American Journal of Public Health, Vol 90, Issue 8 1248-1253, Copyright © 2000 by American Public Health Association

JOURNAL ARTICLE

Bias in proxies' reports of disability: data from the National Health Interview Survey on disability

A Todorov and C Kirchner
Department of Psychology, New York University, NY 10003, USA. alext@psych.nyu.edu

OBJECTIVES: These studies examined whether differences between self-reports and proxy reports of disabilities reflect proxy response biases or only respondent selection factors. METHODS: The data were from the National Health Interview Survey on Disability (1994-1995, phases 1 and 2). In study 1, reports of disabilities were regressed on respondent status, self vs proxy, and demographic factors. In study 2, the ratios of the proportions of self-reports and proxy reports of disabilities were regressed on independent lay ratings of observability of these disabilities and their "interactional" nature. In study 3, the disability reports for people who differed in respondent status in one phase but self-reported the same disability in the other phase were compared. RESULTS: In study 1, proxies under-reported disabilities for people aged 18 to 64 years but overreported for people 65 years or older. In study 2, the observability and interactional scores accounted for more than 60% of the variance of self and proxy differences in an inverse relationship, study 3 confirmed the basic findings of study 1. CONCLUSIONS: Use of proxies in representative surveys on disability introduces systematic biases, affecting national disability estimates.

This article has been cited by other articles:

				K.-L. Chou and J. C. B. Leung Disability Trends in Hong Kong Community-Dwelling Chinese Older Adults: 1996, 2000, and 2004 J Aging Health, June 1, 2008; 20(4): 385 - 404. [Abstract] [PDF]

				E. G. Walsh and G. Khatutsky Mode of Administration Effects on Disability Measures in a Sample of Frail Beneficiaries Gerontologist, December 1, 2007; 47(6): 838 - 844. [Abstract] [Full Text] [PDF]

				T. Y. Lum, W.-C. Lin, and R. L. Kane Use of Proxy Respondents and Accuracy of Minimum Data Set Assessments of Activities of Daily Living J. Gerontol. A Biol. Sci. Med. Sci., May 1, 2005; 60(5): 654 - 659. [Abstract] [Full Text] [PDF]

				A. Horowitz, C. R. Goodman, and J. P. Reinhardt Congruence Between Disabled Elders and Their Primary Caregivers Gerontologist, August 1, 2004; 44(4): 532 - 542. [Abstract] [Full Text] [PDF]

				L. I. Iezzoni, R. B. Davis, J. Soukup, and B. O'Day Quality Dimensions That Most Concern People With Physical and Sensory Disabilities Arch Intern Med, September 22, 2003; 163(17): 2085 - 2092. [Abstract] [Full Text] [PDF]

				J. Baron, D. A. Asch, A. Fagerlin, C. Jepson, G. Loewenstein, J. Riis, M. G. Stineman, and P. A. Ubel Effect of Assessment Method on the Discrepancy between Judgments of Health Disorders People have and do not have: A Web Study Med Decis Making, September 1, 2003; 23(5): 422 - 434. [Abstract] [PDF]

				L. M. Verbrugge and P. Sevak Use, Type, and Efficacy of Assistance for Disability J. Gerontol. B. Psychol. Sci. Soc. Sci., November 1, 2002; 57(6): S366 - 379. [Abstract] [Full Text] [PDF]

				L. I. IEZZONI, R. B. DAVIS, J. SOUKUP, and B. O'DAY Satisfaction with quality and access to health care among people with disabling conditions Int. J. Qual. Health Care, October 1, 2002; 14(5): 369 - 381. [Abstract] [Full Text] [PDF]

				L. I. Tezzoni, E. P. McCarthy, R. B. Davis, L. Harris-David, and B. O'Day Use of Screening and Preventive Services Among Women With Disabilities American Journal of Medical Quality, July 1, 2001; 16(4): 135 - 144. [Abstract] [PDF]