Measuring use of outpatient care among mentally ill individuals: a comparison of self reports and provider records

Psychiatric nurses administered structured interviews to 80 clients in a county mental health clinic. Clients were asked to describe their use of medical and psychiatric outpatient care services during a 180-day period. Responses were compared with medical records abstracted from a comprehensive listing of health care providers. Taken as a group, clients reported only slightly more visits than that found in medical records. Individually, however, client responses were poor predictors of visits reported in provider records. Those considered low utilizers by providers tended to overstate, and high utilizers tended to understate, the number of outpatient visits. Reporting validity did not vary with client demographic characteristics or psychiatric diagnoses. (C) 1999 Elsevier Science Ltd. All rights reserved.