Burns, R., Wyke, S., Boukari, Y., Katikireddi, S. V. , Zenner, D., Campos-Matos, I., Harron, K. and Aldridge, R. W. (2024) Linking migration and hospital data in England: Linkage process and evaluation of bias. International Journal of Population Data Science, 9(1), 03. (doi: 10.23889/ijpds.v9i1.2181) (PMID:38476270) (PMCID:PMC10929707)
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Abstract
Introduction Difficulties ascertaining migrant status in national data sources such as hospital records have limited large-scale evaluation of migrant healthcare needs in many countries, including England. Linkage of immigration data for migrants and refugees, with National Health Service (NHS) hospital care data enables research into the relationship between migration and health for a large cohort of international migrants. Objectives We aimed to describe the linkage process and compare linkage rates between migrant sub-groups to evaluate for potential bias for data on non-EU migrants and resettled refugees linked to Hospital Episode Statistics (HES) in England. Methods We used stepwise deterministic linkage to match records from migrants and refugees to a unique healthcare identifier indicating interaction with the NHS (linkage stage 1 to NHS Personal Demographic Services, PDS), and then to hospital records (linkage stage 2 to HES). We calculated linkage rates and compared linked and unlinked migrant characteristics for each linkage stage. Results Of the 1,799,307 unique migrant records, 1,134,007 (63%) linked to PDS and 451,689 (25%) linked to at least one hospital record between 01/01/2005 and 23/03/2020. Individuals on work, student, or working holiday visas were less likely to link to a hospital record than those on settlement and dependent visas and refugees. Migrants from the Middle East and North Africa and South Asia were four times more likely to link to at least one hospital record, compared to those from East Asia and the Pacific. Differences in age, sex, visa type, and region of origin between linked and unlinked samples were small to moderate. Conclusion This linked dataset represents a unique opportunity to explore healthcare use in migrants. However, lower linkage rates disproportionately affected individuals on shorter-term visas so future studies of these groups may be more biased as a result. Increasing the quality and completeness of identifiers recorded in administrative data could improve data linkage quality.
| Item Type: | Articles |
|---|---|
| Additional Information: | The research costs for the study have been supported byMRC Grant Ref: MR/V028375/1 and by a Wellcome ClinicalResearch Career Development Fellowship (206602). SVKacknowledges funding from the Medical Research Council(MC_UU_00022/2) and the Scottish Government ChiefScientist Office (SPHSU17). |
| Keywords: | data linkage, refugee, Emigration and Immigration, England, administrative data, Transients and Migrants, record linkage, Hospitals, migrant, State Medicine, Humans, hospital records |
| Status: | Published |
| Refereed: | Yes |
| Glasgow Author(s) Enlighten ID: | Katikireddi, Professor Vittal |
| Creator Roles: | |
| Authors: | Burns, R., Wyke, S., Boukari, Y., Katikireddi, S. V., Zenner, D., Campos-Matos, I., Harron, K., and Aldridge, R. W. |
| College/School: | College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > MRC/CSO SPHSU |
| Journal Name: | International Journal of Population Data Science |
| Publisher: | Swansea University |
| ISSN: | 2399-4908 |
| ISSN (Online): | 2399-4908 |
| Copyright Holders: | Copyright: © 2024 The Authors |
| First Published: | First published in International Journal of Population Data Science 9(1): 03 |
| Publisher Policy: | Reproduced under a Creative Commons licence |
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