Health Care Utilization

1. In the past 6 months, how many times did you visit a physician? Do not include visits while in the hospital or to a hospital emergency room. Fill in with "0" or another number. ____ times
2. In the past 6 months, how many time did you go to a hospital emergency room? Fill in with "0" or another number. ____ times
3. How many different times did you stay in a hospital overnight or longer in the past 6 months? Fill in with "0" or another number. ____ times
4. How may total nights did you spend in the hospital in the past 6 months? Fill in with "0" or another number. ____ nights

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. 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 1128 to 1130 subjects with chronic disease. N=51 for test-retest.


Item
No. of
Subjects
No. of
items
Observed
Range

Mean
Standard
Deviation
Internal Consistency
Reliability
Test-Retest
Reliability
Visits to physicians
1,128
1
0-54
5.33
5.23
—
.76
Visits to emergency dept
1,129
1
0-9
.40
.93
—
.94
Times hospitalized
1,129
1
0-14
.23
.76
—
.89
Nights in hospital
1,130
1
0-116
1.31
5.53
—
.97

Source of Psychometric Data

Stanford Chronic Disease Self-Management Study. Psychometrics reported in Lorig K, Stewart A, Ritter P, González V, Laurent D, & Lynch J, Outcome Measures for Health Education and other Health Care Interventions. Thousand Oaks CA: Sage Publications, 1996, pp.24-25

Comments

There is no perfect way to get self-reported utilization data - do not try for a time period of more than six months. The article below discusses the validity of these questions. These items available in Spanish.

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.

Lorig K, Stewart A, Ritter P, González V, Laurent D, & Lynch J, Outcome Measures for Health Education and other Health Care Interventions. Thousand Oaks CA: Sage Publications, 1996, pp.24-25

To download this scale and scoring instructions, right click the link below with your mouse and "Save as" to you hard disk or desktop (for Windows), or double click (Mac):

Download PDF version