Does the relationship of the proxy to the target person affect the concordance between survey reports and medicare claims measures of health services use?

Abstract

Objectives To compare concordance of survey reports of health service use versus claims data between self respondents and spousal and nonspousal relative proxies. Data Sources 1995-2010 data from the Survey on Assets and Health Dynamics among the Oldest Old and 1993-2010 Medicare claims for 3,229 individuals (13,488 person-years). Study Design Regression models with individual fixed effects were estimated for discordance of any hospitalizations and outpatient surgery and for the numbers of under- and over-reported physician visits. Principal Findings Spousal proxies were similar to self respondents on discordance. Nonspousal proxies, particularly daughters/daughters-in-law and sons/sons-in-law, had less discordance, mainly due to reduced under-reporting. Conclusions Survey reports of health services use from nonspousal relatives are more consistent with Medicare claims than spousal proxies and self respondents.