title: Health service utilization in IBD: comparison of self-report and administrative data.
abstract: BACKGROUND
  The reliability of self-report regarding health care utilization in inflammatory bowel disease (IBD) is unknown. If proven reliable, it could help justify self-report as a means of determining health care utilization and associated costs.
  
  
  METHODS
  The Manitoba IBD Cohort Study is a population-based longitudinal study of participants diagnosed within 7 years of enrollment. Health care utilization was assessed through standardized interview. Participants (n = 352) reported the total number of nights hospitalized, frequency of physician contacts in the prior 12 months and whether the medical contacts were for IBD-related reasons or not. Reports of recent antibiotic use were also recorded. Actual utilization was drawn from the administrative database of Manitoba Health, the single comprehensive provincial health insurer.
  
  
  RESULTS
  According to the administrative data, 15% of respondents had an overnight hospitalization, while 10% had an IBD-related hospitalization. Self-report concordance was highly sensitive (92%; 82%) and specific (96%; 97%, respectively). 97% of participants had contact with a physician in the previous year, and 69% had IBD-related visits. Physician visits were significantly under-reported and there was a trend to over-report the number of nights in hospital.
  
  
  CONCLUSIONS
  Self-report data can be helpful in evaluating health service utilization, provided that the researcher is aware of the systematic sources of bias. Outpatient visits are well identified by self-report. The discordance for the type of outpatient visit may be either a weakness of self-report or a flaw in diagnosis coding of the administrative data. If administrative data are not available, self-report information may be a cost-effective alternative, particularly for hospitalizations.
authors.affiliation: University of Manitoba IBD Clinical and Research Centre, Winnipeg, Canada.
authors.forename: Teresa
authors.initials: T
authors.lastname: Longobardi
authors.forename: John R
authors.initials: JR
authors.lastname: Walker
authors.forename: Lesley A
authors.initials: LA
authors.lastname: Graff
authors.forename: Charles N
authors.initials: CN
authors.lastname: Bernstein
mesh_terms: D000328:Adult; D003093:Colitis, Ulcerative; D003362:Cost-Benefit Analysis; D003424:Crohn Disease; D003625:Data Collection / Q000379:methods*; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006296:Health Services / Q000191:economics / Q000706:statistics & numerical data*; D006305:Health Status Indicators; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000191:economics* / Q000453:epidemiology; D038801:International Classification of Diseases; D008297:Male; D008350:Manitoba / Q000453:epidemiology; D057566:Self Report