Parents were accurate proxy reporters of urgent pediatric asthma health services—a retrospective agreement analysis

Abstract

Objective-To assess agreement between parents' proxy reports of children's respiratory-related health service use and administrative data.Study Design and Setting-A retrospective analysis of statistical agreement between clinical and claims data for reports of physician visits, emergency department (ED) visits, and hospitalizations in 545 asthmatic children recruited from sites in the greater Toronto area was conducted. Health services use data were extracted from the Ontario Health Insurance Plan and Canadian Institute for Health Information databases for each child for the interval coinciding with the proxy report for each health service type.Results-Agreement between administrative data and respondent reports (n =545) was substantial for hospitalizations in the past year (κ =0.80 [0.74, 0.86]), moderate for ED visits in the past year (κ =0.60 [0.53, 0.67]), and slight for physician visits (κ =0.13 [0.00, 0.27]) in the past 6 months. Income, parent's education, and child quality-of-life symptom scores did not affect agreement. Agreement for ED visits was significantly higher (P <0.05) for children who had an asthma attack in the past 6 months (κ =0.61 [0.54, 0.68]) compared to children who did not (κ =0.25 [0.00, 0.59 ]).Conclusion-Parents of asthmatic children are reliable reporters of their child's respiratoryrelated urgent health services utilization.

Socioeconomic Factors and Home Allergen Exposure in Children With Asthma

“…All of the data were self-or parent proxy-reported, and accuracy was therefore dependent upon participant recall. Reports of health services by parent proxy respondents in this study showed good to excellent agreement with administrative data (Ungar, Davidson-Grimwood, & Cousins, 2007). The study sample represented a broad urban and suburban population of children with asthma.…”

Relationship of asthma management, socioeconomic status, and medication insurance characteristics to exacerbation frequency in children with asthma

“…In an assessment of recall validity, the parents in this study were found to be highly reliable reporters of prestudy ED visits and hospital admissions. 42 This study did not directly assess the effect of medication adherence on exacerbation; however, the interview data contained detailed information on other potential confounders, unavailable in administrative data. The results regarding the effects of out-of-pocket expenditures on exacerbations are difficult to interpret.…”

Agreement between Internet-Based Self- and Proxy-Reported Health Care Resource Utilization and Administrative Health Care Claims

“…Bhandari and Wagner [2] reported a weighted average of 60% agreement at 3 months recall, 36% agreement at 6 months recall, and 20% agreement at 12 months recall. Finally, the type of HCRU reported can also affect the level of agreement, with self-report accuracy increasing with more rare or memorable visits, including inpatient hospitalizations or visits to a specialist [16,17].…”

“…Although few studies have evaluated the validity of parent proxyreported utilization data, existing studies have found that parental reporting of HCRU data for children correlates well with medical records [10,16,18,19]. These studies used in-person and telephone interviews and focused on parental recall for conditionspecific utilization [16,19] or for service-specific utilization [10].…”

“…These studies used in-person and telephone interviews and focused on parental recall for conditionspecific utilization [16,19] or for service-specific utilization [10]. Proxy reporting for other adults has focused primarily on the use of proxy respondents in studies of older populations and evaluated functioning, cognitive status, and physical health.…”