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NSQIP studies have also underscored the major limitations of claims data and administrative databases in the provision of adequate risk-adjustment models that are crucial for volume-outcome studies" [ 35].
The major limitation of this study is inherent to the use of administrative databases.
The major strengths of this study is the size and quality of the linked datasets and because the linkage is of routine administrative databases there is no responder burden so responder bias is not a problem.
However, this is unlikely to have had a major effect in our study because previous studies have reported high-levels of agreement in the coding of cesarean section between administrative databases and medical reviews (kappa > 0.98, where stated) [ 66- 68].
Health administrative databases can be used to track disease incidence, outcomes, and care quality.
Information in health administrative databases increasingly guides renal care and policy.
Information from administrative databases, industry-sponsored trials, and single institutions has inherent deficiencies.
Diagnostic codes used in administrative databases cause bias due to misclassification of patient disease status.
Thus, administrative databases still offer the only nationwide source of epidemiological data for orthopedic procedures.
Comorbidity measures are widely used in administrative databases to predict mortality.
For the purposes of the analysis deidentified database was created from the hospitals administrative databases.
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