scholarly journals Describing the Linkages of the Citizenship and Immigration Canada Permanent Resident Data and Vital Statistics—Death Registry to Ontario’s Administrative Health Database

2017 ◽  
Vol 1 (1) ◽  
Author(s):  
Astrid Guttmann ◽  
Maria Chiu ◽  
Michael Lebenbaum ◽  
Kelvin Lam ◽  
Nelson Chong ◽  
...  
Keyword(s):  
Record Linkage ◽  
Causes Of Death ◽  
Population Based ◽  
Vital Statistics ◽  
Cross Sectional ◽  
Healthcare Data ◽  
Universal Healthcare ◽  
Permanent Resident ◽  
Linkage Methods ◽  
Health Database

ABSTRACTObjectives Ontario, the most populous province in Canada, has a universal healthcare system that routinely collects health administrative data on its 13 million legal residents that is used for health research. Record linkage has become a vital tool for this research by enriching this data with the Immigration, Refugees and Citizenship Canada (IRCC) Permanent Resident database and the Office of the Registrar General’s Vital Statistics-Death (VSD) registry. Our objectives were to estimate linkage rates and compare characteristics of individuals in the linked versus unlinked files. Approach We used both deterministic and probabilistic linkage methods to link the IRCC database (1985-2012) and VSD registry (1990-2012) to the Ontario’s Registered Persons Database. Linkage rates were estimated and standardized differences were used to assess differences in socio-demographic and other characteristics between the linked and unlinked records. Results The overall linkage rates for the IRCC database and VSD registry were 86.4% and 96.2%, respectively. The majority (68.2%) of the record linkages in IRCC were achieved after the three deterministic passes with the remaining 18.2% being linked probabilistically. Similarly the majority (79.8%) of the record linkages in the ORGD were linked using deterministic record linkage and the remaining 16.3% were linked after probabilistic and manual review. Unlinked and linked files were similar for most characteristics, such as age and marital status for IRCC and sex and most causes of death for VSD. However, lower linkage rates were observed among people born in East Asia (78%) in the IRCC database and certain causes of death in the VSD registry, namely perinatal conditions (61.3%) and congenital anomalies (81.3%). Conclusion The linkages of immigration and vital statistics data to existing population-based healthcare data in Ontario, Canada will enable many novel cross-sectional and longitudinal studies to be conducted. Analytic techniques to account for sub-optimal linkage rates may be required in studies of certain ethnic groups or certain causes of death among children and infants.

scholarly journals Analysis of Causes of Death Among Brought-in-Dead Cases in a Third-Level Hospital in Lusaka, Republic of Zambia, Using the Tariff Method 2.0 for Verbal Autopsy: A Cross-Sectional Study

2019 ◽  
Author(s):  
Yuta Yokobori ◽  
Jun Matsuura ◽  
Yasuo Sugiura ◽  
Charles Mutemba ◽  
Martin Nyahoda ◽  
...  
Keyword(s):  
Verbal Autopsy ◽  
Causes Of Death ◽  
Vital Statistics ◽  
Capital City ◽  
Cross Sectional ◽  
Registration System ◽  
Death Notification ◽  
Hospital Deaths ◽  
Tariff Method ◽  
Level Hospital

Abstract Background Over one third of deaths in Zambian health facilities involve someone who has already died before arrival (i.e., brought in dead [BiD]), and in most BiD cases, the causes of death (CoD) have not been fully analyzed. Therefore, this study aimed to analyze the CoD of BiD cases using the Tariff Method 2.0 for automated verbal autopsy (VA), which is called SmartVA.Methods The target site was one third-level hospital in the Republic of Zambia’s capital city. All BiD cases aged 13 years and older at this facility from January to August 2017 were included. The deceased’s closest relatives were interviewed using a structured VA questionnaire (Population Health Metrics Research Consortium Shortened Questionnaire) and the data were analyzed using the SmartVA to determine the CoD at the individual and population level. The CoDs were compared with description on the death notification forms by using t-test and Cohen’s kappa coefficient.Results Approximately 1500 cases were included (average age = 47.2 years, 61.8% males). The top CoD were infectious diseases, including acquired immunodeficiency syndrome, tuberculosis, and malaria, followed by non-communicable diseases, such as stroke, cardiovascular diseases, and diabetes mellitus (DM). The comparison with the CoD distribution among hospital deaths showed that the trends were similar except for DM, which was greater among hospital deaths, and malaria and accident, which were less frequent in the main CoD. The proportion of cases with a determined CoD was significantly higher when using the SmartVA (75%) than the death notification form (61%). A proportion (42.7%) of the CoD-determined cases matched in both sources, with a low concordance rate (kappa coefficient = 0.1385).Conclusions The CoD of the BiD cases were successfully analyzed using the SmartVA for the first time in Zambia. While there many erroneous descriptions on the death notification form, the SmartVA could determine the CoD among more BiD cases. Since the information on the death notification form is reflected in the national vital statistics, more accurate and complete CoD data are required. In order to strengthen the death registration system with accurate CoD, it will be useful to embed the SmartVA in Zambia’s health information system.

