Presentation (CTI)

OBJECTIVES: Health equity research aims to identify factors that can help improve healthcare access and health outcomes for those who need it most. A significant challenge has been the limited availability of health-equity variables in commonly used data, compounded by privacy concerns. Efforts were undertaken to enrich a large administrative healthcare claims database with health-equity variables through an innovative methodology that upholds patient privacy standards while preserving full usability of all other variables.
METHODS: In accordance with HIPAA, expert re-identification risk determination assessed the potential for individuals to be reidentified in claims data linked to individual-level health equity data (e.g. race/ethnicity, education, and income) obtained from a consumer database. Data flow (describing the origination, usage, and safeguarding of the data), data release context (appropriate control on data access and use), and information contained in the data (classified by identifiability of the data fields) were examined to determine the overall re-identification risk and ensure it was below an acceptable threshold.
RESULTS: By validating robust organizational privacy and security protocols for linking sensitive patient data, demonstrating the population benefits of incorporating health equity-relevant data in the research, and integrating organizational data control mechanisms, the typical risk-reidentification threshold under HIPAA compliance for this dataset was significantly increased. With proper data access and use control, linking claims data to multiple health equity variables was below this threshold and resulted in a very small risk of re-identification for patients.
CONCLUSIONS: Enriching data with health equity variables provides a comprehensive understanding of a patient’s health journey and enables analyses that were not previously possible, helping to uncover obstacles to healthcare access and improve patient health outcomes. This methodology sets a precedent for future initiatives aiming to integrate real-world data with health equity measures, thereby advancing the landscape of health equity research and its applications in improving healthcare delivery and outcomes.