1
|
Berete F, Demarest S, Charafeddine R, De Ridder K, Van Oyen H, Van Hoof W, Bruyère O, Van der Heyden J. Linking health survey data with health insurance data: methodology, challenges, opportunities and recommendations for public health research. An experience from the HISlink project in Belgium. Arch Public Health 2023; 81:198. [PMID: 37968754 PMCID: PMC10648729 DOI: 10.1186/s13690-023-01213-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 11/03/2023] [Indexed: 11/17/2023] Open
Abstract
In recent years, the linkage of survey data to health administrative data has increased. This offers new opportunities for research into the use of health services and public health. Building on the HISlink use case, the linkage of Belgian Health Interview Survey (BHIS) data and Belgian Compulsory Health Insurance (BCHI) data, this paper provides an overview of the practical implementation of linking data, the outcomes in terms of a linked dataset and of the studies conducted as well as the lessons learned and recommendations for future links.Individual BHIS 2013 and 2018 data was linked to BCHI data using the national register number. The overall linkage rate was 92.3% and 94.2% for HISlink 2013 and HISlink 2018, respectively. Linked BHIS-BCHI data were used in validation studies (e.g. self-reported breast cancer screening; chronic diseases, polypharmacy), in policy-driven research (e.g., mediation effect of health literacy in the relationship between socioeconomic status and health related outcomes, and in longitudinal study (e.g. identifying predictors of nursing home admission among older BHIS participants). The linkage of both data sources combines their strengths but does not overcome all weaknesses.The availability of a national register number was an asset for HISlink. Policy-makers and researchers must take initiatives to find a better balance between the right to privacy of respondents and society's right to evidence-based information to improve health. Researchers should be aware that the procedures necessary to implement a link may have an impact on the timeliness of their research. Although some aspects of HISlink are specific to the Belgian context, we believe that some lessons learned are useful in an international context, especially for other European Union member states that collect similar data.
Collapse
Affiliation(s)
- Finaba Berete
- Department of Epidemiology and Public Health, Sciensano, Juliette Wytsmanstraat 14, Brussels, 1050, Belgium.
- Department of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium.
| | - Stefaan Demarest
- Department of Epidemiology and Public Health, Sciensano, Juliette Wytsmanstraat 14, Brussels, 1050, Belgium
| | - Rana Charafeddine
- Department of Epidemiology and Public Health, Sciensano, Juliette Wytsmanstraat 14, Brussels, 1050, Belgium
| | - Karin De Ridder
- Department of Epidemiology and Public Health, Sciensano, Juliette Wytsmanstraat 14, Brussels, 1050, Belgium
| | - Herman Van Oyen
- Department of Epidemiology and Public Health, Sciensano, Juliette Wytsmanstraat 14, Brussels, 1050, Belgium
- Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
| | - Wannes Van Hoof
- Department of Epidemiology and Public Health, Sciensano, Juliette Wytsmanstraat 14, Brussels, 1050, Belgium
| | - Olivier Bruyère
- WHO Collaborating Centre for Public Health Aspects of Musculoskeletal Health and Ageing, Research Unit in Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium
| | - Johan Van der Heyden
- Department of Epidemiology and Public Health, Sciensano, Juliette Wytsmanstraat 14, Brussels, 1050, Belgium
| |
Collapse
|
2
|
O'Hare K, Watkeys O, Whitten T, Dean K, Laurens KR, Harris F, Carr VJ, Green MJ. Cumulative environmental risk in early life is associated with mental disorders in childhood. Psychol Med 2023; 53:4762-4771. [PMID: 35866367 DOI: 10.1017/s0033291722001702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND No single environmental factor is a necessary or sufficient cause of mental disorder; multifactorial and transdiagnostic approaches are needed to understand the impact of the environment on the development of mental disorders across the life course. METHOD Using linked multi-agency administrative data for 71 932 children from the New South Wales Child Developmental Study, using logistic regression, we examined associations between 16 environmental risk factors in early life (prenatal period to <6 years of age) and later diagnoses of mental disorder recorded in health service data (from age 6 to 13 years), both individually and summed as an environmental risk score (ERS). RESULTS The ERS was associated with all types of mental disorder diagnoses in a dose-response fashion, such that 2.8% of children with no exposure to any of the environmental factors (ERS = 0), compared to 18.3% of children with an ERS of 8 or more indicating exposure to 8 or more environmental factors (ERS ⩾ 8), had been diagnosed with any type of mental disorder up to age 13-14 years. Thirteen of the 16 environmental factors measured (including prenatal factors, neighbourhood characteristics and more proximal experiences of trauma or neglect) were positively associated with at least one category of mental disorder. CONCLUSION Exposure to cumulative environmental risk factors in early life is associated with an increased likelihood of presenting to health services in childhood for any kind of mental disorder. In many instances, these factors are preventable or capable of mitigation by appropriate public policy settings.
