Linking Survey and Administrative Data to Measure Income, Inequality, and Mobility.

BACKGROUND: Income is one of the most important measures of well-being, but it is notoriously difficult to measure accurately. In the United States, income data are available from surveys, tax records, and government programs, but each of these sources has important strengths and major limitations when used alone. OBJECTIVES: We link multiple data sources to develop the Comprehensive Income Dataset (CID), a prototype for a restricted micro-level dataset that combines the demographic detail of survey data with the accuracy of administrative measures. METHODS: By incorporating information on nearly all taxable income, tax credits, and cash and in-kind government transfers, the CID surpasses previous efforts to provide an accurate and comprehensive measure of income for the population of United States individuals, families, and households. We also evaluate the accuracy of different income sources and imputation methods. CONCLUSIONS: While still in development, we envision the CID enhancing Census Bureau surveys and statistics by investigating measurement error, improving imputation methods, and augmenting surveys with the best possible estimates of income. It can also be used for policy related research, such as forecasting and simulating changes in programs and taxes. Finally, the CID has substantial advantages over other sources to analyze numerous research topics, including poverty, inequality, mobility, and the distributional consequences of government transfers and taxes.

The Building Blocks of Interoperability. A Multisite Analysis of Patient Demographic Attributes Available for Matching.

BACKGROUND: Patient matching is a key barrier to achieving interoperability. Patient demographic elements must be consistently collected over time and region to be valuable elements for patient matching. OBJECTIVES: We sought to determine what patient demographic attributes are collected at multiple institutions in the United States and see how their availability changes over time and across clinical sites. METHODS: We compiled a list of 36 demographic elements that stakeholders previously identified as essential patient demographic attributes that should be collected for the purpose of linking patient records. We studied a convenience sample of 9 health care systems from geographically distinct sites around the country. We identified changes in the availability of individual patient demographic attributes over time and across clinical sites. RESULTS: Several attributes were consistently available over the study period (2005-2014) including last name (99.96%), first name (99.95%), date of birth (98.82%), gender/sex (99.73%), postal code (94.71%), and full street address (94.65%). Other attributes changed significantly from 2005-2014: Social security number (SSN) availability declined from 83.3% to 50.44% (p<0.0001). Email address availability increased from 8.94% up to 54% availability (p<0.0001). Work phone number increased from 20.61% to 52.33% (p<0.0001). CONCLUSIONS: Overall, first name, last name, date of birth, gender/sex and address were widely collected across institutional sites and over time. Availability of emerging attributes such as email and phone numbers are increasing while SSN use is declining. Understanding the relative availability of patient attributes can inform strategies for optimal matching in healthcare.