Abstract 16776: Can We Rely on Patients to Report Rehospitalizations After Acute Myocardial Infarction? Implications for the Design of Future Practical Clinical Studies
Background: Few studies have described the accuracy of patient-reported hospitalizations and characterized patients who either under- or over-report hospitalizations.
Methods: At scheduled interviews 6 weeks, 6 and 12 months after discharge, acute MI patients in the TRANSLATE-ACS study were asked to report any rehospitalizations. Bills from hospitals in the patient’s geographic area and from 12-month queries at the discharging institution were obtained to confirm reported and screen for unreported hospitalizations. We assessed the accuracy of patient-reported hospitalizations with bill validation as the reference. We also examined the characteristics of patients who accurately, over-, or under-reported the number of hospitalizations.
Results: Among 12,302 acute MI patients, 5,668 patients (46%) reported 8,716 rehospitalizations within the 1 year post-discharge. Only 59% of patient-reported hospitalizations were confirmed by medical bill data (Table). Among the total number of hospital bills collected, 34% were never reported by the patient. Among 5,688 patients confirmed to be rehospitalized, 41% accurately reported the number of hospitalizations, 37% over-reported by a range of 1-12 hospitalizations (median 1) and 22% under-reported by 1-19 hospitalizations (median 1). Compared with accurate reporters, under-reporters were more likely to be female (36% vs. 31%), non-white race (17% vs. 12%), unemployed (67% vs. 54%), non-high school graduate (19% vs. 12%) or to have lower functional status (median EQ5D VAS score 65 vs. 75, p<0.01 for all). Characteristics of over-reporters were more similar to accurate reporters. Clinical risk, as summarized by the ACTION mortality risk score, was not substantially different between groups.
Conclusions: In a large community-based study, the accuracy of patient-reported hospitalizations was low when compared with validation by medical bills, with patients both under- and over-reporting events.
Author Disclosures: A. Krishnamoorthy: Other Research Support; Modest; Novartis Pharmaceutical Corporation, Thoratec Corporation, Maquet. E.D. Peterson: Research Grant; Significant; American College of Cardiology, American Heart Association, Eli Lilly and Company, Jansenn Pharmaceutical Products. Consultant/Advisory Board; Modest; Boehringer Ingelheim, Genentech, Jansenn Pharmaceutical Products, Merck & Co., Sanofi Aventis. E.F. Honeycutt: None. K.J. Anstrom: Research Grant; Significant; AstraZeneca, Medtronic Vascular, Inc.. Consultant/Advisory Board; Modest; Abbot Laboratories, AstraZeneca, Ikaria, Vertex Pharmaceuticals, Inc. M.B. Effron: Employment; Significant; Eli Lilly and Company. M.E. Zettler: Employment; Significant; Eli Lilly and Company. L. Davidson-Ray: None. B.A. Baker: Employment; Significant; Daiichi Sankyo, Inc. P.L. McCollam: Employment; Significant; Eli Lilly and Company. D.B. Mark: Consultant/Advisory Board; Modest; Medtronic, Somahlution, St. Jude, Janssen. Research Grant; Significant; Lilly, Medtronics, Inc., AstraZeneca, Gilead, Bristol Myers Squibb, AGA Medical. T.Y. Wang: Research Grant; Significant; American College of Cardiology, American Society of Nuclear Cardiology, Daiichi Sankyo, Gilead, GlaxoSmithKline, Eli Lilly. Other; Modest; AstraZeneca.
- © 2014 by American Heart Association, Inc.