Accuracy of Heart Disease Prevalence Estimated from Claims Data Compared With an Electronic Health Record

Details

• Journal Article:
  Preventing Chronic Disease (PCD)
• Personal Author:
  Kottke, Thomas E. ; Baechler, Courtney Jordan ; Parker, Emily D.
• Description:
  Introduction
  
  We developed a decision support tool that can guide the development of heart disease prevention programs to focus on the interventions that have the most potential to benefit populations. To use it, however, users need to know the prevalence of heart disease in the population that they wish to help. We sought to determine the accuracy with which the prevalence of heart disease can be estimated from health care claims data.
  
  Methods
  
  We compared estimates of disease prevalence based on insurance claims to estimates derived from manual health records in a stratified random sample of 480 patients aged 30 years or older who were enrolled at any time from August 1, 2007, through July 31, 2008 (N = 474,089) in HealthPartners insurance and had a HealthPartners Medical Group electronic record. We compared randomly selected development and validation samples to a subsample that was also enrolled on August 1, 2005 (n = 272,348). We also compared the records of patients who had a gap in enrollment of more than 31 days with those who did not, and compared patients who had no visits, only 1 visit, or 2 or more visits more than 31 days apart for heart disease.
  
  Results
  
  Agreement between claims data and manual review was best in both the development and the validation samples (Cohen’s κ, 0.92, 95% confidence interval [CI], 0.87–0.97; and Cohen’s κ, 0.94, 95% CI, 0.89–0.98, respectively) when patients with only 1 visit were considered to have heart disease.
  
  Conclusion
  
  In this population, prevalence of heart disease can be estimated from claims data with acceptable accuracy.
  
  
• Subjects:
  Adult Aged Aged, 80 And Over Confidence Intervals Coronary Disease Decision Support Techniques Electronic Health Records Female Humans Insurance Claim Reporting Logistic Models Male Middle Aged Original Research Prevalence Reproducibility Of Results

  More +
• Source:
  Prev Chronic Dis. 9.
• DOI:
  http://dx.doi.org/10.5888/pcd9.120009
• ISSN:
  1545-1151
• Pubmed ID:
  22916996
• Pubmed Central ID:
  PMC3475521
• Document Type:
  Journal Article
• Funding:
  5U50DP000721-04/DP/NCCDPHP CDC HHS/United States ; T32 HL69764/HL/NHLBI NIH HHS/United States
• Place as Subject:
  Minnesota
• Location:
  North America
• Volume:
  9
• Collection(s):
  Preventing Chronic Disease
• Main Document Checksum:
  urn:sha-512:c1e3bacf9f9f6220bcc7f4fd69c34dba6ffa59020059bcf13c61acb660b1a180494797f4830f8e479b391c885bc5353b63256411971ad72c7ff0b92d14937caa
• Download URL:
  https://stacks.cdc.gov/view/cdc/19745/cdc_19745_DS1.pdf
• File Type:
  [PDF - 218.66 KB ]