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Reliability of the recording of schizophrenia and depressive disorder in the Saskatchewan health care datafiles

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Abstract

Administrative data have long been used in psychiatric epidemiology and outcomes evaluation. This article examines the reliability of the recording of schizophrenia and depressive disorder in three Saskatchewan administrative health care utilization datafiles. Due to their comprehensive nature, these datafiles have been used in a wide range of epidemiologic studies. Close agreement was found between hospital computer data and patients' charts for personal and demographic factors (≥94.7%). Diagnostic concordance between computerized hospital data and medical charts was very good for schizophrenia (94%) but poor for depressive disorder (58%). Appropriate physician services were identified for 60% and 72% of hospital discharges for schizophrenia and depressive disorder, respectively, andexact diagnostic agreement between hospital and physician datafiles was 62% for schizophrenia and 66% for depressive disorder. Appropriate provincial mental health branch services were found for 83% and 38% of hospital discharges for schizophrenia and depressive disorder, respectively;exact diagnostic concordance between these datafiles was 75% for schizophrenia and 0% for depressive disorder. A significant number of patients with major or neurotic depression appeared to be wrongly coded as having depressive disorder in the hospital file. The differences in diagnostic agreement may also be partly a function of how the two conditions are differentially treated in the health system. These findings suggest that more specific and severe psychiatric diagnoses are likely to be recorded accurately and consistently in the Saskatchewan datafiles. However, disorders with multiple manifestations or those for which there are several possible codes should be examined with caution and ways sought to validate them. Attention should also be paid to which service sectors are involved in the treatment of specific disorders.

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References

  1. Rawson NSB, D'Arcy C, Blackburn JL, Bowen RC, Wallace SM, Downey W, Senft D (1992) Epidemiologic research using linked computerized health care datafiles in Saskatchewan, Canada. Psychiatric Pharmacoepidemiology Research Consortium Technical Report no. 2, Saskatoon, Saskatchewan

  2. Malcolm E, Downey W, Strand LM, McNutt M, West R (1993) Saskatchewan Health's linkable data bases and pharmacoepidemiology. Post Market Surveill 6: 175–264

    Google Scholar 

  3. Strand LM, Downey W (1994) Health databases in Saskatchewan. In: Strom BL (ed) Pharmacoepidemiology, 2nd edn. Wiley, Chichester, pp 217–229

    Google Scholar 

  4. Cassell WA, Smith CM, Rankin MG (1970) Psychiatric services in Saskatchewan under Medicare. Can Psychiatr Assoc J 15: 63–71

    Google Scholar 

  5. D'Arcy C, Vandem Ham M, Goldie S (1976) The development of a comprehensive psychiatric service utilization research datafile. Can J Public Health 67: 237–248

    Google Scholar 

  6. Beck RG, Horne JM (1980) Utilization of publicly insured health services in Saskatchewan before, during and after copayment. Med Care 18: 787–806

    Google Scholar 

  7. Babiker IE (1987) Comparative efficacy of long-acting depot and oral neuroleptic medications in preventing schizophrenic recidivism. J Clin Psychiatry 48: 94–97

    Google Scholar 

  8. Guess HA, West R, Strand LM, Helston D, Lydick EG, Bergman U, Wolski K (1988) Fatal upper gastrointestinal hemorrhage or perforation among users and non-users of non-steroidal anti-inflammatory drugs in Saskatchewan, Canada 1983. J Clin Epidemiol 41: 35–45

    Google Scholar 

  9. Ray WA, Griffin MR, Downey W (1989) Benzodiazepines of long and short elimination half-life and the risk of hip fracture. JAMA 262: 3303–3307

    Google Scholar 

  10. Thiessen BQ, Wallace SM, Black burn JL, Wilson TW, Bergman U (1990) Increased prescribing of antidepressants subsequent to β-blocker therapy. Arch Intern Med 150: 2286–2290

    Google Scholar 

  11. Spitzer WO, Suissa S, Ernst P, Horwitz RI, Habbick B, Cockcroft D, Boivin J-F, McNutt M, Buist AS, Rebuck AS (1992) The use of β-agonists and the risk of death and near death from asthma. N Engl J Med 326: 501–506

    Google Scholar 

  12. Ray WA, Griffin MR, West R, Strand L, Melton LJ (1990) Incidence of hip fracture in Saskatchewan, Canada, 1976–1985. Am J Epidemiol 131: 502–509

    Google Scholar 

  13. Tennis P, Andrews E, Bombardier C, Wang Y, Strand L, West R, Tilson H, Doi P (1993) Record linkage to conduct an epidemiologic study on the association of rheumatoid arthritis and lymphoma in the province of Saskatchewan, Canada. J Clin Epidemiol 46: 685–695

    Google Scholar 

  14. Rawson NSB (1993) An acute adverse drug reaction alerting system using the Saskatchewan health datafiles. Drug Invest 6: 245–256

    Google Scholar 

  15. Risch HA, Howe GR (1994) Menopausal hormone usage and breast cancer in Saskatchewan: a record-linkage cohort study. Am J Epidemiol 139: 670–683

