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

Published online by Cambridge University Press:  22 October 2009

Martine Hoogendoorn ,
Carel R. van Wetering ,
Annemie M. Schols  and
Maureen P. M. H. Rutten-van Mölken
Martine Hoogendoorn
Affiliation:
Erasmus MC/University
Carel R. van Wetering
Affiliation:
Máxima Medical Centre
Annemie M. Schols
Affiliation:
Maastricht University Medical Centre
Maureen P. M. H. Rutten-van Mölken
Affiliation:
Erasmus MC/University
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Abstract

Objectives: This study aims to compare the impact of two different sources of resource use, self-report versus care provider registrations, on cost and cost utility.

Methods: Data were gathered for a cost-effectiveness study performed alongside a 2-year randomized controlled trial evaluating the effect of an INTERdisciplinary COMmunity-based management program (INTERCOM) for patients with chronic obstructive pulmonary disease (COPD). The program was offered by physiotherapists, dieticians and respiratory nurses. During the 2-year period, patients reported all resource use in a cost booklet. In addition, data on hospital admissions and outpatient visits, visits to the physiotherapist, dietician or respiratory nurse, diet nutrition, and outpatient medication were obtained from administrative records. The cost per quality-adjusted life-year (QALY) was calculated in two ways, using data from the cost booklet or registrations.

Results: In total, 175 patients were included in the study. Agreement between self-report and registrations was almost perfect for hospitalizations (rho = 0.93) and physiotherapist visits (rho = 0.86), but above 0.55, moderate, for all other types of care. The total cost difference between the registrations and the cost booklet was 464 euros with the highest difference for hospitalizations 386 euro. Based on the cost booklet the cost difference between the treatment group and usual care was 2,444 euros (95 percent confidence interval [CI], −819 to 5,950), which resulted in a cost-utility of 29,100 euro/QALY. For the registrations, the results were 2,498 euros (95 percent CI, −88 to 6,084) and 29,390 euro/QALY, respectively.

Conclusions: 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.

Keywords

Self-reportRegistrationsResource UseCostCost utilityCOPDDiary
Type
Research Reports
Information
International Journal of Technology Assessment in Health Care , Volume 25 , Issue 4 , October 2009 , pp. 588 - 595
Copyright
Copyright © Cambridge University Press 2009

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References

REFERENCES

1. Bhandari, A, Wagner, T. Self-reported utilization of health care services: Improving measurement and accuracy. Med Care Res Rev. 2006;63:217–235.CrossRefGoogle ScholarPubMed
2. Bellon, JA, Lardelli, P, Luna, JD, Delgado, A. Validity of self reported utilisation of primary health care services in an urban population in Spain. J Epidemiol Community Health. 2000;54:544–551.CrossRefGoogle Scholar
3. Briggs, AH, Wonderling, DE, Mooney, CZ. Pulling cost-effectiveness analysis up by its bootstraps: A non-parametric approach to confidence interval estimation. Health Econ. 1997;6:327–340.3.0.CO;2-W>CrossRefGoogle ScholarPubMed
4. Cronan, TA, Walen, HR. Accuracy of self-reported healthcare use in patients with osteoarthritis. J Rheumatol. 2002;29:2181–2184.Google ScholarPubMed
5. Fenwick, E, O'Brien, BJ, Briggs, A. Cost-effectiveness acceptability curves–facts, fallacies and frequently asked questions. Health Econ. 2004;13:405–415.CrossRefGoogle ScholarPubMed
6. Goossens, ME, Rutten-van Molken, MP, Vlaeyen, JW, Van Der Linden, SM. The cost diary: A method to measure direct and indirect costs in cost-effectiveness research. J Clin Epidemiol. 2000;53:688–695.CrossRefGoogle ScholarPubMed
7. Hoogendoorn, M, van Wetering, CR, Schols, AM, Rutten-van Molken, MP. Is INTERdisciplinary COMmunity-based COPD management (INTERCOM) in patients with less advanced airflow obstruction cost-effective? Eur Respir J. [Epub ahead of print].Google Scholar
8. Lubeck, DP, Hubert, HB. Self-report was a viable method for obtaining health care utilization data in community-dwelling seniors. J Clin Epidemiol. 2005;58:286–290.CrossRefGoogle ScholarPubMed
9. Marks, AS, Lee, DW, Slezak, J, et al. Agreement between insurance claim and self-reported hospital and emergency room utilization data among persons with diabetes. Dis Manag. 2003;6:199–205.CrossRefGoogle ScholarPubMed
10. O'Callaghan, F. A multiple imputation strategy for missing data in longitudinal studies. Kwantitatieve methoden. 1999;62:111–122.Google Scholar
11. Oostenbrink, JB, Bouwmans, CAM, Koopmanschap, MA, Rutten, FF. Manual for costing research (in Dutch). Amstelveen: Healthcare Board, 2004.Google Scholar
12. Petrou, S, Murray, L, Cooper, P, Davidson, LL. The accuracy of self-reported healthcare resource utilization in health economic studies. Int J Technol Assess Health Care. 2002;18:705–710.CrossRefGoogle ScholarPubMed
13. Reijneveld, SA. The cross-cultural validity of self-reported use of health care: A comparison of survey and registration data. J Clin Epidemiol. 2000;53:267–272.CrossRefGoogle ScholarPubMed
14. Roberts, RO, Bergstralh, EJ, Schmidt, L, Jacobsen, SJ. Comparison of self-reported and medical record health care utilization measures. J Clin Epidemiol. 1996;49:989–995.CrossRefGoogle ScholarPubMed
15. Rosenbaum, PR. Reducing bias in observational studies using subclassification in the propensity score. J Am Stat Assoc. 1984;79:516–524.CrossRefGoogle Scholar
16. Rubin, DB, Schenker, N. Multiple imputation in health-care databases: An overview and some applications. Stat Med. 1991;10:585–598.CrossRefGoogle ScholarPubMed
17. Ungar, WJ, Coyte, PC. Health services utilization reporting in respiratory patients. Pharmacy Medication Monitoring Program Advisory Board. J Clin Epidemiol. 1998;51:1335–1342.CrossRefGoogle ScholarPubMed
18. Van Den Brink, M, Van Den Hout, WB, Stiggelbout, AM, van de Velde, CJ, Kievit, J. Cost measurement in economic evaluations of health care: Whom to ask? Med Care. 2004;42:740–746.CrossRefGoogle ScholarPubMed
19. Van Hout, BA, Al, MJ, Gordon, GS, Rutten, FF. Costs, effects and C/E-ratios alongside a clinical trial. Health Econ. 1994;3:309–319.CrossRefGoogle Scholar
20. Weissman, JS, Levin, K, Chasan-Taber, S, et al. The validity of self-reported health-care utilization by AIDS patients. Aids. 1996;10:775–783.CrossRefGoogle ScholarPubMed
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