Development and validation of an instrument to measure health-related out-of-pocket costs : the cost for patients questionnaire

Objective: The growth of healthcare spending is a major concern for insurers and governments but also for patients whose health problems may result in costs going beyond direct medical costs. To develop a comprehensive tool to measure direct and indirect costs of a health condition for patients and their families to various outpatient contexts. Methods: We conducted a content and face validation including results of a systematic review to identify the items related to direct and indirect costs for patients or their families and an online Delphi to determine the cost items to retain. We conducted a pilot test-retest with 18 naive participants and analyzed data calculating intraclass correlation and kappa coefficients. Results: An initial list of 34 items was established from the systematic review. Each round of the Delphi panel incorporated feedback from the previous round until a strong consensus was achieved. After 4 rounds of the Delphi to reach consensus on items to be included and wording, the questionnaire had a total of 32 cost items. For the test-retest, kappa coefficients ranged from 20.11 to 1.00 (median = 0.86), and intraclass correlation ranged from 20.02 to 0.99 (median = 0.62). Conclusions: A rigorous process of content and face development was implemented for the Cost for Patients Questionnaire, and this study allowed to set a list of cost elements to be considered from the patient's perspective. Additional research including a test-retest with a larger sample will be part of a subsequent validation strategy

Utilisation des relevailles : relevailles et collaborations intersectorielles : rapport bref

Dans une optique de responsabilité populationnelle, les établissements de santé et de services sociaux (ÉSSS) sont appelés à travailler davantage en partenariat avec les organismes communautaires Famille (OCF). Certains OCF offrent un service de relevailles qui consiste à offrir un soutien postnatal à domicile qui s’adapte aux besoins de chaque famille, afin d’écouter, d’encourager, d’informer et de soutenir l’organisation du quotidien. L’utilisation et les impacts de ce service demeurent largement méconnus, de même que les collaborations entourant sa mise en œuvre à même les réseaux locaux de services des établissements de santé et de services sociaux. BUT ET OBJECTIFS But : Évaluer les services de relevailles offerts par quatre OCF et les collaborations intersectorielles qu’ils partagent avec les ÉSSS en vue de consolider les services en période postnatale. Objectifs spécifiques : 1) Évaluer le profil d’utilisation des relevailles offertes par les OCF en termes de continuité, de productivité et de globalité; 2) Explorer les variations d’utilisation des relevailles en fonction des caractéristiques organisationnelles des OCF, des caractéristiques des familles utilisatrices et des besoins exprimés lors de l’inscription aux relevailles. FAITS SAILLANTS • Les OCF desservent une clientèle aux statuts socio-économiques variés présentant principalement des besoins de répit et de soutien pour s’occuper du bébé. Notons que 64 % ont plus d’un enfant, que l’âge moyen du bébé à l’inscription est de 3,6 mois et que 46 % des parents sont informés du service par un professionnel de la santé. • La classification des activités de relevailles en 4 profils permet de situer la spécificité du service et la globalité des tâches réalisées à domicile par les assistantes périnatales. Cela ouvre à une meilleure complémentarité avec le secteur de la santé. • En moyenne, il y a 89 jours entre la première et la dernière visite de relevailles avec un nombre moyen de 9,2 visites par famille. La continuité relationnelle très élevée est un atout pour le développement de liens de confiance. • Malgré un nombre limité d’assistantes périnatales par OCF, la productivité ramenée au plan de la famille se situe autour de 4 visites par mois. • L’utilisation des relevailles est principalement associée aux caractéristiques, prises individuellement, des organisations et à celles des familles. Aucune des variables étudiées ne permet de prédire l’utilisation des relevailles

How well do covariates perform when adjusting for sampling bias in online COVID-19 research? Insights from multiverse analyses

: COVID-19 research has relied heavily on convenience-based samples, which-though often necessary-are susceptible to important sampling biases. We begin with a theoretical overview and introduction to the dynamics that underlie sampling bias. We then empirically examine sampling bias in online COVID-19 surveys and evaluate the degree to which common statistical adjustments for demographic covariates successfully attenuate such bias. This registered study analysed responses to identical questions from three convenience and three largely representative samples (total N = 13,731) collected online in Canada within the International COVID-19 Awareness and Responses Evaluation Study ( www.icarestudy.com ). We compared samples on 11 behavioural and psychological outcomes (e.g., adherence to COVID-19 prevention measures, vaccine intentions) across three time points and employed multiverse-style analyses to examine how 512 combinations of demographic covariates (e.g., sex, age, education, income, ethnicity) impacted sampling discrepancies on these outcomes. Significant discrepancies emerged between samples on 73% of outcomes. Participants in the convenience samples held more positive thoughts towards and engaged in more COVID-19 prevention behaviours. Covariates attenuated sampling differences in only 55% of cases and increased differences in 45%. No covariate performed reliably well. Our results suggest that online convenience samples may display more positive dispositions towards COVID-19 prevention behaviours being studied than would samples drawn using more representative means. Adjusting results for demographic covariates frequently increased rather than decreased bias, suggesting that researchers should be cautious when interpreting adjusted findings. Using multiverse-style analyses as extended sensitivity analyses is recommended.COVID-19 research has relied heavily on convenience-based samples, which-though often necessary-are susceptible to important sampling biases. We begin with a theoretical overview and introduction to the dynamics that underlie sampling bias. We then empirically examine sampling bias in online COVID-19 surveys and evaluate the degree to which common statistical adjustments for demographic covariates successfully attenuate such bias. This registered study analysed responses to identical questions from three convenience and three largely representative samples (total N = 13,731) collected online in Canada within the International COVID-19 Awareness and Responses Evaluation Study (www.icarestudy.com). We compared samples on 11 behavioural and psychological outcomes (e.g., adherence to COVID-19 prevention measures, vaccine intentions) across three time points and employed multiverse-style analyses to examine how 512 combinations of demographic covariates (e.g., sex, age, education, income, ethnicity) impacted sampling discrepancies on these outcomes. Significant discrepancies emerged between samples on 73% of outcomes. Participants in the convenience samples held more positive thoughts towards and engaged in more COVID-19 prevention behaviours. Covariates attenuated sampling differences in only 55% of cases and increased differences in 45%. No covariate performed reliably well. Our results suggest that online convenience samples may display more positive dispositions towards COVID-19 prevention behaviours being studied than would samples drawn using more representative means. Adjusting results for demographic covariates frequently increased rather than decreased bias, suggesting that researchers should be cautious when interpreting adjusted findings. Using multiverse-style analyses as extended sensitivity analyses is recommended