    Google Scholar 

  16. Tennis P, Bombardier C, Malcolm E, Downey W (1993) Validity of rheumatoid arthritis diagnoses listed in the Saskatchewan hospital separations database. J Clin Epidemiol 46: 675–683

    Google Scholar 

  17. Rawson NSB, D'Arcy C (1991) “Validity” and reliability: idealism and reality in the use of computerized health care databases for pharmacoepidemiological research. Post Market Surveill 5: 31–55

    Google Scholar 

  18. Rawson NSB, Malcolm E (1995) Validity of the recording of cholecystectomy and hysterectomy in the Saskatchewan health care datafiles. Pharmacoepidemiology Research Unit Technical Report no. 3, Saskatoon, Saskatchewan

  19. Edouard L, Rawson NSB (1996) Reliability of the recording of hysterectomy in the Saskatchewan health care system. Br J Obstet Gynaecol 103: 891–897

    Google Scholar 

  20. Rawson NSB, Malcolm E (1995) Validity of the recording of ischaemic heart disease and chronic obstructive pulmonary disease in the Saskatchewan health care datafiles. Stat Med 14: 2627–2643

    Google Scholar 

  21. D'Arcy C (1983) The Saskatchewan Mental Health Information System: exposition and comment. In: Bennett EM, Trute B (eds) Mental health information systems: problems and prospects. Edward Mellen Press, New York, pp 131–150

    Google Scholar 

  22. Health and Welfare Canada (1990) Mental health services in Canada, 1990. Minister of Supply and Services, Ottawa

    Google Scholar 

  23. Nair C, Karim R (1993) An overview of health care systems. Canada and selected OECD countries. Health Rep 5: 259–279

    Google Scholar 

  24. World Health Organization (1977) Manual of the international statistical classification of diseases, injuries and causes of death. 9th rev. World Health Organization, Geneva

    Google Scholar 

  25. Statistics Canada (1986) Canadian classification of diagnostic, therapeutic and surgical procedures. Minister of Supply and Services, Ottawa

    Google Scholar 

  26. American Psychiatric Association (1980) Diagnostic and statistical manual of mental disorders, 3rd edn. American Psychiatric Association, Washington, DC

    Google Scholar 

  27. Landis JR, Koch GG (1977) The measurement of observer agreement for categorical data. Biometrics 33: 159–174

    Google Scholar 

  28. Demlo LK, Campbell PM, Brown SS (1978) Reliability of information abstracted from patients' medical records. Med Care 16: 995–1005

    Google Scholar 

  29. Schwartz AH, Perlman BB, Paris M, Schmidt K, Thornton JC (1980) Psychiatric diagnoses as reported to Medicaid and as recorded in patient charts. Am J Public Health 70: 406–408

    Google Scholar 

  30. Roos LL, Roos NP, Cageorge SM, Nicol JP (1982) How good are the data?-reliability of one health care data bank. Med Care 20: 266–276

    Google Scholar 

  31. Roos NP, Henteleff PD, Roos LL (1977) A new audit procedure applied to an old question: is the frequency of T&A justified? Med Care 15: 1–18

    Google Scholar 

  32. Roos NP (1984) Hysterectomies in one Canadian province: a new look at risks and benefits. Am J Public Health 74: 39–46

    Google Scholar 

  33. Avorn J, Everitt DE, Weiss S (1986) Increased antidepressant use in patients prescribed β-blockers. JAMA 255: 357–360

    Google Scholar 

  34. Bright RA, Everitt DE (1992) β-blockers and depression: evidence against an association. JAMA 267: 1783–1787

    Google Scholar 

  35. Johnson JA (1994) New β-blocker use and concurrent antidepressant prescribing: a pharmacoepidemiologic study. MSc thesis, University of Saskatchewan, Saskatoon, Saskatchewan

    Google Scholar 

  36. Johnson JA, Wallace SM (1995) Linkage of the Saskatchewan health databases to investigate the relationship between β-blocker and antidepressant use. Pharmacoepidemiol Drug Safety 4 [Suppl 1]: S30

    Google Scholar 

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Authors and Affiliations

  1. College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, Saskatchewan, Canada

    N. S. B. Rawson

  2. Research Services, Strategic Programs Branch, Saskatchewan Health, Regina, Saskatchewan, Canada

    E. Malcolm

  3. Applied Research, Department of Psychiatry, University of Saskatchewan, Saskatoon, Saskatchewan, Canada

    C. D'Arcy

  4. Royal University Hospital, 103 Hospital Drive, Box 92, S7N 0W8, Saskatoon, Saskatchewan, Canada

    N. S. B. Rawson

Authors
  1. N. S. B. Rawson
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  2. E. Malcolm
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  3. C. D'Arcy
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Rawson, N.S.B., Malcolm, E. & D'Arcy, C. Reliability of the recording of schizophrenia and depressive disorder in the Saskatchewan health care datafiles. Soc Psychiatry Psychiatr Epidemiol 32, 191–199 (1997). https://doi.org/10.1007/BF00788238

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