scholarly journals PREVALENCE OF HYPERTENSION AND ITS ASSOCIATION WITH VITAL STATICS OF ADULTS AMONG URBAN, SEMIURBAN, RURAL AREAS OF UTTARAKHAND

2018 ◽  
Vol 11 (10) ◽  
pp. 222
Author(s):  
Vinita Thapliyal ◽  
Karuna Singh ◽  
Anil Joshi
Keyword(s):  
Blood Pressure ◽  
High Blood Pressure ◽  
Rural Areas ◽  
Nutrition Transition ◽  
Population Based ◽  
Vital Statistics ◽  
Sample Population ◽  
Cross Sectional ◽  
Urban Rural ◽  
Obesity Hypertension

Objective: India is in the affirmed phase of evolution and transition, demographic, economic, epidemiological, and nutrition transition. Moreover, all these transitions are leading non-communicable diseases such as obesity, hypertension, and insulin resistance. The study was aimed to estimate the prevalence of hypertension and its association with vital statics of adults among urban, semiurban, rural areas of Sub-Himalayan Region.Methods: A cross sectional community based study was done, using WHO step questionnaire. A survey was conducted in urban, semi urban, Rural areas of Uttrakhand, to make a sample size of 300 adults (18-45yr), 100 from each zone. Blood pressure and body mass index (BMI) of the participants was calculated. p<0.05 was considered statistically significant.Results: In the sample population based on systolic BP, 61.3% were non-hypertensives, 29.7% were pre-hypertensives, and 9% were hypertensives. Based on diastolic BP, 43.3% were non-hypertensives, 32.7% were pre-hypertensives, and 24% were hypertensives. Participants with hypertension and pre-hypertension have higher BMI and waist circumference.Conclusion: A high prevalence rate of pre-hypertension and hypertension was depicted in urban, semiurban, and rural areas of the sub-Himalayan region. 4.8% of the female participants had systolic high blood pressure compared to the 11.9% of the male participants. On the other hand, 21.8% of the female participants had diastolic high blood pressure compared to the over 25% of the male participants. Dehradun has the highest rates of high blood pressure while Rudraprayag has the lowest. BMI was significantly correlated with systolic BP in Dehradun adults (p<0.05). Diastolic BP was significantly positively correlated with age and BMI in Dehradun adults (p<0.05). Age was positively significantly correlated with pulse rate in Dehradun and Uttarkashi adults (p<0.05). In Rudraprayag adults, weight was significantly positively correlated with both systolic and diastolic BP (p<0.05). No other correlations were seen in anthropometry and vital statistics of Rudraprayag or Uttarkashi adults (p>0.05). 

scholarly journals General Healthcare Utilization and Out-of-Pocket Expenditures Associated with Depression in Adults: A Cross-Sectional Analysis in Nepal

2019 ◽  
Author(s):  
Selina Rajan ◽  
Sujit D Rathod ◽  
Nagendra P Luitel ◽  
Adrianna Murphy ◽  
Tessa Roberts ◽  
...  
Keyword(s):  
Healthcare Utilization ◽  
Low Income ◽  
Negative Binomial ◽  
Mental Healthcare ◽  
Negative Binomial Regression ◽  
Population Based ◽  
Low Income Countries ◽  
Cross Sectional ◽  
Universal Healthcare ◽  
Probable Depression

