Does the relationship of the proxy to the target person affect the concordance between survey reports and Medicare claims measures of health services use?

Objectives. To compare concordance of survey reports of health service use versus claims data between self respondents and spousal and nonspousal relative proxies. Data Sources. 1995-2010 data from the Survey on Assets and Health Dynamics among the Oldest Old and 1993-2010 Medicare claims for 3,229 individuals (13,488 person-years). Study Design. Regression models with individual fixed effects were estimated for discordance of any hospitalizations and outpatient surgery and for the numbers of under- and over-reported physician visits. Principal Findings. Spousal proxies were similar to self respondents on discordance. Nonspousal proxies, particularly daughters/daughters-in-law and sons/sons-in-law, had less discordance, mainly due to reduced under-reporting. Conclusions. Survey reports of health services use from nonspousal relatives are more consistent with Medicare claims than spousal proxies and self respondents. Key Words. Survey reports, Medicare claims, proxy respondents
The use of proxy respondents is common practice in national health and health services use surveys. When surveying older adults, the use of proxies is particularly relevant due to their [...]