%0 Journal Article
%T Official statistics and claims data records indicate non-response and recall bias within survey-based estimates of health care utilization in the older population
%A Hunger Matthias
%A Schwarzkopf Larissa
%A Heier Margit
%A Peters Annette
%J BMC Health Services Research
%D 2013
%I BioMed Central
%R 10.1186/1472-6963-13-1
%X Background 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. Methods We used data from the German KORA-Age study, which included 4,127 people aged 65¨C94 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. Results The 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%). Conclusion Survey 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.
%K Health care utilization
%K Self-report
%K Validity
%K Survey
%K Response bias
%K Recall bias
%K Claims data
%U http://www.biomedcentral.com/1472-6963/13/1