Estimating the completeness of physician billing claims for diabetes case ascertainment using population-based prescription drug data

Lix, Lisa M.; Kuwornu, John Paul; Kroeker, Kristine; Kephart, George; Sikdar, Khokan C.; Smith, Mark; Quan, Hude

doi:10.24095/hpcdp.36.3.02

Cited by 14 publications

(14 citation statements)

References 16 publications

(20 reference statements)

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“…These databases have been used extensively for health services research in Saskatchewan [ 18 , 24 ]. Other researchers have found Saskatchewan’s administrative health data to be reliable and complete [ 24 , 25 ]. The study was approved by the Research Ethics Board, University of Regina.…”

Section: Methodsmentioning

confidence: 99%

Pain-related health care costs for long-term care residents

et al. 2021

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Background We tested for differences in direct health care costs among long-term care (LTC) residents age 65 and older with clinically significant pain (CSP) and with no pain or non-daily mild pain (NP/NDMP). We are not aware of any other large scale investigation that examined the cost of pain in LTC environments. Methods Population-based administrative health data from Saskatchewan, Canada for 2004 to 2015 were used to compare direct health care costs for CSP and NP/NDMP groups up to one year after admission to LTC. Total accumulated costs for hospitalization, physician services, LTC, and prescription drugs were calculated in 2015 Canadian dollars. Group differences were tested using generalized linear models with generalized estimating equations. Results Amongst 24,870 LTC residents, 8289 (33.3%) were censored due to death or discharge in the 365-day study observation period. Of the 16,581 (66.7%) observed residents, 5683 (34.3%) had CSP at admission. Residents (66.3% female) had a mean age of 85 years (SD = 7.4). The mean annual total direct health care cost per resident was higher among the CSP group (CAD $8063) than the NP/NDMP group (CAD $6455). This difference was found even after including LTC costs, and for each cost component (i.e., CSP residents had higher hospitalization, physician, and prescription drug costs). Similar results were obtained after controlling for demographics, comorbidities, physical and cognitive impairment, prior health care costs, and facility characteristics. Conclusion The higher costs incurred by CSP residents compared to NP/NDMP residents are likely underestimated because pain problems are often missed in residents with dementia, who comprise a large portion of the LTC population. Improved pain care can reduce such costs and improve quality of life.

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Section: Methodsmentioning

confidence: 99%

Pain-related health care costs for long-term care residents

et al. 2021

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“…These endpoints were selected as they represent the largest burden of CVD-related morbidity in Canada, are the most relevant to policy makers and most likely to be modified by increased physical activity levels. These outcomes are derived from validated algorithms, providing an extremely accurate and sensitive capture of endpoints 43 46. Heart failure and peripheral artery disease will not be included in the composite outcome as algorithms have yet to be validated in the repository.…”

Section: Methods and Analysismentioning

confidence: 99%

Physical activity trails in an urban setting and cardiovascular disease morbidity and mortality in Winnipeg, Manitoba, Canada: a study protocol for a natural experiment

Hobin

Swanson²,

Booth

et al. 2020

BMJ Open

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IntroductionAspects of the built environment that support physical activity are associated with better population health outcomes. Few experimental data exist to support these observations. This protocol describes the study of the creation of urban trials on cardiovascular disease (CVD)-related morbidity and mortality in a large urban centre.Methods and analysisBetween 2008 and 2010, the city of Winnipeg, Canada, built four, paved, multiuse (eg, cycling, walking and running), two-lane trails that are 5–8 km long and span ~60 neighbourhoods. Linking a population-based health data with census and environmental data, we will perform an interrupted time series analysis to assess the impact of this natural experiment on CVD-related morbidity and mortality among individuals 30–65 years of age residing within 400–1200 m of the trail. The primary outcome of interest is a composite measure of incident major adverse CVD events (ie, CVD-related mortality, ischaemic heart disease, stroke and congestive heart failure). The secondary outcome of interest is a composite measure of incident CVD-related risk factors (ie, diabetes, hypertension and dyslipidaemia). Outcomes will be assessed quarterly in the 10 years before the intervention and 5 years following the intervention, with a 4-year interruption. We will adjust analyses for differences in age, sex, ethnicity, immigration status, income, gentrification and other aspects of the built environment (ie, greenspace, fitness/recreation centres and walkability). We will also assess trail use and trail user profiles using field data collection methods.Ethics and disseminationEthical approvals for the study have been granted by the Health Research Ethics Board at the University of Manitoba and the Health Information Privacy Committee within the Winnipeg Regional Health Authority. We have adopted an integrated knowledge translation approach. Information will be disseminated with public and government partners.Trial registration numberNCT04057417.

