Multimorbidity in Australia: Comparing estimates derived using administrative data sources and survey data.
Multimorbidity in Australia: Comparing estimates derived using administrative data sources and survey data.
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澳大利亚的多种病态：比较使用管理数据源和调查数据得出的估计值。
DOI：
10.1371/journal.pone.0183817
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发表时间：
2017
期刊：
影响因子：
3.7
通讯作者：
Jorm L
中科院分区：
文献类型：
--
作者：
Lujic S;Simpson JM;Zwar N;Hosseinzadeh H;Jorm L
使用行政数据估计多发病（存在两种或两种以上慢性病）变得越来越普遍。我们调查了（1）使用自我报告调查和管理数据集识别慢性疾病和多发性硬化症的一致性;（2）使用不同数据源确定的多发性硬化症患者的特征;以及（3）是否使用不同数据源将同一个人归类为多发性硬化症。45岁及以上研究的90，352名参与者的基线调查数据-澳大利亚新南威尔士州45岁及以上居民的队列研究-与之前两年的药物索赔和住院记录有关。采用敏感性（Sn）、阳性预测值（PPV）和kappa（κ）检验了8例自我报告的慢性疾病（参考）与索赔和医院数据的一致性。在医院和索赔数据中，糖尿病的一致性最高（κ = 0.79，0.78; Sn = 79%，72%; PPV = 86%，90%）。使用自我报告数据（37.4%），其次是索赔数据（36.1%）和医院数据（19.3%），多发病率最高。结合所有三个数据集，共确定了46683人（52%）患有多发性硬化症，其中一半仅使用单个数据集确定，高达20%在所有三个数据集上确定。患有和未患有多项精神疾病的人的特征大体相似。然而，年龄梯度更明显，在家里说英语以外的语言的人更有可能被管理数据确定为多病。当使用不同的数据源时，具有不同条件组合的不同个体被识别为多病。因此，在从单一数据来源确定发病率时应谨慎，因为自我报告和管理数据之间的一致性通常很差。未来的多发病研究探索特定的疾病组合和通常共同发生的疾病群，而不是简单的疾病计数，可能会为患有多种慢性疾病的个人的复杂护理需求提供更有用的见解。
Estimating multimorbidity (presence of two or more chronic conditions) using administrative data is becoming increasingly common. We investigated (1) the concordance of identification of chronic conditions and multimorbidity using self-report survey and administrative datasets; (2) characteristics of people with multimorbidity ascertained using different data sources; and (3) whether the same individuals are classified as multimorbid using different data sources. Baseline survey data for 90,352 participants of the 45 and Up Study—a cohort study of residents of New South Wales, Australia, aged 45 years and over—were linked to prior two-year pharmaceutical claims and hospital admission records. Concordance of eight self-report chronic conditions (reference) with claims and hospital data were examined using sensitivity (Sn), positive predictive value (PPV), and kappa (κ).The characteristics of people classified as multimorbid were compared using logistic regression modelling. Agreement was found to be highest for diabetes in both hospital and claims data (κ = 0.79, 0.78; Sn = 79%, 72%; PPV = 86%, 90%). The prevalence of multimorbidity was highest using self-report data (37.4%), followed by claims data (36.1%) and hospital data (19.3%). Combining all three datasets identified a total of 46 683 (52%) people with multimorbidity, with half of these identified using a single dataset only, and up to 20% identified on all three datasets. Characteristics of persons with and without multimorbidity were generally similar. However, the age gradient was more pronounced and people speaking a language other than English at home were more likely to be identified as multimorbid by administrative data. Different individuals, with different combinations of conditions, are identified as multimorbid when different data sources are used. As such, caution should be applied when ascertaining morbidity from a single data source as the agreement between self-report and administrative data is generally poor. Future multimorbidity research exploring specific disease combinations and clusters of diseases that commonly co-occur, rather than a simple disease count, is likely to provide more useful insights into the complex care needs of individuals with multiple chronic conditions.
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影响因子：
2.9
作者：
Harrison C;Britt H;Miller G;Henderson J
通讯作者：
Henderson J
DOI：
10.1146/annurev.publhealth.25.102802.124401
发表时间：
2004-01-01
影响因子：
20.8
作者：
Crimmins, EM
通讯作者：
Crimmins, EM
影响因子：
2.8
作者：
Halfon, Patricia;Eggli, Yves;Seker, Erol
通讯作者：
Seker, Erol
影响因子：
3
作者：
Elixhauser, A;Steiner, C;Coffey, RN
通讯作者：
Coffey, RN
影响因子：
11.4
作者：
Britt, Helena C.;Harrison, Christopher M.;Knox, Stephanie A.
通讯作者：
Knox, Stephanie A.