Epidemiology of Patient Record Duplication

Abstract

Objectives Duplicate patient records can increase costs and medical errors. We assessed the association between demographic factors, comorbidities, health care usage, and duplicate electronic health records.

Methods We analyzed the association between duplicate patient records and multiple demographic variables (race, Hispanic ethnicity, sex, and age) as well as the Charlson Comorbidity Index (CCI), number of diagnoses, and number of health care encounters. The study population included 3,018,413 patients seen at a large urban academic medical center with at least one recorded diagnosis. Duplication of patient medical records was determined by using a previously validated enterprise Master Person Index.

Results Unknown or missing demographic data, Black race when compared with White race (odds ratio [OR]: 1.35, p < 0.001), Hispanic compared with non-Hispanic ethnicity (OR: 1.48, p < 0.001), older age (OR: 1.01, p < 0.001), and “Other” sex compared with female sex (OR: 4.71, p < 0.001) were associated with higher odds of having a duplicate record. Comorbidities (CCI, OR: 1.10, p < 0.001) and more encounters with the health care system (OR: 1.01, p < 0.001) were also associated with higher odds of having a duplicate record. In contrast, male sex compared with female sex was associated with lower odds of having a duplicate record (OR: 0.88, p < 0.001).

Conclusion The odds of duplications in medical records were higher in Black, Hispanic, older, nonmale patients with more health care encounters, more comorbidities, and unknown demographic data. Understanding the epidemiology of duplicate records can help guide prevention and mitigation efforts for high-risk populations. Duplicate records can contribute to disparities in health care outcomes for minority populations.

Keywords

medical records systems, computerized - patient safety - health care disparities - race factors - epidemiology - clinical data management - clinical information systems

Authors' Contributions

All authors participated in the problem formulation and experimental design. O.S., A.Z., R.J.A., and T.R.J. analyzed the data. All authors participated in drafting and revising the manuscript.

Human Subjects Protection Statement

This study has been approved by the Committee for the Protection of Human Subjects (the UTHSC-H IRB) under protocol HSC-SBMI-13-0549.

Data Availability Statement

The data underlying this article cannot be shared publicly due to the fact that these data are individually identifiable and represent real-world patients.

Publication History

Received: 06 June 2024

Accepted: 26 September 2024

Accepted Manuscript online:
27 September 2024

Article published online:
08 January 2025

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