The anesthesia workforce in Canada: a methodology to identify physician anesthesia providers using health administrative data

Abstract

Background Safe and timely anesthesia services are an integral component of modern health care systems. There are, however, increasing concerns about the availability of anesthesia services in Canada. Thus, a comprehensive approach to assess the capacity of the anesthesia workforce to provide service is a critical need. Data regarding the anesthesia services provided by specialists and family physicians are available through the Canadian Institute for Health Information (CIHI) but collating the data across delivery jurisdictions has proven challenging. As a result, information related to the activity of physician anesthesia providers is routinely excluded from annual physician workforce reports. Our goal was to develop a novel approach to identifying and characterizing the anesthesia workforce on a pan-Canadian scale. Methods The study was approved by the University of Ottawa Office of Research Ethics and Integrity. We developed a methodology to identify physicians who provided anesthesia services in Canada between 1996 and 2018 using data elements from the CIHI National Physician Database. We iteratively consulted with expert advisors and compared the results with Scott’s Medical Database, the Canadian Medical Association (CMA) Masterfile, and the College of Family Physicians of Canada membership database. Results The methodology identified providers of anesthesia services using data elements from the CIHI National Physician Database, including categories of the National Grouping System, specialty designations, activity levels and participation thresholds. Physicians who provided anesthesia services only sporadically and medical residents-in-training were excluded. This methodology produced estimates of anesthesia providers that aligned with other sources. The process we followed was sequential, transparent, and intuitive, and was strengthened by collaboration and iterative consultation with experts and stakeholders. Conclusions Using physician activity patterns, this novel methodology allows stakeholders to identify which physician provide anesthesia services in Canada. It is an essential step in developing a pan-Canadian anesthesia workforce strategy that can be used to examine patterns and trends related to the workforce and support evidence-informed workforce decision-making. It also establishes a foundation for assessing the effectiveness of a variety of interventions aimed at optimizing physician anesthesia services in Canada.

The Physician Anesthesia Workforce in Canada From 1996 to 2018: A Longitudinal Analysis of Health Administrative Data

“…Our estimates of the current and historical stock of anesthesiologists are consistent with other data sources. 6,14…”

“…Our estimates of the current and historical stock of anesthesiologists are consistent with other data sources. 6,14 Copyright © 2023 International Anesthesia Research Society. reproduction of this article is prohibited.…”

“…We collected pan-Canadian data to characterize the anesthesia workforce in Canada between 1996 and 2018 (the most recent year data were available). A fit-for-purpose methodology 6 was developed to identify members of the anesthesia workforce using the Canadian Institute of Health Information (CIHI) National Physician Database, which captures health administrative data from the provincial and territorial health plans of 9 provinces and 1 northern territory. The province of Quebec was not included because data relating to physicians associated with the Régie de l'assurance maladie du Québec may not be used for any purpose other than specific analyses produced by CIHI.…”