Original research| Volume 97, ISSUE 9, P1481-1486, September 2016

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Comparison of Rates of Hospitalization and Emergency Department Visits Using Self-Report and South Carolina Administrative Billing Data Among a Population-Based Cohort With Spinal Cord Injury

Published:April 12, 2016DOI:



      To compare self-report and South Carolina administrative billing data documentation of emergency department (ED) visits and hospitalizations in the past 12 months among a population-based cohort of persons with spinal cord injury (SCI).


      Cross-sectional study.


      SCI surveillance system in South Carolina.


      Persons (N=605) sustaining a traumatic SCI between January 1, 1998 and December 31, 2011 in South Carolina who, at the time of study assessment, were adults, were >1 years postinjury, and had not made a complete recovery.


      Not applicable.

      Main Outcome Measures

      Hospitalizations and ED visits in the past 12 months.


      There was a significantly higher rate of reporting >1 hospitalizations in the past year for self-report (36%) as compared with South Carolina administrative billing data (26%) (P<.001), but not for >1 ED visits (48% vs 45%; P=.11). Decreased physical health and increased injury severity were associated with higher reporting rates of hospitalization. Physical health and injury severity were predictive of both self-report and South Carolina administrative billing data of hospitalizations, whereas years postinjury and race were also predictors of South Carolina administrative billing data hospitalizations.


      Our comparison of self-report and South Carolina administrative billing data hospitalizations and ED visits showed a significantly higher rate of reporting of hospitalizations using self-report, specifically among those with poor physical health and higher injury severity. Future work should look at different ways of asking about health care utilization and compare with South Carolina administrative billing data documentation to identify the best ways to assess through self-report.


      List of abbreviations:

      ED (emergency department), ICD-9-CM (International Classification of Diseases, Ninth Revision, Clinical Modification), PHQ-9 (Patient Health Questionnaire), RQ (research question), SCI (spinal cord injury)
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