Taylor Lee K, Irvine Katie, Iannotti Renee, Harchak Taylor, Lim Kim
Centre for Epidemiology and Evidence, NSW Ministry of Health, Sydney, Australia.
BMC Med Inform Decis Mak. 2014 Sep 25;14:85. doi: 10.1186/1472-6947-14-85.
Linkage of aged care and hospitalisation data provides valuable information on patterns of health service utilisation among aged care service recipients. Many aged care datasets in Australia contain a Statistical Linkage Key (SLK-581) instead of full personal identifiers. We linked hospital and death records using a full probabilistic strategy, the SLK-581, and three combined strategies; and compared results for each strategy.
Linkage of Admitted Patient Data for 2000-01 to 2008-09 and Registry of Births, Deaths and Marriages death registration data for 2008-09 for New South Wales, Australia, was carried out using probabilistic methods and compared to links created using four strategies incorporating a SLK-581. The Basic SLK-581 strategy used the SLK-581 alone. The Most Recent SLK-581, Most Frequent SLK-581, and Any Match SLK-581 strategies leveraged probabilistic links between hospital records drawn from the Centre for Health Record Linkage Master Linkage Key. Rates of hospitalisations among people who died were calculated for each strategy and a range of health conditions.
Compared to full probabilistic linkage, the basic SLK-581 strategy produced substantial rates of missed links that increased over the study period and produced underestimates of hospitalisation rates that varied by health condition. The Most Recent SLK-581, Most Frequent SLK-581, and Any Match SLK-581 strategies resulted in substantially lower rates of underestimation than the Basic SLK-581. The Any Match SLK-581 strategy gave results closest to full probabilistic linkage.
Hospitalisation rates prior to death are substantially underestimated by linkage using a SLK-581 alone. Linkage rates can be increased by combining deterministic methods with probabilistically created links across hospital records.
老年护理与住院数据的关联可为老年护理服务接受者的医疗服务利用模式提供有价值的信息。澳大利亚许多老年护理数据集包含统计关联密钥（SLK - 581）而非完整的个人标识符。我们使用完整概率策略、SLK - 581以及三种组合策略对医院和死亡记录进行关联，并比较每种策略的结果。
采用概率方法对澳大利亚新南威尔士州2000 - 01年至2008 - 09年的入院患者数据与2008 - 09年的出生、死亡和婚姻登记处死亡登记数据进行关联，并与使用包含SLK - 581的四种策略创建的关联进行比较。基本SLK - 581策略仅使用SLK - 581。最新SLK - 581、最频繁SLK - 581和任何匹配SLK - 581策略利用了从健康记录关联中心主关联密钥中提取的医院记录之间的概率关联。针对每种策略和一系列健康状况计算了死亡者的住院率。
与完整概率关联相比，基本SLK - 581策略产生了大量漏连情况，且在研究期间有所增加，还导致不同健康状况下住院率的低估。最新SLK - 581、最频繁SLK - 581和任何匹配SLK - 581策略导致的低估率明显低于基本SLK - 581。任何匹配SLK - 581策略得出的结果最接近完整概率关联。
仅使用SLK - 581进行关联会大幅低估死亡前的住院率。通过将确定性方法与跨医院记录的概率性创建关联相结合，可以提高关联率。
