CORRELATES AND EFFECT OF NONRESPONSE IN A POSTPARTUM SURVEY OF OBSTETRICAL CARE QUALITY

This study investigated the differences between unprompted respondents , prompted respondents, and non-respondents to a postpartum postal sur vey, and determined the likely impact of non-response on the accuracy of calculations of patient assessments of obstetrical care quality. Bi rth certificate and hospital discharge data were obtained for 1664 liv e births at three hospitals in Washington State between 8/91-10/91 and linked with 1268 completed postpartum maternal postal surveys. Non-wh ite race, public insurance payer, unmarried status, and smoking in pre gnancy were independent risk factors for non participation. Among part icipants, non-white race, unmarried status, and having an infant who w as low birthweight, preterm, or discharged late were independent risk factors for prompted response. The inclusion of prompted respondents d id not substantially alter the calculated proportion of women racing o bstetrical care quality as low, and these figures were similar to prop ortions estimated fur the entire intended cohort using a modification of Drane's method. A one-time mailing of an obstetrical care quality s urvey can provide information similar to chat obtained with more exten sive follow-up even though substantial differences may exist-between u nprompted and prompted respondents, and with adjustment for factors re lated to non-participation and timing of response, it may be possible to obtain accurate estimation of outcome prevalences for the entire in tended cohort. (C) 1997 Elsevier Science Inc.