921 The education and child health insights from linked data (ECHILD) database: a newly linked, de-identified health-education data resource

BackgroundThe COVID-19 pandemic has raised concerns about long-term harms to children’s health and education and re-emphasised how strongly interconnected these domains are in childhood and adolescence. It has also highlighted the need to maximise the utility of administrative datasets (which reflect service provision for the whole population) as an evidence base for policy and practice. To date, technical and governance barriers have limited the potential for wide-scale analyses across health and education. Here, we report linking Hospital Episode Statistics (HES) to the National Pupil Database (NPD), which includes important information on children’s functional health and wellbeing, such as attainment in national exams, special educational needs (SEN) support and absence rates. This newly linked health-education database can generate evidence for paediatricians, policymakers and the public on, for example, educational outcomes for children with rare or common health conditions or how SEN support in schools might improve health outcomes.ObjectivesCreate a de-identified, linked HES-NPD database for all children and young people in England aged 0–24 years who were born on or after 01/09/1995 (the Education and Child Health Insights from Linked Data (ECHILD) Database)Assess linkage quality in the ECHILD DatabaseMethodsTo create the ECHILD Database, NHS Digital applied multi-step rules-based algorithms to longitudinal records of names, date of birth, gender and postcodes extracted from HES and NPD (to separate them from health- and education-related information). This produced a bridging file of pseudonymised IDs to link extracts of de-identified NPD and HES data (the ECHILD Database). If data linkage is biased (for example, less accurate for ethnic minority groups), then subsequent analyses could underestimate health needs and further entrench disadvantage. We evaluated linkage quality for three academic cohorts born 1st September to 31st August in 1996/7, 1999/00 and 2004/5. Permissions to create the ECHILD Database are described at: https://www.ucl.ac.uk/child-health/echildResultsIn total, the newly-created ECHILD Database includes de-identified, linked HES-NPD records for approximately 14.7 million individuals. It currently covers a 25-year period (01/09/1995 to 31/03/2020) and will be updated with more recent data as it is available. Our initial assessments indicate high linkage rates, particularly for more recent cohorts. Of pupils born in 2004/05, 99% linked to a HES record and, overall, 96% of pupils linked (1,609,670/1,674,899). Ethnic minority pupils and those living in more deprived areas were less likely to link;however, differences in linked and unlinked pupil characteristics were moderate to small. Throughout childhood, two-thirds of children had at least one admission to hospital (excluding being born in hospital).ConclusionsThe ECHILD Database enables large-scale, longitudinal research exploring interrelationships between health and education. For example, we are exploring how gestational age at birth relates to attainment and SEN. These results will be useful for policymakers and service providers for estimating future need for SEN support in schools based on the population’s birth characteristics. As more recent data becomes available, the ECHILD Database represents a unique opportunity to explore the impact of recent disruptions to health services on health and educational outcomes for children and young people during and after the COVID-19 pandemic.