Using record linkage to monitor equity and variation in screening programmes

BMC Medical Research Methodology

Clare Hall¹  Adrian Mairs¹  Michael Rosato³  Heather Kinnear²  Dermot O’Reilly³ 

[1] Public Health Agency, Belfast, Northern Ireland;Centre for Public Health, Queen’s University Belfast, Mulhouse Building, Grosvenor Road, Belfast, BT12 6BJ, Northern Ireland;Centre for Public Health, Queen’s University Belfast, Belfast, Northern Ireland

关键词: Equity monitoring;    Inequalities;    Breast screening;    Data linkage;   

Others  :  1136686
DOI  :  10.1186/1471-2288-12-59

 received in 2011-05-23, accepted in 2012-04-25,  发布年份 2012

【 摘 要 】

Background

Ecological or survey based methods to investigate screening uptake rates are fraught with many limitations which can be circumvented by record linkage between Census and health services datasets using variations in breast screening attendance as an exemplar. The aim of this current study is to identify the demographic, socio-economic factors associated with uptake of breast screening.

Methods

Record linkage study: combining 2001 Census data within the Northern Ireland Longitudinal Study (NILS) with data relating to validated breast screening histories from the National Breast Screening System. A cohort was identified of 37,059 women aged 48-64 at the Census who were invited for routine breast screening in the three years following the Census. All cohort attributes were as recorded on the Census form.

Results

The record linkage methodology enabled the records of almost 40,000 of those invited for screening to be analysed at an individual level, exceeding the largest published survey by a factor of ten. This produced a more robust analysis and demonstrated (in fully adjusted models) the lower uptake amongst non-married women and those in the lowest social class (OR 0.74; 95%CI 0.66, 0.82), factors that had not been reported earlier in the UK. In addition, with the availability of both individual and area information it was possible to show that the much lower screening uptake in urban areas is not due to differences in population composition suggesting unrecognised organisational problems.

Conclusions

Linkage of screening data to Census-based longitudinal studies is an efficient and powerful way to increase the evidence base on sources of variation in screening uptake within the UK.

【 授权许可】

   
2012 O'Reilly et al.; licensee BioMed Central Ltd.

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