Administrative Database Studies: Goldmine or Goose Chase?

Introduction

There is increasing interest in the use of administrative data in health services and clinical research. Administrative data are routinely collected during clinic, hospital, laboratory, or pharmacy visits for administrative purposes.[1] Administrative databases provide easy and cheap access to large numbers of patients over expansive geographic regions. Although these databases were initially designed to reimburse health care services and to track differences in services and the use for state and national agencies, they are increasingly being used for epidemiological, effectiveness, and safety outcomes research. However, there are several limitations that must be considered, and critical appraisal of studies that utilize administrative databases is important.

• References

• 1 Agency for Healthcare Research Quality (AHRQ). Methods Guide for Effectiveness and Comparative Effectiveness Reviews. AHRQ Publication No. 10(14)-EHC063-EF. Rockville, MD; 2014 . Available at: www.effectivehealthcare.ahrq.gov . Accessed September 4, 2014
• 2 Agency for Healthcare Research Quality (AHRQ). Agency for Healthcare Research Quality (AHRQ). HCUP Databases, Healthcare Cost and Utilization Project (HCUP): Overview of the Nationwide Inpatient Sample (NIS), 2013 . Available at: http://www.hcup-us.ahrq.gov/nisoverview.jsp
• 3 Virnig B, Maderia AD. Strengths and Limitations of CMS Administrative Data in Research. 2012 . Available at: http://www.resdac.org/resconnect/articles/156#broad-limitations-of-cms-administrative-data . Accessed May 7, 2013
• 4 PearlDiver, Inc. Available at: http://www.pearldiverinc.com/ . Accessed September 4, 2014
• 5 IMS Health. Available at: http://www.imshealth.com . Accessed September 4, 2014
• 6 Sarrazin MS, Rosenthal GE. Finding pure and simple truths with administrative data. JAMA 2012; 307 (13) 1433-1435
• 7 Romano PS, Hussey P, Ritley D. Selecting quality and resource use measures: a decision guide for community quality collaboratives. Question 2: What are the strengths and weaknesses of using administrative data, medical record data, and hybrid data?. Rockville, MD: Agency for Healthcare Research and Quality. May 2010. AHRQ Publication No. 09(10)-0073, 2010 . Available at: http://www.ahrq.gov/legacy/qual/perfmeasguide/perfmeaspt1a.htm . Accessed May 7, 2013
• 8 Hertzer NR. Reasons why data from the Nationwide Inpatient Sample can be misleading for carotid endarterectomy and carotid stenting. Semin Vasc Surg 2012; 25 (1) 13-17
• 9 McPhee JT, Schanzer A, Messina LM, Eslami MH. Carotid artery stenting has increased rates of postprocedure stroke, death, and resource utilization than does carotid endarterectomy in the United States, 2005. J Vasc Surg 2008; 48 (6) 1442-1450 , e1
• 10 Lindenauer PK, Lagu T, Shieh MS, Pekow PS, Rothberg MB. Association of diagnostic coding with trends in hospitalizations and mortality of patients with pneumonia, 2003-2009. JAMA 2012; 307 (13) 1405-1413
• 11 RECORD 2014 . Available at: http://record-statement.org/ . Accessed September 4, 2014
• 12 Langan SM, Benchimol EI, Guttmann A , et al. Setting the RECORD straight: developing a guideline for the reporting of studies conducted using observational routinely collected data. Clin Epidemiol 2013; 5: 29-31
• 13 van Walraven C, Austin P. Administrative database research has unique characteristics that can risk biased results. J Clin Epidemiol 2012; 65 (2) 126-131