Abstract
The objective of this study was to determine the accuracy of administrative data (by
use of hospital discharge codes) for measuring comorbidity in patients with heart
disease. One thousand seven hundred and sixty-five medical records of subjects admitted
to hospital for AMI, unstable angina, angina pectoris, chronic IHD or heart failure
were reviewed. The number and types of comorbidities were determined from the medical
records (regarded as the ‘gold standard’). These were compared with the 10 discharge
codes obtained from the hospital administrative records (referred to as the ‘administrative
data’). The rate of false-negative and false-positive comorbidity diagnoses were determined.
Twenty of the 21 comorbidities studied were underreported in the administrative data.
For these 20 comorbidities, the median false-negative rate was 49.5% and ranged from
11% for diabetes to 100% for dementia. False-positive rates were low, less than 1.5%,
except for chronic arrythmia (4.8%) and hypertension (4.2%). Mean percent agreement
was high, ranging from 88% for hypertension to 100% for AIDS/HIV. Administrative data
based on hospital discharge codes consistently underestimate the presence of comorbid
conditions in our population. This has implications for administrators when estimating
mortality, length of stay and disability. Researchers also need to be aware when using
administrative data based on hospital discharge codes to assess subject's comorbidities
that they may be widely underreported.
Keywords
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Article info
Publication history
Accepted:
November 21,
2000
Received in revised form:
October 18,
2000
Received:
September 29,
2000
Recieved ; ;Identification
Copyright
© 2001 Elsevier Science Inc. Published by Elsevier Inc. All rights reserved.
