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Related Experiment Videos

What patient population does visit-based sampling in primary care settings represent?

Martin L Lee1, Elizabeth M Yano, MingMing Wang

  • 1Center for the Study of Healthcare Provider Behavior, VA Greater Los Angeles Health Services Research and Development (HSR&D) Center for Exellence, Sepulveda, CA 91343, USA. martin.l.lee@att.net

Medical Care
|September 10, 2002
PubMed
Summary

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Consecutive sampling of clinic visitors oversamples frequent users, leading to results that may not represent the broader patient population. This method under-represents low-care users, impacting generalizability of outpatient intervention studies.

Area of Science:

  • Health Services Research
  • Outpatient Care
  • Sampling Methods

Background:

  • Outpatient intervention evaluations often use consecutive sampling of clinic visitors.
  • This approach assumes study findings generalize to the entire patient population.
  • The representativeness of this sampling method requires careful assessment.

Purpose of the Study:

  • To assess the representativeness of visit-based sampling compared to the overall patient population.
  • To analyze sociodemographic and clinical characteristics of patient groups yielded by visit-based sampling.
  • To identify potential biases in generalizing findings from clinic visitor samples.

Main Methods:

  • Consecutive sampling of 1,546 continuing patients at an urban VA medical center primary care clinic.

Related Experiment Videos

  • Comparison of visit frequencies between sampled patients and the general patient population.
  • Utilizing administrative and survey data to characterize represented and under-represented patient types.

    • Main Results:

    • Sampled patients visited clinics significantly more often (18.7 vs. 9.5 visits) than the reference population.
    • Sampled patients were older, had poorer health (more cancer, stroke, hypertension), were less likely to smoke, and more likely to be single.
    • Frequent visitors (>=4 visits/year) were more likely to have continuity of care, prefer VA care, and be unemployed.

    Conclusions:

    • Consecutive visit-based sampling over-represents patients with frequent healthcare utilization (4+ visits/year).
    • Studies employing this method risk under-representing patients with low healthcare utilization.
    • Researchers must consider this sampling bias and its impact on generalizability to the broader patient population.