Can caregivers report their care recipients’ post-stroke hospitalizations and outpatient visits accurately? Findings of an Asian prospective stroke cohort
Abstract Background Health services research aimed at understanding service use and improving resource allocation often relies on collecting subjectively reported or proxy-reported healthcare service utilization (HSU) data. It is important to know the discrepancies in such self or proxy reports, as...
| Main Authors: | , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2018-10-01
|
| Series: | BMC Health Services Research |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12913-018-3634-4 |
| _version_ | 1817985837671907328 |
|---|---|
| author | Shilpa Tyagi Gerald Choon-Huat Koh Nan Luo Kelvin Bryan Tan Helen Hoenig David B. Matchar Joanne Yoong Eric A. Finkelstein Kim En Lee N. Venketasubramanian Edward Menon Kin Ming Chan Deidre Anne De Silva Philip Yap Boon Yeow Tan Effie Chew Sherry H. Young Yee Sien Ng Tian Ming Tu Yan Hoon Ang Keng He Kong Rajinder Singh Reshma A. Merchant Hui Meng Chang Tseng Tsai Yeo Chou Ning Angela Cheong Yu Li Ng Chuen Seng Tan |
| author_facet | Shilpa Tyagi Gerald Choon-Huat Koh Nan Luo Kelvin Bryan Tan Helen Hoenig David B. Matchar Joanne Yoong Eric A. Finkelstein Kim En Lee N. Venketasubramanian Edward Menon Kin Ming Chan Deidre Anne De Silva Philip Yap Boon Yeow Tan Effie Chew Sherry H. Young Yee Sien Ng Tian Ming Tu Yan Hoon Ang Keng He Kong Rajinder Singh Reshma A. Merchant Hui Meng Chang Tseng Tsai Yeo Chou Ning Angela Cheong Yu Li Ng Chuen Seng Tan |
| author_sort | Shilpa Tyagi |
| collection | DOAJ |
| description | Abstract Background Health services research aimed at understanding service use and improving resource allocation often relies on collecting subjectively reported or proxy-reported healthcare service utilization (HSU) data. It is important to know the discrepancies in such self or proxy reports, as they have significant financial and policy implications. In high-dependency populations, such as stroke survivors, with varying levels of cognitive impairment and dysphasia, caregivers are often potential sources of stroke survivors’ HSU information. Most of the work conducted on agreement analysis to date has focused on validating different sources of self-reported data, with few studies exploring the validity of caregiver-reported data. Addressing this gap, our study aimed to quantify the agreement across the caregiver-reported and national claims-based HSU of stroke patients. Methods A prospective study comprising multi-ethnic stroke patient and caregiver dyads (N = 485) in Singapore was the basis of the current analysis, which used linked national claims records. Caregiver-reported health services data were collected via face-to-face and telephone interviews, and similar health services data were extracted from the national claims records. The main outcome variable was the modified intraclass correlation coefficient (ICC), which provided the level of agreement across both data sources. We further identified the amount of over- or under-reporting by caregivers across different service types. Results We observed variations in agreement for different health services, with agreement across caregiver reports and national claims records being the highest for outpatient visits (specialist and primary care), followed by hospitalizations and emergency department visits. Interestingly, caregivers over-reported hospitalizations by approximately 49% and under-reported specialist and primary care visits by approximately 20 to 30%. Conclusions The accuracy of the caregiver-reported HSU of stroke patients varies across different service types. Relatively more objective data sources, such as national claims records, should be considered as a first choice for quantifying health care usage before considering caregiver-reported usage. Caregiver-reported outpatient service use was relatively more accurate than inpatient service use over shorter recall periods. Therefore, in situations where objective data sources are limited, caregiver-reported outpatient information can be considered for low volumes of healthcare consumption, using an appropriate correction to account for potential under-reporting. |
