Center for Health Policy Research and Development, National Health Research Institutes, Zhunan, Miaoli County, Taiwan ROC.
J Clin Epidemiol. 2009 Dec;62(12):1316-22. doi: 10.1016/j.jclinepi.2009.01.016. Epub 2009 Apr 28.
To investigate the agreement between self-reported and insurance claim of the utilization of health care.
Data were from the Taiwan National Health Interview Survey, conducted in 2001. There were 22,121 (94.2%) individuals who completed the interview, 18,143 of them aged 12 and above. Among them, 87% signed a consent form to allow us linking their interview with data with the National Health Insurance database. After deleting those with illegible identification code or date of birth, 15,660 subjects were included in the study. Kappa (kappa) was used to describe the visit concordance, whereas the intraclass correlation coefficient was used to describe frequency consistency. Logistic regression was used to investigate factors associated with the agreement.
All had reasonable visit and frequency agreements. Logistic regression showed that males and those living in rural areas tended to have a lower likelihood of agreement in reporting outpatient visits compared with others. In reporting emergency room visits, males and those with a higher education level, self-perceived health of "not good," chronic disease, or at least one difficulty with activities of daily living (ADL) had higher chances of agreement.
Agreement between self-reported utilization and insurance claims were fairly good in general population.
调查健康保健利用的自我报告和保险索赔之间的一致性。
数据来自 2001 年进行的台湾国家健康访谈调查。有 22121 名（94.2%）完成了访谈的个人，其中 18143 名年龄在 12 岁及以上。其中，87%的人签署了同意书，允许我们将他们的访谈与国家健康保险数据库中的数据联系起来。在删除那些识别码或出生日期不清楚的人后，有 15660 名受试者被纳入研究。卡帕（kappa）用于描述就诊一致性，而组内相关系数用于描述频率一致性。使用逻辑回归来研究与一致性相关的因素。
所有报告的就诊和频率均具有合理的一致性。逻辑回归表明，与其他人群相比，男性和居住在农村地区的人群在报告门诊就诊方面不太可能达成一致。在报告急诊就诊方面，男性和受教育程度较高、自我感觉健康状况“不佳”、患有慢性病或至少有一项日常生活活动（ADL）困难的人更有可能达成一致。
一般人群中自我报告的利用率和保险索赔之间的一致性相当好。
