Mind the Gap: A Retrospective Study of Discrepancies in Self-Reported and Administrative Database-Identified Mental Health Issues in Slovenia.

Abstract

Background: This study assessed discrepancies between self-reported and administrative data sources in identifying mental health issues in Slovenia, and investigated associated socio-demographic factors.

Methods: Data were linked from the 2019 Slovenian European Health Interview Survey (EHIS; n=9,900) and national health administrative databases capturing inpatient hospitalisations, outpatient prescription drugs and mental health-related sick leave. Mental health issues were identified in EHIS by self-report and in administrative databases using diagnostic codes and medication claims. Socio-demographic factors were obtained from EHIS. Discrepancies were assessed and multinomial logistic regression was used to analyse the association between these factors and the source of case identification.

Results: Of the 9,900 EHIS respondents, 1,336 (13.5%) self-reported mental health issues, while 1,675 (16.9%) were identified in administrative databases. Only 613 individuals (4.6% of the total sample) were identified in both sources. Older age was associated with being identified in both data sources and administrative data only compared to not being identified. Females and unemployed persons were more likely than males and employed persons to be identified as having mental health issues, regardless of the data source. Compared to those with primary education or lower, individuals with higher education were less likely to be identified in administrative data only or in both data sources.

Conclusions: discrepancies exist between self-reported and administrative data sources in identifying mental health issues. Discrepancies are associated with socio-demographic factors and may lead to different interpretations of population mental health. This study underscores the importance of cautiously interpreting self-reported and administrative health data in public health.