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Linking Maternal and Child Health Data to Create a Comprehensive Longitudinal Dataset: The Florida Experience

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Linking Maternal and Child Health Data to Create a Comprehensive Longitudinal Dataset: The Florida Experience

Hamisu Salihu, Ph.D., Principal Investigator
University of South Florida College of Public Health
R01 HS19997-01
9/30/2010 - 9/29/2013 (3 years)

April 6, 2011

Specific Aims

  1. To create an expanded clinically enhanced maternal-infant dataset for the State of Florida by augmenting the current statewide hospitalization data files through linkages to other data sources.
  2. To validate the created dataset in Specific Aim 1 through a rigorous process that will establish confidence in the use of the dataset.
  3. To demonstrate the utility of the newly created, enriched dataset in conducting comparative effectiveness analysis using early term elective delivery as a case study.

Data Sources

FDOH (Office of Vital Statistics) Data

Live Birth Data 1998-2009

Mortality (Infant and Mom) Data 1998-2009

Fetal Death Data 1998-2009

Agency for Health Care Administration Data

Inpatient Hospitalization Data 1998-2009

Outpatient/Ambulatory Hospitalization Data 1998-2009

Emergency Department Data 2005-2009

Hospital Financial Data 1998-2009

"Follow" Infants Over Time Through Linkage

Arrow pointing to the right to show the passage of time with the following events placed along the arrow from left to right: birth, inpatient hospitalization #1, inpatient hospitalization #2, outpatient hospitalization #1, emergency room visit, death.

"Follow" Moms Over Time Through Linkage

Arrow pointing to the right to show the passage of time with the following events placed along the arrow from left to right: delivery, inpatient hospitalization #1, inpatient hospitalization #2, outpatient hospitalization #1.

Special Challenges to Our Data Linkage

Our Approach to Linking AHCA to VS

Example of Overarching Linkage Approach

Complex flow chart illustrating three stages of linkage approach. Stage 1: Within the inpatient hospital discharge data, first attempt to link infants to their mothers (so called dyad links) with the primary goal of obtaining maternal D O B, an important linking variable (FIND other identifying information). Stage 2: Link these dyad pairs to birth vital records, now incorporating infant's and mom's D O B, mom's S S N, and facility of birth as the primary linking variables. Stage 3: Attempt to link infant and mom hospitalizations that did not link to a maternal record from Stage 1 directly to the birth record.

Software To Facilitate Data Linkage

Decorative graphic showing figure putting a puzzle piece into a puzzle.

SQL Match

Clockwise from upper left:
Screen in S Q L Match software used to set up data linkage.
Screen in S Q L Match software used to view linkage results.
Screen in S Q L Match software used for manual review.

Freely Extensible Biomedical Record Linkage

Clockwise from upper left:
Screen in F E B R L software used to set up data linkage.
Screen in F E B R L software used to view linkage results.
Screen in F E B R L software used for manual review and summary.
Screen in F E B R L software used to set up data linkage.

Link Plus

Clockwise from upper left:
Screen in Link Plus software used to set up data linkage.
Screen in Link Plus software used to view linkage results.
Screen in Link Plus software used for manual review and summary.
Screen in Link Plus software used for manual review and summary.

Link King

Clockwise from upper left:
Screen in Link King software used to set up data linkage.
Decorative graphic of a king.
Screen in Link King software used to select variables.
Screen in Link King software used for manual review.
Screen in Link King software used for manual review.

Fine-Grained Record Linkage (FRIL)

Clockwise from upper left:
Screen in F R I L software used to set up data linkage.
Screen in F R I L software used to select variables and weights.
Screen in F R I L software used for manual review.
Screen in F R I L software used for join methods.

But our choice...SAS

Screen showing SAS code.

Linking Mechanics

Linking Mechanics

Screen showing summary output for two merged clauses.

Additional Challenges

Next Steps


Internet Citation: Linking Maternal and Child Health Data to Create a Comprehensive Longitudinal Dataset: The Florida Experience. Healthcare Cost and Utilization Project (HCUP). August 2014. Agency for Healthcare Research and Quality, Rockville, MD. www.hcup-us.ahrq.gov/datainnovations/clinicalcontentenhancementtoolkit/fl9.jsp.
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Last modified 8/19/14