Transcript Review of internal migration methods using health registrations

Review of migration methods
using health registrations
Nick Wright
Cecilia Macintyre
General Register Office for Scotland
General Register Office
BSPS 2008
for
SCOTLAND
information about Scotland's people
1
Overview of Presentation
• Description of method of estimating
migration for areas in Scotland
• Comparison of NHSCR and CHI estimates
• Developments in sources
• Future work
General Register Office
BSPS 2008
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information about Scotland's people
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Sources of data used in internal
migration
• NHSCR Movements are recorded between
Health Board Areas and UK countries
• CHI movements allow migration to be
measured below health board area
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BSPS 2008
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NHSCR
• Originally set up in 1939 for purpose of
call-up for military service and food
rationing
• Function - to maintain a register of all NHS
patients on lists of general practitioners in
Scotland
• To supply info to organisations in health
service and for medical research
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NHSCR
• Currently holds records for every patient
registered, now or in the past with a Scottish
GP
• Everyone born in Scotland since 1985 who
have not been registered with a Scottish GP
• Patients formerly registered with a Scottish
GP, who died after 1992
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NHSCR dataset
•
•
•
•
•
Unique NHS number
Unique Community Health Index number
Names
Date of birth
Current and previous registrations with UK
health authority
• Medical flags
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NHSCR migration data
• Monthly files provide individual records for
all changes in posting with age and sex
–
–
–
–
–
Scottish Health Board
England & Wales Health area
Northern Ireland
Armed Forces
Immigrants and embarkations
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Community Health Index
• All patients registered with a GP in
Scotland, or those in contact with health
service allocated CHI number
• Since 1997 there has been a unique CHI
number allocated
• Aim to use throughout health service for
identification
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CHI annual extract
• Information includes
–
–
–
–
–
–
CHI identifier (anonymised )
Current status
Age/sex
Health board of residence + Postcode
Transfer in/out dates + Area codes
Immigrant code
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CHI processing(1)
• CHI extract (1)
– Select currently registered patients
• CHI extract (2)
– Select currently registered patients and those
‘leaving’ within last year
General Register Office
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CHI processing(2)
• Match two extracts using unique CHI
– Current patients in both extracts
– Current patient in extract 1 but not in extract 2
– Current patient in extract 2 but not in extract 1
Use information on postcodes and postings to
allocate migration at lower level
General Register Office
BSPS 2008
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SCOTLAND
information about Scotland's people
11
Research questions
• Require to understand relationship between
two sources
• NHSCR will be extended to include
postcode updates from CHI, proving a new
single source
• Understand impact of changes in methods
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12
Comparison of Migrants within Scotland (Male)
2,500
2,000
1,500
1,000
500
90
85
80
75
70
65
60
55
50
45
40
35
30
25
20
15
10
5
0
0
Age
Males, NHSCR
Males, CHI
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Comparison of RUK Migrants out from Scotland (Male)
900
800
700
600
500
400
300
200
100
0
0
5
10
15 20
25 30
35 40
45
50 55
60 65
70 75
80
85 90
Age
Males, NHSCR
Males, CHI
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BSPS 2008
for
SCOTLAND
information about Scotland's people
14
Comparison of RUK Migrants into Scotland (Male)
2,000
1,800
1,600
1,400
1,200
1,000
800
600
400
200
0
0
5
10 15 20 25 30 35 40 45 50 55 60 65 70 75 80 85 90
