Predictors of self-report of heart failure in a population-based survey of older adults.

TitlePredictors of self-report of heart failure in a population-based survey of older adults.
Publication TypeJournal Article
Year of Publication2012
AuthorsGure, TR, McCammon, RJ, Cigolle, CT, Koelling, TM, Blaum, CS, Langa, KM
JournalCirc Cardiovasc Qual Outcomes
Date Published2012 May
ISSN Number1941-7705
KeywordsAge Factors, Aged, Aged, 80 and over, Algorithms, Awareness, Chi-Square Distribution, Comorbidity, Female, Health Knowledge, Attitudes, Practice, Health Status, Health Surveys, Heart Failure, Humans, Insurance Claim Review, Logistic Models, Male, Medicare, Odds Ratio, Patients, Predictive Value of Tests, Self Report, Socioeconomic factors, United States

BACKGROUND: Little research has been conducted on the predictors of self-report or patient awareness of heart failure (HF) in a population-based survey. The objective of this study was to (1) test the agreement between Medicare administrative and Health and Retirement Study (HRS) survey data and (2) determine predictors associated with self-report of HF, using a validated Medicare claims algorithm as the reference standard. We hypothesized that those who self-reported HF were more likely to have a higher number of HF-related claims.

METHODS AND RESULTS: Secondary data analysis was conducted using the 2004 wave of the HRS linked to 2002 to 2004 Medicare claims (n=5573 respondents aged ≥ 67 years). Concordance between self-report of HF in the HRS and Medicare claims was calculated. Logistic regression was performed to identify predictors associated with self-report HF. HF prevalence by self-report was 4.6%. Self-report of HF and claims agreement was 87% (κ=0.34). The presence of >1 HF inpatient claims was associated with greater odds of self-report (odds ratio [OR], 1.92; 95% CI, 1.23-3.00). Greater odds of self-reporting HF was also associated with ≥ 4 HF claims (OR, 2.74; 95% CI, 1.36-5.52). Blacks (OR, 0.28; 95% CI, 0.14-0.55) and Hispanics (OR, 0.30; 95% CI, 0.11-0.83) were less likely to self-report HF compared with whites in the final model.

CONCLUSIONS: Self-report of HF is an insensitive method for accurately identifying HF cases, especially in those with less-severe disease and who are nonwhite. There may be limited awareness of HF among older minority patients despite having clinical encounters during which HF is coded as a diagnosis.

User Guide Notes

Endnote Keywords

medicare claims/heart disease/self-reported health

Endnote ID


Alternate JournalCirc Cardiovasc Qual Outcomes
Citation Key7710
PubMed ID22592753
PubMed Central IDPMC3370939
Grant ListK08 AG031837 / AG / NIA NIH HHS / United States
P30 AG024824 / AG / NIA NIH HHS / United States
U01 AG09740 / AG / NIA NIH HHS / United States
R01 AG027010-02S1 / AG / NIA NIH HHS / United States
R01 AG027010 / AG / NIA NIH HHS / United States
UL1 RR024986 / RR / NCRR NIH HHS / United States
U01 AG009740 / AG / NIA NIH HHS / United States
R01 AG030155 / AG / NIA NIH HHS / United States