Comparison of self-reported and Medicare claims-identified acute myocardial infarction.
Circulation
; 131(17): 1477-85; discussion 1485, 2015 Apr 28.
Article
en En
| MEDLINE
| ID: mdl-25747935
ABSTRACT
BACKGROUND:
Cardiovascular disease is often studied through patient self-report and administrative data. However, these 2 sources provide different information, and few studies have compared them. METHODS ANDRESULTS:
We compared data from a longitudinal, nationally representative survey of older Americans with matched Medicare claims. Self-reported heart attack in the previous 2 years was compared with claims-identified acute myocardial infarction (AMI) and acute coronary syndrome. Among the 3.1% of respondents with self-reported heart attack, 32.8% had claims-identified AMI, 16.5% had non-AMI acute coronary syndrome, and 25.8% had other cardiac claims; 17.3% had no inpatient visits in the previous 2.5 years. Claims-identified AMIs were found in 1.4% of respondents; of these, 67.8% reported a heart attack. Self-reports were less likely among respondents >75 years of age (62.7% versus 74.6%; P=0.006), with less than high school education (61.6% versus 71.4%; P=0.015), with at least 1 limitation in activities of daily living (59.6% versus 74.7%; P=0.001), or below the 25th percentile of a word recall memory test (60.7% versus 71.3%; P=0.019). Both self-reported and claims-identified cardiac events were associated with increased mortality; the highest mortality was observed among those with claims-identified AMI who did not self-report (odds ratio, 2.8; 95% confidence interval, 1.5-5.1) and among those with self-reported heart attack and claims-identified AMI (odds ratio, 2.5; 95% confidence interval, 1.7-3.6) or non-AMI acute coronary syndrome (odds ratio, 2.7; 95% confidence interval, 1.8-4.1).CONCLUSIONS:
There is considerable disagreement between self-reported and claims-identified events. Although self-reported heart attack may be inaccurate, it indicates increased risk of death, regardless of whether the self-report is confirmed by Medicare claims.Palabras clave
Texto completo:
1
Bases de datos:
MEDLINE
Asunto principal:
Medicare
/
Autoinforme
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Formulario de Reclamación de Seguro
/
Infarto del Miocardio
Tipo de estudio:
Diagnostic_studies
/
Prognostic_studies
Límite:
Aged
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Female
/
Humans
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Male
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Middle aged
País/Región como asunto:
America do norte
Idioma:
En
Revista:
Circulation
Año:
2015
Tipo del documento:
Article
País de afiliación:
Marruecos