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Concordance between Self-Reported and Physician-Reported Chronic Co-morbidity among Disabled Older Adults

Published online by Cambridge University Press:  06 August 2013

Esther Iecovich*
Affiliation:
Department of Public Health, Ben-Gurion University of the Negev, Israel
Aya Biderman
Affiliation:
Department of Family Medicine, Ben-Gurion University of the Negev, Israel
*
Correspondence and requests for offprints should be sent to / La correspondance et les demandes de tirés-à-part doivent être adressées à: Esther Iecovich, Ph.D. Department of Public Health Faculty of Health Sciences Ben-Gurion University of the Negev Beer-Sheva 84105, Israel (iecovich@bgu.ac.il)

Abstract

Discordance between self-reports and medical records reflects patient and provider factors that have implications for management and research. This study investigated discordance and socio-demographic factors that explain concordance. A purposive sample of 402 disabled older persons was interviewed using a structured questionnaire. The highest concordances were found for diabetes, cardiovascular accident (CVA), and cancer while the lowest were evident for arthritis, and renal and gastrointestinal conditions. Significant explanatory factors included (a) age for explaining concordance in hypertension; (b) ethnicity in explaining concordance in arthritis and cancer; (c) marital status in explaining concordance in thyroid diseases; (d) education in explaining concordance in gastrointestinal conditions; and (e) functional status in explaining concordance in respiratory, gastrointestinal, and thyroid diseases. Co-morbidity increased concordance for all health conditions and decreased concordance for hypertension. Further investigation is needed to examine the reasons for the disparities between the two sources of information.

Résumé

La discordance entre les auto-rapports et les dossiers médicaux reflètent des éléments concernant les patients et les prestataires qui ont des implications pour la recherche et la gestion. Cette étude a examiné la discordance et les facteurs socio-démographiques qui expliquent la concordance. Un échantillon téléologique de 402 personnes âgées handicapées a été interrogés à l’aide d’un questionnaire structuré. On a trouvé les concordances les plus hauts pour le diabète, l’accident cardiovasculaire (CVA), et le cancer, et les plus bas pour l’arthrite, et les conditions rénales et digestives. Les facteurs explicatifs importants inclurent: (a) l’âge dans l’explication de la concordance dans l’hypertension; (b) l’ethnicité en expliquant la concordance dans l’arthrite et le cancer; (c) la situation de famille en expliquant la concordance dans les maladies de la thyroïde; (d) l’éducation pour expliquer la concordance dans les conditions gastro-intestinales, et (e) l’état fonctionnel en expliquant la concordance dans maladies respiratoires, gastro-intestinales et thyroïdiennes. La comorbidité a accrue la concordance dans toutes les conditions de santé, et a diminué la concordance pour l’hypertension. Une enquête plus poussée est nécessaire pour examiner la cause des disparités entre les deux sources d’information.

Type
Articles
Copyright
Copyright © Canadian Association on Gerontology 2013 

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