Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2020 Nov 23;20(1):1061.
doi: 10.1186/s12913-020-05920-0.

Comparison of self-report and administrative data sources to capture health care resource use in people with chronic obstructive pulmonary disease following pulmonary rehabilitation

Affiliations
Randomized Controlled Trial

Comparison of self-report and administrative data sources to capture health care resource use in people with chronic obstructive pulmonary disease following pulmonary rehabilitation

Chantal L Grimwood et al. BMC Health Serv Res. .

Abstract

Background: The optimal method to collect accurate healthcare utilisation data in people with chronic obstructive pulmonary disease (COPD) is not well established. The aim of this study was to determine feasibility and compare self-report and administrative data sources to capture health care resource use in people with COPD for 12 months following pulmonary rehabilitation.

Methods: This is a secondary analysis of a randomised controlled equivalence trial comparing centre-based and home-based pulmonary rehabilitation. Healthcare utilisation data were collected for 12 months following pulmonary rehabilitation from self-report (monthly telephone questionnaires and diaries) and administrative sources (Medicare Benefits Schedule, medical records). Feasibility was assessed by the proportion of self-reports completed and accuracy was established using month-by-month and per participant comparison of self-reports with administrative data.

Results: Data were available for 145/163 eligible study participants (89%, mean age 69 (SD 9) years, mean forced expiratory volume in 1 s 51 (SD 19) % predicted; n = 83 male). For 1725 months where data collection was possible, 1160 (67%) telephone questionnaires and 331 (19%) diaries were completed. Accuracy of recall varied according to type of health care encounter and self-report method, being higher for telephone questionnaire report of emergency department presentation (Kappa 0.656, p < 0.001; specificity 99%, sensitivity 59%) and hospital admission (Kappa 0.669, p < 0.001; specificity 97%, sensitivity 68%) and lower for general practitioner (Kappa 0.400, p < 0.001; specificity 62%, sensitivity 78%) and medical specialist appointments (Kappa 0.458, p < 0.001; specificity 88%, sensitivity 58%). A wide variety of non-medical encounters were reported (allied health and nursing) which were not captured in administrative data.

Conclusion: For self-reported methods of healthcare utilisation in people with COPD following pulmonary rehabilitation, monthly telephone questionnaires were more frequently completed and more accurate than diaries. Compared to administrative records, self-reports of emergency department presentations and inpatient admissions were more accurate than for general practitioner and medical specialist appointments.

Trial registration: NCT01423227 at clinicaltrials.gov.

Keywords: Accuracy; COPD; Diary; Health care utilisation; Hospitalisation; Medical records; Self-report.

PubMed Disclaimer

Conflict of interest statement

CFM has directed speaker’s fees from Menarini and Astra Zeneca to her institution (unrelated work).

References

    1. Drummond M, Sculpher M, Torrance G, O’Brien J, Stoddart G. Methods for the economic evaluation of health care programmes. 4. London: Oxford University Press; 2015.
    1. Lubeck D, Hubert H. Self-report was a viable method for obtaining health care utilization data in community-dwelling seniors. J Clin Epidemiol. 2005;58:286–290. doi: 10.1016/j.jclinepi.2004.06.011. - DOI - PubMed
    1. World Health Organisation, Global Health Observatory Data . Electronic health records. 2016.
    1. Heslop L. Activity-based funding for safety and quality: a policy discussion of issues and directions for nursing-focused health services outcomes research. Int J Nurs Pract. 2019;25:e12775. doi: 10.1111/ijn.12775. - DOI - PMC - PubMed
    1. Menachemi N, Collum T. Benefits and drawbacks of electronic health record systems. Risk Manag Healthcare Policy. 2011;4:47–55. doi: 10.2147/RMHP.S12985. - DOI - PMC - PubMed

Publication types

Associated data