Parents were accurate proxy reporters of urgent pediatric asthma health services: a retrospective agreement analysis

Objective — To assess agreement between parents' proxy reports of children's respiratory-related health service use and administrative data.

Study Design and Setting — A retrospective analysis of statistical agreement between clinical and claims data for reports of physician visits, emergency department (ED) visits, and hospitalizations in 545 asthmatic children recruited from sites in the greater Toronto area was conducted. Health services use data were extracted from the Ontario Health Insurance Plan and Canadian Institute for Health Information databases for each child for the interval coinciding with the proxy report for each health service type.

Results — Agreement between administrative data and respondent reports (n=545) was substantial for hospitalizations in the past year (κ=0.80 [0.74, 0.86]), moderate for ED visits in the past year (κ=0.60 [0.53, 0.67]), and slight for physician visits (κ=0.13 [0.00, 0.27]) in the past 6 months. Income, parent's education, and child quality-of-life symptom scores did not affect agreement. Agreement for ED visits was significantly higher (P<0.05) for children who had an asthma attack in the past 6 months (κ=0.61 [0.54, 0.68]) compared to children who did not (κ=0.25 [0.00, 0.59]).

Conclusion — Parents of asthmatic children are reliable reporters of their child's respiratory-related urgent health services utilization.