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Patient-reported health care utilization in rheumatoid arthritis: What level of detail is required?

Research output: Contribution to journalArticleResearchpeer review

Authors

  • Jörg Ruof
  • Jan L. Huelsemann
  • Thomas Mittendorf
  • Silke Handelmann
  • J. Matthias Von Der Schulenburg

External Research Organisations

  • Hannover Medical School (MHH)

Details

Original languageEnglish
Pages (from-to)774-781
Number of pages8
JournalArthritis Care and Research
Volume51
Issue number5
Publication statusPublished - 15 Oct 2004

Abstract

Objective. To investigate the level of detail required in self-reported health care utilization questionnaires for administration to patients with rheumatoid arthritis (RA). Methods. A preliminary questionnaire was developed on the basis of existing tools for use in rheumatic conditions and in-depth interviews with 10 RA patients. Data gathered over 1 year of administration in a clinical setting were then matched to a comprehensive database of payer-reported information. Kappa statistics were calculated for each health care utilization domain. For domains where disaggregation into metric data was potentially preferable, histograms of difference were assessed visually and the strength of association examined using Spearman's rank correlation coefficient. Results. Patients (n = 136) included in the base case analysis determined the preferred levels of detail for each domain. Physician visits: occurrence of physician visits (yes/no; κ not applicable) and their number (r = 0.42, P < 0.001). Medication use of the following drug classes (yes/no): disease-modifying antirheumatic drug (DMARD; κ = 0.68), nonsteroidal antiinflammatory drug (κ = 0.64), osteoporosis medication (κ = 0.56), analgesic (κ = 0.38), and steroid (κ = 0.83). Further disaggregation into different DMARD classes was recommended (κ ranging between 1 [use of biologies: yes/no] and 0.67 [use of azathioprine: yes/no]. Imaging: imaging of bones and chest (yes/no; κ = 0.20). Hospitalization: inpatient episodes (yes/no; κ = 0.64) and number of inpatient days (r = 0.80, P < 0.001). Transport: costs incurred (yes/no; κ = 0.13) and amount (r = 0.39, P < 0.001). Conclusion. The use of highly aggregated items to assess health care utilization in RA is supported. Dichotomous assessment (yes/no) was the preferred level of detail for items in the domains covering medication and diagnostic procedures or tests. Metric data is appropriate in 3 areas: number of physician visits, number of inpatient days, and total expenditure on transportation.

Keywords

    Costs, Health care utilization, Questionnaire, Rheumatoid Arthritis

ASJC Scopus subject areas

Cite this

Patient-reported health care utilization in rheumatoid arthritis: What level of detail is required? / Ruof, Jörg; Huelsemann, Jan L.; Mittendorf, Thomas et al.
In: Arthritis Care and Research, Vol. 51, No. 5, 15.10.2004, p. 774-781.

Research output: Contribution to journalArticleResearchpeer review

Ruof, J, Huelsemann, JL, Mittendorf, T, Handelmann, S, Von Der Schulenburg, JM, Zeidler, H, Aultman, R & Merkesdal, S 2004, 'Patient-reported health care utilization in rheumatoid arthritis: What level of detail is required?', Arthritis Care and Research, vol. 51, no. 5, pp. 774-781. https://doi.org/10.1002/art.20686
Ruof, J., Huelsemann, J. L., Mittendorf, T., Handelmann, S., Von Der Schulenburg, J. M., Zeidler, H., Aultman, R., & Merkesdal, S. (2004). Patient-reported health care utilization in rheumatoid arthritis: What level of detail is required? Arthritis Care and Research, 51(5), 774-781. https://doi.org/10.1002/art.20686
Ruof J, Huelsemann JL, Mittendorf T, Handelmann S, Von Der Schulenburg JM, Zeidler H et al. Patient-reported health care utilization in rheumatoid arthritis: What level of detail is required? Arthritis Care and Research. 2004 Oct 15;51(5):774-781. doi: 10.1002/art.20686
Ruof, Jörg ; Huelsemann, Jan L. ; Mittendorf, Thomas et al. / Patient-reported health care utilization in rheumatoid arthritis : What level of detail is required?. In: Arthritis Care and Research. 2004 ; Vol. 51, No. 5. pp. 774-781.
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title = "Patient-reported health care utilization in rheumatoid arthritis: What level of detail is required?",
abstract = "Objective. To investigate the level of detail required in self-reported health care utilization questionnaires for administration to patients with rheumatoid arthritis (RA). Methods. A preliminary questionnaire was developed on the basis of existing tools for use in rheumatic conditions and in-depth interviews with 10 RA patients. Data gathered over 1 year of administration in a clinical setting were then matched to a comprehensive database of payer-reported information. Kappa statistics were calculated for each health care utilization domain. For domains where disaggregation into metric data was potentially preferable, histograms of difference were assessed visually and the strength of association examined using Spearman's rank correlation coefficient. Results. Patients (n = 136) included in the base case analysis determined the preferred levels of detail for each domain. Physician visits: occurrence of physician visits (yes/no; κ not applicable) and their number (r = 0.42, P < 0.001). Medication use of the following drug classes (yes/no): disease-modifying antirheumatic drug (DMARD; κ = 0.68), nonsteroidal antiinflammatory drug (κ = 0.64), osteoporosis medication (κ = 0.56), analgesic (κ = 0.38), and steroid (κ = 0.83). Further disaggregation into different DMARD classes was recommended (κ ranging between 1 [use of biologies: yes/no] and 0.67 [use of azathioprine: yes/no]. Imaging: imaging of bones and chest (yes/no; κ = 0.20). Hospitalization: inpatient episodes (yes/no; κ = 0.64) and number of inpatient days (r = 0.80, P < 0.001). Transport: costs incurred (yes/no; κ = 0.13) and amount (r = 0.39, P < 0.001). Conclusion. The use of highly aggregated items to assess health care utilization in RA is supported. Dichotomous assessment (yes/no) was the preferred level of detail for items in the domains covering medication and diagnostic procedures or tests. Metric data is appropriate in 3 areas: number of physician visits, number of inpatient days, and total expenditure on transportation.",
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Download

