Self-report versus care provider registration of healthcare utilization: Impact on cost and cost-utility

Hoogendoorn, Martine; Wetering, C.R. van; Schols, Annemie; Mölken, Maureen P.M.H. Rutten-van

doi:10.1017/s0266462309990432

Cited by 18 publications

(19 citation statements)

References 17 publications

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“…Hoogendoorn et al compared self-report versus care provider registration of healthcare utilizations and its impact on cost and cost-utility. They found that the degree of under-reporting was independently associated with loss to follow-up and total costs, showing that those lost to follow-up had larger differences in costs between registrations and self-reports compared with full participants [27].…”

Section: Discussionmentioning

confidence: 99%

“…The impact of that difference on, for example, cost-effectiveness studies should be taken into consideration. For example, Hoogendoorn et al found that despite the almost perfect agreement on hospitalizations and hospital days, the cost difference was highest for this type of care, approximately 390 euros [27].…”

Section: Discussionmentioning

confidence: 99%

“…Those who do not respond at follow-up are generally older [21]–[25],less educated [8], [25], have lower socioeconomic status [23], live alone [25], have more functional impairments [8], [21], [25], [26], suffer from more comorbidities [21], [22], and are more inaccurate in self-reporting costs compared with participants who completed the study [27]. However, others found no difference between respondents and those who were lost to follow-up, and assumed that attrition was non-selective [9], [28], [29].…”

Section: Introductionmentioning

confidence: 99%

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Self-Report of Healthcare Utilization among Community-Dwelling Older Persons: A Prospective Cohort Study

et al. 2014

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BackgroundSelf-reported data are often used for estimates on healthcare utilization in cost-effectiveness studies.ObjectiveTo analyze older adults’ self-report of healthcare utilization compared to data obtained from the general practitioners’ (GP) electronic medical record (EMR) and to study the differences in healthcare utilization between those who completed the study, those who did not respond, and those lost to follow-up.MethodsA prospective cohort study was conducted among community-dwelling persons aged 70 years and above, without dementia and not living in a nursing home. Self-reporting questionnaires were compared to healthcare utilization data extracted from the EMR at the GP-office.ResultsOverall, 790 persons completed questionnaires at baseline, median age 75 years (IQR 72–80), 55.8% had no disabilities in (instrumental) activities of daily living. Correlations between self-report data and EMR data on healthcare utilization were substantial for ‘hospitalizations’ and ‘GP home visits’ at 12 months intraclass correlation coefficient 0.63 (95% CI; 0.58–0.68). Compared to the EMR, self-reported healthcare utilization was generally slightly over-reported. Non-respondents received more GP home visits (p<0.05). Of the participants who died or were institutionalized 62.2% received 2 or more home visits (p<0.001) and 18.9% had 2 or more hospital admissions (p<0.001) versus respectively 18.6% and 3.9% of the participants who completed the study. Of the participants lost to follow-up for other reasons 33.0% received 2 or more home visits (p<0.01) versus 18.6 of the participants who completed the study.ConclusionsSelf-report of hospitalizations and GP home visits in a broadly ‘healthy’ community-dwelling older population seems adequate and efficient. However, as people become older and more functionally impaired, collecting healthcare utilization data from the EMR should be considered to avoid measurement bias, particularly if the data will be used to support economic evaluation.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Self-Report of Healthcare Utilization among Community-Dwelling Older Persons: A Prospective Cohort Study

et al. 2014

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“…Like other retrospective cost assessments, this study was prone to recall error regarding utilisation of healthcare services. As far as recall abilities of parents are not associated with their child’s exposure to tobacco smoke, this should only influence the estimated average costs, not the differences between groups [42,43]. Additionally, our results may not be fully representative for the German population with regard to health-related as well as socio-demographic characteristics.…”

Section: Discussionmentioning

confidence: 90%

Exposure to second-hand smoke and direct healthcare costs in children – results from two German birth cohorts, GINIplus and LISAplus

Batscheider

Zakrzewska

Heinrich

et al. 2012

BMC Health Serv Res

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BackgroundAlthough the negative health consequences of the exposure to second hand tobacco smoke during childhood are already known, evidence on the economic consequences is still rare. The aim of this study was to estimate excess healthcare costs of exposure to tobacco smoke in German children.MethodsThe study is based on data from two birth cohort studies of 3,518 children aged 9-11 years with information on healthcare utilisation and tobacco smoke exposure: the GINIplus study (German Infant Study On The Influence Of Nutrition Intervention Plus Environmental And Genetic Influences On Allergy Development) and the LISAplus study (Influence of Life-Style Factors On The Development Of The Immune System And Allergies In East And West Germany Plus The Influence Of Traffic Emissions And Genetics). Direct medical costs were estimated using a bottom-up approach (base year 2007). We investigated the impact of tobacco smoke exposure in different environments on the main components of direct healthcare costs using descriptive analysis and a multivariate two-step regression analysis.ResultsDescriptive analysis showed that average annual medical costs (physician visits, physical therapy and hospital treatment) were considerably higher for children exposed to second-hand tobacco smoke at home (indoors or on patio/balcony) compared with those who were not exposed. Regression analysis confirmed these descriptive trends: the odds of positive costs and the amount of total costs are significantly elevated for children exposed to tobacco smoke at home after adjusting for confounding variables. Combining the two steps of the regression model shows smoking attributable total costs per child exposed at home of €87 [10–165] (patio/balcony) and €144 [6–305] (indoors) compared to those with no exposure. Children not exposed at home but in other places showed only a small, but not significant, difference in total costs compared to those with no exposure.ConclusionsThis study shows adverse economic consequences of second-hand smoke in children depending on proximity of exposure. Tobacco smoke exposure seems to affect healthcare utilisation in children who are not only exposed to smoke indoors but also if parents reported exclusively smoking on patio or balcony. Preventing children from exposure to second-hand tobacco smoke might thus be desirable not only from a health but also from an economic perspective.

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“…9 Several studies have validated use of cost questionnaires for collection of the wide range of these patient expenses. 10,11,12,13 Table 3 is a list of definitions of non-reimbursed and out-of-pocket costs collected in this study. 14 …”

Section: Methodsmentioning

confidence: 99%

Patients' annual income adequacy, insurance premiums and out-of-pocket expenses related to heart failure care

et al. 2014

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Self-report versus care provider registration of healthcare utilization: Impact on cost and cost-utility

Abstract: This study showed that the use of self-reported data or data from registrations effected within-group costs, but not between-group costs or the cost utility.

Cited by 18 publications

References 17 publications

Self-Report of Healthcare Utilization among Community-Dwelling Older Persons: A Prospective Cohort Study

Self-Report of Healthcare Utilization among Community-Dwelling Older Persons: A Prospective Cohort Study

Exposure to second-hand smoke and direct healthcare costs in children – results from two German birth cohorts, GINIplus and LISAplus

Patients' annual income adequacy, insurance premiums and out-of-pocket expenses related to heart failure care

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