Are survey measures of medical care utilisation misleading? A comparison of self-reported medical care consumption with actual medical care utilisation.
Are survey measures of medical care utilisation misleading? A comparison of self-reported medical care consumption with actual medical care utilisation.
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医疗保健利用的调查措施是否具有误导性？
DOI：
10.1071/ah010091
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发表时间：
2001
期刊：
影响因子：
--
通讯作者：
B. O'Toole
中科院分区：
文献类型：
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作者：
R. Marshall;D. Grayson;Anthony F Jorm;B. O'Toole
从流行病学研究的自我报告数据的估计相比，从行政记录中提取的实际成本数据时，发现医疗消费成本的大幅高估。即使少数受试者实际上提供了两个或两个以上的服务，在两个星期的自我报告期间大大低估了他们的医疗保健消费，一个大的净高估的医疗保健消费的自我报告数据。这一发现具有重要意义的使用自我报告数据的调查，如澳大利亚统计局（ABS）的国家健康调查估计医疗服务消费。通过将澳大利亚越南退伍军人健康研究（AVVHS）的流行病学调查数据与健康保险委员会（HIC）或退伍军人事务部（DVA）支付福利的实际医疗保健数据相结合，我们能够直接比较自我报告的医疗保健消费与实际医疗保健利用率。比较显示，退伍军人的自我报告是衡量相对医疗保健消费的有效指标，因为那些在过去两周内报告医疗保健的人比那些没有报告的人更有可能是最近的消费者。如果将自我报告的比较扩大到两周自我报告期之后支付的养恤金数据，这种关系就更加密切。然而，HIC和DVA的数据证实，在过去两周内，只有51%的退伍军人自我报告的医疗保健消费实际上得到了服务。
A substantial over-estimate of medical care consumption cost was found when estimates from self-report data from an epidemiological study were compared to actual cost data extracted from administrative records. Even though the few subjects who were actually provided with two or more services in the two-week self-report period substantially under-reported their medical care consumption, a large net over-estimate of medical care consumption was produced by the self-report data. This finding has important implications for use of self-report data from surveys such as the Australian Bureau of Statistics (ABS) National Health Survey for estimating health service consumption. By combining epidemiological survey data from the Australian Vietnam Veterans Health Study (AVVHS), with data on actual medical care for which the Health Insurance Commission (HIC) or the Department of Veterans' Affairs (DVA) paid benefits, we were able to directly compare self-reported medical care consumption with actual medical care utilisation. The comparison revealed that veterans' self-reports were a valid measure of relative medical care consumption because those who reported care over the past two weeks were much more likely to have been recent consumers than those who did not. This relationship became even stronger if the comparison of self-report was extended to data on benefits paid beyond the two-week self-report period. However, the HIC and DVA data confirmed only 51% of veterans self-reporting medical care consumption during the past two weeks actually received a service.