Department for Quality Measurement and Patient Safety, Norwegian Knowledge Centre for the Health Services, Oslo, Norway.
BMC Health Serv Res. 2010 Feb 10;10:38. doi: 10.1186/1472-6963-10-38.
International health policy surveys are used to compare and evaluate health system performance, but little is known about the effects of non-response. The objective of this study was to assess the effects of non-response in the Norwegian part of the Commonwealth Fund international health policy survey in 2009.
As part of an international health policy survey in 2009 a cross-sectional survey was conducted in Norway among a representative sample of Norwegian general practitioners. 1,400 randomly selected GPs were sent a postal questionnaire including questions about the Norwegian health care system, the quality of the GPs' own practice and the cooperation with specialist health care. The survey included three postal reminders and a telephone follow-up of postal non-respondents. The main outcome measures were increase in response rate for each reminder, the effects of demographic and practice variables on response, the effects of non-response on survey estimates, and the cost-effectiveness of each reminder.
After three postal reminders and one telephone follow-up, the response rate was 59.1%. Statistically significant differences between respondents and non-respondents were found for three variables; group vs. solo practice (p = 0.01), being a specialist or not (p < 0.001) and municipality centrality (least central vs. most central, p = 0.03). However, demographic and practice variables had little association with five outcome variables and the overall survey estimates changed little with additional reminders. In addition, the cost-effectiveness of the final reminders was poor.
The response rate in the Norwegian survey was satisfactory, and the effect of non-response was small indicating adequate representativeness. The cost-effectiveness of the final reminders was poor. The Norwegian findings strengthen the international project, but restrictions in generalizability warrant further study in other countries.
国际卫生政策调查用于比较和评估卫生系统绩效，但对无应答的影响知之甚少。本研究的目的是评估 2009 年英联邦基金国际卫生政策调查中挪威部分无应答的影响。
作为 2009 年国际卫生政策调查的一部分，在挪威对代表性的挪威全科医生样本进行了横断面调查。1400 名随机选择的全科医生收到了一份包含有关挪威医疗保健系统、全科医生自身实践质量以及与专科医疗保健合作问题的邮政问卷。调查包括三次邮政提醒和对未回复的电话随访。主要结局指标是每次提醒的回复率增加，人口统计学和实践变量对回复的影响，无应答对调查估计的影响，以及每次提醒的成本效益。
经过三次邮政提醒和一次电话随访，回复率为 59.1%。在三个变量中发现了应答者和未应答者之间的统计学显著差异；团体与个体执业（p = 0.01）、是否为专科医生（p < 0.001）和市辖区中心性（最不中心与最中心，p = 0.03）。然而，人口统计学和实践变量与五个结果变量的关联不大，并且随着额外的提醒，总体调查估计值变化不大。此外，最后提醒的成本效益很差。
挪威调查的回复率令人满意，无应答的影响很小，表明具有充分的代表性。最后提醒的成本效益很差。挪威的发现加强了国际项目，但推广限制需要在其他国家进一步研究。
