Suchergebnisse

Established in 1995, the Western Australian Data Linkage Branch (DLB) is Australia's longest running data linkage agency. The Western Australian Data Linkage System (WADLS) employs an enduring linkage model spanning over 60 data collections supported by internally developed and supported software and IT infrastructure. DLB has delivered, and continues to deliver, a range of significant data linkage innovations, many of which have been adopted elsewhere. A current restructure within the Western Australian Department of Health (which we will refer to as the Department of Health) will provide an improved funding model geared toward addressing issues with staff retention, capacity and customer service, as well as fostering improvements to data management, governance and availability. Research using linked data provided by DLB has been used in over 800 projects resulting in over 2350 publications and outcomes for policy development, service delivery and public health. Demand continues to grow for data linkage services and with the Department of Health's bolstered commitment to resourcing, DLB looks forward to a future for data linkage in Western Australia that is sustainable, high quality, efficient, and safe.

The Western Australia Data Linkage System (WADLS) is maintained and operated by the WA Data Linkage Branch (DLB) at the Western Australian Department of Health. DLB has pioneered a number of data linkage innovations, including the facilitation of genealogical research via the Family Connections system and streamlined data delivery via the Custodian Administered Research Extract Server. DLB's latest innovation is a new data linkage system called "DLS3", which improves DLB's capability and capacity to handle the increasing volume and complexity of its routine operations. DLS3 was built entirely in-house and customised to meet the specific challenges that DLB has encountered throughout over twenty years of experience with a wide variety of linkages. This article describes the development and rollout of DLS3, including its design, architecture, benefits and limitations.

ABSTRACT
ObjectivesThe Population Health Research Network (PHRN) was established to increase data linkage capacity in Australia. A proof of concept study investigating cross border hospital use and hospital mortality was undertaken to demonstrate the effectiveness of increased data linkage capacity in supporting nationally significant health research. The objective of this study was to evaluate whether cross-jurisdictional linkage of hospital and death records across Australian states could refine estimation of Hospital Standardised Mortality Ratios (HSMRs).
ApproachIn Australia, administrative hospital and death data are collected by individual state governments. The newly established Centre for Data Linkage created a cross-jurisdictional linkage key that brought together hospital and death records belonging to individuals across four Australian states over a five year period (1st July 2004 – 30th June 2009). Hospital inpatient records from public, psychiatric and private hospitals and private day surgery centres were provided by New South Wales, Western Australia and Queensland. South Australia provided public hospital inpatient records only. The linked data underwent extensive cleaning and standardisation to improve the validity of interstate comparisons.
The final cohort comprised 7.7 million hospital patients. In-hospital deaths and deaths within 30 days of hospital discharge from the four state jurisdictions were used to estimate the SMR of hospital groups defined by geography and type of hospital (grouped HSMR) under three record linkage scenarios; 1) cross-jurisdictional person-level linkage, 2) within-jurisdictional (state-based) person-level linkage and 3) unlinked records. All public and private hospitals in New South Wales, Queensland, Western Australia and public hospitals in South Australia were included in this study. Death registrations from all four states were obtained from state-based registries of births, deaths and marriages.
Results Cross-jurisdictional linkage identified 11,116 cross-border hospital transfers of which 170 resulted in a cross-border in-hospital death. An additional 496 cross-border deaths occurred within 30 day of hospital discharge. The inclusion of cross-jurisdictional person-level links to unlinked hospital records reduced the coefficient of variation amongst the grouped HSMRs from 0.19 to 0.15; the inclusion of 30 day deaths reduced the coefficient of variation further to 0.11. There were minor changes in grouped HSMRs between cross-jurisdictional and within-jurisdictional linkages, although the impact of cross-jurisdictional linkage increased when restricted to geographic regions with high cross-border hospital use such as the New South Wales and Queensland border area.
ConclusionCross-jurisdictional data linkage modified estimates of grouped HSMRs, particularly for hospitals groups that were likely to receive a high proportion of cross-border users.