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Vital Status Ascertainment
Department of Veterans Affairs (VA) records are the core source of vital status information.20 We begin with the Beneficiary Identification and Records Locator Subsystem (BIRLS), a computer file of VA transactions concerning benefits to individual veterans. Of particular interest to this study is the recording of death benefit requests. The BIRLS database fields include: name, claim number, claim folder location, Social Security Number, military service number(s), date of claim, claim folder location, and date of death.21 BIRLS can be searched by automated routines using a standard protocol or by "hand," using whatever criteria the analyst seated at the terminal chooses.
Veterans were placed in one of three categories, depending on the success and findings of the BIRLS search.
BIRLS record was found with reference to a death.
BIRLS record was found with no reference to a death.
BIRLS record was not found.
If the BIRLS record for an individual was not found, the next source searched was the Veterans Administration Master Index (VAMI). Now catalogued on microfilm, and replaced by the electronic BIRLS in the early 1970s, the VAMI had been maintained manually on 3 × 5 index cards, one for each veteran with a benefits claim. In addition to mortality information, VAMI is a source of other identifying information (e.g., different spelling of a name) that made subsequent BIRLS searches successful. VAMI searches must be done by hand.
Federal databases other than those maintained by the VA served as sources of vital status ascertainment. The Health Care Financing Administration (HCFA) of the Department of Health and Human Services (DHHS) searched its computerized database on Medicare enrollees and provided vital status on all reasonable to good potential matches, based on Social Security Number (SSN), date of birth, and name. As we discuss later in this section, HCFA information was used as one measure of the completeness of VA-based (BIRLS and VAMI) death information. All veterans not found in BIRLS plus a sample of veterans
Although JAYCOR (for the Defense Nuclear Agency) constructed the participant cohort and MFUA staff constructed the comparison cohort, MFUA followed identical protocols for vital status follow-up of members of both cohorts, using the same data sources and search algorithms.
Data fields available on BIRLS not relevant to this study are: insurance file and policy numbers, death in service, cause of death, power of attorney, dates of entry onto and release from active duty, branch of service, character of service, separation reason code, paygrade, and nonpay days.