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Feasibility and accuracy of a postcard diary system for tracking healthcare utilization of community-dwelling older persons.

Abstract：

OBJECTIVE:To test the feasibility of and to validate a self-report weekly postcard diary of health care utilization. DESIGN:Case-series and validation study. SETTING:Community-based sample of fee-for-service and health maintenance organization (HMO) patients. PARTICIPANTS:A convenience sample of 24 community-dwelling older persons who had failed a self-administered screen and were eligible for a study of outpatient comprehensive geriatric assessment consultation. MEASUREMENTS:Subjects completed and mailed in a weekly postcard diary documenting medical, counseling, or rehabilitation therapy visits. If a subject did not respond within 10 days after the end of the week, a telephone call was placed to gather the information. For a subset of 10 subjects who were HMO enrollees, all records were reviewed to determine accuracy of the postcard diaries. RESULTS:Of the 24 subjects enrolled, one HMO enrollee dropped out following hip surgery after 4 weeks of completing diaries. The remaining 23 subjects (96% of total entered) provided complete information for 12 weeks. Telephone follow-up to either obtain or clarify utilization information was required for 22% of subjects. For the subset of 10 HMO subjects, seven underreporting, two overreporting, and one incorrect day errors were detected-a total of 10 errors representing 9% of diaries and 1.3% of patient-days. Kappa as a measure of agreement between the two methods (self-report and chart review) was 0.82 (P < .0001). Compared with chart review, the diary report was 75.0% sensitive and 99.8% specific. Positive and negative predictive values were 91.3% and 99.2%, respectively. CONCLUSION:These findings suggest that a postcard diary system with telephone follow-up is both a feasible and reasonably accurate method of tracking health care utilization by community-dwelling older persons, although a small percentage will be unable to adhere to this method.

journal_name

J Am Geriatr Soc

journal_title

Journal of the American Geriatrics Society

authors

Reuben DB,Wong RC,Walsh KE,Hays RD

doi

10.1111/j.1532-5415.1995.tb06105.x

subject

Has Abstract

pub_date

1995-05-01 00:00:00

pages

550-2

issue

eissn

0002-8614

issn

1532-5415

journal_volume

pub_type

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Feasibility and accuracy of a postcard diary system for tracking healthcare utilization of community-dwelling older persons.