Describing the linkages of the immigration, refugees and citizenship Canada permanent resident data and vital statistics death registry to Ontario's administrative health database.

Maria Chiu,Mahmoud Azimaee,Astrid Guttmann,Nelson Chong,Kelvin Lam,Karey Iron,Doug Manuel,Michael Lebenbaum

doi:10.1186/s12911-016-0375-3

Abstract

BackgroundOntario, the most populous province in Canada, has a universal healthcare system that routinely collects health administrative data on its 13 million legal residents that is used for health research. Record linkage has become a vital tool for this research by enriching this data with the Immigration, Refugees and Citizenship Canada Permanent Resident (IRCC-PR) database and the Office of the Registrar General’s Vital Statistics-Death (ORG-VSD) registry. Our objectives were to estimate linkage rates and compare characteristics of individuals in the linked versus unlinked files.MethodsWe used both deterministic and probabilistic linkage methods to link the IRCC-PR database (1985–2012) and ORG-VSD registry (1990–2012) to the Ontario’s Registered Persons Database. Linkage rates were estimated and standardized differences were used to assess differences in socio-demographic and other characteristics between the linked and unlinked records.ResultsThe overall linkage rates for the IRCC-PR database and ORG-VSD registry were 86.4 and 96.2 %, respectively. The majority (68.2 %) of the record linkages in IRCC-PR were achieved after three deterministic passes, 18.2 % were linked probabilistically, and 13.6 % were unlinked. Similarly the majority (79.8 %) of the record linkages in the ORG-VSD were linked using deterministic record linkage, 16.3 % were linked after probabilistic and manual review, and 3.9 % were unlinked. Unlinked and linked files were similar for most characteristics, such as age and marital status for IRCC-PR and sex and most causes of death for ORG-VSD. However, lower linkage rates were observed among people born in East Asia (78 %) in the IRCC-PR database and certain causes of death in the ORG-VSD registry, namely perinatal conditions (61.3 %) and congenital anomalies (81.3 %).ConclusionsThe linkages of immigration and vital statistics data to existing population-based healthcare data in Ontario, Canada will enable many novel cross-sectional and longitudinal studies to be conducted. Analytic techniques to account for sub-optimal linkage rates may be required in studies of certain ethnic groups or certain causes of death among children and infants.Electronic supplementary materialThe online version of this article (doi:10.1186/s12911-016-0375-3) contains supplementary material, which is available to authorized users.

Highlights

Ontario, the most populous province in Canada, has a universal healthcare system that routinely collects health administrative data on its 13 million legal residents that is used for health research
Institute for Clinical Evaluative Sciences (ICES) has recently acquired data from Immigration, Refugees and Citizenship Canada Permanent Resident (IRCC-PR, formerly Citizenship and Immigration Canada) database for more general use and the Office of the Registrar General’s Vital Statistics– Death (ORG-VSD) registry to fill in these important data gaps and to facilitate new lines of research [14, 15]
A data sharing agreement was reached between ICES and the Office of the Registrar General of Ontario to facilitate the disclosure of registered vital statistics death information to ICES

Summary

Introduction

The most populous province in Canada, has a universal healthcare system that routinely collects health administrative data on its 13 million legal residents that is used for health research. Under approved ethical and legal permissions and with rigorous privacy and security policies in place, these data are held at the Institute for Clinical Evaluative Sciences (ICES), one of the largest repositories of health data in Canada This has enabled ICES to use a consistent set of identifiers, including unique Ontario health card numbers, to link across health administrative databases, allowing researchers to build individual histories of patient cohorts and health care outcomes over time and across healthcare sectors (e.g. outpatient claims, emergency care, hospitalizations, long-term care). ICES has recently acquired data from Immigration, Refugees and Citizenship Canada Permanent Resident (IRCC-PR, formerly Citizenship and Immigration Canada) database for more general use (in the past this has only been used for a limited number of approved projects) and the Office of the Registrar General’s Vital Statistics– Death (ORG-VSD) registry to fill in these important data gaps and to facilitate new lines of research [14, 15]

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Conclusion