A 40-Year Prospective Study of Adversity Over the Early Life Course Predicting Hospital Morbidity Using Linked Administrative Health Data

To link the following Queensland-wide administrative health databases to a longitudinal, population-based birth cohort recruited in Brisbane between 1983 & 84 to assess the health outcomes of early maternal/childhood adversity: 1. The Queensland Hospital Admitted Patients’ Data Collection (QHAPDC) of all admissions for all diagnoses to public and private hospitals in Queensland from 1 January 2000 for public hospitals and 1 July 2007 for private hospitals up till 31 December 2019. 2. The Consumer Integrated Mental Health Application (CIMHA) of all contacts with state-run community-based or outpatient mental health services in the State from 1 January 2010 till 31 December 2019 3. The Emergency Data Collection (EDC) of all Emergency Department presentations state-wide from 1 July 2008 till 31 December 2019. The birth cohort is from the Mater-University of Queensland Study of Pregnancy (MUSP), a 40-year longitudinal study from Brisbane that examined a variety of environmental risk factors for cognitive, psychological, and behavioural health outcomes for over 7000 women and their children. Between 1981 and 1983, 8556 consecutive pregnant women attending the Mater Misericordiae Mothers’ Hospital for their first prenatal visit were invited to participate. The final cohort numbered 7223 mother and infant pairs, which included only consenting participants who delivered live, singleton infants at the study hospital. A major limitation of the existing cohort study has been the possibility of attrition bias with differential and high rates of loss to follow-up of participants with markers of greater socio-economic disadvantage. Use of Queensland—wide administrative health data will mean that we can capture all health service contacts throughout the state in case cohort participants have moved from the South Metropolitan area. The cohort are now aged 40 years of age. All data will be directly collected from existing health databases and participants will not be actively involved. The data custodians of each database (MUSP, EDC, QHAPDC and CIMHA) will send patient identifiers stripped of any other information. Linkages will be done by the Statistical Services Branch (SSB) of Queensland Health Within the SSB, probabilistic and deterministic matching is used to link within and between the datasets based on identifying information (ID), including name, date of birth (DOB), aliases, and gender. Each person will be assigned a unique project ID that will be returned to the data custodians. The data custodian will attach the relevant clinical or service information to the unique project ID, but no identifying information. These anonymized data extracts are then released to the third-party researchers analyst (in this case the researchers at PA Hospital). The third-party analyst will use the project IDs from the anonymized data to link the four datasets. No identifying data will be released to the researchers conducting the analysis. Exposures include childhood poverty, behavioural disorders in childhood and adolescence, as well as notifications to child protection services.