Abstract
BackgroundThe aim of this body of research is to determine whether injuries in the home are more common in particular types of housing. Previous home injuries research has tended to focus on behaviours or the provision of safety equipment to families with young children. There has been little consideration of the physical environment. This study reports methodological developments in database linkage and analysis to improve researchers abilities to utilise large administrative and clinical databases to carry out health and health services research.MethodsThe study involved linking a database of home injuries obtained from an emergency department surveillance system with an external survey of all homes in an area and population denominators for home types derived from a health service administrative database. Analysis of injury incidence by housing type was adjusted for potential biases due to deprivation and distance to hospital. For non-injured individuals data confidentiality considerations required the deprivation and distance measures be imputed. The process of randomly imputing these variables and the testing of the validity of this approach is detailed.ResultsThere were 14,081 first injuries in 112,248 residents living in 54,081 homes over a two-year period. The imputation method worked well with imputed and observed measures in the injured group being very similar. Re-randomisation and a repeated analysis gave identical results to the first analysis. One particular housing type had a substantially elevated odds ratio for injury occurrence, OR = 2.07 (95% CI: 1.87 to 2.30).ConclusionsThe method of data linkage, imputation and statistical analysis used provides a basis for improved analysis of database linkage studies.
Highlights
The aim of this body of research is to determine whether injuries in the home are more common in particular types of housing
Previous home injuries research has tended to focus on behaviours or the provision of safety equipment to families with young children
The analyses for deprivation and proximity and the results of multivariate analyses for build type and other variables were altered, but only to a very minor degree. These results provide considerable reassurance that the random element that was necessary in order to achieve the linkage process introduced very little additional uncertainty into the final analyses
Summary
The aim of this body of research is to determine whether injuries in the home are more common in particular types of housing. It is evident that the risks of some types of injuries, such as falls or injuries resulting from fire, could well be related to the built form of the home. BMC Health Services Research 2005, 5:12 http://www.biomedcentral.com/1472-6963/5/12 robust evidence based on large numbers of cases is quite limited[2]. Previous home injuries research has tended to focus on behaviours or the provision of safety equipment to families with young children. Linkage of existing large datasets has the potential to yield substantial evidence
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