scholarly journals 517Challenges in data linkage – experiences from an upper gastrointestinal cancer data linkage study

2021 ◽  
Vol 50 (Supplement_1) ◽  
Author(s):  
Nadia Khan ◽  
Liane Ioannou ◽  
Charles Pilgrim ◽  
Arul Earnest ◽  
Ashika Maharaj ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Service ◽  
Data Linkage ◽  
Population Level ◽  
Data Access ◽  
Health Service Utilisation ◽  
Service Utilisation ◽  
Financial Barriers ◽  
Level Data ◽  
Upper Gastrointestinal

Abstract Background Linked, population-level data is valuable for mapping patterns of care and evaluating health service utilisation, particularly in difficult-to-reach populations. Upper gastrointestinal (UGI) cancers have a dismal prognosis, creating difficulties engaging patients in research. The utility of a linked dataset in this population is of high value. Methods Key objectives included identifying the operational and feasibility issues associated with linking Australian state-based administrative and registry data for understanding health service utilisation in UGI cancers. Datasets pertained to hospital admissions, radiotherapy, community health, primary care, palliative care, Medicare and Pharmaceutical Benefits Schedule’s and UGI cancers. Results From a logistical perspective, data access request approval processes varied, with some requiring consent to be sought from individual services contributing data. The availability of unique person-level identifying information varied widely. Additionally, the time period of data capture differed between and within datasets, limiting the quality of the linked data. Significant costs were associated with linking with primary care and Medicare and Pharmaceutical Benefits Schedule’s. Federal dataset linkage required at least a one-year waiting period. Conclusions Whilst in theory data linkage is a powerful mechanism for obtaining population-level data, in reality, there are many logistical and financial barriers to linking multiple datasets. Consequently, critical data, which has the potential to inform policy and improve patient outcomes, cannot be procured. Key messages Logistical and financial challenges are associated with linking administrative and registry datasets for research, limiting the potential of data linkage.

scholarly journals Impact of COVID-19 on loneliness, mental health, and health service utilisation: a prospective cohort study of older adults with multimorbidity in primary care

2020 ◽  
Vol 70 (700) ◽  
pp. e817-e824
Author(s):  
Samuel Yeung Shan Wong ◽  
Dexing Zhang ◽  
Regina Wing Shan Sit ◽  
Benjamin Hon Kei Yip ◽  
Roger Yat-nork Chung ◽  
...  
Keyword(s):  
Mental Health ◽  
Older Adults ◽  
Primary Care ◽  
Health Service ◽  
Psychological Health ◽  
Mental Health Problems ◽  
Health Service Utilisation ◽  
Rank Test ◽  
Service Utilisation ◽  
Record System

BackgroundThe COVID-19 pandemic has impacted the psychological health and health service utilisation of older adults with multimorbidity, who are particularly vulnerable.AimTo describe changes in loneliness, mental health problems, and attendance to scheduled medical care before and after the onset of the COVID-19 pandemic.Design and settingTelephone survey on a pre-existing cohort of older adults with multimorbidity in primary care.MethodMental health and health service utilisation outcomes were compared with the outcomes before the onset of the COVID-19 outbreak in Hong Kong using paired t-tests, Wilcoxon’s signed-rank test, and McNemar’s test. Loneliness was measured by the De Jong Gierveld Loneliness Scale. The secondary outcomes (anxiety, depression, and insomnia) were measured by the 9-item Patient Health Questionnaire, the 7-item Generalized Anxiety Disorder tool, and the Insomnia Severity Index. Appointments attendance data were extracted from a computerised medical record system. Sociodemographic factors associated with outcome changes were examined by linear regression and generalised estimating equations.ResultsData were collected from 583 older (≥60 years) adults. There were significant increases in loneliness, anxiety, and insomnia, after the onset of the COVID-19 outbreak. Missed medical appointments over a 3-month period increased from 16.5% 1 year ago to 22.0% after the onset of the outbreak. In adjusted analysis, being female, living alone, and having >4 chronic conditions were independently associated with increased loneliness. Females were more likely to have increased anxiety and insomnia.ConclusionPsychosocial health of older patients with multimorbidity markedly deteriorated and missed medical appointments substantially increased after the COVID-19 outbreak.

scholarly journals Health literacy and age-related health-care utilisation: a multi-dimensional approach

