Medical consumption of respondents and non-respondents to a mailed health survey

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Abstract
Non-response bias can distort the results of health surveys. The occurrence of selective non-response can be assessed when data are available for both respondents and non-respondents. The objective of this study was to compare the medical consumption of respondents and non-respondents to a mailed health survey. A mailed health survey was conducted among approximately 13,500 adults and among parents of approximately 1,500 children aged 5–15 years. The net response rate was 70.4%. A panel data set that could be matched with the health survey data was available for all eligible persons. This data set comprises administrative information on hospitalizations, annual health care expenditures and demographic variables. The results of this study show that response was associated with age, sex, degree of urbanization and type of insurance. After correcting for differences in demographic variables, respondents and non-respondents differ in the utilization of several types of care. Relatively more users than non-users responded. Response was not associated with the utilization of care related to severe conditions such as in-patient hospital care. The conclusion from this study is that when a mailed health survey is used to measure medical consumption, the non-response bias will result in a small overestimation of utilization.

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