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    Under-ascertainment of Aboriginality in records of cardiovascular disease in hospital morbidity and mortality data in Western Australia: a record linkage study

    153511_28553_Briffa_Under-ascertainment of Aboriginality in records.pdf (159.6Kb)
    Access Status
    Open access
    Authors
    Briffa, T.
    Sanfilippo, F.
    Hobbs, M.
    Ridout, S.
    Katzenellenbogen, Judy
    Thompson, P.
    Thompson, Sandra
    Date
    2010
    Type
    Journal Article
    
    Metadata
    Show full item record
    Citation
    Briffa, Tom G. and Sanfilippo, Frank M. and Hobbs, Michael S.T. and Ridout, Stephen C. and Katzenellenbogen, Judy M. and Thompson, Peter L. and Thompson, Sandra C. 2010. Under-ascertainment of Aboriginality in records of cardiovascular disease in hospital morbidity and mortality data in Western Australia: a record linkage study. BMC Medical Research Methodology. 10 (111): pp. 1-6.
    Source Title
    BMC Medical Research Methodology
    DOI
    10.1186/1471-2288-10-111
    ISSN
    14712288
    School
    Centre for International Health (Curtin Research Centre)
    Remarks

    This article is published under the Open Access publishing model and distributed under the terms of the Creative Commons Attribution License http://creativecommons.org/licenses/by/3.0/ Please refer to the licence to obtain terms for any further reuse or distribution of this work.

    URI
    http://hdl.handle.net/20.500.11937/41614
    Collection
    • Curtin Research Publications
    Abstract

    Background. Measuring the real burden of cardiovascular disease in Australian Aboriginals is complicated by under-identification of Aboriginality in administrative health data collections. Accurate data is essential to measure Australia's progress in its efforts to intervene to improve health outcomes of Australian Aboriginals. We estimated the under-ascertainment of Aboriginal status in linked morbidity and mortality databases in patients hospitalised with cardiovascular disease. Methods. Persons with public hospital admissions for cardiovascular disease in Western Australia during 2000-2005 (and their 20-year admission history) or who subsequently died were identified from linkage data. The Aboriginal status flag in all records for a given individual was variously used to determine their ethnicity (index positive, and in all records both majority positive or ever positive) and stratified by region, age and gender. The index admission was the baseline comparator.Results. Index cases comprised 62,692 individuals who shared a total of 778,714 hospital admissions over 20 years, of which 19,809 subsequently died. There were 3,060 (4.9%) persons identified as Aboriginal on index admission. An additional 83 (2.7%) Aboriginal cases were identified through death records, increasing to 3.7% when cases with a positive Aboriginal identifier in the majority (≥50%) of previous hospital admissions over twenty years were added and by 20.8% when those with a positive flag in any record over 20 years were incorporated. These results equated to underestimating Aboriginal status in unlinked index admission by 2.6%, 3.5% and 17.2%, respectively. Deaths classified as Aboriginal in official records would underestimate total Aboriginal deaths by 26.8% (95% Confidence Interval 24.1 to 29.6%). Conclusions. Combining Aboriginal determinations in morbidity and official death records increases ascertainment of unlinked cardiovascular morbidity in Western Australian Aboriginals. Under-identification of Aboriginal status is high in death records.

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