AN ANALYSIS OF CONCORDANCE AMONG HOSPITAL DATABASES AND PHYSICIAN RECORDS

Background: Hospital databases contain vital demographic patient infor mation, which is increasingly being used as a basis to dictate care. I t is hypothesized that the validity of data administratively generated from such sources is suboptimal, especially for rare subspecialties. The authors examined three databases to determine their concordance in an academic orthopaedic oncology subspecialty practice. Methods: A 2- year retrospective review was performed on three databases searching f or seven fundamental variables: additions/deletions; identification nu mber; birthdate; procedure date; admit/discharge date; procedure code; and diagnostic code. Two university-maintained hospital databases (me dical records and physician billing) were compared to the surgeon's pe rsonal handwritten daily log, which served as the ''gold standard.'' R esults: All seven variables were in agreement with the physician's log in only 60% of the medical records and 61% of the physician billing p atient entries (n = 564). On more detailed statistical analysis using chi(2), cross tabulations, and the kappa statistic for interobserver a greement, it was determined that poor concordance exists among the dat abases. Conclusion: Surgeons delivering quartenary care should maintai n his or her own database because the hospital's information often dif fers on one or more important variables. Further investigation into th e accuracy of hospital databases regarding commonly practiced medical disciplines appears warranted.