Abstract
The objective of this study was to develop methodologies for creating child–parent ‘links’ in two healthcare-related data sources. We linked children and parents who were patients in a network of Oregon clinics with a shared electronic health record (EHR), using data that reported the child’s emergency contact information or the ‘guarantor’ for the child’s visits. We also linked children and parents enrolled in the Oregon Health Plan (OHP; Oregon’s public health insurance programs), using administrative data; here, we defined a ‘child’ as aged <19 years and identified potential ‘parents’ from among adults sharing the same OHP household identification (ID) number. In both data sources, parents had to be 12–55 years older than the child. We used OHP individual client ID and EHR patient ID numbers to assess the quality of our linkages through cross-validation. Of the 249,079 children in the EHR dataset, we identified 62,967 who had a ‘linkable’ parent with patient information in the EHR. In the OHP data, 889,452 household IDs were assigned to at least one child; 525,578 with a household ID had a ‘linkable’ parent (272,578 households). Cross-validation of linkages revealed 99.8 % of EHR links validated in OHP data and 97.7 % of OHP links validated in EHR data. The ability to link children and their parents in healthcare-related datasets will be useful to inform efforts to improve children’s health. Thus, we developed strategies for linking children with their parents in an EHR and a public health insurance administrative dataset.
References
Yamauchi, M., Carlson, M. J., Wright, B. J., Angier, H., & Devoe, J. E. (2012). Does health insurance continuity among low-income adults impact their children’s insurance coverage? Maternal and Child Health Journal. Epub 2012/02/24.
Wisk, L. E., & Witt, W. P. (2012). Predictors of delayed or forgone needed health care for families with children. Pediatrics, 130(6), 1027–1037.
DeVoe, J. E., Tillotson, C. J., Wallace, L. S., Angier, H., Carlson, M. J., & Gold, R. (2011). Parent and child usual source of care and children’s receipt of health care services. Annals of Family Medicine, 9(6), 504–513. Epub 2011/11/16.
DeVoe, J. E., Tillotson, C. J., & Wallace, L. S. (2009). Children’s receipt of health care services and family health insurance patterns. Annals of Family Medicine, 7(5), 406–413.
Sarnoff, R., & Hughes, D. (2005). Increasing health insurance coverage in the first year of life. Maternal and Child Health Journal, 9(4), 343–350.
DeVoe, J. E., Krois, L., Edlund, C., Smith, J., & Carlson, N. E. (2008). Uninsured but eligible children: Are their parents insured? Recent findings from Oregon. Medical Care, 46(1), 3.
Guendelman, S., Megan, W., Veronica, A., & Doug, O. (2006). The effects of child-only insurance coverage and family coverage on health care access and use: Recent findings among low-income children in California. Health Services Research, 41(1), 125–147.
DeVoe, J. E., Krois, L., Edlund, T., Smith, J., & Carlson, N. E. (2008). Uninsurance among children whose parents are losing Medicaid coverage: Results from a statewide survey of Oregon families. Health Services Research, 43(1 Pt 2), 401–418. Epub 2008/01/18.
Ziegenfuss, J. Y., & Davern, M. E. (2010). Twenty years of coverage: An enhanced current population survey-1989–2008. Health Services Research, 46(1 Pt 1), 199–209.
Blakely, S. (2010). Employers, workers, and the future of employment-based health benefits. EBRI Issue Brief, 339, 1–23.
Gould, E. (2010). Employer-sponsored health insurance erosion continues in 2008 and is expected to worsen. International Journal of Health Services, 40(4), 743–776. Epub 2010/11/10.
Kaiser Family Foundation and Health Research & Educational Trust. (2012). Employer health benefits 2012 annual survey. Cited 2013 May 28, http://ehbs.kff.org/?page=abstract&id=1.
Vistnes, J. P., Zawacki, A., Simon, K., & Taylor, A. (2012). Declines in employer-sponsored insurance coverage between 2000 and 2008: Examining the components of coverage by firm size. Health Services Research, 47(3 Pt 1), 919–38.
Angier, H., DeVoe, J. E., Tillotson, C. J., & Wallace, L. S. (2013). Changes in US family health insurance coverage patterns: Comparing 2003 to 2008. Family Medicine, 45(1), 26–32.
Hsiao, C.-J., Hing, E., Socey, T. C., & Cai, B. Electronic health record systems and intent to apply for meaningful use incentives among office-based physician practices: United States, 2001–2011.
111th Congress. (2009). American Recovery and Reinvestment Act of 2009. Cited 2013 May 28, http://www.gpo.gov/fdsys/pkg/PLAW-111publ5/pdf/PLAW-111publ5.pdf.
Kho, A. N., Lemmon, L., Commiskey, M., Wilson, S. J., & McDonald, C. J. (2008). Use of a regional health information exchange to detect crossover of patients with MRSA between urban hospitals. Journal of the American Medical Informatics Association, 15(2), 212–216.
