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Official statistics and claims data records indicate non-response and recall bias within survey-based estimates of health care utilization in the older population.

BMC Health Serv. Res. 13:1 (2013)
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Open Access Gold
Creative Commons Lizenzvertrag
UNLABELLED: ABSTRACT: BACKGROUND: The validity of survey-based health care utilization estimates in the older population has been poorly researched. Owing to data protection legislation and a great number of different health care insurance providers, the assessment of recall and non-response bias is challenging to impossible in many countries. The objective of our study was to compare estimates from a population-based study in older German adults with external secondary data. METHODS: We used data from the German KORA-Age study, which included 4,127 people aged 65-94 years. Self-report questions covered the utilization of long-term care services, inpatient services, outpatient services, and pharmaceuticals. We calculated age- and sex-standardized mean utilization rates in each domain and compared them with the corresponding estimates derived from official statistics and independent statutory health insurance data. RESULTS: The KORA-Age study underestimated the use of long-term care services (-52%), in-hospital days (-21%) and physician visits (-70%). In contrast, the assessment of drug consumption by postal self-report questionnaires yielded similar estimates to the analysis of insurance claims data (-9%). CONCLUSION: Survey estimates based on self-report tend to underestimate true health care utilization in the older population. Direct validation studies are needed to disentangle the impact of recall and non-response bias.
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Publikationstyp Artikel: Journalartikel
Dokumenttyp Wissenschaftlicher Artikel
Schlagwörter health care utilization; self-report; validity; survey; response bias; recall bias; claims data; Long-term-care ; Self-reports ; Service Utilization ; Insurance Claims ; Medicine Use ; Kora-age ; Costs ; Germany ; Cohort ; Risk
ISSN (print) / ISBN 1472-6963
e-ISSN 1472-6963
Quellenangaben Band: 13, Heft: 1 Seiten: , Artikelnummer: 1 Supplement: ,
Verlag BioMed Central
Begutachtungsstatus Peer reviewed