| first_indexed | 2024-04-14T00:03:02Z |
| format | Article |
| id | doaj.art-6193a2cbe11f4faf98752a03279c16f6 |
| institution | Directory Open Access Journal |
| issn | 1472-6963 |
| language | English |
| last_indexed | 2024-04-14T00:03:02Z |
| publishDate | 2018-10-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Health Services Research |
| spelling | doaj.art-6193a2cbe11f4faf98752a03279c16f62022-12-22T02:23:39ZengBMCBMC Health Services Research1472-69632018-10-011811810.1186/s12913-018-3634-4Can caregivers report their care recipients’ post-stroke hospitalizations and outpatient visits accurately? Findings of an Asian prospective stroke cohortShilpa Tyagi0Gerald Choon-Huat Koh1Nan Luo2Kelvin Bryan Tan3Helen Hoenig4David B. Matchar5Joanne Yoong6Eric A. Finkelstein7Kim En Lee8N. Venketasubramanian9Edward Menon10Kin Ming Chan11Deidre Anne De Silva12Philip Yap13Boon Yeow Tan14Effie Chew15Sherry H. Young16Yee Sien Ng17Tian Ming Tu18Yan Hoon Ang19Keng He Kong20Rajinder Singh21Reshma A. Merchant22Hui Meng Chang23Tseng Tsai Yeo24Chou Ning25Angela Cheong26Yu Li Ng27Chuen Seng Tan28Saw Swee Hock School of Public Health, National University of SingaporeSaw Swee Hock School of Public Health, National University of SingaporeSaw Swee Hock School of Public Health, National University of SingaporePolicy Research & Economics Office, Ministry of HealthPhysical Medicine and Rehabilitation Service, Durham VA Medical CentreProgram in Health Services and Systems Research, Duke-NUS Graduate Medical SchoolSaw Swee Hock School of Public Health, National University of SingaporeProgram in Health Services and Systems Research, Duke-NUS Graduate Medical SchoolLee Kim En Neurology Pte LtdRaffles Neuroscience Centre, Raffles HospitalSt. Andrew’s Community HospitalMount Alvernia HospitalNational Neuroscience Institute, Singapore General Hospital campusGeriatric Medicine, Khoo Teck Puat HospitalSt. Luke’s HospitalDepartment of Rehabilitation Medicine, National University HospitalDepartment of Rehabilitation Medicine, Changi General HospitalDepartment of Rehabilitation Medicine, Singapore General HospitalDepartment of Neurology, National Neuroscience Institute, Neurology, Tan Tock Seng HospitalGeriatric Medicine, Khoo Teck Puat HospitalDepartment of Rehabilitation Medicine, Tan Tock Seng HospitalDepartment of Neurology, National Neuroscience Institute, Neurology, Tan Tock Seng HospitalDepartment of Medicine, Yong Loo Lin School of Medicine, National University of SingaporeNational Neuroscience Institute, Singapore General Hospital campusDepartment of Neurosurgery, National University HospitalDepartment of Neurosurgery, National University HospitalSaw Swee Hock School of Public Health, National University of SingaporePolicy Research & Economics Office, Ministry of HealthSaw Swee Hock School of Public Health, National University of SingaporeAbstract Background Health services research aimed at understanding service use and improving resource allocation often relies on collecting subjectively reported or proxy-reported healthcare service utilization (HSU) data. It is important to know the discrepancies in such self or proxy reports, as they have significant financial and policy implications. In high-dependency populations, such as stroke survivors, with varying levels of cognitive impairment and dysphasia, caregivers are often potential sources of stroke survivors’ HSU information. Most of the work conducted on agreement analysis to date has focused on validating different sources of self-reported data, with few studies exploring the validity of caregiver-reported data. Addressing this gap, our study aimed to quantify the agreement across the caregiver-reported and national claims-based HSU of stroke patients. Methods A prospective study comprising multi-ethnic