Comparison of self-reported and medical record health care utilization measures
Comparison of self-reported and medical record health care utilization measures
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DOI：
10.1016/0895-4356(96)00143-6
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发表时间：
1996-09-01
影响因子：
7.2
通讯作者：
Jacobsen, SJ
中科院分区：
文献类型：
--
作者：
Roberts, RO;Bergstralh, EJ;Jacobsen, SJ
自我报告的卫生保健服务利用率在流行病学研究和卫生保健规划、政策和研究中很重要，这些信息的准确性至关重要。本研究在明尼苏达州奥姆斯特德县随机选择的500名年龄在40至79岁的社区居民中评估了自我报告的医疗保健服务利用率的有效性。男性之前完成了一份自我管理的问卷调查，该问卷调查了有关医疗保健服务利用的信息;问题包括前一年的住院总天数，前一年的门诊总就诊次数以及前2周的就诊次数。完整的社区医疗记录的男性进行了审查，自我报告的信息的准确性进行了评估，通过评估自我报告的使用和实际的医疗记录的使用，从医疗记录确定之间的差异，以及这些差异的分布。住院天数的准确同意率为93%，2周内门诊医生就诊的准确同意率为91%，上一年门诊医生就诊的准确同意率为30%。有一个增加的差异，自我报告和医疗记录的利用与住院夜或门诊医生访问的数量增加，以及一个显着的偏见，漏报与门诊医生访问的数量增加，在过去的一年。这些研究结果表明，自我报告的住院夜在前一年和门诊医生访问在2周内是合理准确的，但自我报告的门诊医生访问在前一年可能不太准确，并可能偏向于漏报在较高的访问次数。研究人员和卫生规划人员应使用自我报告的利用措施来考虑这些信息。
Self-reported utilization of health care services is important in epidemiological studies and in health care planning, policy, and research, and the accuracy of such information is essential. This study assessed the validity of self reported utilization of health care services in a randomly selected cohort of 500 community-dwelling men aged 40 to 79 years in Olmsted County, Minnesota. Men had previously completed a self-administered questionnaire that elicited information on utilization of health care services; questions included total inpatient hospital nights in the previous year, total ambulatory physician visits in the previous year, and physician visits in the previous 2 weeks. The complete community medical records of the men were reviewed, and the accuracy of self-reported information was evaluated by assessing the difference between self reported utilization and actual medical record utilization as ascertained from the medical records, and the distribution of these differences. Exact agreement was 93% for inpatient hospital nights, 91% for ambulatory physician visits in 2 weeks, and 30% for ambulatory physician visits in the previous year. There was an increase in the variability of the difference between self-reported and medical record utilization with an increasing number of inpatient nights or ambulatory physician visits, and a significant bias toward underreporting with an increasing number of ambulatory physician visits in the previous year. These findings suggest that self reported inpatient nights in the previous year and ambulatory physician visits in 2 weeks are reasonably accurate, but self-reported ambulatory physician visits in the previous year may be less accurate and likely to be biased toward underreporting at higher numbers of visits. This information should be taken into account by researchers and health planners using self-reported measures of utilization.