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Development of the Drug-Exposed Infant Identification Algorithm (DEIIA) and Its Application to Measuring Part C Early Intervention Referral and Eligibility in Massachusetts, 1998–2005

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Abstract

The objectives of this study were to develop an algorithm using government-collected administrative data to identify prenatally drug-exposed infants (DEI) and determine the percent who were referred to and eligible for Part C Early Intervention (EI) in Massachusetts. Data from the population-based Pregnancy to Early Life Longitudinal (PELL) Data System were used to develop the Drug-Exposed Infant Identification Algorithm (DEIIA). The DEIIA uses positive toxicology screens on the birth certificate and International Classification of Diseases, 9th Edition, Clinical Modification diagnostic codes in hospital records of the mother (prenatal and birth) and infant (birth and postnatal) to identify infants affected by substance abuse/dependence, withdrawal, and/or prenatal exposure to non-medical use of controlled substances. PELL-EI data linkages were used to determine the percent referred, evaluated, and eligible. The DEIIA identified 7,348 drug-exposed infants born in Massachusetts from 1998 to 2005 to resident mothers (1.2 % of all births). Most DEI (82.6 %) were identified from maternal/infant birth hospital records. Sixty-one percent of all DEI were referred to EI; 87.2 % of those referred were evaluated, and 89.4 % of those evaluated were found eligible. EI data contained information on drug exposure for 59.9 % of referred DEI. Only 2.8 % of MA resident births who were referred to EI but not identified by the DEIIA had drug indicators in EI data. DEI referrals to EI are federally mandated, but many are not referred. The DEIIA uses data available in most states and could be used as a public health screening tool to improve access to developmental services for DEI.

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Acknowledgments

The author is indebted to Drs. William McAuliffe (Harvard University), Barry Zuckerman, Jason Wang, and Barbara (Bobbi) Philipp (all from Boston Medical Center), for their assistance in the design of the Drug Exposed Infant Identification Algorithm. Drs. Milton Kotelchuck (Massachusetts General Hospital/Harvard University) and Marji Erickson Warfield (Brandeis University) provided guidance on this project and comments on the study design and manuscript. Drs. Candice Belanoff (Boston University School of Public Health) and Dominic Hodgkin (Brandeis University) provided editorial assistance. Methodological guidance and instrumental assistance were provided by the following individuals: from the Massachusetts Department of Public Health (MDPH), Ron Benham, Dr. Hafsatou Diop, Lynne Deschamps, Carol Davin, Patti Fougere, Dr. Susan Manning, Jean Shimer, and Michael Silver; from Boston University School of Public Health, Dr. Judith Weiss, Daksha Gopal, Qi Yu, Dr. Howard Cabral, and especially Manjusha Gokhale. This study was funded through a doctoral fellowship with the Lurie Institute on Disability Policy at Brandeis University, and through dissertation Grants from The Heller School for Social Policy and Management Alumni Association and the Office of the Provost, Brandeis University. The PELL Data System is a university-government partnership between the Boston University School of Public Health, the Massachusetts Department of Public Health, and the Centers for Disease Control and Prevention (CDC) and was funded by the CDC (PELL Data System Expansion and Associated Analyses Contract No. 200-2009-31671).

Conflict of interest

The author has indicated no financial relationships relevant to this article to disclose. The author reports no conflict of interest related to the design and conduct of the study or in the data analysis and manuscript preparation.

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  1. The Heller School for Social Policy and Management, Brandeis University, 415 South Street, MS 035, Waltham, MA, 02454, USA

    Taletha Mae Derrington

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Correspondence to Taletha Mae Derrington.

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Derrington, T.M. Development of the Drug-Exposed Infant Identification Algorithm (DEIIA) and Its Application to Measuring Part C Early Intervention Referral and Eligibility in Massachusetts, 1998–2005. Matern Child Health J 17, 1567–1575 (2013). https://doi.org/10.1007/s10995-012-1157-x

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