Spanish Diabetes Health Care Utilization

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1. ¿Cuántas veces ha visitado al médico durante los últimos 6 meses? (Si estuvo en el hospital, no incluya estas visitas.) Por favor llene con "0" u otro número. ____ veces
2. Cuántas veces visitó la sala de emergencia en los últimos 6 meses? (No incluya visitas a clínicas de atención inmediata.) Por favor llene con "0" u otro número. ____ veces
3. ¿Cuántas noches en total estuvo hospitalizado, toda la noche, en los últimos 6 meses? Por favor llene con "0" u otro número. ____ noches
4. ¿Cuántas veces en los últimos 6 meses le examinaron los ojos? (ejemplo: por glaucoma o algún otro problema) Por favor llene con "0" u otro número. ____ veces
5. ¿Cuántas veces en los últimos 6 meses, su médico o enfermera(o) le examinó sus pies? Por favor llene con "0" u otro número. ____ veces

Scoring

These are single items. We have found that we often have to follow up with telephone clarification for these items, no matter how they are written. We always do telephone clarification for people that have more than 1 MD visit per month and for all hospitalizations and ER visits. You will need to figure out how stringent you want to be in your own research. For example, do you want to count an ER visit that resulted in an in-patient admission? Do you want to distinguish between acute and SNF nights in hospital (patients often can't distinguish)? Do you want to clarify whether the physician visits include infusions, allergy shots, dialysis, or diagnostic tests?

Characteristics

Tested on 189 Spanish-speaking subjects with diabetes.

Item
No. of
items
Observed
Range

Mean
Standard
Deviation
Internal Consistency
Reliability
Test-Retest
Reliability
1. MD visits
1
0-20
3.00
2.63
NA
2. Emergency dept visits
1
0-6
.380
1.01
NA
3. Nights in hospital
1
0-30
.651
3.12
NA
4. Eye exams
1
0-5
.910
.797
NA
5. Foot exams
1
0-6
1.000
1.28
NA

Source of Psychometric Data

Stanford Spanish Diabetes Self-Management (Tomando Control de su Diabetes) Study, ongoing. Unpublished.

Comments

There is no gold standard - self-report is not perfect. Especially when one has many visits, there tends to be an under-reporting of visits. At the same time there are significant problems with both chart audits and electronic medical records. The article below discusses these and makes a strong case of the use of self-report, at least for community-based studies.

References

Ritter PL, Kaymaz H, Stewart A, Sobel DS, Lorig KR, Self-reports of health care utilization compared to provider records. Journal of Clinical Epidemiology, 2001, 54, pp.136-141.

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