Growth of linked hospital data use in Australia: a systematic review

Abstract

Objective. The aim of the present study was to quantify and understand the utilisation of linked hospital data for research purposes across Australia over the past two decades.Methods. A systematic review was undertaken guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2009 checklist. Medline OVID, PsycINFO, Embase, EconLit and Scopus were searched to identify articles published from 1946 to December 2014. Information on publication year, state(s) involved, type of data linkage, disease area and purpose was extracted.Results. The search identified 3314 articles, of which 606 were included; these generated 629 records of hospital data linkage use across all Australian states and territories. The major contributions were from Western Australia (WA; 51%) and New South Wales (NSW; 32%) with the remaining states and territories having significantly fewer publications (total contribution only 17%). WA's contribution resulted from a steady increase from the late 1990s, whereas NSW's contribution is mostly from a rapid increase from 2010. Current data linkage is primarily used in epidemiological research (73%).Conclusion. More than 80% of publications were from WA and NSW, whereas other states significantly lag behind. The observable growth in these two states clearly demonstrates the underutilised opportunities for data linkage to add value in health services research in the other states.What is known about the topic? Linking administrative hospital data to other data has the potential to be a cost-effective method to significantly improve health policy. Over the past two decades, Australia has made significant investments in improving its data linkage capabilities. However, several articles have highlighted the many barriers involved in using linked hospital data. What does this paper add? This paper quantitatively evaluates the performance across all Australian states in terms of the use of their administrative hospital data for research purposes. The performance of states varies considerably, with WA and NSW the clear stand-out performers and limited outputs currently seen for the other Australian states and territories. What are the implications for practitioners? Given the significant investments made into data linkage, it is important to continue to evaluate and monitor the performance of the states in terms of translating this investment into outputs. Where the outputs do not match the investment, it is important to identify and overcome those barriers limiting the gains from this investment. More generally, there is a need to think about how we improve the effective and efficient use of data linkage investments in Australia.

Health data linkage research in Australia remains challenging

“…It was set up by the National Collaborative Research Infrastructure Strategy to provide nationwide linkage infrastructure to support cross‐jurisdictional health research endeavours. Almost a decade and A$93 million later, health data linkage still remains a challenging process . Access to multijurisdictional linked data involves many pivotal players.…”

Access to linked data: challenges and progress

“…The authors were critical of the number of publications attributed to the use of the new DLU based on a paper by Tew et al . This paper only included publications involving linked hospital data and counted publications up to 2014 when the new DLU were still in their infancy.…”

Use of data linkage to improve communicable disease surveillance and control in Australia: existing practices, barriers and enablers

“… 8,9 Use of data linkage in Australia has been steadily increasing as a relatively inexpensive method of conducting epidemiological research or monitoring health at a population level 10 . It is often used to improve understanding of chronic diseases including cancer, cardiovascular and respiratory diseases, as well as for injury, and mother and child health research, where long‐term monitoring, treatment or care is required 10–13 . Most data linkage studies in Australia are conducted in New South Wales (NSW) and Western Australia (WA), where linkage infrastructure is well developed and utilised 10,11,13 .…”

“…It is often used to improve understanding of chronic diseases including cancer, cardiovascular and respiratory diseases, as well as for injury, and mother and child health research, where long‐term monitoring, treatment or care is required 10–13 . Most data linkage studies in Australia are conducted in New South Wales (NSW) and Western Australia (WA), where linkage infrastructure is well developed and utilised 10,11,13 . In the communicable diseases setting, data linkage can be used to evaluate public health interventions and guide policy development 14 .…”