Evaluation of the ambulatory and home care record: Agreement between self-reports and administrative data

Int J Technol Assess Health Care. Spring 2006;22(2):203-10. doi: 10.1017/S0266462306051026.


Objectives: Although measuring the utilization of ambulatory and home-based healthcare resources is an essential component of economic analyses, very little methodological attention has been devoted to the development and evaluation of resource costing tools. This study evaluated a newly developed tool, the Ambulatory and Home Care Record (AHCR), which comprehensively evaluates costs incurred by the health system and care recipients and their unpaid caregivers.

Methods: The level of agreement between self-reports from 110 cystic fibrosis care recipients and administrative data was assessed for four categories of health services: home-based visits with healthcare professionals, ambulatory visits with healthcare professionals, laboratory and diagnostic tests, and prescription medications.

Results: Agreement between care recipients' reports on the AHCR and administrative data ranged from moderate (kappa = 0.41; 95 percent confidence interval, 0.16-0.61) for physician specialist visits to perfect (kappa = 1.0) for physiotherapy visits.

Conclusions: By evaluating and standardizing a resource and costing tool, such as the AHCR, economic evaluations may be improved and comparisons of the resource implications for different services and for diverse populations are possible.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Ambulatory Care / economics*
  • Ambulatory Care / statistics & numerical data
  • Caregivers / economics*
  • Caregivers / statistics & numerical data
  • Costs and Cost Analysis
  • Cystic Fibrosis / economics
  • Female
  • Health Expenditures*
  • Home Care Services / economics*
  • Home Care Services / statistics & numerical data
  • Humans
  • Male
  • Medical Records*