Concordance between survey reported childhood asthma and linked Medicaid administrative records

Area of Science:

• Pediatric Health Research
• Health Services Research
• Data Linkage and Analysis

Background:

• Parental reporting of childhood asthma is crucial but varies by condition.
• Limited research exists on the concordance of parental asthma reports with administrative data.
• Understanding data agreement is vital for accurate public health surveillance.

Purpose of the Study:

• To assess the agreement between parent-reported asthma in the National Health Interview Survey (NHIS) and Medicaid administrative claims.
• To identify factors influencing the concordance between survey and claims data for childhood asthma.
• To investigate the impact of co-occurring conditions on data agreement.

Main Methods:

• Linked National Health Interview Survey (NHIS) data (2001-2005) with Medicaid Analytic eXtract (MAX) data (2000-2005).
• Calculated concordance measures (percent agreement, Cohen's kappa, prevalence-adjusted bias-adjusted kappa).
• Employed structural equation modeling to analyze demographic, service utilization, and co-occurring condition factors.

Main Results:

• High overall agreement (90% percent agreement, kappa=0.80) between NHIS parent reports and Medicaid claims.
• Agreement varied based on demographics, service utilization, and presence of allergies.
• Co-occurring conditions, particularly allergies, significantly reduced agreement between data sources.

Conclusions:

• General agreement exists between parent-reported asthma (NHIS) and medical claims data.
• Discordance in asthma reporting is most pronounced among children with co-occurring health conditions.
• Findings highlight the need to consider data source limitations, especially for complex pediatric cases.