Age
Males, NHSCR
Males, CHI
General Register Office
BSPS 2008
for
SCOTLAND
information about Scotland's people
15
Comparison of RUK Migrants into Scotland (Female)
2,000
1,800
1,600
1,400
1,200
1,000
800
600
400
90
85
80
75
70
65
60
55
50
45
40
35
30
25
20
15
10
5
0
200
0
Age
Females, NHSCR
Females, CHI
General Register Office
BSPS 2008
for
SCOTLAND
information about Scotland's people
16
Comparison of Overseas Migrants into Scotland (Male)
2,000
1,800
1,600
1,400
1,200
1,000
800
600
400
200
0
0
5
10 15 20 25 30 35 40 45 50 55 60 65 70 75 80 85 90
Age
Males, NHSCR
Males, CHI
General Register Office
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SCOTLAND
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17
14,000
140%
12,000
120%
10,000
100%
8,000
80%
6,000
60%
4,000
40%
2,000
20%
0%
Ar
g
Ay y ll
rs & C
hi
re ly d
e
&
D
Ar
um
ra
n
fri
B
es
or
de
&
r
G
al s
lo
w
ay
Fo
F
rth ife
Va
l le
G
re Gra y
at
m
er
pi
a
G
la n
sg
ow
H
ig
La hla
na nd
rk
sh
i re
O
Lo
rk
th
n
ia
n
Sh ey
e t Isl a
la
nd nds
Is
la
nd
Ta s
W
e s ys id
te
rn e
Is
le
s
0
CHI as %age of EWMIG
Migrants to RUK
Absolute Com parison of CHI vs NHSCR Migrants to the Rest of the UK
Health Boards
2007 CHI
2007 NHSCR
CHI as %age of NHSCR
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SCOTLAND
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18
12,000
140%
10,000
120%
100%
8,000
80%
6,000
60%
4,000
40%
2,000
20%
0%
Fo
F
rth ife
Va
l le
G
y
G
ra
re
m
at
pi
er
an
G
la
sg
ow
H
ig
La hlan
na
d
rk
sh
i re
O
Lo
rk
ne thi a
n
Sh y I
sl
et
an
la
ds
nd
Is
la
nd
Ta s
W
e s ys id
te
e
rn
Is
le
s
0
Ar
gy
ll
Ay
rs & C
hi
re ly de
&
Ar
D
ra
um
fri
Bo n
es
rd
&
er
s
G
al
lo
w
ay
CHI as %age of SMIG
Migrants from RUK
Absolute Com parison of CHI vs NHSCR m igrants from the Rest of the UK
Health Boards
2007 CHI
2007 NHSCR
CHI as % of NHSCR
General Register Office
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for
SCOTLAND
information about Scotland's people
19
Issues to consider in understanding
patterns
• Differences in what is being measured
– Counts of events (NHSCR)
– Change in status one year apart
• Exclusion of some situations e.g. cancelled
records
• Impact of multiple movements within a year
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SCOTLAND
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20
Patterns of short term cross-border
migration
• Current approach of identifying in migrants
on CHI will undercount total because of
moves within year
• Identified new patients on second CHI
extract who had moved within the year
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21
Distributions of STM Migrants m oving betw een RUK to Scotland In Under
a Year
10.0%
9.0%
8.0%
% of Total
7.0%
6.0%
5.0%
4.0%
3.0%
2.0%
1.0%
0.0%
0
5
10
15
20
25
30
35
40
45
50
55
60
65
70
75
80
85
90
Age
Females
Males
General Register Office
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22
So what?
• Current allocation of in-migrants to
Scotland from Rest of UK will use
distribution of migrants who do not move
subsequently
• Require to compare this with the
destinations of people to move more
frequently
General Register Office
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SCOTLAND
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23
NHSCR extract development
• Transfer of Scottish NHSCR system has
provided opportunities
– Additional fields on database
– Additional capability for analysis
General Register Office
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information about Scotland's people
24
NHSCR extract (2)
• New fields on database will include
– Postcode (updated through CHI system)
– Country of Birth
General Register Office
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information about Scotland's people
25
NHSCR extract (3)
• Additional capability for analysis
– Project underway to receive monthly extract
from NHSCR system
– Details of all people on system
– Complete history of postings
– Complete history of postcode from 2008
onwards
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BSPS 2008
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26
Thank you
Questions?
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