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Research Currents
Ascertaining
Vital Status of Veterans
Knowledge of veteran vital status is important
to the Department of Veterans Affairs (VA) from
both research and policy perspectives. For many
years, VA researchers have used the Beneficiary
Identification Record Locator Subsystem (BIRLS)
death file to determine vital status of veterans.
This file can be accessed through the Austin Automation
Center, and costs associated with its use have
been minimal. However, BIRLS data are not complete
for those veterans who do not use VA health care
or use it sporadically. The National Death Index
(NDI), maintained by the National Center for Health
Statistics, has national vital status information
that is based on death certificates assembled from
state vital statistics records. This file is viewed
as the “gold standard” for mortality
ascertainment, but using it is more costly and
involves a lengthier application process than BIRLS.
[1]
Recently, VA researchers compared the accuracy of a merged death record file
with the NDI. [2] Death information from BIRLS, Social Security Death Master
File, Medicare Vital Status File, and Medical SAS Inpatient Files was merged
into a single file for 3000 randomly selected veterans who received VA benefits
and were alive as of January 1, 1999. The accuracy of this file was compared
to the NDI. The combined file identified 98.3% of deaths in the NDI and had 98%
agreement with the exact date of death as recorded in the NDI. The specificity
of the merged file was 99.8%, indicating there were very few false positives.
As a result of these findings and the efforts of the VA Information Resource
Center and National Data Systems, 3 new VA vital status files are now available
at the Austin Automation Center. These files include over 12 million living and
deceased veterans who currently receive benefits or received them in the past.
A significant feature is the inclusion of presumed living status as well as date
of death for those who are deceased. There is a mini-file which includes 1 record
per veteran and a master file which includes all possible matches made on the
basis of social security number and date of birth. The researcher must then decide
which record is the most likely match. A third file is a crosswalk file that
links both the scrambled and real social security numbers. The mini and master
files include only the scrambled number. Current plans call for these files to
be updated several times per year. Documentation, including file names and content,
is available at http://vaww.va.gov/nds/AACInfoSystems/VAVitalStatusFile.asp.
Procedures for obtaining access to the files can be found at http://www.virec.research.va.gov/Support/Training-NewUsersToolkit/ACRSrequest.htm.
The new vital status files provide VA researchers with complete, timely, and
accurate information on mortality. Vital status in these files has high sensitivity
and specificity in relation to the NDI and can be obtained rapidly and at a fraction
of the cost.
References
1. Cowper DC, Kubal JD, Maynard C, Hynes DM.
A primer and comparative review of major US mortality
databases. Annals of Epidemiology 2002;12:462-468.
2. Sohn MW, Arnold N, Maynard C, Hynes D. Accuracy
and completeness of mortality data in the Department
of Veterans Affairs. Population Health Metrics
2006;4:2. www.pophealthmetrics.com/content/4/1/2.
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