PURPOSE: Self-reports of health care utilization are sometimes used to determine the effectiveness of interventions used in the care of patients with asthma. We compared self-reported (SR) frequency of emergency department (ED) and hospital admissions, number of in-patient hospital days, and number of clinic visits for a 6 month period in adult asthmatics to medical records (MR) for health care utilization.
METHODS: Patients admitted to the university hospital for acute asthma exacerbation were invited to participate in an asthma research study approved by the institutional review board. At 1, 3 and 6 months, a research associate contacted each subject and completed a questionnaire regarding health care utilization. SR health care utilization values for the 6 month period were compared to existing medical records for each subject using the t-test for dependent samples. Pearson product-moment correlations were calculated to determine whether SR data correlated with the medical record.
RESULTS: Subjects (n=155) had a mean age of 43±13 and were 84% female. There were significant differences (p>.05) between SR and MR for ED visits, number of in-patient days and number of clinical visits. There was no significant difference between SR and MR for hospitalizations (p=.25). There were significant correlations (p<.001) between SR and MR for ED visits (r=.52), hospitalizations (r=.32) and in-patient days (r=.36). There was no correlation between SR and MR for clinic visits (r=-.02, p=.81). SR accounted for 27% of the variance in MR ED visits, 10% of the variance in MR hospitalizations and 13% of the variance in MR in-patient days.
CONCLUSION: There were significant differences in SR and MR for most measures of health care utilization and SR only accounted for a small percentage of the variation observed in MR.
CLINICAL IMPLICATIONS: Self report data for health care utilization should be used with caution in assessment of treatment effectiveness in adult asthmatics.
DISCLOSURE: David Shelledy, No Financial Disclosure Information; No Product/Research Disclosure Information