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Research

Self-reported versus health administrative data: implications for assessing chronic illness burden in populations. A cross-sectional study

Martin Fortin, Jeannie Haggerty, Steven Sanche and José Almirall
September 25, 2017 5 (3) E729-E733; DOI: https://doi.org/10.9778/cmajo.20170029
Martin Fortin
Department of Family Medicine and Emergency Medicine (Fortin, Almirall), Université de Sherbrooke, Sherbrooke, Que.; Faculty of Medicine (Haggerty), McGill University; St. Mary's Research Centre (Sanche), St. Mary's Hospital, Montréal, Que.
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Jeannie Haggerty
Department of Family Medicine and Emergency Medicine (Fortin, Almirall), Université de Sherbrooke, Sherbrooke, Que.; Faculty of Medicine (Haggerty), McGill University; St. Mary's Research Centre (Sanche), St. Mary's Hospital, Montréal, Que.
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Steven Sanche
Department of Family Medicine and Emergency Medicine (Fortin, Almirall), Université de Sherbrooke, Sherbrooke, Que.; Faculty of Medicine (Haggerty), McGill University; St. Mary's Research Centre (Sanche), St. Mary's Hospital, Montréal, Que.
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José Almirall
Department of Family Medicine and Emergency Medicine (Fortin, Almirall), Université de Sherbrooke, Sherbrooke, Que.; Faculty of Medicine (Haggerty), McGill University; St. Mary's Research Centre (Sanche), St. Mary's Hospital, Montréal, Que.
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    Figure 1

    Prevalence of multimorbidity with self-reported data, health administrative data (HAD) and the 2 data sources pooled together, according to number of chronic conditions considered in the operational definition of multimorbidity.

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    Table 1: Sociodemographic characteristics of participants
    CharacteristicNo. (%) of participants
    n = 1177
    Age group, yr
        25-34120 (10.2)
        35-44182 (15.5)
        45-54295 (25.1)
        55-64343 (29.1)
        65-75223 (18.9)
        Missing14 (1.2)
    Female684 (58.1)
    Education
        No high school diploma248 (21.1)
        High school or college diploma614 (52.2)
        University diploma310 (26.3)
        Missing5 (0.4)
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    Table 2: Frequency of chronic conditions by self-report and with health administrative data, and agreement between the 2 data sources
    Chronic conditionPrevalence, %Total no. of participants*Method; no. (%) of participantsκ (95% CI)
    Self-reportHealth administrative dataBoth methods
    Diabetes10.5124109 (87.9)104 (83.9)89 (71.8)0.82 (0.76 to 0.88)
    Thyroid disorder13.1154147 (95.4)77 (50.0)70 (45.4)0.59 (0.51 to 0.67)
    Hypertension34.9411363 (88.3)260 (63.3)212 (51.6)0.57 (0.52 to 0.62)
    Any cardiac disease12.0141111 (78.7)87 (61.7)57 (40.4)0.54 (0.45 to 0.62)
    Cancer8.510045 (45.0)92 (92.0)37 (37.0)0.52 (0.41 to 0.62)
    Asthma12.6148129 (87.2)63 (42.6)44 (29.7)0.42 (0.33 to 0.51)
    Arthrosis28.6337290 (86.1)127 (37.7)80 (23.7)0.28 (0.21 to 0.34)
    Rheumatoid arthritis4.85735 (61.4)33 (57.9)11 (19.3)0.30 (0.16 to 0.45)
    Osteoporosis6.67871 (91.0)22 (28.2)15 (19.2)0.30 (0.18 to 0.43)
    Chronic obstructive pulmonary disease6.37454 (73.0)31 (41.9)11 (14.9)0.23 (0.11 to 0.36)
    Intestinal disease9.911697 (83.6)34 (29.3)15 (12.9)0.19 (0.1 to 0.29)
    Hypercholesterolemia28.6337332 (98.5)17 (5.0)12 (3.6)0.04 (0.01 to 0.07)

    Note: CI = confidence interval.

    *Total number of participants with the condition who were identified either by self-report or by health administrative data.

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      Table 3: Comparison of agreement by age group
      Chronic conditionAge; κ (95% CI)
      < 65 yr65-75 yr
      Diabetes0.85 (0.77 to 0.91)0.74 (0.62 to 0.86)
      Hypertension0.59 (0.52 to 0.65)0.42 (0.30 to 0.53)
      Thyroid disorder0.60 (0.50 to 0.69)0.58 (0.43 to 0.72)
      Any cardiac disease0.57 (0.46 to 0.67)0.44 (0.29 to 0.57)
      Cancer0.52 (0.40 to 0.63)0.52 (029 to 0.72)
      Asthma0.40 (0.29 to 0.50)0.49 (0.26 to 0.69)
      Arthrosis0.26 (0.19 to 0.34)0.26 (0.13 to 0.38)
      Rheumatoid arthritis0.38 (0.20 to 0.54)0.08 (-0.05 to 0.32)
      Osteoporosis0.39 (0.24 to 0.55)0.12 (-0.03 to 0.33)
      Chronic obstructive pulmonary disease0.22 (0.07 to 0.37)0.25 (0.03 to 0.47)
      Intestinal disease0.20 (0.09 to 0.31)0.19 (0.01 to 0.38)
      Hypercholesterolemia0.05 (0.01 to 0.09)0.04 (0.00 to 0.08)

      Note: CI = confidence interval.

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      CMAJ Open: 5 (3)
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      25 Sep 2017
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      Self-reported versus health administrative data: implications for assessing chronic illness burden in populations. A cross-sectional study
      Martin Fortin, Jeannie Haggerty, Steven Sanche, José Almirall
      Sep 2017, 5 (3) E729-E733; DOI: 10.9778/cmajo.20170029

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      Self-reported versus health administrative data: implications for assessing chronic illness burden in populations. A cross-sectional study
      Martin Fortin, Jeannie Haggerty, Steven Sanche, José Almirall
      Sep 2017, 5 (3) E729-E733; DOI: 10.9778/cmajo.20170029
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