VALIDATION EVIDENCE OF HEALTHCARE UTILISATION MEASURES FOR PAEDIATRIC POPULATIONS: A SYSTEMATIC REVIEW
Author(s)
Zhaohua Huo, PhD1, Xuechen Xiong, PhD2, Benjamin H. Yip, PhD3, Allen TC Lee, MD1, Linda CW Lam, MD1;
1The Chinese University of Hong Kong, Department of Psychiatry, Hong Kong SAR, China, 2The Hong Kong Polytechnic University, Department of Applied Social Sciences, Hong Kong SAR, China, 3The Chinese University of Hong Kong, Jockey Club School of Public Health and Primary Care, Hong Kong SAR, China
1The Chinese University of Hong Kong, Department of Psychiatry, Hong Kong SAR, China, 2The Hong Kong Polytechnic University, Department of Applied Social Sciences, Hong Kong SAR, China, 3The Chinese University of Hong Kong, Jockey Club School of Public Health and Primary Care, Hong Kong SAR, China
OBJECTIVES: Compared to the wide range of healthcare utilization measures available for adults, instruments for children and adolescents under 18 remain limited. This study aimed to systematically review and synthesize validation evidence for healthcare utilization questionnaires (HUQs) in paediatric populations.
METHODS: A systematic review was conducted to identify validation studies of self- or proxy-reported HUQs for individuals under 18 years of age. Searches were performed across Medline, EMBASE, PsycINFO, CINAHL, and DIRUM up to December 2025 using terms related to “healthcare,” “utilization,” “questionnaire,” “validation,” and “paediatric.” Two reviewers independently extracted study characteristics and instrument features. Methodological quality and measurement properties were assessed using COSMIN checklists.
RESULTS: Of 1,849 records screened, 21 studies were included, predominantly from Europe or North America (90.5%), in non-institutional settings (100%), and using non-trial designs (95.2%). Qualitative and quantitative methods were applied in 57.1% and 81.0% of studies, respectively. Fourteen HUQs were identified; most (90.5%) were completed by parents or caregivers, while 52.4% allowed self-report by children or adolescents. Target conditions included mental and neurodevelopmental disorders, oncology, rheumatology, immunology, respiratory diseases, and other chronic or infectious conditions. All HUQs assessed medical services, with fewer addressing social care (57.1%), caregiving time (14.3%), or productivity loss (19.0%). Content validity was most frequently evaluated (61.9%), followed by construct validity (38.1%), reliability (28.6%), criterion validity (23.8%), and internal consistency (23.8%). Evidence supporting was found for 11 HUQs in content validity, 7 in construct validity, 6 in reliability, and 5 each in criterion validity and internal consistency.
CONCLUSIONS: Several HUQs (e.g., WHAT, CHC-/YHC-SUN, AMHSS, RUD-P) demonstrate acceptable validity for measuring healthcare utilization in paediatric populations. Researchers should consider instrument constructs, target age and disease groups, and application settings when selecting HUQs. Further development of paediatric HUQ and validation across diverse psychometric properties is needed to strengthen their use in practice.
METHODS: A systematic review was conducted to identify validation studies of self- or proxy-reported HUQs for individuals under 18 years of age. Searches were performed across Medline, EMBASE, PsycINFO, CINAHL, and DIRUM up to December 2025 using terms related to “healthcare,” “utilization,” “questionnaire,” “validation,” and “paediatric.” Two reviewers independently extracted study characteristics and instrument features. Methodological quality and measurement properties were assessed using COSMIN checklists.
RESULTS: Of 1,849 records screened, 21 studies were included, predominantly from Europe or North America (90.5%), in non-institutional settings (100%), and using non-trial designs (95.2%). Qualitative and quantitative methods were applied in 57.1% and 81.0% of studies, respectively. Fourteen HUQs were identified; most (90.5%) were completed by parents or caregivers, while 52.4% allowed self-report by children or adolescents. Target conditions included mental and neurodevelopmental disorders, oncology, rheumatology, immunology, respiratory diseases, and other chronic or infectious conditions. All HUQs assessed medical services, with fewer addressing social care (57.1%), caregiving time (14.3%), or productivity loss (19.0%). Content validity was most frequently evaluated (61.9%), followed by construct validity (38.1%), reliability (28.6%), criterion validity (23.8%), and internal consistency (23.8%). Evidence supporting was found for 11 HUQs in content validity, 7 in construct validity, 6 in reliability, and 5 each in criterion validity and internal consistency.
CONCLUSIONS: Several HUQs (e.g., WHAT, CHC-/YHC-SUN, AMHSS, RUD-P) demonstrate acceptable validity for measuring healthcare utilization in paediatric populations. Researchers should consider instrument constructs, target age and disease groups, and application settings when selecting HUQs. Further development of paediatric HUQ and validation across diverse psychometric properties is needed to strengthen their use in practice.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
MSR173
Topic
Methodological & Statistical Research
Topic Subcategory
PRO & Related Methods, Survey Methods
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, SDC: Pediatrics