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Hospital chart review provided more accurate comorbidity information than data from a general practitioner survey or

David B Preen1, C D'Arcy J Holman, David M Lawrence

  • 1Centre for Health Services Research, School of Population Health, The University of Western Australia, 35 Stirling Highway, Crawley WA 6009, Australia. davidp@sph.uwa.edu.au

Journal of Clinical Epidemiology
|December 25, 2004
PubMed

Insights

Administrative data significantly underreports comorbidity compared to hospital charts, with high false-negative rates. General practitioner surveys also fall short of hospital chart accuracy for comprehensive comorbidity assessment.

Area of Science:

  • Health Services Research
  • Medical Informatics
  • Epidemiology

Background:

  • Accurate comorbidity data is essential for health outcome research.
  • The Western Australian Data Linkage System is a valuable resource, but its comorbidity data accuracy requires validation.

Purpose of the Study:

  • To evaluate the accuracy of comorbidity data in the Western Australian Data Linkage System.
  • To compare administrative data accuracy with hospital chart reviews and general practitioner (GP) surveys.

Main Methods:

  • A cohort of 2,037 patients admitted between 1991-1996 was selected.
  • 100 comorbidities were extracted from linked administrative data and compared against clinical chart reviews and GP surveys.
  • False-positive and false-negative diagnoses were ascertained for each data source.

Main Results:

  • Administrative data captured only 45.5% of comorbidities found in hospital charts, with significant underascertainment across all diagnostic chapters.
  • False-positive rates were generally low (0-1.5%), but false-negative rates were high (16.3-91.3%).
  • GP surveys identified 20% more comorbidities than administrative data but less than hospital charts (42.0% agreement).

Conclusions:

  • Hospital chart review is superior to administrative data for accurate comorbidity information in health outcome research.
  • General practitioner surveys are an unsatisfactory alternative to hospital charts for retrospective comorbidity data collection in Australia.
Abstract

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