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Household Survey Comparison. Melissa Heinen, M.P.H. Margaret Warner, Ph.D. Lois Fingerhut, M.A. Montreal 2002. Importance of Household Surveys. Not limited to medical records Health professionals description More detail about the event Costs and resources.
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Household Survey Comparison Melissa Heinen, M.P.H. Margaret Warner, Ph.D. Lois Fingerhut, M.A. Montreal 2002
Importance of Household Surveys • Not limited to medical records • Health professionals description • More detail about the event • Costs and resources
National Household Injury Surveys Surveys reviewed • Canada – Canadian Community Health Survey (CCHS) and the National Population Health Survey (NPHS) • New Zealand – National Health Survey • Scotland – Scottish Health Survey • South Africa – South African Demographic and Health Survey • United States – National Health Interview Survey SOURCE: CDC/NCHS
National Household Injury Surveys Items compared • Recall Period • Severity Threshold • Survey Methodology • Unit of Analysis • Injury Definitions • Survey Frequency • Probing / Screening Question SOURCE: CDC/NCHS
Recall Period Items to consider • Memory decay • Telescoping • Heaping • Sample size / relative standard error SOURCE: CDC/NCHS
Annual estimates of injury and poisoning conditions using different recall periods, NHIS 1997
Recall Period SOURCE: CDC/NCHS
Severity Threshold Measurements • Limitation in daily activities • Medical advice or treatment • Hospitalization status SOURCE: CDC/NCHS
Severity Threshold Items to consider • Health insurance coverage • Subjective - health seeking behaviors • Accessibility of health professional (rural vs. urban) • Emergency department visits SOURCE: CDC/NCHS
Severity Threshold SOURCE: CDC/NCHS
Survey Methodology Items to consider • Non-response rates • Representation • Sensitive questions and non-reporting • Cost and resources SOURCE: CDC/NCHS
Survey Methodology SOURCE: CDC/NCHS
Unit of Analysis Items to consider • Comparability of numbers • Events (e.g., car crash) • Persons • Most severe • Most recent • Conditions (e.g., fractured leg) SOURCE: CDC/NCHS
Unit of Analysis SOURCE: CDC/NCHS
Injury Definitions Items to consider • Self report vs. coding of self reports (ICD coding) • Comparability SOURCE: CDC/NCHS
Injury Definitions SOURCE: CDC/NCHS
Survey Frequency Items to consider • Trends over time • Assess data • Sample size SOURCE: CDC/NCHS
Survey Frequency SOURCE: CDC/NCHS
Screener Question Items to consider • Length • Complexity • Embedded examples SOURCE: CDC/NCHS
Screener Question SOURCE: CDC/NCHS
Screener Question SOURCE: CDC/NCHS
US Survey • Decrease injury rate • Cognitive testing -screening question • Length • Definitions • Severity
Screener Question Proposed changes for US • During the past 3 months, that is since ##, did you have an injurywhere any part of your body was hurt, for example, with a broken bone, sprain, burn, wound, cut, bruise, or animal or insect bite? • During the past 3 months, how many times were you injured? • Did you talk to or see a medical professional about any of these injuries? • Of the # times that you were injured, how many of those times was the injury serious enough that you consulted a medical professional? SOURCE: CDC/NCHS
Screener Question Proposed changes for US • During the past 3 months, that is since ##, were you poisoned by swallowing or breathing in a harmful substance such as bleach, carbon monoxide, or too many pills or drugs? (Do not include food poisoning, sun poisoning, or poison ivy rashes) • During the past 3 months, how many different times were poisoned? • Did you talk to or see a medical professional about any of these poisonings? • Of the # times that you werepoisoned, how many of those times was the poisoning serious enough that you consulted a medical professional? SOURCE: CDC/NCHS
National Household Injury Surveys Additional items to consider • Placement of injury section within a larger survey • Length of survey • Sample selection • Definitions of injuries and poisonings • Narrative introduction to the section • Weighting of data • Respondent vs. Proxy SOURCE: CDC/NCHS
National Household Injury Surveys Generic considerations • Continuous funding • Strong lobbying • Demonstrating usefulness of data SOURCE: CDC/NCHS
Website: http://www.cdc.gov/nchs/about/otheract/ice/housesur.htm
Considerations • Should our goal be to compare our selves to each other to have better questions and survey methodology? • Is it a worthwhile goal to standardize questions? • Cause compatible with ICD? • Should health behaviors be a priority? • Is it even worth comparing numbers?