Self-report was a viable method for obtaining health care utilization data in community-dwelling seniors.
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.


METHODS
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.


CONCLUSIONS
Participant self-report is a viable, reasonably accurate method to obtain information on most types of medical utilization in an older study cohort.
Lubeck
Deborah P
DP
Division of Immunology and Rheumatology, Stanford University, School of Medicine, 701 Welch Road, Suite 3305, Palo Alto, CA 94304, USA.
Hubert
Helen B
HB
D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D003625:Data Collection / Q000379:methods*; D005260:Female; D006302:Health Services Research / Q000379:methods; D006299:Health Services for the Aged / Q000706:statistics & numerical data*; D006761:Hospitals / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008499:Medical Records / Q000706:statistics & numerical data; D008511:Medicine / Q000706:statistics & numerical data; D011939:Mental Recall; D009819:Office Visits / Q000706:statistics & numerical data; D010414:Pennsylvania; D015203:Reproducibility of Results; D012650:Self Disclosure; D013038:Specialization; D014600:Utilization Review