2020 ◽  
pp. 1-22
Author(s):  
Joachim Gerich ◽  
Robert Moosbrugger ◽  
Christoph Heigl
Keyword(s):  
Health Literacy ◽  
Health Service ◽  
Health Care Utilisation ◽  
Health Service Utilisation ◽  
Service Utilisation ◽  
Significant Interaction Effect ◽  
Medication Costs ◽  
Age Related ◽  
Care Utilisation ◽  
Health Related

Abstract Inefficient health service utilisation puts pressure on health systems and may cause such negative individual consequences as over-medicalisation or exacerbation of health problems. While previous research has considered the key relevance of health literacy (HL) for efficient use of health services, the results of that research have been somewhat inconclusive. Possible reasons for diverging results of prior research may be grounded in different measurement concepts of HL and the disregarding of age-specific effects. This paper analyses the association between individuals’ HL typology based on a two-dimensional concept and indicators of health service utilisation measured by registered data covering the number of doctor visits and medication costs. Our results confirm a significant interaction effect between age and HL typology. The age-related increase in health service utilisation is strongest for individuals with the combination of high subjective HL but low health-related knowledge, while the smallest increase is for individuals with the constellation of high subjective HL combined with high health-related knowledge. Individuals with specific constellations of HL (that is, individuals with high subjective HL but low health-related knowledge) are associated with reduced service utilisation in younger ages but higher service utilisation in later stages of life, compared to other groups. These results are likely to be attributed to a higher external health-related locus of control and more traditional paternalistic role expectations in such groups.

scholarly journals Enhancing Joint Replacement Outcomes Through Registry Linkage with National Health Administrative Data in Australia

2020 ◽  
Vol 5 (5) ◽  
Author(s):  
Katherine Duszynski ◽  
Stephen E Graves ◽  
Nicole Pratt ◽  
Maria Inacio ◽  
Richard De Steiger ◽  
...  
Keyword(s):  
Health Service ◽  
Administrative Data ◽  
Joint Replacement ◽  
Linked Data ◽  
Data Linkage ◽  
Service Utilisation ◽  
Prescription Data ◽  
National Data ◽  
Joint Replacement Surgery ◽  
Replacement Surgery

IntroductionMonitoring of joint replacement (JR) data from the Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR) has reduced revision rates and improved surgical practice. Outcome assessment post-arthroplasty is limited however, to revision (reoperation) surgery and mortality outcomes. The AOANJRR National Data Linkage project seeks to broaden the scope of outcomes investigation in Australia by linking registry and health administrative datasets. Objectives and ApproachUsing linked registry and administrative data, the project seeks to describe and quantify national/regional trends and variation in major complications (infection, dislocation, arthrofibrosis, chronic pain, venous thromboembolism, cardiac events), malignancy and health service utilisation (readmissions, emergency encounters and inpatient rehabilitation) following hip, knee and shoulder joint replacement surgery. Evidence will be generated on how these outcomes are associated with and vary according to patient, surgical, implant, hospital and pharmacological factors. As Australia lacks a national identifier, seven linkage agencies are probabilistically linking AOANJRR hip, knee and shoulder replacement data (1999-2017) with 20 datasets. Datasets include government-subsidised health services, procedural and prescription data. Hospital separations and emergency attendance data from Australia’s eight jurisdictions together with national cancer registry and rehabilitation service data are also planned for linkage. Linked data are maintained in a secure remote access computing environment. ResultsTo date, national Medicare Benefits Schedule, Pharmaceutical Benefits Scheme and the Australian Cancer Database data have been linked with >900,000 AOANJRR patients, representing 607.6 million health service records (1999-2018), 467.7 million prescriptions (2002-2018) and 184,000 cancer records, respectively. Remaining linked data will be available in mid-2020. Some initial summary results across a selected range of studies will be presented. Conclusion / ImplicationsThis national data-linkage program will identify areas for improvement in joint replacement surgery and modifiable risk factors contributing to poor patient outcomes.

Patterns in Health Service Utilisation and Healthcare Entitlements

2020 ◽  
pp. 83-99
Author(s):  
Lorna Roe ◽  
Christine McGarrigle ◽  
Belinda Hernandez ◽  
Aisling O'Halloran ◽  
Siobhan Scarlett ◽  
...  
Keyword(s):  
Health Service ◽  
Health Service Utilisation ◽  
Service Utilisation
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