Year-end Sale % OFF 
Abstract
BackgroundThe validity of survey-based health care utilization estimates in the older population has been poorly researched. Owing to data protection legislation and a great number of different health care insurance providers, the assessment of recall and non-response bias is challenging to impossible in many countries. The objective of our study was to compare estimates from a population-based study in older German adults with external secondary data.MethodsWe used data from the German KORA-Age study, which included 4,127 people aged 65–94 years. Self-report questions covered the utilization of long-term care services, inpatient services, outpatient services, and pharmaceuticals. We calculated age- and sex-standardized mean utilization rates in each domain and compared them with the corresponding estimates derived from official statistics and independent statutory health insurance data.ResultsThe KORA-Age study underestimated the use of long-term care services (−52%), in-hospital days (−21%) and physician visits (−70%). In contrast, the assessment of drug consumption by postal self-report questionnaires yielded similar estimates to the analysis of insurance claims data (−9%).ConclusionSurvey estimates based on self-report tend to underestimate true health care utilization in the older population. Direct validation studies are needed to disentangle the impact of recall and non-response bias.
Highlights
The validity of survey-based health care utilization estimates in the older population has been poorly researched
The purpose of this study was to compare estimates of health care utilization calculated from the populationbased German KORA-Age study with corresponding estimates obtained from official statistics and an independent statutory health insurance sample
As AOK insures a higher proportion of individuals with lower socio-economic status compared with other health insurance funds and as this may be associated with higher health service use, we conducted another sensitivity analysis in which we only considered KORAAge participants insured by the AOK
Summary
The validity of survey-based health care utilization estimates in the older population has been poorly researched. Owing to data protection legislation and a great number of different health care insurance providers, the assessment of recall and non-response bias is challenging to impossible in many countries. The objective of our study was to compare estimates from a population-based study in older German adults with external secondary data. Studies on resource utilization in the elderly population will gain in importance for reasons of financing and health services research. Health insurance claims data are generally considered to provide the most precise information on service utilization and costs [2]. In many countries linking health surveys with administrative data is challenging if not impossible [3]. Researchers have to contact numerous payers and service providers to collect comprehensive data, making this approach costly and timeconsuming in practice [4,5]
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
