Evaluation of the ambulatory and home care record: Agreement between self-reports and administrative data.
OBJECTIVE
Although measuring the utilization of ambulatory and home-based healthcare resources is an essential component of economic analyses, very little methodological attention has been devoted to the development and evaluation of resource costing tools. This study evaluated a newly developed tool, the Ambulatory and Home Care Record (AHCR), which comprehensively evaluates costs incurred by the health system and care recipients and their unpaid caregivers.


METHODS
The level of agreement between self-reports from 110 cystic fibrosis care recipients and administrative data was assessed for four categories of health services: home-based visits with healthcare professionals, ambulatory visits with healthcare professionals, laboratory and diagnostic tests, and prescription medications.


RESULTS
Agreement between care recipients' reports on the AHCR and administrative data ranged from moderate (kappa = 0.41; 95 percent confidence interval, 0.16-0.61) for physician specialist visits to perfect (kappa = 1.0) for physiotherapy visits.


CONCLUSIONS
By evaluating and standardizing a resource and costing tool, such as the AHCR, economic evaluations may be improved and comparisons of the resource implications for different services and for diverse populations are possible.
Guerriere
Denise N
DN
Department of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario M5T 3M6, Canada. denise.guerriere@utoronto.ca
Ungar
Wendy J
WJ
Corey
Mary
M
Croxford
Ruth
R
Tranmer
Jennifer E
JE
Tullis
Elizabeth
E
Coyte
Peter C
PC
D000328:Adult; D000553:Ambulatory Care / Q000191:economics* / Q000706:statistics & numerical data; D017028:Caregivers / Q000191:economics* / Q000706:statistics & numerical data; D003365:Costs and Cost Analysis; D003550:Cystic Fibrosis / Q000191:economics; D005260:Female; D005102:Health Expenditures; D006699:Home Care Services / Q000191:economics* / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008499:Medical Records