TY - JOUR

T1 - Patient-reported health care utilization in rheumatoid arthritis

T2 - What level of detail is required?

AU - Ruof, Jörg

AU - Huelsemann, Jan L.

AU - Mittendorf, Thomas

AU - Handelmann, Silke

AU - Von Der Schulenburg, J. Matthias

AU - Zeidler, Henning

AU - Aultman, Rick

AU - Merkesdal, Sonja

PY - 2004/10/15

Y1 - 2004/10/15

N2 - Objective. To investigate the level of detail required in self-reported health care utilization questionnaires for administration to patients with rheumatoid arthritis (RA). Methods. A preliminary questionnaire was developed on the basis of existing tools for use in rheumatic conditions and in-depth interviews with 10 RA patients. Data gathered over 1 year of administration in a clinical setting were then matched to a comprehensive database of payer-reported information. Kappa statistics were calculated for each health care utilization domain. For domains where disaggregation into metric data was potentially preferable, histograms of difference were assessed visually and the strength of association examined using Spearman's rank correlation coefficient. Results. Patients (n = 136) included in the base case analysis determined the preferred levels of detail for each domain. Physician visits: occurrence of physician visits (yes/no; κ not applicable) and their number (r = 0.42, P < 0.001). Medication use of the following drug classes (yes/no): disease-modifying antirheumatic drug (DMARD; κ = 0.68), nonsteroidal antiinflammatory drug (κ = 0.64), osteoporosis medication (κ = 0.56), analgesic (κ = 0.38), and steroid (κ = 0.83). Further disaggregation into different DMARD classes was recommended (κ ranging between 1 [use of biologies: yes/no] and 0.67 [use of azathioprine: yes/no]. Imaging: imaging of bones and chest (yes/no; κ = 0.20). Hospitalization: inpatient episodes (yes/no; κ = 0.64) and number of inpatient days (r = 0.80, P < 0.001). Transport: costs incurred (yes/no; κ = 0.13) and amount (r = 0.39, P < 0.001). Conclusion. The use of highly aggregated items to assess health care utilization in RA is supported. Dichotomous assessment (yes/no) was the preferred level of detail for items in the domains covering medication and diagnostic procedures or tests. Metric data is appropriate in 3 areas: number of physician visits, number of inpatient days, and total expenditure on transportation.

AB - Objective. To investigate the level of detail required in self-reported health care utilization questionnaires for administration to patients with rheumatoid arthritis (RA). Methods. A preliminary questionnaire was developed on the basis of existing tools for use in rheumatic conditions and in-depth interviews with 10 RA patients. Data gathered over 1 year of administration in a clinical setting were then matched to a comprehensive database of payer-reported information. Kappa statistics were calculated for each health care utilization domain. For domains where disaggregation into metric data was potentially preferable, histograms of difference were assessed visually and the strength of association examined using Spearman's rank correlation coefficient. Results. Patients (n = 136) included in the base case analysis determined the preferred levels of detail for each domain. Physician visits: occurrence of physician visits (yes/no; κ not applicable) and their number (r = 0.42, P < 0.001). Medication use of the following drug classes (yes/no): disease-modifying antirheumatic drug (DMARD; κ = 0.68), nonsteroidal antiinflammatory drug (κ = 0.64), osteoporosis medication (κ = 0.56), analgesic (κ = 0.38), and steroid (κ = 0.83). Further disaggregation into different DMARD classes was recommended (κ ranging between 1 [use of biologies: yes/no] and 0.67 [use of azathioprine: yes/no]. Imaging: imaging of bones and chest (yes/no; κ = 0.20). Hospitalization: inpatient episodes (yes/no; κ = 0.64) and number of inpatient days (r = 0.80, P < 0.001). Transport: costs incurred (yes/no; κ = 0.13) and amount (r = 0.39, P < 0.001). Conclusion. The use of highly aggregated items to assess health care utilization in RA is supported. Dichotomous assessment (yes/no) was the preferred level of detail for items in the domains covering medication and diagnostic procedures or tests. Metric data is appropriate in 3 areas: number of physician visits, number of inpatient days, and total expenditure on transportation.

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