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精神病患者的医疗服务利用情况:在一项随机对照试验中自我报告与行政数据相比的有效性

Health Service Utilisation of People Living with Psychosis: Validity of Self-report Compared with Administrative Data in a Randomised Controlled Trial.

作者信息

Dolar Vergil, Chatterton Mary Lou, Le Long Khanh-Dao, Mihalopoulos Cathrine, Thomas Neil, Engel Lidia

机构信息

Deakin Health Economics, School of Health and Social Development, Deakin University, Geelong, VIC, Australia.

Monash University Health Economics Group, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.

出版信息

Appl Health Econ Health Policy. 2024 Mar;22(2):255-264. doi: 10.1007/s40258-023-00849-x. Epub 2023 Nov 21.

Abstract

BACKGROUND

Self-reported service use informs resource utilisation and cost estimates, though its validity for use within economic evaluations is uncertain.

OBJECTIVE

The aim of this study is to assess agreement in health resource-use measurement between self-reported and administrative data across different resource categories, over time and between different recall periods by subgroups among Australians living with psychosis.

METHODS

Data were obtained for 104 participants with psychotic disorders from a randomised controlled trial. Agreement between self-reported resource-use questionnaires and administrative data on community-based services and medication use was assessed through estimating differences of group mean number of visits and medications used and intraclass correlation coefficients (ICC) over multiple time periods.

RESULTS

ICC showed moderate agreement across most time periods for general practitioners, psychiatrists and mental health medications. No clear trends were discernible over time, between varying lengths of recall periods nor across participant subgroups.

CONCLUSION

Despite poor agreement, when measuring visits to psychologists and other health professionals, small overall differences in group mean number of visits indicate that self-reported data may still be valid for use in economic evaluations in people living with psychosis.

摘要

背景

自我报告的服务使用情况有助于资源利用和成本估算,但其在经济评估中的有效性尚不确定。

目的

本研究旨在评估澳大利亚患有精神病的人群中,不同资源类别、不同时间以及不同回忆期的亚组之间,自我报告数据与行政数据在卫生资源使用测量方面的一致性。

方法

从一项随机对照试验中获取了104名患有精神障碍参与者的数据。通过估计多个时间段内就诊次数和用药数量的组均值差异以及组内相关系数(ICC),评估自我报告的资源使用问卷与基于社区服务和用药的行政数据之间的一致性。

结果

对于全科医生、精神科医生和精神类药物,ICC在大多数时间段显示出中等程度的一致性。在不同时间、不同回忆期长度之间以及不同参与者亚组中,均未发现明显趋势。

结论

尽管一致性较差,但在测量对心理学家和其他卫生专业人员的就诊次数时,就诊次数的组均值总体差异较小,这表明自我报告数据在患有精神病的人群的经济评估中仍可能有效。

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