Measuring multimorbidity series. An overlooked complexity - Comparison of self-report vs. administrative data in community-living adults: Paper 3. Agreement across data sources and implications for estimating associations with health service use
Measuring multimorbidity series. An overlooked complexity - Comparison of self-report vs. administrative data in community-living adults: Paper 3. Agreement across data sources and implications for estimating associations with health service use
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DOI：
10.1016/j.jclinepi.2020.04.018
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发表时间：
2020-08-01
影响因子：
7.2
通讯作者：
Upshur, Ross
中科院分区：
文献类型：
--
作者：
Gruneir, Andrea;Griffith, Lauren E.;Upshur, Ross
目的：本研究的目的是描述关于慢性病（CC）数量和类型的行政和自我报告数据之间的一致性，并确定CC计数与卫生服务使用之间的关联是否因数据源而异。研究设计和背景：我们将加拿大社区健康调查和安大略省45岁以上成年人队列的管理数据联系起来，并从两个数据源中确定了12个cc。通过计数和组成cc来描述协议。我们估计了1年内CC计数（自我报告和管理数据）与卫生服务使用（仅管理数据）之间的关联。结果：在71317名成年人中，26.9%的人对cc的数量和组成一致，但随着cc的增加，一致性下降。卫生服务的使用随着CC计数的增加而增加，但当CC与行政数据测量时，相关性更强。例如，当使用行政数据测量时，全科医生就诊5+ cc的几率为20.3 (95% CI 20.0-20.5)，但当使用自我报告数据时，估计为8.0 （95% CI 7.8-8.2）。结论：对CC数量的一致性较低，导致对与卫生服务使用的关联的不同估计，说明了CC测量和解释对结果的影响的能力方面的挑战。(C) 2020爱思唯尔公司版权所有。
Objective: The objective of this study is to describe agreement between administrative and self-report data on the number and type of chronic conditions (CCs) and determine whether associations between CC count and health service use differ by data source.Study Design and Setting: We linked Canadian Community Health Survey and administrative data for a cohort of adults aged 45+ years in Ontario and identified 12 CCs from both data sources. Agreement was described by count and constituent CCs. We estimated associations between CC count (self-report and administrative data) and health service use (administrative data only) over 1 year.Results: Among 71,317 adults, 26.9% showed agreement on both count and constituent CCs but agreement declined with increasing CCs. Health service use increased with CC count but the association was stronger when CCs were measured with administrative data. For example, when measured with administrative data, the odds of a general practitioner visit for 5+ CCs vs. none was 20.3 (95% CI 20.0-20.5) but when using self-report data, the estimate was 8.0 (95% CI 7.8-8.2).Conclusion: Agreement on the number of CCs was low and resulted in different estimates on the association with health service use, illustrating the challenges in CC measurement and the ability to interpret the effects on outcomes. (C) 2020 Elsevier Inc. All rights reserved.