edoc

Investigating the effect of recall period on estimates of inpatient out-of-pocket expenditure from household surveys in Vietnam

Le, L. M. and Flores, G. and Edejer, T. T. and Tran, T. K. and Nguyen, C. T. K. and Tran, D. T. and Ho, P. D. and Agorinya, I. A. and Tediosi, F. and Ross, A.. (2020) Investigating the effect of recall period on estimates of inpatient out-of-pocket expenditure from household surveys in Vietnam. PLoS One, 15 (11). e0242734.

[img] PDF - Published Version
Available under License CC BY (Attribution).

555Kb

Official URL: https://edoc.unibas.ch/91182/

Downloads: Statistics Overview

Abstract

Out-of-pocket payments (OOPs), direct payments by households or individuals for healthcare are part of the health financing landscape. Data on OOPs is needed to monitor progress in financial risk protection, and the evaluation of health financing policies. In low-and-middle-income countries, estimates of OOPs rely heavily on self-reported data from household surveys. These surveys require respondents to recall events in the past and can suffer from recall biases. This study investigates the effect of recall period on the agreement of the amount and timing of inpatient OOPs between household reports and provider records in Bavi, Vietnam. We recruited 1397 households for interview using records from the district hospital. The households were interviewed with identical questionnaires except that the recall period was either 12 or 6 months. We linked household with provider data and excluded medicine costs from both household and provider OOPs since they could be purchased outside the hospital. We estimated the effect of recall period on the overall mean and variability of ratios of household to hospital reported OOPs using the Bland-Altman approach for method comparison. We estimated the effect of recall period on whether a transaction was recalled correctly in expenditure and time using multinomial regression. The households reported higher amounts of OOPs than did the hospital for both recall periods. There was no evidence of an effect of recall period on the mean of the ratios of household- to hospital-reported OOPs, although the confidence intervals are not inconsistent with previous studies indicating higher OOPs for shorter recall periods. The geometric mean ratio for the 6-month period was estimated to be a multiple of 1.4 (95% CI 0.9, 2.1) times that of the 12-month period. Similarly, there was no evidence of an effect of recall period on the risk of reporting lower or higher amounts than provider OOPs. The occurrence and timing of inpatient stays generally recalled well, with 70% remembered in the correct month declining slightly over time. Respondents for the 6-month recall period had a significantly lower risk of failing to report the event (RR 0.8 (0.7, 1.0)). The results suggest the best recall period may depend on whether the purpose of a survey is for the recall of the timing of events, in which case the 6 month period may be better, or the amounts of OOPs, where there was no significant difference and the provider records are not a gold standard but the 12 month period had a tendency to be in closer agreement with the provider OOPs.
Faculties and Departments:09 Associated Institutions > Swiss Tropical and Public Health Institute (Swiss TPH)
09 Associated Institutions > Swiss Tropical and Public Health Institute (Swiss TPH) > Department of Epidemiology and Public Health (EPH) > Biostatistics > Biostatistics Frequentist Modelling (Kwiatkowski)
09 Associated Institutions > Swiss Tropical and Public Health Institute (Swiss TPH) > Department of Epidemiology and Public Health (EPH) > Household Economics and Health Systems Research > Health Systems and Policy (Tediosi)
UniBasel Contributors:Le, My Lan and Tediosi, Fabrizio and Ross, Amanda and Agorinya, Isaiah Awintuen
Item Type:Article, refereed
Article Subtype:Research Article
ISSN:1932-6203 (Electronic)1932-6203 (Linking)
Note:Publication type according to Uni Basel Research Database: Journal article
Language:English
Related URLs:
Identification Number:
edoc DOI:
Last Modified:28 Dec 2022 13:27
Deposited On:28 Dec 2022 13:27

Repository Staff Only: item control page