A comparison of a multistate inpatient EHR database to the HCUP Nationwide Inpatient Sample

TLDR

Electronic health records are increasingly available in the US and may provide more detailed, clinically relevant data than claims, but they require different analytic techniques and further research to understand their differences. This study compared the large Health Facts EHR database to the Nationwide Inpatient Sample population estimate. Weighted comparisons using t‑values and relative differences across diagnoses and procedures for 2010 were performed to assess similarity. The two databases showed similar distribution patterns, with 24 of 50 data elements statistically comparable, while differences were consistent across categories and mainly observed in psychiatric‑behavioral and obstetrics‑gynecology services.

Abstract

The growing availability of electronic health records (EHRs) in the US could provide researchers with a more detailed and clinically relevant alternative to using claims-based data. In this study we compared a very large EHR database (Health Facts©) to a well-established population estimate (Nationwide Inpatient Sample). Weighted comparisons were made using t-value and relative difference over diagnoses and procedures for the year 2010. The two databases have a similar distribution pattern across all data elements, with 24 of 50 data elements being statistically similar between the two data sources. In general, differences that were found are consistent across diagnosis and procedures categories and were specific to the psychiatric–behavioral and obstetrics–gynecology services areas. Large EHR databases have the potential to be a useful addition to health services researchers, although they require different analytic techniques compared to administrative databases; more research is needed to understand the differences.