Use of automated record linkage to measure patient fertility after family planning service.

Record linkage was used to identify births in 1974 to patients who had received contraceptive services from public family planning clinics in metropolitan Atlanta. The record linkage methodology is described. Results indicated that patient educational level, age, contraceptive choice, and race were the factors most associated with subsequent patient fertility. Black teenage patients experienced the highest fertility. Patients age 20 years and over with some education beyond high school experienced approximately one-third the fertility of less-educated patients. The program effectiveness of the IUD and the Pill was substantially better than that of foam and condoms. Excluding teenagers, the program effectiveness of the IUD was better than the Pill. Changes in family planning services for high-risk patients may help them achieve their fertility control objectives. Linking family planning clinic records to official birth records as described in this study can help determine clinic success in meeting patient objectives. Other applications of record linkage are discussed briefly.