Self-reports of health care utilization compared to provider records (original) (raw)
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Self-reports of health-care utilization: Diary or questionnaire?
International Journal of Technology Assessment in Health Care, 2005
Objectives:The feasibility and convergent validity of a cost diary and a cost questionnaire was investigated.Methods:Data were obtained as part of a cost-utility analysis alongside a multicenter clinical trial in patients with resectable rectal cancer. A sample of 107 patients from 30 hospitals was asked to keep a weekly diary during the first 3 months after surgery, and a monthly diary from 3 to 12 months after surgery. A second sample of seventy-two patients from twenty-eight hospitals in the trial received a questionnaire at 3, 6, and 12 months after surgery, referring to the previous 3 or 6 months. Format and items of the questions were similar and included a wide range of medical and nonmedical items and costs after hospitalization for surgery.Results:Small differences were found with respect to nonresponse (range, 79 to 86 percent) and missing questions (range, 1 to 6 percent between the diary and questionnaire). For most estimates of volumes of care and of costs, the diary an...
Patient and Physician Perceptions of Dimensions of Necessity of Medical Utilization
The goal of this research was to understand better the perspectives held by physicians and patients regarding what factors determine the appropriateness of medical visits. We also wished to create a convenient measure of those perspectives. In our first study, we conducted focus groups separately composed of 22 physicians and 16 patients to determine their respective views. In our second study, a 40-item measure derived from Study 1 themes was administered to a sample of 202 patients. Study 1 identified 20 themes, collapsing into 6 dimensions. Physicians held views that some patients were manipulative when seeking medical care. Study 2 revealed factors of “Symptom Experience” and “Doctor Expertise.” The two studies revealed that the perception of medical utilization varies between patients and physicians, but both groups share many similar beliefs.