The Hospital for Sick Children, Toronto, Canada, M5G 1X8.
Department of Pediatrics, University of Toronto, Toronto, Canada, M5G 1X8.
Int J Popul Data Sci. 2021 Feb 11;6(1):1407. doi: 10.23889/ijpds.v6i1.1407.
Linkage of demographic, health, and developmental administrative data can enrich population-based surveillance and research on developmental and educational outcomes. Transparency of the record linkage process and results are required to assess potential biases.
To describe the approach used to link records of kindergarten children from the Early Development Instrument (EDI) in Ontario to health administrative data and test differences in characteristics of children by linkage status. We demonstrate how socio-demographic and medical risk factors amass in their contribution to early developmental vulnerability and test the concordance of health diagnoses in both the EDI and health datasets of linked records.
Children with records in the 2015 EDI cycle were deterministically linked to a population registry in Ontario, Canada. We compared sociodemographic and developmental vulnerability data between linked and unlinked records. Among linked records, we examined the contribution of medical and social risk factors obtained from health administrative data to developmental vulnerability identified in the EDI using descriptive analyses.
Of 135,937 EDI records, 106,217 (78.1%) linked deterministically to a child in the Ontario health registry using birth date, sex, and postal code. The linked cohort was representative of children who completed the EDI in age, sex, rural residence, immigrant status, language, and special needs status. Linked data underestimated children living in the lowest neighbourhood income quintile (standardized difference [SD] 0.10) and with higher vulnerability in physical health and well-being (SD 0.11) , social competence (SD 0.10), and language and cognitive development (SD 0.12). Analysis of linked records showed developmental vulnerability is sometimes greater in children with social risk factors compared to those with medical risk factors. Common childhood conditions with records in health data were infrequently recorded in EDI records.
Linkage of early developmental and health administrative data, in the absence of a single unique identifier, can be successful with few systematic biases introduced. Cross-sectoral linkages can highlight the relative contribution of medical and social risk factors to developmental vulnerability and poor school achievement.
人口统计学、健康和发展行政数据的链接可以丰富基于人群的监测和发展及教育成果研究。为了评估潜在的偏差，需要对记录链接过程和结果的透明度进行评估。
描述将安大略省早期发展工具（EDI）中幼儿园儿童的记录与健康行政数据进行链接的方法，并测试链接状态下儿童特征的差异。我们展示了社会人口统计学和医疗风险因素如何在其对早期发展脆弱性的贡献中积累，并测试了链接记录的 EDI 和健康数据集之间健康诊断的一致性。
在 2015 年 EDI 周期中具有记录的儿童使用确定性链接到加拿大安大略省的人口登记处。我们比较了链接和未链接记录的社会人口统计学和发展脆弱性数据。在链接记录中，我们使用描述性分析检查从健康行政数据中获得的医疗和社会风险因素对 EDI 中确定的发展脆弱性的贡献。
在 135937 份 EDI 记录中，有 106217 份（78.1%）通过出生日期、性别和邮政编码确定性链接到安大略省健康登记处的儿童。链接队列在年龄、性别、农村居住、移民身份、语言和特殊需求状况方面代表完成 EDI 的儿童。链接数据低估了居住在收入最低五分位数的儿童（标准化差异 [SD] 0.10）以及在身体健康和幸福感（SD 0.11）、社会能力（SD 0.10）和语言和认知发展（SD 0.12）方面更脆弱的儿童。对链接记录的分析表明，与有医疗风险因素的儿童相比，有社会风险因素的儿童的发展脆弱性有时更大。在健康数据中有记录的常见儿童疾病在 EDI 记录中很少记录。
在没有单一独特标识符的情况下，早期发展和健康行政数据的链接可以成功进行，并且很少有系统偏差引入。跨部门链接可以突出医疗和社会风险因素对发展脆弱性和学业成绩不佳的相对贡献。
