eol_care_migrations_presentation.Rmd

---
title: "What are the implications of retirement migration for informal care at the end of life?"
subtitle: "An analysis of linked Scottish census and administrative data"
author: "Jan Savinc"
institute: "Edinburgh Napier University/SCADR"
date: "27th November 2020"
output:
  xaringan::moon_reader:
    lib_dir: libs
    nature:
      highlightStyle: github
      highlightLines: true
      countIncrementalSlides: false
---

```{r setup, include=FALSE}
options(htmltools.dir.version = FALSE)
```

# Introduction

I'm a newcomer to this project.

Collaborators:

* Iain Atherton, 
* Anna Schneider, 
* Annetta Smith, 
* Hugo van Woerden, 
* Deirdrie McLaughlin,
* David Henderson,
* Janni Leung 


---

# Background


## Retirement migration

### Small proportion of people relocate on or around time of retirement to areas perceived as conducive to quality of life

### Retirement migration can have a marked demographic impact in local areas


## Informal care

### Adult children remain an important source of support

### Proximity an important influence on type and level of informal support 

---

# What is Administrative data?

## Data collected by governments, organisations, businesses, etc., for purposes of overview, registration, bookkeeping, etc.

###  Also 'routinely collected data'

## Usually not collected for statistical purposes

### 'Secondary analysis' - used other than for its original purpose

## Usually there's a lot of it - but the quality varies...


---

# Safeguards, privacy

## 'Information governance'

## GDPR

## Public Benefit Privacy Panel - PBPP

### Researchers submit proposals for projects involving data

### De-anonymised data used only

#### Medical records may still be identifiable!


---

# Data linkage

* Scottish census, 2011
  - Entire Scottish population, 93.76% coverage

* Community Health Index (CHI) register
  - 'NHS number' - assigned to individual at GP registration

* National Records Scotland (NRS) Death records

* Hospital admissions - Scottish Morbidity Records (SMR):
  * SMR01 physical health admissions
  * SMR01 Geriatric Long-term Stay
  * SMR04 psychiatric admissions
  * SMR06 cancer registrations

* Prescribing Information System (PIS)

* ...

---

# Methods 

## Defining End-of-life care

* aged 70+ 
* living independently
* in final year of life at time of 2011 census

TODO: insert illustration here