in elin. We fis geneed mse ble h conined he numbe of ll childen by ode ge nd egion. Then we geneed muliple bih ble h conined muliple bihs by ode ge nd egion. Finlly fom he mse ble we subced hlf of ll muliple bihs of given ode. These childen wee hen dded o he couns of he nex bih ode. Fo simpliciy we ssumed h ll muliple bihs e win bihs. 8 The Peinl Sisics conined sevel cses wih missing infomion on pio live bihs. These wee ll ccoding o infomion fom he QS nullipous women. We conduced some consisency checks in which we ook ino ccoun infomion on he pegnncy hisoy of he women. This consisency 6
pecen of he cses of he w d of he Peinl Sisics. In he QUAG Sisics he numbe of omied cses fom he w d is wih 7 pecen howeve subsnilly highe. We used his d o check how well he Peinl Sisics nd he QUAG Sisics cove ll hospil nd ou-of hospil bihs in Gemny see Tble 2 nd Tble 3. Howeve when we ied o genee weighs we n ino poblem. Fo geneing weighs see below we equied he bih couns fom he Gemn Sisicl Office. A he ime when we woe his ppe we only hd ccess o bih couns by single ges fo he ge nge 15-44. The bihs fo he ges below 15 nd bove 45 wee povided in ems of open inevls below ge 15 nd bove ge 45. As we wee unsue how o genee weighs fo he open inevls we decided o omi hese ges fom he fuhe nlysis. We heefoe educed he smple fuhe nd only consideed women ges 15-44. Tble 4: Numbe of Live-on Childen 2001-2008 in Peinl nd QUAG Sisics Peinl Sisics QUAG Sisics Live-bon childen in w file 4982707 71963 Deleed cses 4326 5234 Remining smple ges 11-50 4978381 66729 Remining smple ges 15-44 4970422 66640 Souce: QS Peinl Sisics nd QUAG Sisics own clculions 4 Mehod Ou min gol hs been o use he Peinl Sisics o genee he numbe of bihs by ode nd ge fo Gemny nd sepely fo is esen nd wesen ps. We seek o povide esimes h mch he ol numbe of bihs in Gemny e.g. o clcule bih es populion level. Fo his eson we geneed weighing fco h e-weighs he bihs fom he Peinl Sisics in wy h hey mch he ol numbe of bihs in Gemny. 9 We povided wo ses of esimes. The fis one uses only d fom he Peinl Sisics secion 4.1. In ddiion o h he second ppoch elies on d fom boh he Peinl Sisics nd he QUAG Sisics secion 4.2. check buessed he ssumpion h cses wih missing infomion on pio live bihs wee childless women. 9 We use he sme weigh fo ech bih ode. 7
4.1 Esimion bsed on Peinl Sisics We hve consuced weighing fco h consides ge ye nd egion esen nd wesen Gemny. Le be he numbe of bihs in he vil sisics be he numbe of bihs in he Peinl Sisics nd be he weigh. The weigh ccouns fo ge ye nd egion. I is clculed s he io of he numbe of bihs in he vil sisics o he numbe of bihs in he Peinl Sisics: V P w w p V = 1 Then he numbes of ode-specific bihs fom he Peinl Sisics whee i denoes he ode of he bihs e muliplied by hese weighs. This gives he esimed numbe of ode-specific bihs by ge ye nd egion h is bsed on he Peinl Sisics. P i = ˆ w P i i 2 4.2 Esimion bsed on boh Peinl nd QUAG Sisics We consuced n ddiionl weighing fco which lso ccouns fo he bihs in he QUAG Sisics. Le be he numbe of bihs in he vil sisics be he numbe of bihs in he QUAG Sisics be he numbe of bihs in he Peinl Sisics i be he ode of he bihs nd w* be he new weighing fco. The weigh gin ccouns fo ge ye nd egion. I is geneed by dividing he numbe of bihs fom he vil sisics by he sum of he numbe of bihs in he Peinl nd he QUAG Sisics: V Q P * w Q P V + = 3 In he nex sep he numbe of ode-specific bihs by ge ye nd egion fom he Peinl nd he QUAG Sisics e muliplied by he new weighs o obin he esimed numbe of bihs: i [ ] ˆ * * w Q i P i i + = 4 8
