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2005: Lubeck Deborah P; Hubert Helen B
Self-report was a viable method for obtaining health care utilization data in community-dwelling seniors.
Journal of clinical epidemiology 2005;58(3):286-90.
OBJECTIVE: Patient self-report and audits of medical records are the most common approaches for obtaining information on utilization of medical services. Because of the time and cost savings associated with self-report, it is important to demonstrate the reliability of this approach, particularly in older persons who use more medical resources but may have poorer recall. STUDY DESIGN AND SETTING: We contacted the medical providers of a random sample of seniors (n = 150) who participated in an ongoing study of health care use. Providers' reports on the participant's medical utilization in the prior year were compared with patients' self-report over the same time period using weighted kappa statistics. RESULTS: Perfect or almost perfect agreement (weighted kappa = 0.80-1.00) was obtained for physician, hospital, and emergency department visits and high-cost therapies (chemotherapy, radiation therapy). Agreement was substantial (weighted kappa = 0.60-0.80) for x-ray procedures and prescription medications and moderate (weighted kappa = 0.40-0.60) for outpatient procedures and diagnostic tests. CONCLUSION: Participant self-report is a viable, reasonably accurate method to obtain information on most types of medical utilization in an older study cohort.

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