Accuracy of administrative data for assessing outcomes after knee replacement surgery

• Published in: Journal of clinical epidemiology Vol. 50; no. 3; pp. 265 - 273
• Main Authors: Hawker, Gillian A., Coyte, Peter C., Wright, James G., Paul, John E., Bombardier, Claire
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.03.1997; Elsevier
• Subjects: Administrative databases; Biological and medical sciences; Comorbidity; Databases, Factual; Epidemiology; General aspects; Hospital Records; Humans; Joint Diseases - complications; Joint Diseases - surgery; Knee Prosthesis - standards; Knee Prosthesis - statistics & numerical data; knee replacement surgery; medical outcome assessment; Medical sciences; Methodology; Ontario; Outcome Assessment (Health Care); outcomes research; Pilot Projects; Postoperative Complications; Public health. Hygiene; Public health. Hygiene-occupational medicine; Registries; research methods; Canada; North America; Ontario; America; research methods; hospital records; outcomes research; knee replacement surgery; medical outcome assessment; Administrative databases; Knee; Human; Hospital discharge; Prognosis; Methodology; Prosthesis; Diseases of the osteoarticular system; Accuracy; Orthopedic surgery; Information source; Database; Medical record; Hospital; Comparative study; Public health
• ISSN: 0895-4356; 1878-5921
• DOI: 10.1016/S0895-4356(96)00368-X

Objective: To assess the accuracy of information in an administrative database (Canadian Institute for Health Information; CIHI) compared with the hospital record for patients undergoing knee replacement (KR). Methods: A stratified random sample of 185 KR recipients from 5 Ontario hospitals were chosen. Their hospital records and corresponding CIHI files were compared to assess percent complete agreement, false negative (FN) and false positive (FP) rates for demographic data, procedures, and diagnoses. Results: Of 185 records, 175 (95%) were reviewed. Percent complete agreement was greater than 94% for each of patient demographics and procedures (mean FN rates: 0%; mean FP rates: 0–5%). For comorbidities and complications, although mean percent complete agreement was high, and FP rates were low, mean FN rates were 63% for specific comorbid conditions and 70% for organ systems. Conclusions: High FN rates have been found in documentation of comorbidities and in-hospital complications for CIHI data compared with the hospital record. Under-coding of comorbidities and in-hospital complications has potential implications for researchers using administrative databases.