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Self-reports of health-care utilization: Diary or questionnaire?

Published online by Cambridge University Press:  04 August 2005

Mandy van den Brink ,
Wilbert B. van den Hout ,
Anne M. Stiggelbout ,
Hein Putter ,
Cornelis J. H. van de Velde  and
Job Kievit
Mandy van den Brink
Affiliation:
Leiden University Medical Center
Wilbert B. van den Hout
Affiliation:
Leiden University Medical Center
Anne M. Stiggelbout
Affiliation:
Leiden University Medical Center
Hein Putter
Affiliation:
Leiden University Medical Center
Cornelis J. H. van de Velde
Affiliation:
Leiden University Medical Center
Job Kievit
Affiliation:
Leiden University Medical Center
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Abstract

Objectives: The feasibility and convergent validity of a cost diary and a cost questionnaire was investigated.

Methods: Data were obtained as part of a cost-utility analysis alongside a multicenter clinical trial in patients with resectable rectal cancer. A sample of 107 patients from 30 hospitals was asked to keep a weekly diary during the first 3 months after surgery, and a monthly diary from 3 to 12 months after surgery. A second sample of seventy-two patients from twenty-eight hospitals in the trial received a questionnaire at 3, 6, and 12 months after surgery, referring to the previous 3 or 6 months. Format and items of the questions were similar and included a wide range of medical and nonmedical items and costs after hospitalization for surgery.

Results: Small differences were found with respect to nonresponse (range, 79 to 86 percent) and missing questions (range, 1 to 6 percent between the diary and questionnaire). For most estimates of volumes of care and of costs, the diary and questionnaire did not differ significantly. Total 3-month nonhospital costs were €1,860, €1,280, and €1,050 in the diary sample and €1,860, €1,090, and €840 in the questionnaire sample at 3, 6, and 12 months after surgery, respectively (p =.50). However, with respect to open questions, the diary sample tended to report significantly more care.

Conclusions: For the assessment of health-care utilization in economic evaluations alongside clinical trials, a cost questionnaire with structured closed questions may replace a cost diary for recall periods up to 6 months.

Keywords

Economic evaluationClinical trialCost measurementSelf-reportMethodologyRectal cancer
Type
GENERAL ESSAYS
Information
International Journal of Technology Assessment in Health Care , Volume 21 , Issue 3 , July 2005 , pp. 298 - 304
Copyright
© 2005 Cambridge University Press

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