Development and Validation of a Primary Care Electronic Health Record Phenotype to Study Migration and Health in the UK

Neha Pathak, Claire X. Zhang, Yamina Boukari, Rachel Burns, Rohini Mathur, Arturo Gonzalez-Izquierdo, Spiros Denaxas, Pam Sonnenberg, Andrew Hayward and Robert W. Aldridge
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Neha Pathak: Institute of Health Informatics, University College London, 222 Euston Rd., London NW1 2DA, UK
Claire X. Zhang: Institute of Health Informatics, University College London, 222 Euston Rd., London NW1 2DA, UK
Yamina Boukari: Institute of Health Informatics, University College London, 222 Euston Rd., London NW1 2DA, UK
Rachel Burns: Institute of Health Informatics, University College London, 222 Euston Rd., London NW1 2DA, UK
Rohini Mathur: Department of Non-Communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, Keppel Street, London WC1E 7HT, UK
Arturo Gonzalez-Izquierdo: Institute of Health Informatics, University College London, 222 Euston Rd., London NW1 2DA, UK
Spiros Denaxas: Institute of Health Informatics, University College London, 222 Euston Rd., London NW1 2DA, UK
Pam Sonnenberg: Institute for Global Health, University College London, 30 Guilford Street, London WC1N 1EH, UK
Andrew Hayward: Institute of Epidemiology & Health Care, University College London, 1-19 Torrington Place, London WC1E 7HB, UK
Robert W. Aldridge: Institute of Health Informatics, University College London, 222 Euston Rd., London NW1 2DA, UK

IJERPH, 2021, vol. 18, issue 24, 1-14

Abstract: International migrants comprised 14% of the UK’s population in 2020; however, their health is rarely studied at a population level using primary care electronic health records due to difficulties in their identification. We developed a migration phenotype using country of birth, visa status, non-English main/first language and non-UK-origin codes and applied it to the Clinical Practice Research Datalink (CPRD) GOLD database of 16,071,111 primary care patients between 1997 and 2018. We compared the completeness and representativeness of the identified migrant population to Office for National Statistics (ONS) country-of-birth and 2011 census data by year, age, sex, geographic region of birth and ethnicity. Between 1997 to 2018, 403,768 migrants (2.51% of the CPRD GOLD population) were identified: 178,749 (1.11%) had foreign-country-of-birth or visa -status codes, 216,731 (1.35%) non-English-main/first-language codes, and 8288 (0.05%) non-UK-origin codes. The cohort was similarly distributed versus ONS data by sex and region of birth. Migration recording improved over time and younger migrants were better represented than those aged ≥50. The validated phenotype identified a large migrant cohort for use in migration health research in CPRD GOLD to inform healthcare policy and practice. The under-recording of migration status in earlier years and older ages necessitates cautious interpretation of future studies in these groups.

Keywords: migration; phenotype; validation; algorithm; primary care; clinical practice research datalink (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
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