Linking health survey data with health insurance data: methodology, challenges, opportunities and recommendations for public health research. An experience from the HISlink project in Belgium.
Health administrative insurance data; Health claims data; Health interview surveys; Record linkage; data linkage; Public Health, Environmental and Occupational Health
Abstract :
[en] In recent years, the linkage of survey data to health administrative data has increased. This offers new opportunities for research into the use of health services and public health. Building on the HISlink use case, the linkage of Belgian Health Interview Survey (BHIS) data and Belgian Compulsory Health Insurance (BCHI) data, this paper provides an overview of the practical implementation of linking data, the outcomes in terms of a linked dataset and of the studies conducted as well as the lessons learned and recommendations for future links.Individual BHIS 2013 and 2018 data was linked to BCHI data using the national register number. The overall linkage rate was 92.3% and 94.2% for HISlink 2013 and HISlink 2018, respectively. Linked BHIS-BCHI data were used in validation studies (e.g. self-reported breast cancer screening; chronic diseases, polypharmacy), in policy-driven research (e.g., mediation effect of health literacy in the relationship between socioeconomic status and health related outcomes, and in longitudinal study (e.g. identifying predictors of nursing home admission among older BHIS participants). The linkage of both data sources combines their strengths but does not overcome all weaknesses.The availability of a national register number was an asset for HISlink. Policy-makers and researchers must take initiatives to find a better balance between the right to privacy of respondents and society's right to evidence-based information to improve health. Researchers should be aware that the procedures necessary to implement a link may have an impact on the timeliness of their research. Although some aspects of HISlink are specific to the Belgian context, we believe that some lessons learned are useful in an international context, especially for other European Union member states that collect similar data.
Disciplines :
Public health, health care sciences & services
Author, co-author :
Berete, Finaba ; Université de Liège - ULiège > Unité de recherche Santé publique, épidémiologie et économie de la santé (URSAPES) ; Department of Epidemiology and Public Health, Sciensano, Juliette Wytsmanstraat 14, Brussels, 1050, Belgium. finaba.berete@sciensano.be
Demarest, Stefaan; Department of Epidemiology and Public Health, Sciensano, Juliette Wytsmanstraat 14, Brussels, 1050, Belgium
Charafeddine, Rana; Department of Epidemiology and Public Health, Sciensano, Juliette Wytsmanstraat 14, Brussels, 1050, Belgium
De Ridder, Karin; Department of Epidemiology and Public Health, Sciensano, Juliette Wytsmanstraat 14, Brussels, 1050, Belgium
Van Oyen, Herman; Department of Epidemiology and Public Health, Sciensano, Juliette Wytsmanstraat 14, Brussels, 1050, Belgium ; Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
Van Hoof, Wannes; Department of Epidemiology and Public Health, Sciensano, Juliette Wytsmanstraat 14, Brussels, 1050, Belgium
Bruyère, Olivier ; Université de Liège - ULiège > Unité de recherche Santé publique, épidémiologie et économie de la santé (URSAPES)
Van der Heyden, Johan; Department of Epidemiology and Public Health, Sciensano, Juliette Wytsmanstraat 14, Brussels, 1050, Belgium
Language :
English
Title :
Linking health survey data with health insurance data: methodology, challenges, opportunities and recommendations for public health research. An experience from the HISlink project in Belgium.
This work did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. The Belgian Health Interview Survey (BHIS) is financed by the Federal and Inter-Federated Belgian Public Health authorities. The linkage between BHIS data and the Belgian Compulsory Health Insurance data is financed by the National Institute for Health and Disability Insurance.
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