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Co-morbidity data in outcomes research: are clinical data derived from administrative databases a reliable

K H Humphries1, J M Rankin, R G Carere

  • 1Centre for Health Evaluation and Outcome Sciences, St. Paul's Hospital, Vancouver, BC, Canada. karinh@cheos.ubc.ca

Journal of Clinical Epidemiology
|April 29, 2000
PubMed

Insights

Canadian hospitalization databases provide reliable co-morbidity data for health outcomes research. This study found good agreement between administrative data and chart reviews for conditions influencing survival after percutaneous coronary intervention.

Area of Science:

  • Health outcomes research
  • Cardiovascular research
  • Medical informatics

Background:

  • Accurate co-morbidity data is crucial for health outcomes research.
  • Administrative databases are often criticized for co-morbidity data accuracy.
  • Percutaneous coronary intervention (PCI) patient data requires reliable co-morbidity assessment.

Purpose of the Study:

  • To compare co-morbidity data accuracy from a Canadian provincial hospitalization database against chart review.
  • To assess the reliability of administrative co-morbidity data for patients undergoing PCI.
  • To evaluate the impact of data source on multivariate risk models for mortality.

Main Methods:

  • Retrospective comparison of co-morbidity data from administrative database versus chart review.
  • Study included 817 adult patients treated with PCI between 1994-1995 at a tertiary care hospital.
  • Analysis focused on agreement levels for various co-morbid conditions and impact on mortality risk models.

Main Results:

  • Administrative data underestimated some co-morbid conditions but showed good to very good agreement with chart review for most.
  • Lower agreement was observed for asymptomatic conditions.
  • Multivariate risk models for all-cause mortality were nearly identical using both data sources, indicating minimal misclassification.

Conclusions:

  • Clinical data from Canadian hospitalization databases offers reliable co-morbidity information for PCI populations.
  • Administrative co-morbidity data can be effectively used in health outcomes research, particularly for survival analysis.
  • The findings support the utility of administrative data for assessing baseline co-morbidities influencing outcomes in cardiovascular interventions.

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