The European Journal of Health Economics

, Volume 6, Issue 3, pp 261–266 | Cite as

Comparison of general practitioner records and patient self-report questionnaires for estimation of costs

  • Hema MistryEmail author
  • Martin Buxton
  • Louise Longworth
  • Judy Chatwin
  • Robert Peveler
  • on behalf of the Assessing Health Economics of Antidepressants (AHEAD) Team
Original Papers


This study compared resource use data and estimated costs over a 12-month period, based on patient self-report questionnaires and general practitioner records. The level of agreement was measured by weighted κ. Differences in total costs were plotted against mean total costs. Of 324 patients with complete GP records for the period only 85 (26.2%) had complete self-report data. The recorded number of contacts per patient was higher for patient questionnaires than GP records (17.20 vs. 12.64), and the level of agreement between the two sources was moderate (κw=0.465). The plots of differences in total costs showed a slight downward bias, suggesting that estimation of total cost from GP records is lower than patient questionnaires. The incompleteness of patient questionnaires forces reliance on GP records as the main source of information for economic evaluations.


General practitioner medical records Patient self-report questionnaires Agreement Accuracy Costs 



We acknowledge the important contribution of the patients, the health professionals and the rest of the AHEAD team involved with the trial. The original research was funded by the NHS R&D Health Technology Assessment Programme (project number 96/61/11). Support to the Health Economics Research Group for this methodological study was part of a Programme Grant from the Department of Health Policy Research Programme. The views and opinions expressed therein are those of the authors and do not necessarily reflect those of the Department of Health.


  1. 1.
    Johnston K, Buxton M, Jones D, Fitzpatrick R (1999) Assessing the costs of healthcare technologies in clinical trials. Health Technol Assess 3 (6)Google Scholar
  2. 2.
    Verbrugge L (1980) Health diaries. Med Care 18:73–95PubMedGoogle Scholar
  3. 3.
    Peveler R, Kendrick T, Buxton M et al. (2005) Randomised controlled trial to compare the cost-effectiveness of tricyclic antidepressants, selective serotonin reuptake inhibitors, and lofepramine. Health Technol Assess 9:1–148Google Scholar
  4. 4.
    Kendrick T, Peveler R, Longworth L et al. (2005) Randomised controlled trial to compare the cost-effectiveness and cost-utility of tricyclic antidepressants, selective serotonin reuptake inhibitors, and lofepramine: the Assessing Health Economics of Antidepressants (AHEAD) study. Br J Psychiatry (in press)Google Scholar
  5. 5.
    Lubeck DP, Hubert HB (2005) Self-report viable method for obtaining health care utilization data in community-dwelling seniors. J Clin Epidemiol 58:286–290CrossRefPubMedGoogle Scholar
  6. 6.
    Roberts RO, Bergstralh EJ, Schmidt L, Jacobsen SJ (1996) Comparison of self-reported and medical record health care utilisation measures. J Clin Epidemiol 49:989–995CrossRefPubMedGoogle Scholar
  7. 7.
    Bland J, Altman D (1986) Statistical methods for assessing agreement between two methods of clinical measurement. Lancet 1:307–310PubMedGoogle Scholar
  8. 8.
    Coyle D, Lee K, Drummond M (1999) Comparison of alternative sources of data on health service encounters. J Health Serv Res Policy 4:210–214PubMedGoogle Scholar
  9. 9.
    Zhu K, McKnight B, Stergachis A et al. (1999) Comparison of self-report data and medical records data: results from a case-control study on prostate cancer. Int J Epidemiol 28:409–417Google Scholar
  10. 10.
    Ruof J, Huelsemann JL, Mittendorf T et al. (2004) Patient reported health care utilization in rheumatoid arthritis: what level of detail is required? Arthritis Rheum 51:774–781CrossRefPubMedGoogle Scholar
  11. 11.
    Brink M van der, van de Hout WB, Stiggelbout AM et al. (2004) Cost measurement in economic evaluations of health care—whom to ask? Med Care 42:740–746CrossRefPubMedGoogle Scholar
  12. 12.
    McGee MA, Howie DW, Ryan P et al. (2002) Comparison of patient and doctor responses to a total hip arthroplasty clinical evaluation questionnaire. J Bone Joint Surg Am 84-A:1745–1752Google Scholar
  13. 13.
    Cotterchio M, Kreiger N, Darlington G, Steingart A (1999) Comparison of self-reported and physician-reported antidepressant medication use. Ann Epidemiol 9:283–289CrossRefPubMedGoogle Scholar

Copyright information

© Springer Medizin Verlag 2005

Authors and Affiliations

  • Hema Mistry
    • 1
    • 3
    Email author
  • Martin Buxton
    • 1
  • Louise Longworth
    • 1
  • Judy Chatwin
    • 2
  • Robert Peveler
    • 2
  • on behalf of the Assessing Health Economics of Antidepressants (AHEAD) Team
  1. 1.Health Economics Research GroupBrunel UniversityUxbridgeUK
  2. 2.School of MedicineUniversity of SouthamptonUK
  3. 3.Research Fellow in Health Economics, Health Economics Research GroupBrunel UniversityUxbridgeUK

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