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Linkage Methods for Connecting Children with Parents in Electronic Health Record and State Public Health Insurance Data


The objective of this study was to develop methodologies for creating child–parent ‘links’ in two healthcare-related data sources. We linked children and parents who were patients in a network of Oregon clinics with a shared electronic health record (EHR), using data that reported the child’s emergency contact information or the ‘guarantor’ for the child’s visits. We also linked children and parents enrolled in the Oregon Health Plan (OHP; Oregon’s public health insurance programs), using administrative data; here, we defined a ‘child’ as aged <19 years and identified potential ‘parents’ from among adults sharing the same OHP household identification (ID) number. In both data sources, parents had to be 12–55 years older than the child. We used OHP individual client ID and EHR patient ID numbers to assess the quality of our linkages through cross-validation. Of the 249,079 children in the EHR dataset, we identified 62,967 who had a ‘linkable’ parent with patient information in the EHR. In the OHP data, 889,452 household IDs were assigned to at least one child; 525,578 with a household ID had a ‘linkable’ parent (272,578 households). Cross-validation of linkages revealed 99.8 % of EHR links validated in OHP data and 97.7 % of OHP links validated in EHR data. The ability to link children and their parents in healthcare-related datasets will be useful to inform efforts to improve children’s health. Thus, we developed strategies for linking children with their parents in an EHR and a public health insurance administrative dataset.

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This work was financially supported by the Agency for Healthcare Research and Quality (AHRQ) (1 R01 HS018569), the Patient-Centered Outcomes Research Institute (PCORI), and the Oregon Health & Science University, Department of Family Medicine. The funding agencies had no involvement in the preparation, review, or approval of the manuscript. We would also like to acknowledge OCHIN, Inc. and all clinics in the network for participating in this research. The authors are grateful for editing and publication assistance from Ms. LeNeva Spires, Publications Manager, Department of Family Medicine, Oregon Health & Science University, Portland, OR.

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Correspondence to Heather Angier.

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Angier, H., Gold, R., Crawford, C. et al. Linkage Methods for Connecting Children with Parents in Electronic Health Record and State Public Health Insurance Data. Matern Child Health J 18, 2025–2033 (2014). https://doi.org/10.1007/s10995-014-1453-8

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  • Children
  • Electronic health records
  • Public health insurance
  • Family