Abstract Background: Despite attempts to improve universal healthcare coverage (UHC) in low income countries like Nepal, most healthcare utilization is still financed by out-of-pocket (OOP) payments, with detrimental effects on the poorest and most in need. Evidence from high income countries shows that depression is associated with increased healthcare utilization, which may lead to increased OOP expenditures, placing greater stress on families. To inform policies for integrating mental healthcare into UHC in LMIC, we must understand general healthcare utilization and OOP expenditure patterns in people with depression. Aims: We examined associations between symptoms of depression and frequency and type of general healthcare utilization and OOP expenditure among adults in Chitwan District, Nepal. Methods: We analysed data from a population-based survey of 2040 adults in 2013, who completed the PHQ-9 screening tool for depression and answered questions about general healthcare utilization. We modelled associations between increasing PHQ-9 score and healthcare utilization frequency and OOP expenditure using negative binomial regression. We also compared sector-specific utilization of outpatient healthcare and their related costs among adults with and without probable depression, determined by a PHQ-9 score of 10 or more. Results: We classified 80 (3.6%) participants with probable depression, 70.9% of whom used some form of general healthcare in the past year compared to 43.9% of people without probable depression. Mean annual OOP healthcare expenditures were $118 USD in people with probable depression, compared to $110 USD in people without. With each unit increase in PHQ-9 score, there was a 14% increase in total healthcare visits (95% CI 7%-22%, p<0.0001) and $9 USD increase in OOP expenditures (95% CI $2-$17; p<0.0001). People with depression sought most general healthcare from pharmacists (30.1%) but reported the greatest expenditure on specialist doctors ($36 USD). Conclusions: In this population-based sample from Central Nepal, we identified dose-dependent increases in healthcare utilization and OOP expenditure with increasing PHQ-9 scores. Strengthening UHC to include early detection and treatment for people affected by depression as an integrated component of general healthcare should lead to a reduction in financial pressures on families, which is likely to reduce the incidence of depression in Nepal.

scholarly journals 1018Long-term risk of distant metastasis and post-metastasis survival for breast cancer: health record linkage study

2021 ◽  
Vol 50 (Supplement_1) ◽  
Author(s):  
Sarah Lord ◽  
Benjamin Daniels ◽  
Belinda Kiely ◽  
Dianne O'Connell ◽  
Sallie-Anne Pearson ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Distant Metastasis ◽  
Record Linkage ◽  
Cumulative Incidence ◽  
Population Based ◽  
Linkage Study ◽  
Health Record ◽  
Free Interval ◽  
Linkage Methods ◽  
Long Term Prognosis

Abstract Background After early breast cancer (BC) treatment, women need information about long-term prognosis. In this population-based health record linkage study, we assessed the cumulative incidence of distant metastasis (DM) conditional on the DM-free interval; and BC-specific survival post-metastasis. Methods We included all women diagnosed with non-metastatic BC in the NSW Cancer Registry, 2001-2002. We used linked records from hospitals, dispensed medicines, radiotherapy services and death registrations and applied stringent criteria to determine time to first DM and BC death. Results 6338 women were included (BC: localised 3885, regional 2453). The 5-year cumulative incidence of DM was 7.4% (95% confidence interval 6.6-8.3) for localised BC; 22.8% (21.2-24.5) for regional BC. For women DM-free at 5 years, it was 5.7% (5.0-6.6); and 11.4% (10.0-13.0) to year 10, respectively. The annual hazard for BC death following localised BC remained lower than that for non-BC causes; for regional BC, it was similar to that for non-BC causes at 8 years. Following DM (N = 1492), BC-specific survival varied widely (median 25 months, interquartile range 6-127). The probability of surviving BC for ≥5 years was 32.0% (29.4-34.7) overall; and 47.1% (42.6-51.5) for those with a DM-free interval &gt;5 years. Conclusions Women’s risk of DM improves over time since diagnosis; and post-metastasis survival is longer for women with later DM. Key messages Health record linkage methods can be used for conditional risk estimates to inform women who remain DM-free after early BC about their risk of DM in subsequent years; and post-metastasis survival.

scholarly journals Healthcare Utilization and Out-of-Pocket Expenditures Associated with Depression in Adults: A Cross-Sectional Analysis in Nepal

2019 ◽  
Author(s):  
Selina Rajan ◽  
Sujit D Rathod ◽  
Nagendra P Luitel ◽  
Adrianna Murphy ◽  
Tessa Roberts ◽  
...  
Keyword(s):  
Healthcare Utilization ◽  
Low Income ◽  
Negative Binomial ◽  
Mental Healthcare ◽  
Negative Binomial Regression ◽  
Population Based ◽  
Low Income Countries ◽  
Cross Sectional ◽  
Universal Healthcare ◽  
Probable Depression

