Felicitas Vogelgesang, Roma Thamm, Timm Frerk, Thomas G Grobe, Joachim Saam, Catharina Schumacher, Julia Thom
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引用次数: 0
Abstract
Background: The frequency of medical diagnoses is a figure of central importance in epidemiology and health services research. Prevalence estimates vary depending on the underlying data. For a better understanding of such discrepancies, we compared patients' diagnoses as reported by themselves in response to our questioning with their diagnoses as stated in the routine data of their health insurance carrier.
Methods: For 6558 adults insured by BARMER, one of the statutory health insurance carriers in Germany, we compared the diagnoses of various illnesses over a twelve-month period, as reported by the patients themselves in response to our questioning (October to December 2021), with their ICD-10-based diagnosis codes (Q4/2020-Q3/2021). The degree of agreement was assessed with two kappa values, sensitivity, and specificity.
Results: The patients' stated diagnoses of diabetes and hypertension agreed well or very well with their diagnosis codes, with kappa and PABAK values near 0.8, as well as very high sensitivity and specificity. Moderately good agreement with respect to kappa was seen for the diagnoses of heart failure (0.4), obesity, anxiety disorder, depression, and coronary heart disease (0.5 each). The poorest agreement (kappa ≤ 0.3) was seen for posttraumatic stress disorder, alcohol-related disorder, and mental and somatoform disorder. Agreement was worse with increasing age.
Conclusion: Diagnoses as stated by patients often differ from those found in routine health insurance data. Discrepancies that can be considered negligible were found for only two of the 11 diseases that we studied. Our investigation confirms that these two sources of data yield different estimates of prevalence. Age is a key factor; further reasons for the discrepancies should be investigated, and avoidable causes should be addressed.
患者陈述的诊断与常规健康保险数据中包含的诊断之间的一致性--数据链接研究的结果》(The Agreement between Diagnoses as Stated by Patients and Those Contained in Routine Health Insurance Data-Results of a Data Linkage Study)。
期刊介绍:
Deutsches Ärzteblatt International is a bilingual (German and English) weekly online journal that focuses on clinical medicine and public health. It serves as the official publication for both the German Medical Association and the National Association of Statutory Health Insurance Physicians. The journal is dedicated to publishing independent, peer-reviewed articles that cover a wide range of clinical medicine disciplines. It also features editorials and a dedicated section for scientific discussion, known as correspondence.
The journal aims to provide valuable medical information to its international readership and offers insights into the German medical landscape. Since its launch in January 2008, Deutsches Ärzteblatt International has been recognized and included in several prestigious databases, which helps to ensure its content is accessible and credible to the global medical community. These databases include:
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By being indexed in these databases, Deutsches Ärzteblatt International's articles are made available to researchers, clinicians, and healthcare professionals worldwide, contributing to the global exchange of medical knowledge and research.