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Can cardiovascular clinical characteristics be identified and outcome models be developed from an in-patient claims database?

Publication ,  Journal Article
Weintraub, WS; Deaton, C; Shaw, L; Mahoney, E; Morris, DC; Saunders, C; Canup, D; Connolly, S; Culler, S; Becker, ER; Kosinski, A; Boccuzzi, SJ
Published in: Am J Cardiol
July 15, 1999

The objective of this study was to assess whether administrative (claims) databases can be used to assess clinical variables and predict outcome. Although administrative databases are useful for assessing resource utilization, their utility for assessing clinical information is less certain. Prospectively gathered clinical databases, however, are expensive and not widely available. The UB92 formulation of the hospital bill was used as an administrative source of data and compared with the clinical cardiovascular database at Emory University. The claims database was compared with the clinical database for 11 variables. Outcome models were developed with multivariate methods. A total of 11,883 patients who underwent catheterization (5,255 underwent percutaneous transluminal coronary angioplasty [PTCA] and 3,794 underwent coronary artery bypass surgery [CABG]) between 1991 and 1995 were included. For some variables, the claims database correlated well (diabetes, sensitivity 87%, specificity 99%), whereas for others the claims database was less accurate (peripheral vascular disease, sensitivity 20%, specificity 99%). Uncertain coding in the claims database, which can result in the same code being used for co-morbid states and severity of disease, as well as complications, limited the ability of claims to predict outcome. Clinical databases may also be limited by lack of objectivity and missing data. The utility of claims databases to assess severity of disease and co-morbid states is limited, and outcome modeling and risk assessment from claims databases may be inappropriate and spurious. Developing better data standards and less expensive methods for acquisition of clinical data is necessary for improved outcome assessment.

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Published In

Am J Cardiol

DOI

ISSN

0002-9149

Publication Date

July 15, 1999

Volume

84

Issue

2

Start / End Page

166 / 169

Location

United States

Related Subject Headings

  • Severity of Illness Index
  • Outcome Assessment, Health Care
  • Office Automation
  • Multivariate Analysis
  • Middle Aged
  • Male
  • Integrated Advanced Information Management Systems
  • Humans
  • Female
  • Databases as Topic
 

Citation

APA
Chicago
ICMJE
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Weintraub, W. S., Deaton, C., Shaw, L., Mahoney, E., Morris, D. C., Saunders, C., … Boccuzzi, S. J. (1999). Can cardiovascular clinical characteristics be identified and outcome models be developed from an in-patient claims database? Am J Cardiol, 84(2), 166–169. https://doi.org/10.1016/s0002-9149(99)00228-3
Weintraub, W. S., C. Deaton, L. Shaw, E. Mahoney, D. C. Morris, C. Saunders, D. Canup, et al. “Can cardiovascular clinical characteristics be identified and outcome models be developed from an in-patient claims database?Am J Cardiol 84, no. 2 (July 15, 1999): 166–69. https://doi.org/10.1016/s0002-9149(99)00228-3.
Weintraub WS, Deaton C, Shaw L, Mahoney E, Morris DC, Saunders C, et al. Can cardiovascular clinical characteristics be identified and outcome models be developed from an in-patient claims database? Am J Cardiol. 1999 Jul 15;84(2):166–9.
Weintraub, W. S., et al. “Can cardiovascular clinical characteristics be identified and outcome models be developed from an in-patient claims database?Am J Cardiol, vol. 84, no. 2, July 1999, pp. 166–69. Pubmed, doi:10.1016/s0002-9149(99)00228-3.
Weintraub WS, Deaton C, Shaw L, Mahoney E, Morris DC, Saunders C, Canup D, Connolly S, Culler S, Becker ER, Kosinski A, Boccuzzi SJ. Can cardiovascular clinical characteristics be identified and outcome models be developed from an in-patient claims database? Am J Cardiol. 1999 Jul 15;84(2):166–169.
Journal cover image

Published In

Am J Cardiol

DOI

ISSN

0002-9149

Publication Date

July 15, 1999

Volume

84

Issue

2

Start / End Page

166 / 169

Location

United States

Related Subject Headings

  • Severity of Illness Index
  • Outcome Assessment, Health Care
  • Office Automation
  • Multivariate Analysis
  • Middle Aged
  • Male
  • Integrated Advanced Information Management Systems
  • Humans
  • Female
  • Databases as Topic