Creation of a linked cohort of children and their parents in a large, national electronic health record dataset

Creation of a linked cohort of children and their parents in a large, national electronic health record dataset

Background

Electronic health record (EHR) data provide a unique opportunity to assess connections between parent and child healthcare and health outcomes without self-report biases. EHR data also have potential to facilitate a better understanding of multi-level influences (i.e., individual, parent, family, and community-level) on children’s receipt of recommended healthcare. Linking children to their parents within EHR data is challenging, however, as most EHR datasets do not create direct linkages for family members.

Useful Findings

We applied a previously validated EHR-based algorithm to identify a national cohort of children seen in a network of community health centers that link to at least one parent in the same clinical dataset using emergency contact and guarantor record fields.

Our final cohort included 213,513 distinct children with either one or two parent-links; all included parents identified as ‘mother’ or ‘father’ in the EHR fields. Linked to these distinct children were 126,327 parents and 220,959 child-parent pairs. 86% of links derived from the guarantor record (n= 189,602), 4% from an emergency contact (n=9,040), and 10% were found in both the guarantor record and emergency contact (n= 22,317) fields.

Bottom Line

This study highlights our ability to link 33% of children to at least one parent in EHR data. We will use this rich cohort to investigate the relationships among parental health status and healthcare utilization and a child’s receipt of recommended services and health.

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