stroke patient and caregiver dyads (N = 485) in Singapore was the basis of the current analysis, which used linked national claims records. Caregiver-reported health services data were collected via face-to-face and telephone interviews, and similar health services data were extracted from the national claims records. The main outcome variable was the modified intraclass correlation coefficient (ICC), which provided the level of agreement across both data sources. We further identified the amount of over- or under-reporting by caregivers across different service types. Results We observed variations in agreement for different health services, with agreement across caregiver reports and national claims records being the highest for outpatient visits (specialist and primary care), followed by hospitalizations and emergency department visits. Interestingly, caregivers over-reported hospitalizations by approximately 49% and under-reported specialist and primary care visits by approximately 20 to 30%. Conclusions The accuracy of the caregiver-reported HSU of stroke patients varies across different service types. Relatively more objective data sources, such as national claims records, should be considered as a first choice for quantifying health care usage before considering caregiver-reported usage. Caregiver-reported outpatient service use was relatively more accurate than inpatient service use over shorter recall periods. Therefore, in situations where objective data sources are limited, caregiver-reported outpatient information can be considered for low volumes of healthcare consumption, using an appropriate correction to account for potential under-reporting.http://link.springer.com/article/10.1186/s12913-018-3634-4HealthcareValidationCaregiverIntraclass correlation coefficientStroke |
| spellingShingle | Shilpa Tyagi Gerald Choon-Huat Koh Nan Luo Kelvin Bryan Tan Helen Hoenig David B. Matchar Joanne Yoong Eric A. Finkelstein Kim En Lee N. Venketasubramanian Edward Menon Kin Ming Chan Deidre Anne De Silva Philip Yap Boon Yeow Tan Effie Chew Sherry H. Young Yee Sien Ng Tian Ming Tu Yan Hoon Ang Keng He Kong Rajinder Singh Reshma A. Merchant Hui Meng Chang Tseng Tsai Yeo Chou Ning Angela Cheong Yu Li Ng Chuen Seng Tan Can caregivers report their care recipients’ post-stroke hospitalizations and outpatient visits accurately? Findings of an Asian prospective stroke cohort BMC Health Services Research Healthcare Validation Caregiver Intraclass correlation coefficient Stroke |
| title | Can caregivers report their care recipients’ post-stroke hospitalizations and outpatient visits accurately? Findings of an Asian prospective stroke cohort |
| title_full | Can caregivers report their care recipients’ post-stroke hospitalizations and outpatient visits accurately? Findings of an Asian prospective stroke cohort |
| title_fullStr | Can caregivers report their care recipients’ post-stroke hospitalizations and outpatient visits accurately? Findings of an Asian prospective stroke cohort |
| title_full_unstemmed | Can caregivers report their care recipients’ post-stroke hospitalizations and outpatient visits accurately? Findings of an Asian prospective stroke cohort |
| title_short | Can caregivers report their care recipients’ post-stroke hospitalizations and outpatient visits accurately? Findings of an Asian prospective stroke cohort |
| title_sort | can caregivers report their care recipients post stroke hospitalizations and outpatient visits accurately findings of an asian prospective stroke cohort |
| topic | Healthcare Validation Caregiver Intraclass correlation coefficient Stroke |
| url | http://link.springer.com/article/10.1186/s12913-018-3634-4 |
