Completeness of state administrative databases for surveillance of congenital heart disease

Cronk, Christine E.; Malloy, Marsha; Pelech, Andrew N.; Miller, R Eric; Meyer, Sally A.; Cowell, Melissa; McCarver, D. Gail

doi:10.1002/bdra.10107

Cited by 86 publications

(82 citation statements)

References 35 publications

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“…8,[22][23][24][25] This study highlights an alternative approach involving linking an administrative data set with clinical registry data. The detailed information regarding diagnoses and procedures in the STS-CHS Database allowed a precise evaluation of several operations across varying levels of complexity, and collected preoperative characteristics allowed for more detailed risk adjustment.…”

Section: Discussionmentioning

confidence: 99%

Variation in Congenital Heart Surgery Costs Across Hospitals

Pasquali

Jacobs²,

et al. 2014

Pediatrics

114

104

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WHAT'S KNOWN ON THIS SUBJECT: Congenital heart disease is known to be a commonly treated and resource-intense condition across children' s hospitals, yet knowledge regarding the degree of cost variation across hospitals and associated factors is lacking.WHAT THIS STUDY ADDS: Using a linked clinical and administrative data set, we establish benchmarks for hospital costs for common congenital heart operations, and demonstrate wide variation in cost between hospitals related in part to differences in length of stay and complications. abstract BACKGROUND: A better understanding of costs associated with common and resource-intense conditions such as congenital heart disease has become increasingly important as children' s hospitals face growing pressure to both improve quality and reduce costs. We linked clinical information from a large registry with resource utilization data from an administrative data set to describe costs for common congenital cardiac operations and assess variation across hospitals. METHODS:Using linked data from The Society of Thoracic Surgeons and Pediatric Health Information Systems Databases (2006Databases ( -2010, estimated costs/case for 9 operations of varying complexity were calculated. Between-hospital variation in cost and associated factors were assessed by using Bayesian methods, adjusting for important patient characteristics. RESULTS:Of 12 718 operations (27 hospitals) included, median cost/ case increased with operation complexity (atrial septal defect repair, [$25 499] to Norwood operation, [$165 168]). Significant betweenhospital variation (up to ninefold) in adjusted cost was observed across operations. Differences in length of stay (LOS) and complication rates explained an average of 28% of between-hospital cost variation. For the Norwood operation, high versus low cost hospitals had an average LOS of 50.8 vs 31.8 days and a major complication rate of 50% vs 25.3%. High volume hospitals had lower costs for the most complex operations.CONCLUSIONS: This study establishes benchmarks for hospital costs for common congenital heart operations and demonstrates wide variability across hospitals related in part to differences in LOS and complication rates. These data may be useful in designing initiatives aimed at both improving quality of care and reducing cost. Pediatrics 2014;133:e553-e560 AUTHORS:

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Section: Discussionmentioning

confidence: 99%

Variation in Congenital Heart Surgery Costs Across Hospitals

Pasquali

Jacobs²,

et al. 2014

Pediatrics

114

104

View full text Add to dashboard Cite

show abstract

“…A high proportion of false positives is also noted when compared to medical records or active surveillance systems (Hexter et al, 1990;Callif-Daley et al, 1995;Cronk et al, 2003;Frohnert et al, 2005). Although the validity of hospital discharge data varied according to condition, major defects were better ascertained than rare conditions, and accuracy improved when broader categories of defects were considered (Hexter et al, 1990;Cronk et al, 2003;Frohnert et al, 2005). Finally, discharge data consistently captured more cases than did birth certificates (Hexter et al, 1990;Cronk et al, 2003;Frohnert et al, 2005).…”

Section: Introductionmentioning

confidence: 94%

“…A handful of studies have evaluated the usefulness of such data for generating estimates of birth defects prevalence, and the findings generally indicate a widespread under-ascertainment of specific defects, with about one-third to one-half of cases omitted in the discharge diagnoses (Hexter et al, 1990;Calle and Khoury, 1991;Callif-Daley et al, 1995;Cronk et al, 2003;Frohnert et al, 2005). A high proportion of false positives is also noted when compared to medical records or active surveillance systems (Hexter et al, 1990;Callif-Daley et al, 1995;Cronk et al, 2003;Frohnert et al, 2005). Although the validity of hospital discharge data varied according to condition, major defects were better ascertained than rare conditions, and accuracy improved when broader categories of defects were considered (Hexter et al, 1990;Cronk et al, 2003;Frohnert et al, 2005).…”

Section: Introductionmentioning

confidence: 99%

Feasibility of using the national hospital discharge survey to estimate the prevalence of selected birth defects

Boulet

Correa‐Villaseñor

Hsia

et al. 2006

Birth Defects Research

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“…The completeness of a registry, that is, the ability to identify and register all new cases diagnosed within a population, is essential to produce accurate statistics and conduct valid studies on birth defects in a population. In the past decades, a number of studies were conducted to assess the completeness of birth defects registries' data (Boyed et al, 2005;Czeizel, 1997;Honein and Paulozzi, 1999;Larsen et al, 2003;Wang et al, 2001;Wen et al, 2000;Berghold et al, 2001;Cronk et al, 2003;Knox et al, 1984). Interestingly, only a few of these studies used the capture-recapture methods (Honein and Paulozzi, 1999;Berghold et al, 2001).…”

Section: Introductionmentioning

confidence: 96%

Problems in using birth certificate files in the capture‐recapture model to estimate the completeness of case ascertainment in a population‐based birth defects registry in New York State

Wang

Druschel

Cross

et al. 2006

Birth Defects Research

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Discrepancies in birth defect categories in the two data sources and false positives in the birth certificates were the major problems encountered in estimating the completeness of the CMR using the simple two-source capture-recapture method. The estimated completeness for selected major birth defects was only about 71%. Stratified analyses resulted in relatively high estimated completeness for oral clefts (90%) and Down syndrome (88%). CONCLUSIONS Although the birth certificate data was not a good source for estimating the completeness of case ascertainment of the CMR using capture-recapture methods, the analyses provided reasonable estimates for some conditions that were relatively easy to identify and diagnose at birth, such as oral clefts and Down syndrome.

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Completeness of state administrative databases for surveillance of congenital heart disease

Abstract: State databases identified 60% of generic CHD and exactly matched about half of specific CHD diagnoses. The postnatal hospital discharge summaries performed best in both in identifying generic CHD and matching specific CHD diagnoses. Vital records had limited value in ascertaining CHD.

Cited by 86 publications

References 35 publications

Variation in Congenital Heart Surgery Costs Across Hospitals

Variation in Congenital Heart Surgery Costs Across Hospitals

Feasibility of using the national hospital discharge survey to estimate the prevalence of selected birth defects

Problems in using birth certificate files in the capture‐recapture model to estimate the completeness of case ascertainment in a population‐based birth defects registry in New York State

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