Agreement between self-reported healthcare service use and administrative records in a longitudinal study of adults recently released from prison.

Stuart A. Kinner,Anna Kemp-Casey,Megan Carroll,Georgina Sutherland

doi:10.1186/s40352-016-0042-x

Abstract

BackgroundStudies of healthcare service use often rely on self-reported data, especially in disadvantaged populations. Despite this, the reliability of self-reported healthcare service use is often questioned and routinely-collected, administrative data are usually considered preferable. In this paper we examine the agreement between self-reported healthcare service use and administrative records, in a large cohort of adults recently released from prison in Australia.MethodsBaseline interviews within 6 weeks of expected release from prison and follow-up interviews at 1, 3 and 6 months post-release were linked to routinely-collected, administrative health records over the same time period. Outcomes of interest included use of primary care, emergency department presentation, hospitalisation and dispensing of subsidised pharmaceuticals. Kappa statistics and positive and negative predictive values were calculated for each service type and time point, and a modified Poisson regression was used to identify participant characteristics associated with better agreement.Results864 participants completed interviews and were successfully linked to administrative records. There was good agreement between self-report and administrative health records. Agreement between data sources at 1 month was best for psychotropic medications (kappa = 0.79) and primary care visits (kappa = 0.69).ConclusionDespite a common perception that studies using self-reported data are subject to bias, particularly among the disadvantaged, our findings suggest that self-reported healthcare may be valid in vulnerable populations.

Highlights

Studies of healthcare service use often rely on self-reported data, especially in disadvantaged populations
One quarter of participants (23%) were female and 20% identified as Indigenous (Aboriginal and/or Torres Strait Islander); the majority (61%) were aged 25 to 44 years (Table 1)
We found that agreement between self-report and administrative records was better over shorter time periods, with concordance between 7 and 11 percentage points lower when recall was over 3 months, than when it was over 1 month

Summary

Introduction

Studies of healthcare service use often rely on self-reported data, especially in disadvantaged populations. Given its frequent use in research, many studies have attempted to determine the validity of self-reported healthcare service utilisation (Bhandari and Wagner, 2006; Ritter et al 2001). There is often doubt about the accuracy of self-report among vulnerable groups such as drug users and ex-prisoners, there is little evidence that self-report to support this (Gelberg and Siecke 1997, Reijneveld and Stronks 2001, Raina et al 2002, Glass and Bucholz 2011 (Somers et al, 2016) This doubt can lead to a distrust of research based on self-report with these populations, and may contribute to suspicion of patients’ self-reported medical histories

Objectives

Methods

Results

Discussion

Conclusion