| work_keys_str_mv | AT shilpatyagi cancaregiversreporttheircarerecipientspoststrokehospitalizationsandoutpatientvisitsaccuratelyfindingsofanasianprospectivestrokecohort AT geraldchoonhuatkoh cancaregiversreporttheircarerecipientspoststrokehospitalizationsandoutpatientvisitsaccuratelyfindingsofanasianprospectivestrokecohort AT nanluo cancaregiversreporttheircarerecipientspoststrokehospitalizationsandoutpatientvisitsaccuratelyfindingsofanasianprospectivestrokecohort AT kelvinbryantan cancaregiversreporttheircarerecipientspoststrokehospitalizationsandoutpatientvisitsaccuratelyfindingsofanasianprospectivestrokecohort AT helenhoenig cancaregiversreporttheircarerecipientspoststrokehospitalizationsandoutpatientvisitsaccuratelyfindingsofanasianprospectivestrokecohort AT davidbmatchar cancaregiversreporttheircarerecipientspoststrokehospitalizationsandoutpatientvisitsaccuratelyfindingsofanasianprospectivestrokecohort AT joanneyoong cancaregiversreporttheircarerecipientspoststrokehospitalizationsandoutpatientvisitsaccuratelyfindingsofanasianprospectivestrokecohort AT ericafinkelstein cancaregiversreporttheircarerecipientspoststrokehospitalizationsandoutpatientvisitsaccuratelyfindingsofanasianprospectivestrokecohort AT kimenlee cancaregiversreporttheircarerecipientspoststrokehospitalizationsandoutpatientvisitsaccuratelyfindingsofanasianprospectivestrokecohort AT nvenketasubramanian cancaregiversreporttheircarerecipientspoststrokehospitalizationsandoutpatientvisitsaccuratelyfindingsofanasianprospectivestrokecohort AT edwardmenon cancaregiversreporttheircarerecipientspoststrokehospitalizationsandoutpatientvisitsaccuratelyfindingsofanasianprospectivestrokecohort AT kinmingchan cancaregiversreporttheircarerecipientspoststrokehospitalizationsandoutpatientvisitsaccuratelyfindingsofanasianprospectivestrokecohort AT deidreannedesilva cancaregiversreporttheircarerecipientspoststrokehospitalizationsandoutpatientvisitsaccuratelyfindingsofanasianprospectivestrokecohort AT philipyap cancaregiversreporttheircarerecipientspoststrokehospitalizationsandoutpatientvisitsaccuratelyfindingsofanasianprospectivestrokecohort AT boonyeowtan cancaregiversreporttheircarerecipientspoststrokehospitalizationsandoutpatientvisitsaccuratelyfindingsofanasianprospectivestrokecohort AT effiechew cancaregiversreporttheircarerecipientspoststrokehospitalizationsandoutpatientvisitsaccuratelyfindingsofanasianprospectivestrokecohort AT sherryhyoung cancaregiversreporttheircarerecipientspoststrokehospitalizationsandoutpatientvisitsaccuratelyfindingsofanasianprospectivestrokecohort AT yeesienng cancaregiversreporttheircarerecipientspoststrokehospitalizationsandoutpatientvisitsaccuratelyfindingsofanasianprospectivestrokecohort AT tianmingtu cancaregiversreporttheircarerecipientspoststrokehospitalizationsandoutpatientvisitsaccuratelyfindingsofanasianprospectivestrokecohort AT yanhoonang cancaregiversreporttheircarerecipientspoststrokehospitalizationsandoutpatientvisitsaccuratelyfindingsofanasianprospectivestrokecohort AT kenghekong cancaregiversreporttheircarerecipientspoststrokehospitalizationsandoutpatientvisitsaccuratelyfindingsofanasianprospectivestrokecohort AT rajindersingh cancaregiversreporttheircarerecipientspoststrokehospitalizationsandoutpatientvisitsaccuratelyfindingsofanasianprospectivestrokecohort AT reshmaamerchant cancaregiversreporttheircarerecipientspoststrokehospitalizationsandoutpatientvisitsaccuratelyfindingsofanasianprospectivestrokecohort AT huimengchang cancaregiversreporttheircarerecipientspoststrokehospitalizationsandoutpatientvisitsaccuratelyfindingsofanasianprospectivestrokecohort AT tsengtsaiyeo cancaregiversreporttheircarerecipientspoststrokehospitalizationsandoutpatientvisitsaccuratelyfindingsofanasianprospectivestrokecohort AT chouning cancaregiversreporttheircarerecipientspoststrokehospitalizationsandoutpatientvisitsaccuratelyfindingsofanasianprospectivestrokecohort AT angelacheong cancaregiversreporttheircarerecipientspoststrokehospitalizationsandoutpatientvisitsaccuratelyfindingsofanasianprospectivestrokecohort AT yuling cancaregiversreporttheircarerecipientspoststrokehospitalizationsandoutpatientvisitsaccuratelyfindingsofanasianprospectivestrokecohort AT chuensengtan cancaregiversreporttheircarerecipientspoststrokehospitalizationsandoutpatientvisitsaccuratelyfindingsofanasianprospectivestrokecohort |