Newman, T. B., & Brown, A. N. (1997). Use of commercial record linkage software and vital statistics to identify patient deaths. Journal of the American Medical Informatics Association, 4(3), 233–237.
Victor, T. W., & Mera, R. M. (2001). Record linkage of health care insurance claims. Journal of the American Medical Informatics Association, 8(3), 281–288.
Korzeniewski, S. J., Grigorescu, V., Copeland, G., Gu, G., Thoburn, K. K., Rogers, J. D., et al. (2010). Methodological innovations in data gathering: Newborn screening linkage with live births records, Michigan, 1/2007–3/2008. Maternal and Child Health Journal, 14(3), 360–364.
DeVoe, J. E., Gold, R., Spofford, M., Chauvie, S., Muench, J., Turner, A., et al. (2011). Developing a network of community health centers with a common electronic health record: Description of the Safety Net West Practice-based Research Network (SNW-PBRN). The Journal of the American Board of Family Medicine, 24(5), 597–604. Epub 2011/09/09.
DeVoe, J., & Sears, A. (2013). The OCHIN community information network: Bringing together community health centers, information technology, and data to support a patient-centered medical village. The Journal of the American Board of Family Medicine, 26, 271–278.
Howard, R. N., Marshall, L. M., Peterson, J. M., & Kohn, M. A. (2002). Tracking Oregon Medicaid patients’ enrollment and health utilization patterns. Journal of Public Health Management and Practice, 8(4), 70–76.
Oregon Department of Human Services. (2006). Oregon health plan: An historical overview. Salem, OR. July, Report No.: 9036.
Beardslee, W. R., Gladstone, T. R., Wright, E. J., & Cooper, A. B. (2003). A family-based approach to the prevention of depressive symptoms in children at risk: Evidence of parental and child change. Pediatrics, 112(2), e119–e131. Epub 2003/08/05.
Schor, E. L. (2003). Family pediatrics: Report of the Task Force on the Family. Pediatrics, 111(6 Pt 2), 1541–1571. Epub 2003/06/05.
Melnyk, B. M., Alpert-Gillis, L., Feinstein, N. F., Crean, H. F., Johnson, J., Fairbanks, E., et al. (2004). Creating opportunities for parent empowerment: Program effects on the mental health/coping outcomes of critically ill young children and their mothers. Pediatrics, 113(6), e597–e607. Epub 2004/06/03.
Gould, E. (2007). Health insurance eroding for working families: Employer-provided coverage declines for fifth consecutive year. International Journal of Health Services, 37(3), 441–467. Epub 2007/09/12.
111th Congress. (2010). Compilation of patient protection and Affordable Care Act. Cited 2013 May 28, http://docs.house.gov/energycommerce/ppacacon.pdf.
Medicaid.gov. (2012). Children’s Health Insurance Program. Baltimore, MD: Centers for Medicare & Medicaid Services. Cited 2013 May 28, http://www.medicaid.gov/Medicaid-CHIP-Program-Information/By-Topics/Childrens-Health-Insurance-Program-CHIP/Childrens-Health-Insurance-Program-CHIP.html.
Shoen, C., Doty, M. M., Robertson, R. H., & Collins, S. R. (2011). Affordable Care Act reforms could reduce the number of uninsured US adults By 70 Percent. Health Affairs, 30(9), 1762–1771.
The Henry J. Kaiser Family Foundation. (2012). Implementing the ACA’s Medicaid-related health reform provisions after the Supreme Court’s decision. Washington, DC, 2012 August, Report No.: 8348.
Love, D., Custer, W., & Miller, P. (2010). All-payer claims databases: State initiatives to improve health care transparency. Contract No.: 1439.
Heberlein, M., Brooks, T., Guyer, J., Artiga, S., & Stephens, J. (2011) Holding steady, looking ahead: Annual findings of a 50-state survey of eligibility rules, enrollment and renewal procedures, and cost sharing practices in Medicaid and CHIP, 2010–2011. Washington, DC.
Hess, C., Basini, L. O., & Plaza, C. I. (2012). Keeping children’s coverage strong in the context of the Affordable Care Act: Perspectives from state children’s health insurance leaders. Portland, ME.
Acknowledgments
This work was financially supported by the Agency for Healthcare Research and Quality (AHRQ) (1 R01 HS018569), the Patient-Centered Outcomes Research Institute (PCORI), and the Oregon Health & Science University, Department of Family Medicine. The funding agencies had no involvement in the preparation, review, or approval of the manuscript. We would also like to acknowledge OCHIN, Inc. and all clinics in the network for participating in this research. The authors are grateful for editing and publication assistance from Ms. LeNeva Spires, Publications Manager, Department of Family Medicine, Oregon Health & Science University, Portland, OR.
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Angier, H., Gold, R., Crawford, C. et al. Linkage Methods for Connecting Children with Parents in Electronic Health Record and State Public Health Insurance Data. Matern Child Health J 18, 2025–2033 (2014). https://doi.org/10.1007/s10995-014-1453-8
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DOI: https://doi.org/10.1007/s10995-014-1453-8