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精神障碍患者医疗保健消费和生产力损失问卷(TiC-P)的可行性、可靠性和有效性。

Feasibility, reliability and validity of a questionnaire on healthcare consumption and productivity loss in patients with a psychiatric disorder (TiC-P).

机构信息

Institute for Medical Technology Assessment, Erasmus University Rotterdam, PO Box 1738, 3000 DR Rotterdam, The Netherlands.

出版信息

BMC Health Serv Res. 2013 Jun 15;13:217. doi: 10.1186/1472-6963-13-217.

Abstract

BACKGROUND

Patient self-report allows collecting comprehensive data for the purpose of performing economic evaluations. The aim of the current study was to assess the feasibility, reliability and a part of the construct validity of a commonly applied questionnaire on healthcare utilization and productivity losses in patients with a psychiatric disorder (TiC-P).

METHODS

Data were derived alongside two clinical trials performed in the Netherlands in patients with mental health problems. The response rate, average time of filling out the questionnaire and proportions of missing values were used as indicators of feasibility of the questionnaire. Test-retest analyses were performed including Cohen's kappa and intra class correlation coefficients to assess reliability of the data. The construct validity was assessed by comparing patient reported data on contacts with psychotherapists and reported data on long-term absence from work with data derived from registries.

RESULTS

The response rate was 72%. The mean time needed for filling out the first TiC-P was 9.4 minutes. The time needed for filling out the questionnaire was 2.3 minutes less for follow up measurements. Proportions of missing values were limited (< 2.4%) except for medication for which in 10% of the cases costs could not be calculated. Cohen's kappa was satisfactory to almost perfect for most items related to healthcare consumption and satisfactory for items on absence from work and presenteeism. Comparable results were shown by the ICCs on variables measuring volumes of medical consumption and productivity losses indicating good reliability of the questionnaire.Absolute agreement between patient-reported data and data derived from medical registrations of the psychotherapists was satisfactory. Accepting a margin of +/- seven days, the agreement on reported and registered data on long-term absence from work was satisfactory. The validity of self-reported data using the TiC-P is promising.

CONCLUSIONS

The results indicate that the TiC-P is a feasible and reliable instrument for collecting data on medical consumption and productivity losses in patients with mild to moderate mental health problems. Additionally, the construct validity of questions related to contacts with psychotherapist and long-term absence from work was satisfactory.

摘要

背景

患者自我报告可用于收集全面的数据,以进行经济评估。本研究的目的是评估一种常用于评估精神障碍患者医疗保健利用和生产力损失的常见问卷(TiC-P)的可行性、可靠性和部分构建有效性。

方法

数据来自荷兰两项针对心理健康问题患者的临床试验。问卷的可行性通过响应率、填写问卷的平均时间和缺失值的比例来衡量。进行了测试-重测分析,包括 Cohen's kappa 和组内相关系数,以评估数据的可靠性。通过将患者报告的与心理治疗师的接触数据与报告的长期缺勤数据与从登记处获得的数据进行比较来评估结构有效性。

结果

响应率为 72%。填写第一个 TiC-P 的平均时间为 9.4 分钟。随访测量的填写问卷时间减少了 2.3 分钟。除了 10%的情况下无法计算药物费用外,缺失值的比例有限(<2.4%)。大多数与医疗保健消费相关的项目的 Cohen's kappa 值为满意至几乎完美,与缺勤和出勤相关的项目的 Cohen's kappa 值为满意。测量医疗消费和生产力损失量的变量的 ICC 结果表明问卷具有良好的可靠性。患者报告的数据与心理治疗师的医疗登记数据之间的绝对一致性令人满意。接受报告和登记的长期缺勤数据之间的差异为 +/- 七天时,协议令人满意。TiC-P 自我报告数据的有效性很有希望。

结论

结果表明,TiC-P 是一种可行且可靠的工具,可用于收集轻度至中度心理健康问题患者的医疗消费和生产力损失数据。此外,与与心理治疗师的接触和长期缺勤相关的问题的结构有效性令人满意。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/84c4/3694473/40c4c11b2029/1472-6963-13-217-1.jpg

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