Consequences for healthcare quality and research of the exclusion of records from the Death Master File.

> In November 2011, the Social Security Administration removed ≈5% of death records from its Death Master File and started excluding ≈40% of new death records, having determined that data submitted electronically by states cannot be publicly shared. Before this determination, the Death Master File provided an accessible source of national vital status data with a short time lag and high specificity and sensitivity and was routinely used by healthcare researchers and hospitals to determine study participants’ survival and to monitor postdischarge outcomes. Its effective loss means comparative effectiveness studies will be unnecessarily delayed, more costly, or unfeasible. Likewise, timely identification and correction of poor hospital performance will be more difficult, undermining the safety and quality of care and threatening hospital financing as the Centers for Medicare and Medicaid launch the Readmissions Reduction Program in October 2012 and link reimbursement to 30-day mortality under the Value-Based Purchasing Program in 2013. In summary, the action of the Social Security Administration will substantially hamper healthcare research and quality. We describe the origins of the Death Master File and the basis for excluding electronically submitted state data. We then examine the consequences for healthcare research and operations, consider alternative sources, and evaluate possible mechanisms to restore a timely national data source. On November 1, 2011, the Social Security Administration (SSA) removed ≈5% of the data in its publicly available Death Master File (DMF) and stopped reporting ≈40% of new deaths.1 The SSA explained that it had determined that §205(r) of the Social Security Act (added by the Act of April 20, 1983)2 prohibits the disclosure of state records that the SSA has been including in the public version of the DMF since 2002.1 This is a “demise of a vital resource”3 that will hamper healthcare outcomes research, as well as …