Abstract Background: Despite attempts to improve universal healthcare coverage (UHC) in low income countries like Nepal, most healthcare utilization is still financed by out-of-pocket (OOP) payments, with detrimental effects on the poorest and most in need. Evidence from high income countries shows that depression is associated with increased healthcare utilization, which may lead to increased OOP expenditures, placing greater stress on families. To inform policies for integrating mental healthcare into UHC in LMIC, we must understand healthcare utilization and OOP expenditure patterns in people with depression. Aims: We examined associations between symptoms of depression and frequency and type of healthcare utilization and OOP expenditure among adults in Chitwan District, Nepal. Methods: We analysed data from a population-based survey of 2040 adults in 2013, who completed the PHQ-9 screening tool for depression and answered questions about healthcare utilization. We modelled associations between increasing PHQ-9 score and healthcare utilization frequency and OOP expenditure using negative binomial regression. We also compared sector-specific utilization of outpatient healthcare and their related costs among adults with and without probable depression, determined by a PHQ-9 score of 10 or more. Results: We classified 80 (3.6%) participants with probable depression, 70.9% of whom used some form of healthcare in the past year compared to 43.9% of people without probable depression. Mean annual OOP healthcare expenditures were $118 USD in people with probable depression, compared to $110 USD in people without. With each unit increase in PHQ-9 score, there was a 14% increase in total healthcare visits (95% CI 7%-22%, p<0.0001) and $9 USD increase in OOP expenditures (95% CI $2-$17; p<0.0001). People with depression sought most healthcare from pharmacists (30.1%) but reported the greatest expenditure on specialist doctors ($36 USD). Conclusions: In this population-based sample from Central Nepal, we identified dose-dependent increases in healthcare utilization and OOP expenditure with increasing PHQ-9 scores. Strengthening UHC to include early detection and treatment for people affected by depression as an integrated component of healthcare should lead to a reduction in financial pressures on families, which is likely to reduce the incidence of depression in Nepal.

scholarly journals Causes of death among homeless people: a population-based cross-sectional study of linked hospitalisation and mortality data in England.

2019 ◽  
Vol 4 ◽  
pp. 49 ◽  
Author(s):  
Robert W Aldridge ◽  
Dee Menezes ◽  
Dan Lewer ◽  
Michelle Cornes ◽  
Hannah Evans ◽  
...  
Keyword(s):  
Causes Of Death ◽  
Hospital Admissions ◽  
Social Deprivation ◽  
Homeless People ◽  
Population Based ◽  
Cross Sectional Study ◽  
Mortality Data ◽  
Cross Sectional ◽  
Icd 10 ◽  
External Causes

Background: Homelessness has increased by 165% since 2010 in England, with evidence from many settings that those affected experience high levels of mortality. In this paper we examine the contribution of different causes of death to overall mortality in homeless people recently admitted to hospitals in England with specialist integrated homeless health and care (SIHHC) schemes. Methods: We undertook an analysis of linked hospital admission records and mortality data for people attending any one of 17 SIHHC schemes between 1st November 2013 and 30th November 2016. Our primary outcome was death, which we analysed in subgroups of 10th version international classification of disease (ICD-10) specific deaths; and deaths from amenable causes. We compared our results to a sample of people living in areas of high social deprivation (IMD5 group).Results: We collected data on 3,882 individual homeless hospital admissions that were linked to 600 deaths. The median age of death was 51.6 years (interquartile range 42.7-60.2) for SIHHC and 71.5 for the IMD5 (60.67-79.0).  The top three underlying causes of death by ICD-10 chapter in the SIHHC group were external causes of death (21.7%; 130/600), cancer (19.0%; 114/600) and digestive disease (19.0%; 114/600).  The percentage of deaths due to an amenable cause after age and sex weighting was 30.2% in the homeless SIHHC group (181/600) compared to 23.0% in the IMD5 group (578/2,512).Conclusion: Nearly one in three homeless deaths were due to causes amenable to timely and effective health care. The high burden of amenable deaths highlights the extreme health harms of homelessness and the need for greater emphasis on prevention of homelessness and early healthcare interventions.

scholarly journals Which factors are associated with bone marrow oedema suspicious of axial spondyloarthritis as detected by MRI in the sacroiliac joints and the spine in the general population?

