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ascertainment of chronic diseases using population health data a comparison of health administrative data and patient self-report确定使用人口健康的慢性病数据比较卫生行政数据和病人自我报告
Muggah et al. BMC Public Health 2013, 13:16
/1471-2458/13/16
RESEARCH ARTICLE Open Access
Ascertainment of chronic diseases using
population health data: a comparison of health
administrative data and patient self-report
Elizabeth Muggah1,2*, Erin Graves3,4, Carol Bennett3,4 and Douglas G Manuel1,3,4,5,6,7
Abstract
Background: Health administrative data is increasingly being used for chronic disease surveillance. This study
explored agreement between administrative and survey data for ascertainment of seven key chronic diseases, using
individually linked data from a large population of individuals in Ontario, Canada.
Methods: All adults who completed any one of three cycles of the Canadian Community Health Survey
(2001, 2003 or 2005) and agreed to have their responses linked to provincial health administrative data were
included. The sample population included 85,549 persons. Previously validated case definitions for myocardial
infarction, asthma, diabetes, chronic lung disease, stroke, hypertension and congestive heart failure based on
hospital and physician billing codes were used to identify cases in health administrative data and these were
compared with self-report of each disease from the survey. Concordance was measured using the Kappa statistic,
percent positive and negative agreement and prevalence estimates.
Results: Agreement using the Kappa statistic was good or very good (kappa range: 0.66-0.80) for diabetes and
hypertension, moderate for myocardial infarction and asthma and poor or fair (kappa range: 0.29-0.36) for stroke,
congestive heart failure and COPD. Prevalence was higher in health administrative data for all diseases except
stroke and myocardial infarction. Health Utilities Index scores were higher for cases identified by health
administrative data compared with self-reported data for so
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