How Do Self-reported Health Care Utilization and Absenteeism Measures Compare to Administrative Data?

In health promotion, researchers often rely upon self-reported health risk, utilization and productivity measures, usually through the administration of a health risk questionnaire (HRA) to assess population health. Self-reported measures can be unreliable but are useful when access to actual administrative data (medical claims and absenteeism records) are unavailable or expensive to analyze. In a study funded by NHLBI, self-reported healthcare utilization and absenteeism were compared to administrative records to determine the validity of self-reported responses. HRAs were distributed to employees at The Dow Chemical Company, whose medical claims and administrative absenteeism data were also available. Monthly and yearly doctors' visits, emergency room visits, hospital admissions and annual absent days were compared for the same individual using HRA and administrative data in 2005 and 2006, respectively. Percent agreement, over-reporting, under-reporting and Pearson's correlations determined the validity and strength of the relationship between self-reported HRA responses and claims data. Results were stratified by age, gender, race/ethnicity, job type, education, body mass index (BMI) and the Charlson Co-morbidity Index (CCI), to determine statistical significance in characteristics of the sample. The majority of participants' self-reported estimates of prior year's healthcare utilization and absenteeism correctly matched the data from administrative claims. Percent agreement for monthly claims was higher than for yearly claims. Males were more likely to have agreement for the outcomes compared to females. Overall, this comparison can be useful for researchers who rely upon self-reported HRA responses as a gauge of employee healthcare utilization and absenteeism rates when administrative claims are unavailable.