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Published on: August 14, 2019
Validity of administrative data for characterizing traumatic brain injury-related hospitalizations
Andrew D Shore1, Melissa L McCarthy, Tracey Serpi
1Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA. ashore@jhsph.edu
Primary Objective:
To examine the validity of Maryland Hospital Discharge (MHD) data for identifying and characterizing traumatic brain injury (TBI)-related hospitalizations.
Methods:
All TBI-related hospitalizations in 1999 were identified using MHD and Maryland Trauma Registry (MTR) data. In addition, a sample of records were abstracted to compare agreement between MHD and chart data.
Results:
The MHD file identified fewer TBI cases (61%) compared to the MTR (95%). Overall, TBI-related hospitalization rates based on MHD were significantly fewer (95; 95% CI 92, 98) vs MHD and MTR (144; 95% CI 140, 147). There was good agreement between the MHD and chart data regarding skull fractures or intracranial lesions (kappa = 0.73 and 0.83, respectively), but poor agreement for neurologic abnormalities or amnesia. The MHD significantly underestimated TBI severity.
Conclusions:
TBI cases, especially mild ones, were under-reported by MHD data. MHD data are better at detecting anatomic injuries compared to TBI symptoms and sequella.
