Validity of maternal report of acute health care use for children younger than 3 years

Background: National household surveys often rely on parents' recall to assess children's use of health care services. However, little is known about the accuracy of parental reporting of hospitalizations and emergency department (ED) use. Objectives: To assess the agreement between maternal reported and medical record acute health care data for children younger than 3 years and to determine if agreement between the 2 varies by maternal characteristics. Design and Methods: Data were obtained from the national evaluation of the Healthy Steps for Young Children for 2937 families who completed parent interviews at 2 to 4 and 30 to 33 months and whose children's medical records were abstracted. Services assessed included hospitalizations and ED visits since birth (2-4 and 30-33 months) and in the last 12 months (30-33 months). Absolute and beyond chance agreements were calculated. Results were stratified by maternal age (<20, 20-29, or ≥30 years), parity (first-time, second-time, or greater mother), income (<$20000, $20000-$49999, or >$50000), and the presence or absence of maternal depressive symptoms. Result: Absolute agreement was high for hospitalizations (≥90%) at both time points. It was high for ED use (>90%) only at 2 to 4 months. Beyond chance agreement was higher for hospitalizations than for ED use at 2 to 4 and 30 to 33 months. Beyond chance agreement declined with increased duration of recall and younger maternal age. No differences were found by other maternal characteristics. Conclusions: Mothers have good recall for acute health care events during the first 3 years of their children's lives. This finding suggests that mothers are a good source of information regarding children's acute health care use.