Research Article
Following Up Crack Users after Hospital Discharge
Using Record Linkage Methodology:
An Alternative to Find Hidden Populations
Veralice Maria Gonçalves,
1,2
Rosemeri Pedroso,
1
Antônio Marcos dos Santos,
2
Lisia Von Diemen,
1
and Flavio Pechansky
1
1
Center for Drug and Alcohol Research, Clinics Hospital of Porto Alegre, Federal University of Rio Grande do Sul,
400 Professor Alvaro Alvim Street, 90420-020 Porto Alegre, RS, Brazil
2
Information Technology Department of the Unifed Health System, National Ministry of Health, Brazil
Correspondence should be addressed to Veralice Maria Gonc ¸alves; veralice@terra.com.br
Received 7 May 2015; Accepted 4 August 2015
Academic Editor: Handan Wand
Copyright © 2015 Veralice Maria Gonc ¸alves et al. Tis is an open access article distributed under the Creative Commons
Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is
properly cited.
Tis paper presents the probabilistic record linkage (PRL) methodology as an alternative way to fnd or follow up hard-to-reach
population as crack users. PRL was based on secondary data from public health information systems and the strategy used from
standardization; phonetic encoding and the rounds of matching data were described. A total of 293 patient records from medical
database and two administrative datasets obtained from Ministry of Health Information Systems were used. Patient information
from the medical database was the identifers to the administrative datasets containing data on outpatient treatment and hospital
admissions. 40% of patient records were found in the hospital database and 12% were found in the outpatient database; 95% of
the patients were hospitalized up to 5 times, and only 10 out of them had outpatient information. Te record linkage methodology
by linking government databases may help to address research questions about the path of patients in the care network without
spending time and fnancial resources with primary data collection.
1. Introduction
In 2012, about 3.5 to 7.0 percent of the world population aged
between 15 and 64 had used an illegal drug at least once
in a previous year [1]. In the Americas, the most prevalent
primary drug of abuse among those seeking treatment was
cocaine [1]. In Brazil, crack-cocaine consumption has become
more prominent; however, treatment of this specifc type of
drug use remains a challenge [2, 3]. Longitudinal follow-
up studies about this type of drug use ofen cannot fnd
these patients at the appropriate level of retention and
there are too many losses, since they seem to evade afer
hospital discharge. Attempts to follow up this hidden and
hard-to-reach population for evaluating the efectiveness of
interventions face methodological difculties. Furthermore,
longitudinal studies and clinical trials are conducted at
very high costs. One option to overcome these limitations
is to utilize another method for evaluating interventions:
the record linkage methodology based on secondary data
available from the existing information systems.
Record linkage techniques based on medical and admin-
istrative databases have been used on epidemiological studies
in several countries. Tese studies generally involve the use
of hospital, population, and outpatient data, which allow for
the collection of comprehensive patient information and for
more robust analyses [4, 5]. Retrospective cohort studies have
been employed in Canada [4], Australia [6], and the United
States [7], as well as in a number of European and Scandina-
vian countries [8], to investigate issues such as cause-specifc
mortality [9], hospital admissions [10], prevalence of mental
disorders [11], and antecedents of deliberate self-harm [12].
Record linkage (RL) studies involve the comparison of
data in medical and administrative databases with the aim
of fnding records that are believed to relate to the same
Hindawi Publishing Corporation
BioMed Research International
Volume 2015, Article ID 973857, 5 pages
http://dx.doi.org/10.1155/2015/973857