Resource use data by patient report or hospital records: Do they agree?

Kennedy, Amy; Leigh-Brown, Anne P.; Torgerson, David; Campbell, James; Grant, Adrian

doi:10.1186/1472-6963-2-2

Cited by 24 publications

(17 citation statements)

References 11 publications

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“…Finally, the primary outcome in this study was based on patient self-reported completion of the follow-up visit. Other studies 59,60 have demonstrated high correlation between self-reports and documented health care use, particularly within a short recall period.…”

Section: Discussionmentioning

confidence: 93%

Patient-Centered Community Health Worker Intervention to Improve Posthospital Outcomes

et al. 2014

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IMPORTANCE Socioeconomic and behavioral factors can negatively influence posthospital outcomes among patients of low socioeconomic status (SES). Traditional hospital personnel often lack the time, skills, and community linkages required to address these factors.OBJECTIVE To determine whether a tailored community health worker (CHW) intervention would improve posthospital outcomes among low-SES patients. DESIGN, SETTING, AND PARTICIPANTSA 2-armed, single-blind, randomized clinical trial was conducted between April 10, 2011, and October 30, 2012, at 2 urban, academically affiliated hospitals. Of 683 eligible general medical inpatients (ie, low-income, uninsured, or Medicaid) that we screened, 237 individuals (34.7%) declined to participate. The remaining 446 patients (65.3%) were enrolled and randomly assigned to study arms. Nearly equal percentages of control and intervention group patients completed the follow-up interview (86.6% vs 86.9%).INTERVENTIONS During hospital admission, CHWs worked with patients to create individualized action plans for achieving patients' stated goals for recovery. The CHWs provided support tailored to patient goals for a minimum of 2 weeks. MAIN OUTCOMES AND MEASURESThe prespecified primary outcome was completion of primary care follow-up within 14 days of discharge. Prespecified secondary outcomes were quality of discharge communication, self-rated health, satisfaction, patient activation, medication adherence, and 30-day readmission rates.RESULTS Using intention-to-treat analysis, we found that intervention patients were more likely to obtain timely posthospital primary care (60.0% vs 47.9%; P = .02; adjusted odds ratio [OR], 1.52; 95% CI, 1.03-2.23), to report high-quality discharge communication (91.3% vs 78.7%; P = .002; adjusted OR, 2.94; 95% CI, 1.5-5.8), and to show greater improvements in mental health (6.7 vs 4.5; P = .02) and patient activation (3.4 vs 1.6; P = .05). There were no significant differences between groups in physical health, satisfaction with medical care, or medication adherence. Similar proportions of patients in both arms experienced at least one 30-day readmission; however, intervention patients were less likely to have multiple 30-day readmissions (2.3% vs 5.5%; P = .08; adjusted OR, 0.40; 95% CI, 0.14-1.06). Among the subgroup of 63 readmitted patients, recurrent readmission was reduced from 40.0% vs 15.2% (P = .03; adjusted OR, 0.27; 95% CI, 0.08-0.89). CONCLUSIONS AND RELEVANCEPatient-centered CHW intervention improves access to primary care and quality of discharge while controlling recurrent readmissions in a high-risk population. Health systems may leverage the CHW workforce to improve posthospital outcomes by addressing behavioral and socioeconomic drivers of disease. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT01346462

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Section: Discussionmentioning

confidence: 93%

Patient-Centered Community Health Worker Intervention to Improve Posthospital Outcomes

et al. 2014

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“…Some studies have shown that patient self-reporting underestimates resource use compared with medical records,5 – 7 although it is less inaccurate with shorter recall periods 7. Others, however, reported an overestimation of healthcare utilisation on the basis of patient self-reporting8 9 In reporting the timing of clinical events, patients have been shown to underestimate time intervals since last screening tests 10 11. There are, however, few data on the accuracy of self-reported waiting times.…”

Section: Discussionmentioning

confidence: 99%

Measuring access: how accurate are patient-reported waiting times?

Rutland

Rowberry

Patel

et al. 2008

Sexually Transmitted Infections

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“…In this way, we were able to achieve purposive sampling of distinct study groups for comparison. Participants were approached in person at the point of care and utilization history was based on participant self-report and confirmed with chart abstraction (Kennedy, Leigh-Brown, Torgerson, Campbell, & Grant, 2002). Information on presenting concern and visit diagnosis was extracted from the health record and categorized according to an obstetric triage acuity scale ranging from 1 (most acute) to 5 (least acute) (Smithson et al, 2013).…”

Section: Methodsmentioning

confidence: 99%

Understanding High Utilization of Unscheduled Care in Pregnant Women of Low Socioeconomic Status

Mehta

Carter

Vinoya

et al. 2017

Women's Health Issues

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Background Pregnant high utilizers of unscheduled care may be at particular risk for poor perinatal outcomes, but the drivers of this association have not been explored from the patient perspective. Purpose We sought to understand maternal preference for unscheduled hospital-based obstetric care to inform interventions and improve value of publicly funded care during pregnancy. Methods We conducted a comparative qualitative analysis of in-depth semistructured interviews. Low-income pregnant women presenting to an inner city hospital-based obstetric triage unit were purposively sampled, categorized as either high or low utilizers of unscheduled care, and interviewed about challenges faced in obtaining pregnancy care and reasons for choosing between unscheduled versus scheduled care delivery. Results Demographically, high utilizers were similar to low utilizers, but were more likely to report adverse childhood experiences (p = .01). All 40 participants reported resource constraints and perceived hospital-based unscheduled obstetric care to be more accessible than outpatient prenatal care. Beyond this, high (n = 20) and low (n = 20) utilizer narratives differed significantly. Two distinct high utilizer profiles emerged. Some high utilizers repetitively used unscheduled hospital-based services owing to psychosocial determinants. Other high utilizing participants were driven by severe experiences of illness insufficiently addressed by outpatient prenatal care. Low utilizer narratives demonstrated high self-efficacy and social support compared with high utilizers. Conclusions Low-value, unscheduled, hospital-based care utilization by pregnant women of low socioeconomic status was driven by unmet clinical and psychosocial need. Implications for Policy and/or Practice Tailored community-focused innovations that use unscheduled visits as signals of risk may improve value of both outpatient and inpatient maternity care and better address adverse perinatal outcomes in vulnerable subgroups.

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Resource use data by patient report or hospital records: Do they agree?

Cited by 24 publications

References 11 publications

Patient-Centered Community Health Worker Intervention to Improve Posthospital Outcomes

Patient-Centered Community Health Worker Intervention to Improve Posthospital Outcomes

Measuring access: how accurate are patient-reported waiting times?

Understanding High Utilization of Unscheduled Care in Pregnant Women of Low Socioeconomic Status

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