Identifying care home residents in electronic health records: An OpenSAFELY short data report

Journal article

Background: Care home residents have been severely affected by the COVID-19 pandemic. Electronic Health Records (EHR) hold significant potential for studying the healthcare needs of this vulnerable population; however, identifying care home residents in EHR is not straightforward. We describe and compare three different methods for identifying care home residents in the newly created OpenSAFELY-TPP data analytics platform.
Methods: Working on behalf of NHS England, we identified individuals aged 65 years or older potentially living in a care home on the 1st of February 2020 using (1) a complex address linkage, in which cleaned GP registered addresses were matched to old age care home addresses using data from the Care and Quality Commission (CQC); (2) coded events in the EHR; (3) household identifiers, age and household size to identify households with more than 3 individuals aged 65 years or older as potential care home residents. Raw addresses were not available to the investigators.
Results: Of 4,437,286 individuals aged 65 years or older, 2.27% were identified as potential care home residents using the complex address linkage, 1.96% using coded events, 3.13% using household size and age and 3.74% using either of these methods. 53,210 individuals (32.0% of all potential care home residents) were classified as care home residents using all three methods. Address linkage had the largest overlap with the other methods; 93.3% of individuals identified as care home residents using the address linkage were also identified as such using either coded events or household age and size.
Conclusion: We have described the partial overlap between three methods for identifying care home residents in EHR, and provide detailed instructions for how to implement these in OpenSAFELY-TPP to support research into the impact of the COVID-19 pandemic on care home residents.

Authors: Schultze, A; Bates, C; Cockburn, J; MacKenna, B; Nightingale, E

• Publication status: Published
• Peer review status: Peer reviewed
• Publisher: F1000Research
• Journal: Wellcome Open Research
• Volume: 6
• Article number: 90
• Place of publication: England
• Publication date: 2021-04-27
• Acceptance date: 2021-08-18
• DOI: 10.12688/wellcomeopenres.16737.1
• EISSN: 2398-502X
• Language: English
• Keywords: FFR; electronic health records; address linkage; care homes