Seong L Cheah1, Vanessa L Scarf2, Chris Rossiter1, Charlene Thornton3, Caroline S E Homer4. 1. Centre for Midwifery, Child and Family Health, Faculty of Health, University of Technology Sydney, NSW, Australia. 2. Centre for Midwifery, Child and Family Health, Faculty of Health, University of Technology Sydney, NSW, Australia. Electronic address: vanessa.scarf@uts.edu.au. 3. College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia. 4. Centre for Midwifery, Child and Family Health, Faculty of Health, University of Technology Sydney, NSW, Australia; Burnet Institute, Melbourne, Victoria, Australia.
Abstract
BACKGROUND: Data linkage offers a powerful mechanism for examining healthcare outcomes across populations and can generate substantial robust datasets using routinely collected electronic data. However, it presents methodological challenges, especially in Australia where eight separate states and territories maintain health datasets. This study used linked data to investigate perinatal and maternal outcomes in relation to place of birth. It examined data from all eight jurisdictions regarding births planned in hospitals, birth centres and at home. Data linkage enabled the first Australia-wide dataset on birth outcomes. However, jurisdictional differences in data collection created challenges in obtaining comparable cohorts of women with similar low-risk pregnancies in all birth settings. The objective of this paper is to describe the techniques for managing previously linked data, and specifically for ensuring the resulting dataset contained only low-risk pregnancies. METHODS: This paper indicates the procedures for preparing and merging linked perinatal, inpatient and mortality data from different sources, providing technical guidance to address challenges arising in linked data study designs. RESULTS: We combined data from eight jurisdictions linking four collections of administrative healthcare and civil registration data. The merging process ensured that variables were consistent, compatible and relevant to study aims. To generate comparable cohorts for all three birth settings, we developed increasingly complex strategies to ensure that the dataset eliminated women with pregnancies at risk of complications during labour and birth. It was then possible to compare birth outcomes for comparable samples, enabling specific examination of the impact of birth setting on maternal and infant safety across Australia. CONCLUSIONS: Data linkage is a valuable resource to enhance knowledge about birth outcomes from different settings, notwithstanding methodological challenges. Researchers can develop and share practical techniques to address these challenges. Study findings suggest that jurisdictions develop more consistent data collections to facilitate future data linkage.
BACKGROUND: Data linkage offers a powerful mechanism for examining healthcare outcomes across populations and can generate substantial robust datasets using routinely collected electronic data. However, it presents methodological challenges, especially in Australia where eight separate states and territories maintain health datasets. This study used linked data to investigate perinatal and maternal outcomes in relation to place of birth. It examined data from all eight jurisdictions regarding births planned in hospitals, birth centres and at home. Data linkage enabled the first Australia-wide dataset on birth outcomes. However, jurisdictional differences in data collection created challenges in obtaining comparable cohorts of women with similar low-risk pregnancies in all birth settings. The objective of this paper is to describe the techniques for managing previously linked data, and specifically for ensuring the resulting dataset contained only low-risk pregnancies. METHODS: This paper indicates the procedures for preparing and merging linked perinatal, inpatient and mortality data from different sources, providing technical guidance to address challenges arising in linked data study designs. RESULTS: We combined data from eight jurisdictions linking four collections of administrative healthcare and civil registration data. The merging process ensured that variables were consistent, compatible and relevant to study aims. To generate comparable cohorts for all three birth settings, we developed increasingly complex strategies to ensure that the dataset eliminated women with pregnancies at risk of complications during labour and birth. It was then possible to compare birth outcomes for comparable samples, enabling specific examination of the impact of birth setting on maternal and infant safety across Australia. CONCLUSIONS: Data linkage is a valuable resource to enhance knowledge about birth outcomes from different settings, notwithstanding methodological challenges. Researchers can develop and share practical techniques to address these challenges. Study findings suggest that jurisdictions develop more consistent data collections to facilitate future data linkage.
Authors: Susan Yuill; Louiza S Velentzis; Megan Smith; Sam Egger; C David Wrede; Deborah Bateson; Marc Arbyn; Karen Canfell Journal: Hum Vaccin Immunother Date: 2021-10-03 Impact factor: 4.526
Authors: Caroline S E Homer; Seong L Cheah; Chris Rossiter; Hannah G Dahlen; David Ellwood; Maralyn J Foureur; Della A Forster; Helen L McLachlan; Jeremy J N Oats; David Sibbritt; Charlene Thornton; Vanessa L Scarf Journal: BMJ Open Date: 2019-10-29 Impact factor: 2.692