2020 ◽  
pp. annrheumdis-2020-218669
Author(s):  
Xenofon Baraliakos ◽  
Adrian Richter ◽  
Daniel Feldmann ◽  
Anne Ott ◽  
Robin Buelow ◽  
...  
Keyword(s):  
Bone Marrow ◽  
General Population ◽  
Record Linkage ◽  
Negative Binomial ◽  
Axial Spondyloarthritis ◽  
Population Based ◽  
Bone Marrow Oedema ◽  
Hla B27 ◽  
Sacroiliac Joints ◽  
Cross Sectional

ObjectiveIdentify factors associated with presence and extension of spinal and sacroiliac joints (SIJ)–MRI lesions suggestive of axial spondyloarthritis (axSpA) in a population-based cohort (Study of Health in Pomerania) aged <45 years.MethodsSpinal (sagittal T1/T2) and SIJ (semicoronal STIR sequences) MRIs were evaluated by two trained blinded readers. The presence (yes/no) and extension (Berlin MRI Score) of bone marrow oedema (BME) were captured. Degenerative spinal lesions were excluded and discrepancies resolved by consensus. Cross-sectional associations between clinical factors and presence/extension of BME were analysed by logistic/negative binomial regression. Record linkage of claims data was applied to identify participants with axSpA.ResultsMRIs of 793 volunteers were evaluated. The presence of SIJ–BME (odds ratio) was strongly associated delivery during the last year (4.47, 1.49–13.41). For SIJ–BME extension, associations (incidence rate ratios, 95% CI) were found for delivery ((during last year) 4.52, 1.48–13.84), human leucocyte antigen (HLA)-B27+ (2.32, 1.30–4.14), body mass index (25–30 vs <25 kg/m²; 1.86 (1.19–2.89)) and back pain ((last 3 months) 1.55, 1.04–2.31), while for spinal BME, associations were found for age per decade (1.46, 1.13–1.90) and physically demanding work (1.46, 1.06–2.00). Record linkage was available for 694 (87.5%) participants and 9/694 (1.3%) had a record of axSpA (ICD M45.09).ConclusionThese population-based data support the hypothesis of mechanic strain contributing to BME in the general population aged <45 years and the role of HLA-B27+ as a severity rather than a susceptibility factor for SIJ–BME.

scholarly journals Analysis of Causes of Death Among Brought-in-Dead Cases in a Third-Level Hospital in Lusaka, Republic of Zambia, Using the Tariff Method 2.0 for Verbal Autopsy: A Cross-Sectional Study

2019 ◽  
Author(s):  
Yuta Yokobori ◽  
Jun Matsuura ◽  
Yasuo Sugiura ◽  
Charles Mutemba ◽  
Martin Nyahoda ◽  
...  
Keyword(s):  
Verbal Autopsy ◽  
Causes Of Death ◽  
Vital Statistics ◽  
Capital City ◽  
Cross Sectional ◽  
Registration System ◽  
Death Notification ◽  
Hospital Deaths ◽  
Tariff Method ◽  
Level Hospital

Abstract Background Over one third of deaths in Zambian health facilities involve someone who has already died before arrival (i.e., brought in dead [BiD]), and in most BiD cases, the causes of death (CoD) have not been fully analyzed. Therefore, this study aimed to analyze the CoD of BiD cases using the Tariff Method 2.0 for automated verbal autopsy (VA), which is called SmartVA.Methods The target site was one third-level hospital in the Republic of Zambia’s capital city. All BiD cases aged 13 years and older at this facility from January to August 2017 were included. The deceased’s closest relatives were interviewed using a structured VA questionnaire (Population Health Metrics Research Consortium Shortened Questionnaire) and the data were analyzed using the SmartVA to determine the CoD at the individual and population level. The CoDs were compared with description on the death notification forms by using t-test and Cohen’s kappa coefficient.Results Approximately 1500 cases were included (average age = 47.2 years, 61.8% males). The top CoD were infectious diseases, including acquired immunodeficiency syndrome, tuberculosis, and malaria, followed by non-communicable diseases, such as stroke, cardiovascular diseases, and diabetes mellitus (DM). The comparison with the CoD distribution among hospital deaths showed that the trends were similar except for DM, which was greater among hospital deaths, and malaria and accident, which were less frequent in the main CoD. The proportion of cases with a determined CoD was significantly higher when using the SmartVA (75%) than the death notification form (61%). A proportion (42.7%) of the CoD-determined cases matched in both sources, with a low concordance rate (kappa coefficient = 0.1385).Conclusions The CoD of the BiD cases were successfully analyzed using the SmartVA for the first time in Zambia. While there many erroneous descriptions on the death notification form, the SmartVA could determine the CoD among more BiD cases. Since the information on the death notification form is reflected in the national vital statistics, more accurate and complete CoD data are required. In order to strengthen the death registration system with accurate CoD, it will be useful to embed the SmartVA in Zambia’s health information system.

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