Collapse
Affiliation(s)
- Kirstie O'Hare
- Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, Australia
| | - Oliver Watkeys
- Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, Australia
| | - Tyson Whitten
- Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, Australia
- School of Social Sciences, University of Adelaide, Adelaide, South Australia, Australia
| | - Kimberlie Dean
- Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, Australia
- Justice Health and Forensic Mental Health Network, Sydney, New South Wales, Australia
| | - Kristin R Laurens
- Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, Australia
- School of Psychology and Counselling, Queensland University of Technology (QUT), Brisbane, Australia
| | - Felicity Harris
- Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, Australia
| | - Vaughan J Carr
- Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, Australia
- Neuroscience Research Australia, Sydney, Australia
- Department of Psychiatry, Monash University, Melbourne, Australia
| | - Melissa J Green
- Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, Australia
- Neuroscience Research Australia, Sydney, Australia
| |
Collapse
|
3
|
Sinclair J, Davies S, Janus M. Student achievement trajectories in Ontario: Creating and validating a province-wide, multi-cohort and longitudinal database. Int J Popul Data Sci 2023; 8:1843. [PMID: 37636836 PMCID: PMC10450363 DOI: 10.23889/ijpds.v8i1.1843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Introduction Longitudinal data that tracks student achievement over many years are crucial for understanding children's learning and for guiding effective policies and interventions. Despite being Canada's most populous province, Ontario lacks such large-scale and longitudinal data on student learning. Linking datasets across cohorts requires rigorous linkage protocols, flexible handling of complex cohort structures, methods to validate linked datasets, and viable organizational partnerships. We linked administrative data on early child development and educational achievement and merged two datasets on characteristics of students' neighborhoods and schools. We developed a linkage protocol and validated how the resulting database could be generalized to Ontario's student population. Methods and analysis Two main individual-level data sources were linked: 1) the Early Development Instrument (EDI), a school readiness assessment of all Ontario public school kindergartners that is administered in three-year cycles, and 2) Ontario's Educational Quality and Assessment Office's (EQAO) math and reading assessments in grades 3, 6, 9, and 10. To compensate for their lack of a common personal identification number, a deterministic linkage process was developed using several administrative variables. A school-level and a neighborhood-level dataset were also later linked. We examined differences between unlinked and linked cases across several variables. Results and implications We successfully linked 50% of the EDI's 374,239 cases, 86,778 of which contained all five datapoints, creating a database tracking achievement for multiple cohorts from kindergarten through grade 10, with covariates for their development, demographics, affect, neighborhoods, and schools. Analyses revealed only negligible differences between linked and unlinked cases across several demographic measures, while small differences were detected across a neighborhood socioeconomic index and some measures of child development. In conclusion, we recommend the filling of key voids in sustainable research capacity by creating representative data through linkage protocols and data verification.
Collapse
Affiliation(s)
- Jeanne Sinclair
- Memorial University Faculty of Education, 323 Prince Philip Drive, St. John’s, NL A1B 3X8, Canada
| | - Scott Davies
- Department of Leadership, Higher and Adult Education, Ontario Institute for Studies in Education, 252 Bloor Street West, Toronto, ON M5S 1V6, Canada
| | - Magdalena Janus
- Offord Centre for Child Studies, BAHT 132, 1280 Main Street West, Hamilton, ON L8S 4K1, Canada
| |
Collapse
|
4
|
Taylor CL, Christensen D, Venn AJ, Preen DB, Stafford J, Hansen E, Jose K, Zubrick SR. Use of administrative record linkage to examine patterns of universal early childhood health and education service use from birth to Kindergarten (age four years) and developmental vulnerability in the Preparatory Year (age five years) in Tasmania, Australia. Int J Popul Data Sci 2022; 6:1681. [PMID: 35136844 PMCID: PMC8780991 DOI: 10.23889/ijpds.v6i1.1681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND In Australia, the health and education sectors provide universal early childhood services for the same population of children. Therefore, there is a strong imperative to view service use and outcomes through a cross-sectoral lens to better understand and address the service needs of young children and their families. OBJECTIVES To investigate patterns of health and education service use from birth through Kindergarten (age four years), the associations with cumulative risks, and developmental vulnerability in the first year of full-time school (age five years). METHODS A retrospective cohort study that used population-wide linkage of health and education administrative data records for 5,440 children with a Tasmanian 2015 Australian Early Development Census (AEDC) record who were born in Tasmania (2008-2010). RESULTS Four service use patterns were identified: Regular (46% of children), Declining (24%); Low (18%); and Selective service use (12%). Regular service use (aOR 0.8, 95% CI 0.7 to 0.9), adjusted for cumulative risks, was associated with decreased odds of developmental vulnerability, compared to the other service use groups. Low (OR 6.1, 95% CI 4.5 to 8.2) and Declining service use (OR 2.5 95% CI 1.9 to 3.4) were more likely for children with the highest levels of cumulative risks. Low and Declining service use, adjusted for cumulative risks were associated with increased odds of developmental vulnerability, compared to the Regular service use group. CONCLUSION This study provides a whole population view of the differential use of universal services and the complex risk circumstances that influence service use. The association between patterns of multiple risk and service use points to barriers to service use, and the varying level of developmental vulnerability within each service use group draws attention to children who may benefit from higher sustained participation in core health and education services across the whole of early childhood.
Collapse
Affiliation(s)
- Catherine L. Taylor
- Telethon Kids Institute, The University of Western Australia, Nedlands, Western Australia, Australia,Corresponding author: Catherine L. Taylor
| | - Daniel Christensen
- Telethon Kids Institute, The University of Western Australia, Nedlands, Western Australia, Australia
| | - Alison J. Venn
- Menzies Institute for Medical Research, The University of Tasmania. Hobart, Tasmania, Australia
| | - David B. Preen
- School of Population and Global Health, The University of Western Australia, Nedlands, Western Australia, Australia
| | - Joel Stafford
- Telethon Kids Institute, The University of Western Australia, Nedlands, Western Australia, Australia
| | - Emily Hansen
- School of Social Sciences, University of Tasmania, Hobart, Tasmania
| | - Kim Jose
- Menzies Institute for Medical Research, The University of Tasmania. Hobart, Tasmania, Australia
| | - Stephen R. Zubrick
- Telethon Kids Institute, The University of Western Australia, Nedlands, Western Australia, Australia
| |
Collapse
|