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Can caregivers report their care recipients' post-stroke hospitalizations and outpatient visits accurately? Findings of an Asian prospective stroke cohort.

Publication ,  Journal Article
Tyagi, S; Koh, GC-H; Luo, N; Tan, KB; Hoenig, H; Matchar, DB; Yoong, J; Finkelstein, EA; Lee, KE; Venketasubramanian, N; Menon, E; Chan, KM ...
Published in: BMC Health Serv Res
October 25, 2018

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.

Duke Scholars

Published In

BMC Health Serv Res

DOI

EISSN

1472-6963

Publication Date

October 25, 2018

Volume

18

Issue

1

Start / End Page

817

Location

England

Related Subject Headings

  • Survivors
  • Stroke
  • Singapore
  • Self Report
  • Research Design
  • Proxy
  • Prospective Studies
  • Primary Health Care
  • Middle Aged
  • Mental Recall
 

Citation

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Tyagi, S., Koh, G.-H., Luo, N., Tan, K. B., Hoenig, H., Matchar, D. B., … Tan, C. S. (2018). Can caregivers report their care recipients' post-stroke hospitalizations and outpatient visits accurately? Findings of an Asian prospective stroke cohort. BMC Health Serv Res, 18(1), 817. https://doi.org/10.1186/s12913-018-3634-4
Tyagi, Shilpa, Gerald Choon-Huat Koh, Nan Luo, Kelvin Bryan Tan, Helen Hoenig, David B. Matchar, Joanne Yoong, et al. “Can caregivers report their care recipients' post-stroke hospitalizations and outpatient visits accurately? Findings of an Asian prospective stroke cohort.BMC Health Serv Res 18, no. 1 (October 25, 2018): 817. https://doi.org/10.1186/s12913-018-3634-4.
Tyagi S, Koh GC-H, Luo N, Tan KB, Hoenig H, Matchar DB, et al. Can caregivers report their care recipients' post-stroke hospitalizations and outpatient visits accurately? Findings of an Asian prospective stroke cohort. BMC Health Serv Res. 2018 Oct 25;18(1):817.
Tyagi, Shilpa, et al. “Can caregivers report their care recipients' post-stroke hospitalizations and outpatient visits accurately? Findings of an Asian prospective stroke cohort.BMC Health Serv Res, vol. 18, no. 1, Oct. 2018, p. 817. Pubmed, doi:10.1186/s12913-018-3634-4.
Tyagi S, Koh GC-H, Luo N, Tan KB, Hoenig H, Matchar DB, Yoong J, Finkelstein EA, Lee KE, Venketasubramanian N, Menon E, Chan KM, De Silva DA, Yap P, Tan BY, Chew E, Young SH, Ng YS, Tu TM, Ang YH, Kong KH, Singh R, Merchant RA, Chang HM, Yeo TT, Ning C, Cheong A, Ng YL, Tan CS. Can caregivers report their care recipients' post-stroke hospitalizations and outpatient visits accurately? Findings of an Asian prospective stroke cohort. BMC Health Serv Res. 2018 Oct 25;18(1):817.
Journal cover image

Published In

BMC Health Serv Res

DOI

EISSN

1472-6963

Publication Date

October 25, 2018

Volume

18

Issue

1

Start / End Page

817

Location

England

Related Subject Headings

  • Survivors
  • Stroke
  • Singapore
  • Self Report
  • Research Design
  • Proxy
  • Prospective Studies
  • Primary Health Care
  • Middle Aged
  • Mental Recall