Potter Beth K, Manuel Douglas, Speechley Kathy N, Gutmanis Iris A, Campbell M Karen, Koval John J
Department of Epidemiology and Biostatistics, University of Western Ontario, London, Canada.
BMC Health Serv Res. 2005 Feb 18;5(1):15. doi: 10.1186/1472-6963-5-15.
Administrative health care databases may be particularly useful for injury surveillance, given that they are population-based, readily available, and relatively complete. Surveillance based on administrative data, though, is often restricted to injuries that result in hospitalization. Adding physician billing data to administrative data-based surveillance efforts may improve comprehensiveness, but the feasibility of such an approach has rarely been examined. It is also not clear how injury surveillance information obtained using administrative health care databases compares with that obtained using self-report surveys. This study explored the value of using physician billing data along with hospitalization data for the surveillance of adolescent injuries in Ontario, Canada. We aimed i) to document the burden of adolescent injury using administrative health care data, focusing on the relative contribution of physician billing information; and ii) to explore data quality issues by directly comparing adolescent injuries identified in administrative and self-report data.
The sample included adolescents aged 12 to 19 years who participated in the 1996-1997 cross-sectional Ontario Health Survey, and whose survey responses were linked to administrative health care datasets (N = 2067). Descriptive analysis was used to document the burden of injuries as a proportion of all physician care by gender and location of care, and to examine the distribution of both administratively-defined and self-reported activity-limiting injuries according to demographic characteristics. Administratively-defined and self-reported injuries were also directly compared at the individual level.
Approximately 10% of physician care for the sample was identified as injury-related. While 18.8% of adolescents had self-reported injury in the previous year, 25.0% had documented administratively-defined injury. The distribution of injuries according to demographic characteristics was similar across data sources, but congruence was low at the individual level. Possible reasons for discrepancies between the data sources included recall errors in the survey data and errors in the physician billing data algorithm.
If further validated, physician billing data could be used along with hospital inpatient data to make an important and unique contribution to adolescent injury surveillance. The limitations inherent in different datasets highlight the need to continue rely on multiple information sources for complete injury surveillance information.
鉴于行政医疗保健数据库以人群为基础、易于获取且相对完整，它们对于伤害监测可能特别有用。然而，基于行政数据的监测通常仅限于导致住院的伤害。将医生计费数据添加到基于行政数据的监测工作中可能会提高全面性，但这种方法的可行性很少得到检验。同样不清楚使用行政医疗保健数据库获得的伤害监测信息与使用自我报告调查获得的信息相比如何。本研究探讨了将医生计费数据与住院数据一起用于加拿大安大略省青少年伤害监测的价值。我们的目标是：i）使用行政医疗保健数据记录青少年伤害负担，重点关注医生计费信息的相对贡献；ii）通过直接比较行政数据和自我报告数据中识别出的青少年伤害来探索数据质量问题。
样本包括1996 - 1997年参与安大略省横断面健康调查的12至19岁青少年，其调查回复与行政医疗保健数据集相关联（N = 2067）。描述性分析用于将伤害负担记录为所有医生护理的比例，按性别和护理地点划分，并根据人口统计学特征检查行政定义和自我报告的活动受限伤害的分布。行政定义的伤害和自我报告的伤害也在个体层面进行了直接比较。
样本中约10%的医生护理被确定与伤害相关。虽然18.8%的青少年在前一年自我报告有伤害，但25.0%有行政定义的记录伤害。不同数据源之间按人口统计学特征划分的伤害分布相似，但个体层面的一致性较低。数据源之间差异的可能原因包括调查数据中的回忆误差和医生计费数据算法中的误差。
如果进一步验证，医生计费数据可与医院住院患者数据一起用于为青少年伤害监测做出重要且独特的贡献。不同数据集固有的局限性凸显了继续依赖多个信息源以获取完整伤害监测信息的必要性。
