患者陈述的诊断与常规医疗保险数据中包含的诊断之间的一致性 数据链接研究的结果
Felicitas Vogelgesang1, Roma Thamm, Timm Frerk
1Department 2: Epidemiology and Health Monitoring, Mental Health, Robert Koch Institute, Berlin, Germany; Department 2: Epidemiology and Health Monitoring, Physical Healthe, Robert Koch Institute, Berlin, Germany; Department of Health Monitoring & Biometrics, aQua-Institute for Applied Quality Improvement and Research in Health Care GmbH, Göttingen, Germany; Department of Health Monitoring & Biometrics, aQua-Institute for Applied Quality Improvement and Research in Health Care GmbH, Göttingen, Germany; BARMER Health Insurace, Berlin, Germany; BARMER Health Insurance, Berlin, Germany; Department 2: Epidemiology and Health Monitoring, Mental Health, Robert Koch Institute, Berlin, Germany.
患者报告的诊断与糖尿病和高血压等疾病的医疗保险数据保持一致,但对于其他疾病,特别是老年人,显示出差异. 了解这些差异对于准确的健康研究至关重要.
科学领域:
- 流行病学 流行病学
- 医疗保健服务研究 医疗服务研究
- 医疗数据分析 医学数据分析
背景情况:
- 准确的医疗诊断频率对于流行病学和卫生服务研究至关重要.
- 根据数据来源,流行率估计可能会有很大的差异.
- 这项研究调查了患者报告的诊断和医疗保险记录之间的差异.
研究的目的:
- 将患者报告的诊断与医疗保险数据中记录的诊断进行比较.
- 了解来自不同数据源的患病率估计的变化.
- 确定影响诊断差异的因素.
主要方法:
- 将6558名成年人的自我报告诊断与来自医疗保险的ICD-10诊断码进行了比较.
- 分析了十二个月的数据 (Q4/2020-Q3/2021).
- 使用kappa值,灵敏度和特异性的评估协议.
主要成果:
- 在糖尿病和高血压方面达成高度一致 (卡帕接近0.8).
- 对心力衰竭,肥胖,焦虑,抑郁和冠状动脉心脏病的适度协议 (kappa 0.4-0.5).
- 对于PTSD,与酒精有关的疾病和精神/体形疾病的低一致性 (kappa ≤0.3);随着年龄的增长,一致性下降.
结论:
- 患者报告的诊断往往不同于医疗保险数据,影响流行率估计.
- 在研究的11种疾病中,只有2种发现了微不足道的差异.
- 年龄是一个重要的因素;对其他导致差异的原因进行进一步研究是有必要的.
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