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Health Status Assessments Using the Veterans SF-12 and SF-36: Methods for Evaluating Outcomes in the Veterans Health Administration

Jones, Debra PhD; Kazis, Lewis ScD; Lee, Austin PhD; Rogers, William PhD; Skinner, Katherine PhD; Cassar, Liana MA; Wilson, Nancy MD; Hendricks, Ann PhD

Journal of Ambulatory Care Management: July 2001 - Volume 24 - Issue 3 - p 68–86
Consumer Involvement in Health Care
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This article describes a study in which the administration of two health surveys, the Veterans SF-36 and SF-12, by telephone and mail-out was used to assess the differences in the health surveys' costs and scores by mode of administration and determine which mode was cost-efficient. The study employed a crossover design: after 12 unsuccessful attempts to contact patients by telephone, the patients were administered the survey by mail, and after 2 unsuccessful mail-outs, up to three attempts were made to interview the patients by telephone. The analysis of the data showed that mail administration, with or without crossover to telephone, was more cost-efficient than telephone administration, having both lower average total and variable costs per completed questionnaire. Overall, telephone administration was about 30% more expensive that mail administration, primarily due to the cost of labor. The marginal cost of an additional completed Veterans SF-12 or Veterans SF-36 was also substantially lower for mail administration. Mail administration without crossover to telephone administration was the most cost-efficient strategy for administering both the Veterans SF-12 and SF-36. The results of this study strongly suggest the need to consider the mode of administration if questionnaires like the Veterans SF-12 or SF-36 are to be used to assess health outcomes within and across large health care systems.

Center for Health Quality, Outcomes and Economic Research, HSR&D Field Program, VAMC, Bedford, Massachusetts (Jones)

Health Services Department, Boston University School of Public Health, Boston, Massachusetts (Jones)

Center for Health Quality, Outcomes and Economic Research, HSR&D Field Program, VAMC, Bedford, Massachusetts (Kazis)

Health Services Department, Boston University School of Public Health, Boston, Massachusetts (Kazis)

Center for Health Quality, Outcomes and Economic Research, HSR&D Field Program, VAMC, Bedford, Massachusetts (Lee)

Health Services Department, Boston University School of Public Health, Boston, Massachusetts (Lee)

Department of Mathematics and Statistics, Boston University, Boston, Massachusetts (Lee)

Health Institute, New England Medical Center, Boston, Massachusetts (Rogers)

Center for Health Quality, Outcomes and Economic Research, HSR&D Field Program, VAMC, Bedford, Massachusetts (Skinner)

Health Services Department, Boston University School of Public Health, Boston, Massachusetts (Skinner)

Harvard School of Public Health, Boston, Massachusetts (Cassar)

Voluntary Hospitals of America, Houston, Texas (Wilson)

Center for Health Quality, Outcomes and Economic Research, HSR&D Field Program, VAMC, Bedford, Massachusetts (Hendricks)

Health Services Department, Boston University School of Public Health, Boston, Massachusetts (Hendricks)

This research was supported by SDR 91006.S, Health Related Quality of Life in Veterans: The Veterans Health Study, Health Services Research and Development Service, Washington, DC; The Veterans SF-36, Special Projects, Office of Quality and Performance (10Q), Washington, DC.

Copyright © 2001 by Aspen Publishers, Inc.