Abstract
BackgroundValidated instruments collecting data on health-related resource use are lacking, but required, for example, to investigate predictors of healthcare use or for health economic evaluation.The objective of the study was to develop, test and refine a questionnaire collecting data on health-related resource use and expenditure in patients with diabetes.MethodsThe questionnaire was tested in 43 patients with diabetes mellitus types 1 and 2 in Germany. Response behaviour suggestive of problems with questions (item non-response, request for clarification, comments, inadequate answer, “don’t know”) was systematically registered. Cognitive interviews focusing on information retrieval and comprehension problems were carried out.ResultsMany participants had difficulties answering questions pertaining to frequency of visits to the general practitioner (26%), time spent receiving healthcare services (39%), regular medication currently taken (35%) and out of pocket expenditure on medication (42%). These difficulties seem to result mainly from poor memory. A number of comprehension problems were established and relevant questions were revised accordingly.ConclusionThe questionnaire on health-related resource use and expenditure for use in diabetes research in Germany was developed and refined after careful testing. Ideally, the questionnaire should be externally validated for different modes of administration and recall periods within a variety of populations.
Highlights
Validated instruments collecting data on health-related resource use are lacking, but required, for example, to investigate predictors of healthcare use or for health economic evaluation
Bertoldi et al [3] conducted a review of the methodologies used in household surveys on medication use (61 studies published between January 1995 and June 2008 were included in the review)
Development of a questionnaire on health-related resource use and expenditure for use in diabetes research Potentially relevant questions on health care utilisation were identified by reviewing German questionnaires obtained via Internet and personal communication with different research groups – mainly, instruments developed for large scale German health surveys and epidemiologic studies, by Robert Koch institute, by TNS Health care for the Health Care Monitor project, as well as instruments developed for the Cooperative Health Research in the Region of Augsburg (KORA) study [5] and the Heinz Nixdorf Recall study [6]
Summary
Validated instruments collecting data on health-related resource use are lacking, but required, for example, to investigate predictors of healthcare use or for health economic evaluation. Considerable work is usually undertaken in individual projects to develop selfreport tools (i.e. questionnaires or diaries) collecting data on health-related resource use. These tools and the results of their validation are seldom published and there seems to be a tendency to develop new questionnaires for new studies [3,4]. Bertoldi et al [3] conducted a review of the methodologies used in household surveys on medication use (61 studies published between January 1995 and June 2008 were included in the review) They showed that 70% of the studies did not publish the questions used to assess medication use; and 93.4% of the studies provided no information on the validity of the questionnaire employed to collect data on medication use. Publication of questionnaires, as well as results of their validation can contribute to the standardisation of data collection methods and comparability of results across different studies
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