Please use this identifier to cite or link to this item: https://doi.org/10.1186/s12913-018-3634-4
Title: Can caregivers report their care recipients' post-stroke hospitalizations and outpatient visits accurately? Findings of an Asian prospective stroke cohort 11 Medical and Health Sciences 1117 Public Health and Health Services
Authors: Tyagi S. 
Koh G.C.-H. 
Luo N. 
Tan K.B.
Hoenig H.
Matchar D.B. 
Yoong J. 
Finkelstein E.A. 
Lee K.E.
Venketasubramanian N.
Menon E. 
Chan K.M.
De Silva D.A.
Yap P.
Tan B.Y.
Chew E. 
Young S.H.
Ng Y.S.
Tu T.M.
Ang Y.H.
Kong K.H.
Singh R.
Merchant R.A. 
Chang H.M. 
Yeo T.T.
Ning C.
Cheong A. 
Ng Y.L.
Tan C.S. 
Keywords: adult
article
caregiver
cohort analysis
controlled study
correlation coefficient
emergency ward
female
health science
hospital patient
hospitalization
human
major clinical study
male
outcome variable
outpatient care
primary medical care
prospective study
public health
recall
recipient
Singapore
stroke patient
telephone interview
validation process
validity
aged
ambulatory care
caregiver
cerebrovascular accident
clinical trial
cohort analysis
hospitalization
methodology
middle aged
multicenter study
primary health care
prospective study
proxy
psychology
self report
standards
statistics and numerical data
survivor
Adult
Aged
Ambulatory Care
Caregivers
Cohort Studies
Facilities and Services Utilization
Female
Hospitalization
Humans
Male
Mental Recall
Middle Aged
Primary Health Care
Prospective Studies
Proxy
Research Design
Self Report
Singapore
Stroke
Survivors
Issue Date: 2018
Citation: Tyagi S., Koh G.C.-H., Luo N., Tan K.B., Hoenig H., Matchar D.B., Yoong J., Finkelstein E.A., Lee K.E., Venketasubramanian N., Menon E., Chan K.M., De Silva D.A., Yap P., Tan B.Y., Chew E., Young S.H., Ng Y.S., Tu T.M., Ang Y.H., Kong K.H., Singh R., Merchant R.A., Chang H.M., Yeo T.T., Ning C., Cheong A., Ng Y.L., Tan C.S. (2018). Can caregivers report their care recipients' post-stroke hospitalizations and outpatient visits accurately? Findings of an Asian prospective stroke cohort 11 Medical and Health Sciences 1117 Public Health and Health Services. BMC Health Services Research 18 (1) : 817. ScholarBank@NUS Repository. https://doi.org/10.1186/s12913-018-3634-4
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. © 2018 The Author(s).
Source Title: BMC Health Services Research
URI: https://scholarbank.nus.edu.sg/handle/10635/175361
ISSN: 1472-6963
DOI: 10.1186/s12913-018-3634-4
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