How should we collect health care resource use data in trials conducted in care homes? A comparison of data collected from GP records versus care home records
Type of research:
Primary data analysis
Background & Scientific Rationale:
In an economic evaluation alongside a clinical trial, there are alternative ways of obtaining the same health resource utilisation data, some more reliable than others. For example, health service contacts over a period of time can be obtained from medical records or by interviewing patients themselves. Methods based on interviews may be subject to recall bias, yet obtaining medical records from potentially many different sources is time consuming and costly. A scoping review of the literature identified over 100 comparisons of different data collection techniques in different patient populations over different recall periods. For example self-report medication use vs pharmacy claims data, self-report vs medical record count of GP consultations in stroke patients and micro- vs macro costing approaches. A number of systematic reviews have explored the reliability of collection methods in specific situations, for example general health service use, questionnaire design in collecting drug use data and health service use in older people. However, none of these compare different methods of obtaining resource use data for elderly care home residents, and in particular none have studied the use of care home records as a potential source of this data. Outcome 21 of the CQC Essential standard requires homes to keep accurate medical records.
Research questions / aims:
To compare resource use data collected from GP records with that collected from care home records for elderly patients living in care homes in order to assess level of agreement and to make recommendations as to the most reliable data collection method for future economic studies in this population.
Using data collected as part of the CAREMED trial (funded by the Research for Patient Benefit (RfPB) Programme), the study used the data collected to answer the methodological question of how comparable health resource utilisation data collected from two different sources are (GP medical records versus care home held records).
Key findings and outputs:
The two record sources gave different amounts of use for the same resource (eg numbers of GP visits). The level of agreement between the two record systems differed by the type of resource. Neither system consistently reported more or less use. The level of agreement between the sources also differed by care home. The data from this research highlights the main resources and drivers of costs in care homes, and about which resource items the different data sources vary most. This information can be used to conduct better resource use measurement and,consequently, improved costings for future economic evaluations.
For a ‘BITE’ sized summary of the research, please see:
- BITE number 5: Health Economics – How should healthcare resource use data be collected in care homes?
For further information on this project, contact Professor Tracey Sach at firstname.lastname@example.org