5 Conclusion The min pupose of his Technicl Repo ws o povide moe deiled echnicl infomion eled o he ppe Ode-Specific Feiliy Res fo Gemny: Esimes fom Peinl Sisics fo he Peiod 2001-2008 h ws published in Compive Populion Sudies in 2010. This Technicl Repo lso includes wo Excel files h povide he bih couns fo he esimion of ode-specific feiliy es. The fis file conins he odespecific bih couns bsed on esimion wih he Peinl Sisics only Mehod 1. The second file povides he ode-specific bih couns h ddiionlly ke ino ccoun ou-ofhospil bihs Mehod 2. oh files lso include he weighs h wee pplied. The wo ses povide vey simil bih couns by ge of mohe. This confims h he esimes fom Mehod 1 e obus. Fom his we concluded h he inclusion of ou-ofhospil bihs does no ffec he esuls see Keyenfeld Scholz Pees nd Wlosnewski 2010. This migh be elevn fo fuue nlyses in which eseches migh use he Peinl Sisics o genee ode-specific feiliy es fo he ime befoe 2001 o fe 2008. 9
6 Refeences undesgeschäfsselle Quliässicheung 2009: Fgebogen Densz Gebushilfe. hp://www.bqs-online.com/downlod/boegen-2009/16-1.pdf Downlod 16-02-2009 Keyenfeld Michel/ Scholz Rembnd/ Pees Fedeik/ Wlosnewski Ines 2010: Ode- Specific Feiliy Res fo Gemny: Esimes fom Peinl Sisics fo he Peiod 2001-2008. Compive Populion Sudies 35 Zeischif fü evölkeungswissenschf: 207-224. hp://www.compivepopulionsudies.de/index.php/cpos/icle/view/31/2 2. Loyved Chisine 2009: Quliäsbeich 2006. Außeklinische Gebushilfe in Deuschlnd. Im Aufg de Gesellschf fü Quliä in de ußeklinischen Gebushilfe e.v.. URL: hp://www.qug.de/downlods/quag_beich2006.pdf 28.10.2010. Loyved Chisine/ Wenzlff Pul 2007: Außeklinische Gebu in Deuschlnd. Gemn Ou-Of-Hospil ih Sudy 2000-2004. en: Hube. Loyved C. 2009: Quliäsbeich 2007. Außeklinische Gebushilfe in Deuschlnd. Im Aufg de Gesellschf fü Quliä in de ußeklinischen Gebushilfe e.v. hp://www.qug.de/downlods/quag_beich2007.pdf Downlod 19-01-2010. Sisisches undesm 2009: Enbindungen und Gebuen im Knkenhus nch Länden. Excel Shees povided upon coespondence o Ue öl Sisisches undesm 30-10- 2009. 10
7 Appendix Figue 1: Exc fom he Peinl Sisics fom 11
Noes o Figue 1: The quesionnie documens chceisics of he mohe. I sks fo sevel idenificion numbes of mohe nd bih 0.5 o 1.2 he numbe of muliples 1.3 de of bih of he mohe de of ccommodion in hospil dignosis ccommodion nd emens 2 o 5 couny of oigin of mohe 5 o 7 pneship sus of mohe 8 employmen 9 nd numbe of peceding pegnncies plus numbe of live-bihs sillbihs bos nd eminions of pegnncy 10. Souce: undesgeschäfsselle Quliässicheung 2009. 12
Figue 2: Quesionnie QUAG Sisics 13
Noes o Figue 2: This quesionnie povides deiled infomion bou he pocedue on bihs ou-ofhospils. I offes fo idenificion of he midwife 1 o 3 infomion bou he pegnn women such s numbe of peceding pegnncies numbe of live-bihs sillbihs boions/ eminions of pegnncy 4 o 7 chceisics of he pegnncy nd pevenive check-ups 8-16 he pogess of bih 17-29 endees duing he bih 30-32 possible nsfeing of mohe o hospil 33-43 chceisics of he child like de of bih sex weigh nd helh sus 44-56 nd plce of bih 57-59. Souce: Loyved 2009 14