title: Accuracy of Self-Reported Health Care Use in a Population-Based Sample of Homeless Adults.
abstract: OBJECTIVE
  To assess the accuracy of self-reported ambulatory care visits, emergency department (ED) encounters, and overnight hospitalizations in a population-based sample of homeless adults.
  
  
  METHODS
  Self-report survey data and administrative health care utilization databases.
  
  
  METHODS
  Self-reported health care use in the past 12 months was compared to administrative encounter records among 1,163 homeless adults recruited in 2004-2005 from shelters and meal programs in Toronto, Ontario.
  
  
  METHODS
  Self-reported health care use was assessed using a structured face-to-face survey. Each participant was linked to administrative databases using a unique personal health number or their first name, last name, sex, and date of birth.
  
  
  RESULTS
  The sensitivity of self-report for ambulatory care visits, ED encounters, and overnight hospitalizations was 89, 80, and 73 percent, respectively; specificity was 37, 83, and 91 percent. The mean difference between self-reported and documented number of encounters in the past 12 months was +1.6 for ambulatory care visits (95 percent CI = 0.4, 2.8), -0.6 for ED encounters (95 percent CI = -0.8, -0.4), and 0.0 for hospitalizations (95 percent CI = 0.0, 0.1).
  
  
  CONCLUSIONS
  Adults experiencing homelessness are quite accurate reporters of their use of health care, especially for ED encounters and hospitalizations.
authors.affiliation: Centre for Research on Inner City Health, Li Ka Shing Knowledge Institute of St. Michael's Hospital, Toronto, ON, Canada.|Division of General Internal Medicine, Department of Medicine, University of Toronto, Toronto, ON, Canada.
authors.forename: Stephen W
authors.initials: SW
authors.lastname: Hwang
authors.affiliation: Centre for Research on Inner City Health, Li Ka Shing Knowledge Institute of St. Michael's Hospital, Toronto, ON, Canada.
authors.forename: Catharine
authors.initials: C
authors.lastname: Chambers
authors.affiliation: Department of Research Design and Biostatistics, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.
authors.forename: Marko
authors.initials: M
authors.lastname: Katic
mesh_terms: D000328:Adult; D000367:Age Factors; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006304:Health Status; D006703:Ill-Housed Persons / Q000706:statistics & numerical data*; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D009864:Ontario; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D015203:Reproducibility of Results; D057566:Self Report; D012959:Socioeconomic Factors
keywords: Homeless persons; administrative data; health care utilization; self-report