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“…The physician billing claims database captures all fee-for-service physician visits, which comprises the vast majority of visits. A study from 2004 estimated that 93% of physicians in Winnipeg are remunerated on a fee-for-service basis [ 32 ], while two recent studies estimated that 84.1% and 86.4% of patients diagnosed with diabetes in Manitoba were treated by a fee-for-service physician [ 33 , 34 ]. The diagnosis deemed most responsible for the physician visit is recorded using a three-digit International Classification of Diseases, 9th revision, Clinical Modification (i.e., ICD-9-CM) code.…”

Section: Methodsmentioning

confidence: 99%

Changes in healthcare use among individuals who move into public housing: a population-based investigation

Hinds

Bechtel

Distasio

et al. 2018

BMC Health Serv Res

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BackgroundResidence in public housing, a subsidized and managed government program, may affect health and healthcare utilization. We compared healthcare use in the year before individuals moved into public housing with usage during their first year of tenancy. We also described trends in use.MethodsWe used linked population-based administrative data housed in the Population Research Data Repository at the Manitoba Centre for Health Policy. The cohort consisted of individuals who moved into public housing in 2009 and 2010. We counted the number of hospitalizations, general practitioner (GP) visits, specialist visits, emergency department visits, and prescriptions drugs dispensed in the twelve 30-day intervals (i.e., months) immediately preceding and following the public housing move-in date. Generalized linear models with generalized estimating equations tested for a period (pre/post-move-in) by month interaction. Odds ratios (ORs), incident rate ratios (IRRs), and means are reported along with 95% confidence intervals (95% CIs).ResultsThe cohort included 1942 individuals; the majority were female (73.4%) who lived in low income areas and received government assistance (68.1%). On average, the cohort had more than four health conditions. Over the 24 30-day intervals, the percentage of the cohort that visited a GP, specialist, and an emergency department ranged between 37.0% and 43.0%, 10.0% and 14.0%, and 6.0% and 10.0%, respectively, while the percentage of the cohort hospitalized ranged from 1.0% to 5.0%. Generally, these percentages were highest in the few months before the move-in date and lowest in the few months after the move-in date. The period by month interaction was statistically significant for hospitalizations, GP visits, and prescription drug use. The average change in the odds, rate, or mean was smaller in the post-move-in period than in the pre-move-in period.ConclusionsUse of some healthcare services declined after people moved into public housing; however, the decrease was only observed in the first few months and utilization rebounded. Knowledge of healthcare trends before individuals move in are informative for ensuring the appropriate supports are available to new public housing residents. Further study is needed to determine if decreased healthcare utilization following a move is attributable to decreased access.Electronic supplementary materialThe online version of this article (10.1186/s12913-018-3109-7) contains supplementary material, which is available to authorized users.

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Estimating the completeness of physician billing claims for diabetes case ascertainment using population-based prescription drug data

Cited by 14 publications

References 16 publications

Pain-related health care costs for long-term care residents

Pain-related health care costs for long-term care residents

Physical activity trails in an urban setting and cardiovascular disease morbidity and mortality in Winnipeg, Manitoba, Canada: a study protocol for a natural experiment

Changes in healthcare use among individuals who move into public housing: a population-based investigation

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