Linkage methods for connecting children with parents in electronic health record and state public health insurance data

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.

Fig. 1

Linking children and parents in OCHIN's EHR data. Asterisk The guarantor is the person responsible for paying for a given visit. Double asterisk Of the linked children and parents with both an emergency contact and a guarantor ID, we used the guarantor relationship if they did not agree

Fig. 2

Linking children and parents in the OHP administrative data. Asterisk Household case ID numbers include all people in a household. Double asterisk Within the 889,452 household case ID numbers, 1,720,499 were unique individual client ID numbers in the dataset. Triple asterisk Within the 315,409 household case ID numbers, 1,072,616 were unique individual client ID numbers in the dataset. Hat Went to the next youngest child and then the next to see if we could identify anyone with an age difference of 12–55 years until all children with the household case ID number were excluded or linked to a potential parent