Self-Reported Utilization of Health Care Services: Improving Measurement and Accuracy
University of California, Berkeley, CA, USA.Medical Care Research and Review (Impact Factor: 2.62). 05/2006; 63(2):217-35. DOI: 10.1177/1077558705285298
Self-report is often used to estimate health care utilization. However, the accuracy of such data is of paramount concern. The authors conducted a systematic review of 42 studies that evaluated the accuracy of self-report utilization data, where utilization was defined as a visit to a clinical provider or entity. They also present a broad conceptual model that identifies major issues to consider when collecting, analyzing, and reporting such data. The results show that self-report data are of variable accuracy. Factors that affect accuracy include (1) sample population and cognitive abilities, (2) recall time frame, (3) type of utilization, (4) utilization frequency, (5) questionnaire design, (6) mode of data collection, and (7) memory aids and probes.
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- "Study participants were required to have an Ontario health insurance number , which resulted in the exclusion of individuals who were refugees or refugee claimants , had no legal status in Canada , or had arrived in Ontario within the past 3 months . Our study utilized a recall period of 12 months ( one of the most common recall time periods ) ; however , substantially different results might have been obtained using a shorter recall period ( Bhandari and Wagner 2006 ; Clifasefi et al . 2011 ) . "
ABSTRACT: To assess the accuracy of self-reported ambulatory care visits, emergency department (ED) encounters, and overnight hospitalizations in a population-based sample of homeless adults. Self-report survey data and administrative health care utilization databases. Self-reported health care use in the past 12 months was compared to administrative encounter records among 1,163 homeless adults recruited in 2004-2005 from shelters and meal programs in Toronto, Ontario. Self-reported health care use was assessed using a structured face-to-face survey. Each participant was linked to administrative databases using a unique personal health number or their first name, last name, sex, and date of birth. The sensitivity of self-report for ambulatory care visits, ED encounters, and overnight hospitalizations was 89, 80, and 73 percent, respectively; specificity was 37, 83, and 91 percent. The mean difference between self-reported and documented number of encounters in the past 12 months was +1.6 for ambulatory care visits (95 percent CI = 0.4, 2.8), -0.6 for ED encounters (95 percent CI = -0.8, -0.4), and 0.0 for hospitalizations (95 percent CI = 0.0, 0.1). Adults experiencing homelessness are quite accurate reporters of their use of health care, especially for ED encounters and hospitalizations. © Health Research and Educational Trust.Health Services Research 06/2015; DOI:10.1111/1475-6773.12329 · 2.78 Impact Factor
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- "Moreover, first, service utilization has been assessed by self-report, but the validity and reliability of such data has been challenged, especially in terms of non-response and recall bias, which is no issue in large health care utilization databases , . However, the NCS-A has not been linked with health care utilization databases, but instead provides self-reported information on service utilization for mental disorders based on a well-established instrument , . "
ABSTRACT: Background School mental health services are important contact points for children and adolescents with mental disorders, but their ability to provide comprehensive treatment is limited. The main objective was to estimate in mentally disordered adolescents of a nationally representative United States cohort the role of school mental health services as guide to mental health care in different out-of-school service sectors. Methods Analyses are based on weighted data (N = 6483) from the United States National Comorbidity Survey Replication Adolescent Supplement (participants' age: 13–18 years). Lifetime DSM-IV mental disorders were assessed using the fully structured WHO CIDI interview, complemented by parent report. Adolescents and parents provided information on mental health service use across multiple sectors, based on the Service Assessment for Children and Adolescents. Results School mental health service use predicted subsequent out-of-school service utilization for mental disorders i) in the medical specialty sector, in adolescents with affective (hazard ratio (HR) = 3.01, confidence interval (CI) = 1.77–5.12), anxiety (HR = 3.87, CI = 1.97–7.64), behavior (HR = 2.49, CI = 1.62–3.82), substance use (HR = 4.12, CI = 1.87–9.04), and eating (HR = 10.72, CI = 2.31–49.70) disorders, and any mental disorder (HR = 2.97, CI = 1.94–4.54), and ii) in other service sectors, in adolescents with anxiety (HR = 3.15, CI = 2.17–4.56), behavior (HR = 1.99, CI = 1.29–3.06), and substance use (HR = 2.48, CI = 1.57–3.94) disorders, and any mental disorder (HR = 2.33, CI = 1.54–3.53), but iii) not in the mental health specialty sector. Conclusions Our findings indicate that in the United States, school mental health services may serve as guide to out-of-school service utilization for mental disorders especially in the medical specialty sector across various mental disorders, thereby highlighting the relevance of school mental health services in the trajectory of mental care. In light of the missing link between school mental health services and mental health specialty services, the promotion of a stronger collaboration between these sectors should be considered regarding the potential to improve and guarantee adequate mental care at early life stages.PLoS ONE 06/2014; 9(6):e99675. DOI:10.1371/journal.pone.0099675 · 3.23 Impact Factor
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- "In line with previous studies, the level of agreement between self-reported and registered data decreases with the length of the recall period (cf. Bhandari and Wagner, 2006). The percentages of correctly self-reported hospitalization are 98.5, 98.4, 96.0, and 93.6 for w = 30, w = 91, w = 183, and w = 365, respectively. "
ABSTRACT: Self-reported data on health care use is a key input in a range of studies. However, the length of recall period in self-reported health care questions varies between surveys, and this variation may affect the results of the studies. This study uses a large survey experiment to examine the role of the length of recall periods for the quality of self-reported hospitalization data by comparing registered with self-reported hospitalizations of respondents exposed to recall periods of one, three, six, or twelve months. Our findings have conflicting implications for survey design, as the preferred length of recall period depends on the objective of the analysis. For an aggregated measure of hospitalization, longer recall periods are preferred. For analysis oriented more to the micro-level, shorter recall periods may be considered since the association between individual characteristics (e.g., education) and recall error increases with the length of the recall period.Journal of Health Economics 02/2014; 35C(1):34-46. DOI:10.1016/j.jhealeco.2014.01.007 · 2.58 Impact Factor