Citation

Glass JE, Bucholz KK. Drug Alcohol Depend. 2011; 116(1-3): 57-63.

Affiliation

George Warren Brown School of Social Work, Washington University in St. Louis, 1 Brookings Drive, Campus Box 1196, St. Louis, MO 63130, United States.

Copyright

(Copyright © 2011, Elsevier Publishing)

DOI

10.1016/j.drugalcdep.2010.11.021

PMID

21237585

PMCID

PMC3105172

Abstract

OBJECTIVE: The accuracy of self-reported healthcare use among individuals with alcohol use disorders (AUD) has been questioned. The present study attempts to compare the accuracy of self-reported physician visits for individuals who differ with respect to their history of AUDs. METHODS: Our data source was a 14-year follow-up of individuals interviewed at the St. Louis site of the 1981-1983 Epidemiologic Catchment Area Study (ECA). We used a case-control design (n=237) to compare the accuracy of self-reports among ECA participants with stably diagnosed AUDs (cases; n=75) to two comparison groups: those with problem/very heavy drinking (n=81) and those unaffected by alcohol (n=81). Intraclass correlation coefficients (ICC) described the concordance between self-reports and archival records of physician visits in the prior six months. We used multinomial logistic regression to identify characteristics associated with under-reporting and over-reporting, and zero-truncated Poisson regression to identify characteristics associated with discordance severity. RESULTS: Self-reports of cases had substantial concordance with physician records (ICC=0.74, CI=0.61-0.83). As compared to cases, those with problem/very heavy drinking had a significantly higher ICC, and those who were unaffected by alcohol had a significantly lower ICC. However, differences in concordance disappeared when using regression models that adjusted for factors known to affect the accuracy of self-reported healthcare use. Utilization frequency was a strong predictor of inaccurate reporting. CONCLUSIONS: These findings suggest AUD status may not independently affect the accuracy of self-reports. Counts of physician visits for those with AUD may be considered accurate when utilization frequency is low.

Language: en