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Enhancing Data Resources for Researching Patterns of Mortality in Patient Centered Outcomes Research

Linking the National Death Index to other sources to increase the availability of information on the cause of death.
  • Centers for Disease Control and Prevention (CDC) 
  • Food and Drug Administration (FDA)
  • Centers for Medicare and Medicaid Services (CMS) 
Start Date
  • CDC- 2/1/2017
  • FDA- 2/1/2017
  • CMS-3/1/2017


  • Use of Clinical Data for Research
  • Linking of Clinical and Other Data for Research
  • Use of Enhanced Publically-Funded Data Systems for Research


STATUS: Active Project


National Center for Health Statistics (NCHS) worked with state offices to establish the National Death Index (NDI), which is a centralized database of death record information on file in state vital statistics offices. The NDI is a resource that helps epidemiologists and other health and medical investigators with their research. In particular, the NDI is used for mortality ascertainment to assess the causes and risk factors of diseases and conditions and for the effectiveness of a wide range of interventions and drug therapies.


Through collaboration between the Centers for Disease Control (CDC), Centers for Medicare and Medicaid (CMS), and Food and Drug Administration (FDA), the overall goal of this project is to increase the availability of information on the cause of death by linking NDI data to other sources. Enabling linkages will allow researchers to develop national estimates of cause-specific death rates following ED visits and/or hospital stays for specific conditions.

The CDC objectives include:

  • Link the 2014 NHCS inpatient and emergency department (ED) claims data to the 2014 and 2015 NDI (to ensure at least 12 months of post-discharge follow up for each hospital event).

  • Link the 2014 CMS Master Beneficiary Summary File (MBSF) and Chronic Conditions Warehouse (CCW) to 2014 and 2015 NDI.

  • Link the 2016 NHCS inpatient and ED claims and EHR data to the 2016 and 2017 NDI.

  • Develop a long-term strategy for the access and use of NDI to support PCOR.

The FDA objectives include:

  • To develop standard, repeatable, and efficient technical solutions for linking the NDI’s death and cause of death data to large, commercially and publicly insured populations.

  • To demonstrate the feasibility of linkage by using use cases to assess associations between select medications and death or cause of death as an outcome.  

The CMS objectives include:

  • Purchase NDI data to link to Medicare decedents data from 2008-2016 and Medicaid decedents data from 2007-2015.

  • Link the NDI data on cause and manner of death with claims data to produce updated Medicare and Medicaid research files.