317879
Maximizing Value of Hospital Discharge Data to Enhance Health Disparity Assessment: Link and geocode Hospital Discharge Data to gain race and social economic status information to assess health disparity in Nebraska
Hospital discharge data (HDD) is the primary dataset for public health surveillance. However, the majority of Nebraska HDD records (92%) lack either race or ethnicity information because there is no state mandate for reporting them, which creates challenges for public health to conduct health surveillance and disparity assessment. Therefore, an innovative approach is warranted to link HDD with other datasets to obtain race information and geocode HDD to provide social economic status information at census tract level.
Method
Probabilistic linkage method was used to link the 2005 to 2011 HDD data with other population based datasets with race information as required, which includes the Birth Certificate, Driver’s License, Cancer Registry, and Death Certificate. Based on the racial composition of each tract, ‘race’ was imputed for those records that could not be linked without race information. Linkage was implemented at the Nebraska Hospital Association due to data security and confidentiality concerns. GIS was used to geocode HDD records.
Results:
Linkage resulted in 90% of the total of 1.5 million HDD records with race information, which includes inpatient, ED patients and Non-ED outpatient visits. The race of the remaining 10% records was imputed. Eventually, 100% of the hospital discharge records had race and ethnicity information in addition to social economic status information at census tract level. In addition, a race index was created which will be used for updating and further linking purposes. Primary data analysis was conducted in order to assess the disparities of the most common chronic diseases by race and poverty level based on the linked data.
Discussion: This study demonstrates the usefulness of the data linkage and GIS in leveraging the value of the HDD data. This approach not only provides a comprehensive data source but also significantly enhances a population based health disparity study and deepens our understanding of the impact of certain factors including the social economic status on health. Further efforts should be directed to promoting utilization of the data in order to conduct future research.
Learning Areas:
Administration, management, leadershipCommunication and informatics
Diversity and culture
Epidemiology
Public health or related research
Systems thinking models (conceptual and theoretical models), applications related to public health
Learning Objectives:
Explain the importance and use of technology in data linkage and geocoding to increase the values of Hospital Discharge Data;
Discuss the use of the comprehensive data in conducting a population based health disparity assessment.
Keyword(s): Epidemiology, Health Disparities/Inequities
Qualified on the content I am responsible for because: In charge of epidemiology and public health informatics since 2007. Provide leadership in establishing and managing the Nebraska Public Health Data Center. Manage federal and state-funded annual budget approximate $7 million annually.
Serve as Principal Investigators for a number of federal grants; Direct supervise 11 public health professionals, including Office Administrators, State Epidemiologist, Cancer Epidemiologist, Injury/Nutrition Physical Activities Epidemiologist, CODES epidemiologists, GIS coordinator, and CSTE Fellow. Have rich experiences in data linkage and integration.
Any relevant financial relationships? No
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.