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Cited by 261Survey Methodology and NonresponseHealth and Medical StudiesMedical Coding and Health Information

The DOI matches its Crossref record; 40 of the 40 references it cites were found in a registry or an index.

Official statistics and claims data records indicate non-response and recall bias within survey-based estimates of health care utilization in the older population

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KORA Study Group, Hunger, Matthias, Schwarzkopf, Larissa, Heier, Margit, Peters, Annette, Holle, Rolf·2013·BMC Health Services Research
DOI 10.1186/1472-6963-13-1PMC PMC3545728
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Abstract

BACKGROUND: The validity of survey-based health care utilization estimates in the older population has been poorly researched. Owing to data protection legislation and a great number of different health care insurance providers, the assessment of recall and non-response bias is challenging to impossible in many countries. The objective of our study was to compare estimates from a population-based study in older German adults with external secondary data. METHODS: We used data from the German KORA-Age study, which included 4,127 people aged 65-94 years. Self-report questions covered the utilization of long-term care services, inpatient services, outpatient services, and pharmaceuticals. We calculated age- and sex-standardized mean utilization rates in each domain and compared them with the corresponding estimates derived from official statistics and independent statutory health insurance data. RESULTS: The KORA-Age study underestimated the use of long-term care services (-52%), in-hospital days (-21%) and physician visits (-70%). In contrast, the assessment of drug consumption by postal self-report questionnaires yielded similar estimates to the analysis of insurance claims data (-9%). CONCLUSION: Survey estimates based on self-report tend to underestimate true health care utilization in the older population. Direct validation studies are needed to disentangle the impact of recall and non-response bias.

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Figure 1 Location of Middle Franconia and the KORA study region in the state of Bavaria.
Figure 1 Location of Middle Franconia and the KORA study region in the state of Bavaria.CC BY · PubMed Central
Figure 2 Percentage of individuals entitled to long-term care services. Percentage of individuals entitled to long-term care services; age- and sex-standardized for the Bavarian resident population NA: Not applicable; Care level unknown or application for long-term care is under consideration but not yet decided.
Figure 2 Percentage of individuals entitled to long-term care services. Percentage of individuals entitled to long-term care services; age- and sex-standardized for the Bavarian resident population NA: Not applicable; Care level unknown or application for long-term care is under consideration but not yet decided.CC BY · PubMed Central

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Show all 40 references

Research works printed but not linked: 6

  1. John J, Holle R: [Problems of buildling up and using statutory health insurance data for population-based economic evaluation studies: Experiences from KORA]. Informatik, Biometrie und Epidemiologie in Medizin und Biologie. 2003, 34 (2): 96-111.
  2. Busse R, Riesberg A: Health Care Systems in Transition: Germany. 2004, Copenhagen: WHO Regional Office for Europe on behalf of the European Observatory on Health Systems and Policies
  3. Bavarian Office for Statistics and Data Processing: Statistische Berichte. Pflegeeinrichtungen, ambulante sowie stationäre und Pflegegeldempfänger in Bayern. Ergebnisse der Pflegestatistik 2006. 2007, Munich
  4. Bavarian Office for Statistics and Data Processing: Statistische Berichte. Pflegeeinrichtungen, ambulante sowie stationäre und Pflegegeldempfänger in Bayern. Ergebnisse der Pflegestatistik 2009. 2010, Munich
  5. Grobe TG, Dörning H, Schwartz FW: GEK-Report ambulant-ärztliche Versorgung 2007. 2007, St. Augustin: Asgard Verlag
  6. Bitzer EM, Grobe TG, Dörning H, Schwartz FW: GEK-Report akut-stationäre Versorgung 2007. 2007, St. Augustin: Asgard Verlag

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Metadata

Authors
KORA Study Group, Hunger, M., Schwarzkopf, L., Heier, M., Peters, A., & Holle, R.
Affiliations
Helmholtz Munich (DE)
ORCID
Venue
BMC Health Services Research
Publisher
Springer Science and Business Media LLC
Published
2013-01-03
Volume
13
Issue
1
Pages
1-1
ISSN
1472-6963 (ISSN-L)
DOI
10.1186/1472-6963-13-1
PMC
PMC3545728
OpenAlex
W2032279019
Cited by
261
References
40
Citations by year
2026: 7 · 2025: 20 · 2024: 27 · 2023: 14 · 2022: 20 · 2021: 30 · 2020: 15 · 2019: 23 · 2018: 23 · 2017: 30 · 2016: 23 · 2015: 15 · 2014: 13 · 2013: 1
FWCI
53.40
Type
journal article
Language
en
Open access
Licence
Locations
  • BMC Health Services Research (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
  • Site cant be reached (submittedVersion, cc-by)
Funders
  • Bundesministerium für Bildung und Forschung (BMBF FKZ 01ET0713, FKZ 01ET0713, 01ET0713)
  • Helmholtz Zentrum München (FKZ 01ET0713)
Topics
  • Social Sciences › Sociology and Political Science › Survey Methodology and Nonresponse
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Health and Medical Studies
  • Health Sciences › Health Professions › Health Information Management › Medical Coding and Health Information
Keywords
health care utilization, older adults, recall bias, nonresponse bias, survey validity, self-report questionnaire, long-term care, inpatient services, physician visits, drug use, health insurance claims, KORA-Age study
MeSH terms
Aged, Aged, 80 and over, Chronic Disease, Drug Utilization, Female, Germany, Health Services, Humans, Insurance Claim Review, Male, Mental Recall, Bias, Confidence Intervals, Odds Ratio, Sex Distribution, Health Care Surveys, Self Report

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