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Under-reporting of inpatient services utilisation in household surveys -- a population-based study in Hong Kong.

Tsui EL, Leung GM, Woo PP, Choi S, Lo SV - BMC Health Serv Res (2005)

Bottom Line: Between-year differences on net under-reporting were quantified by Cohen's d effect size.Under-reporting was substantial in Hong Kong's THS.A proper full-design record-check study should be carried out to confirm the present findings.

View Article: PubMed Central - HTML - PubMed

Affiliation: Hospital Authority, 5/F, HA Building, 147B Argyle Street, Kowloon, Hong Kong, China. elhtsui@ha.org.hk

ABSTRACT

Background: Recognising that household interviews may produce biased estimates of health services utilisation, we examined for under- and over-reporting of hospitalisation episodes in three recent, consecutive population-based household surveys in Hong Kong.

Methods: Territory-wide inpatient service utilisation volumes as estimated from the 1999, 2001 and 2002 Thematic Household Surveys (THS) were benchmarked against corresponding statistics derived from routine administrative databases. Between-year differences on net under-reporting were quantified by Cohen's d effect size. To assess the potential for systematic biases in under-reporting, age- and sex-specific net under-reporting rates within each survey year were computed and the F-test was performed to evaluate differences between demographic subgroups. We modelled the effects of age and sex on the likelihood of ever hospitalisation through logistic regression to compare the odds ratios respectively derived from survey and administrative data.

Results: The extent of net under-reporting was moderately large in all three years amounting to about one-third of all inpatient episodes. However, there did not appear to be significant systematic biases in the degree of under-reporting by age or sex on stratified analyses and logistic regression modelling.

Conclusion: Under-reporting was substantial in Hong Kong's THS. Recall bias was likely most responsible for such reporting inaccuracies. A proper full-design record-check study should be carried out to confirm the present findings.

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Comparison of odds ratios for age-sex effects on the likelihood of ever hospitalisation in public hospitals between administrative and survey data for year 2002.
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Figure 3: Comparison of odds ratios for age-sex effects on the likelihood of ever hospitalisation in public hospitals between administrative and survey data for year 2002.

Mentions: As an alternative approach, we modelled the effects of age and sex on the likelihood of ever hospitalisation in public hospitals. The full model with the interaction term of age-sex was first fitted, but was subsequently dropped due to insignificant age-sex interaction effects. Figures 1, 2 and 3 plot age- and sex-specific odds ratios of ever hospitalisation and 95% confidence intervals (CIs) using both survey and administrative data. Both sets of curves are very similar in both direction and magnitude and largely overlap in their 95% CIs, confirming that the two data sources show consistent relativity in ever hospitalisation rate by age and sex. It suggests that there are no substantial systematic biases in under-reporting among age and sex subgroups.


Under-reporting of inpatient services utilisation in household surveys -- a population-based study in Hong Kong.

Tsui EL, Leung GM, Woo PP, Choi S, Lo SV - BMC Health Serv Res (2005)

Comparison of odds ratios for age-sex effects on the likelihood of ever hospitalisation in public hospitals between administrative and survey data for year 2002.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC1131900&req=5

Figure 3: Comparison of odds ratios for age-sex effects on the likelihood of ever hospitalisation in public hospitals between administrative and survey data for year 2002.
Mentions: As an alternative approach, we modelled the effects of age and sex on the likelihood of ever hospitalisation in public hospitals. The full model with the interaction term of age-sex was first fitted, but was subsequently dropped due to insignificant age-sex interaction effects. Figures 1, 2 and 3 plot age- and sex-specific odds ratios of ever hospitalisation and 95% confidence intervals (CIs) using both survey and administrative data. Both sets of curves are very similar in both direction and magnitude and largely overlap in their 95% CIs, confirming that the two data sources show consistent relativity in ever hospitalisation rate by age and sex. It suggests that there are no substantial systematic biases in under-reporting among age and sex subgroups.

Bottom Line: Between-year differences on net under-reporting were quantified by Cohen's d effect size.Under-reporting was substantial in Hong Kong's THS.A proper full-design record-check study should be carried out to confirm the present findings.

View Article: PubMed Central - HTML - PubMed

Affiliation: Hospital Authority, 5/F, HA Building, 147B Argyle Street, Kowloon, Hong Kong, China. elhtsui@ha.org.hk

ABSTRACT

Background: Recognising that household interviews may produce biased estimates of health services utilisation, we examined for under- and over-reporting of hospitalisation episodes in three recent, consecutive population-based household surveys in Hong Kong.

Methods: Territory-wide inpatient service utilisation volumes as estimated from the 1999, 2001 and 2002 Thematic Household Surveys (THS) were benchmarked against corresponding statistics derived from routine administrative databases. Between-year differences on net under-reporting were quantified by Cohen's d effect size. To assess the potential for systematic biases in under-reporting, age- and sex-specific net under-reporting rates within each survey year were computed and the F-test was performed to evaluate differences between demographic subgroups. We modelled the effects of age and sex on the likelihood of ever hospitalisation through logistic regression to compare the odds ratios respectively derived from survey and administrative data.

Results: The extent of net under-reporting was moderately large in all three years amounting to about one-third of all inpatient episodes. However, there did not appear to be significant systematic biases in the degree of under-reporting by age or sex on stratified analyses and logistic regression modelling.

Conclusion: Under-reporting was substantial in Hong Kong's THS. Recall bias was likely most responsible for such reporting inaccuracies. A proper full-design record-check study should be carried out to confirm the present findings.

Show MeSH
Related in: MedlinePlus