Prehosp Emerg Care. 2020 Jan-Feb;24(1):1-7. doi: 10.1080/10903127.2019.1604925. Epub 2019 May 9.
: To describe the process, benefits, and challenges of linking Arizona's prehospital registry to hospital discharge data. Data were queried from the Arizona Prehospital Information and Emergency Medical Services Registry System (AZ-PIERS) and the Arizona Hospital Discharge Database (HDD) for the calendar year 2015. To maximize the number of matched records, the databases were deterministically linked in 17 steps using different combinations/variations of patient personal identifiers. Random samples of at least 1% of matched pairs from each of 16 linkage steps (excluding Step 1) were manually reviewed to assess the rate of false positive matches. A total of 626,413 records were reported to AZ-PIERS in 2015. Of those, 503,715 qualified for linkage. These records were matched against 3,125,689 discharge records reported to the HDD in 2015. The first step, which involved exact matching on first name, last name, date of birth, gender, and date of incident/date of admission, yielded a linkage of 64.6% ( = 325,156). The 16 successive steps yielded a further linkage of 26.6% ( = 134,006) for a total linkage of 91.2% ( = 459,162). The manual review indicated an overall false positive match rate for the 16 reviewed steps of 6.96% ( = 99). The 2 steps with the highest false positive match rates were Step 16 (43.02%, = 77) and Step 17 (31.43%, = 11). It is feasible to link prehospital and hospital data using stepwise deterministic linkage; this method returns a high linkage rate with a low false positive error rate. Data linkage is vital to identifying and bridging gaps in the continuum of care and is a useful tool in statewide and agency-specific research and quality improvement.
描述将亚利桑那州的院前注册系统与医院出院数据进行链接的过程、益处和挑战。2015 年，从亚利桑那州院前信息和紧急医疗服务注册系统（AZ-PIERS）和亚利桑那州医院出院数据库（HDD）查询数据。为了最大限度地增加匹配记录的数量，使用患者个人标识符的不同组合/变化，通过 17 步确定链接数据库。从每个链接步骤（不包括步骤 1）的至少 1%的匹配对中随机抽取样本进行手动审查，以评估假阳性匹配的比率。2015 年向 AZ-PIERS 报告了 626413 条记录。其中，503715 条记录符合链接条件。这些记录与 2015 年向 HDD 报告的 3125689 条出院记录进行了匹配。第一步涉及姓名、姓氏、出生日期、性别和事件/入院日期的精确匹配，产生了 64.6%（ = 325156）的链接。接下来的 16 个步骤又产生了 26.6%（ = 134006）的链接，总链接率为 91.2%（ = 459162）。手动审查表明，16 个已审查步骤的总体假阳性匹配率为 6.96%（ = 99）。假阳性匹配率最高的两个步骤是第 16 步（43.02%， = 77）和第 17 步（31.43%， = 11）。使用逐步确定性链接链接院前和医院数据是可行的；这种方法返回的链接率高，假阳性错误率低。数据链接对于识别和弥合护理连续性中的差距至关重要，是全州和机构特定研究和质量改进的有用工具。
