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Assessing record linkage between health care and Vital Statistics databases using deterministic methods.

https://arctichealth.org/en/permalink/ahliterature169901
Source
BMC Health Serv Res. 2006;6:48
Publication Type
Article
Date
2006
Author
Bing Li
Hude Quan
Andrew Fong
Mingshan Lu
Author Affiliation
Department of Community Health Sciences, University of Calgary, Calgary, Alberta, T2N 4N1, Canada. LIB@UCALGARY.CA
Source
BMC Health Serv Res. 2006;6:48
Date
2006
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Birth Certificates
Canada - epidemiology
Child
Child, Preschool
Databases, Factual
Death Certificates
Female
Hospital Records - statistics & numerical data
Humans
Infant
Male
Medical Record Linkage
Middle Aged
Patient Discharge - statistics & numerical data
Patient Identification Systems
Population Surveillance
Public Health Informatics
Registries
Vital statistics
Abstract
We assessed the linkage and correct linkage rate using deterministic record linkage among three commonly used Canadian databases, namely, the population registry, hospital discharge data and Vital Statistics registry.
Three combinations of four personal identifiers (surname, first name, sex and date of birth) were used to determine the optimal combination. The correct linkage rate was assessed using a unique personal health number available in all three databases.
Among the three combinations, the combination of surname, sex, and date of birth had the highest linkage rate of 88.0% and 93.1%, and the second highest correct linkage rate of 96.9% and 98.9% between the population registry and Vital Statistics registry, and between the hospital discharge data and Vital Statistics registry in 2001, respectively. Adding the first name to the combination of the three identifiers above increased correct linkage by less than 1%, but at the cost of lowering the linkage rate almost by 10%.
Our findings suggest that the combination of surname, sex and date of birth appears to be optimal using deterministic linkage. The linkage and correct linkage rates appear to vary by age and the type of database, but not by sex.
Notes
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PubMed ID
16597337 View in PubMed
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Assessing validity of ICD-9-CM and ICD-10 administrative data in recording clinical conditions in a unique dually coded database.

https://arctichealth.org/en/permalink/ahliterature155447
Source
Health Serv Res. 2008 Aug;43(4):1424-41
Publication Type
Article
Date
Aug-2008
Author
Hude Quan
Bing Li
L Duncan Saunders
Gerry A Parsons
Carolyn I Nilsson
Arif Alibhai
William A Ghali
Author Affiliation
Department of Community Health Sciences and Centre for Health and Policy Studies, University of Calgary, 3330 Hospital Dr. NW, Calgary, AB T2N4N1, Canada.
Source
Health Serv Res. 2008 Aug;43(4):1424-41
Date
Aug-2008
Language
English
Publication Type
Article
Keywords
Alberta - epidemiology
Current Procedural Terminology
Databases, Factual
Diagnostic Tests, Routine - classification - statistics & numerical data
Forms and Records Control - statistics & numerical data
Humans
International Classification of Diseases - classification - statistics & numerical data
Medical Records - classification - statistics & numerical data
Medical Records Department, Hospital - classification - statistics & numerical data
Patient Discharge - statistics & numerical data
Quality Indicators, Health Care
Reproducibility of Results
Retrospective Studies
Sensitivity and specificity
Abstract
The goal of this study was to assess the validity of the International Classification of Disease, 10th Version (ICD-10) administrative hospital discharge data and to determine whether there were improvements in the validity of coding for clinical conditions compared with ICD-9 Clinical Modification (ICD-9-CM) data.
We reviewed 4,008 randomly selected charts for patients admitted from January 1 to June 30, 2003 at four teaching hospitals in Alberta, Canada to determine the presence or absence of 32 clinical conditions and to assess the agreement between ICD-10 data and chart data. We then re-coded the same charts using ICD-9-CM and determined the agreement between the ICD-9-CM data and chart data for recording those same conditions. The accuracy of ICD-10 data relative to chart data was compared with the accuracy of ICD-9-CM data relative to chart data.
Sensitivity values ranged from 9.3 to 83.1 percent for ICD-9-CM and from 12.7 to 80.8 percent for ICD-10 data. Positive predictive values ranged from 23.1 to 100 percent for ICD-9-CM and from 32.0 to 100 percent for ICD-10 data. Specificity and negative predictive values were consistently high for both ICD-9-CM and ICD-10 databases. Of the 32 conditions assessed, ICD-10 data had significantly higher sensitivity for one condition and lower sensitivity for seven conditions relative to ICD-9-CM data. The two databases had similar sensitivity values for the remaining 24 conditions.
The validity of ICD-9-CM and ICD-10 administrative data in recording clinical conditions was generally similar though validity differed between coding versions for some conditions. The implementation of ICD-10 coding has not significantly improved the quality of administrative data relative to ICD-9-CM. Future assessments like this one are needed because the validity of ICD-10 data may get better as coders gain experience with the new coding system.
Notes
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PubMed ID
18756617 View in PubMed
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Association of child and adolescent psychiatric disorders with somatic or biomedical diagnoses: do population-based utilization study results support the adverse childhood experiences study?

https://arctichealth.org/en/permalink/ahliterature122998
Source
Perm J. 2012;16(2):23-6
Publication Type
Article
Date
2012
Author
T C R Wilkes
Lindsay Guyn
Bing Li
Mingshan Lu
David Cawthorpe
Author Affiliation
Foothills Hospital, Calgary, Alberta, Canada. chris.wilkes@albertahealthservices.ca
Source
Perm J. 2012;16(2):23-6
Date
2012
Language
English
Publication Type
Article
Keywords
Adolescent
Alberta - epidemiology
Ambulatory Care - economics
Child
Child, Preschool
Comorbidity
Diagnosis-Related Groups - statistics & numerical data
Female
Health Services - utilization
Humans
Infant
Male
Mental Disorders - economics - epidemiology
Somatoform Disorders - economics - epidemiology
Abstract
Few population-based studies have examined the relationship between psychiatric and somatic or biomedical disorders.
We examined the effect of the presence or absence of any psychiatric disorder on somatic or biomedical diagnosis disorder costs. Guided by the Kaiser Permanente and Centers for Disease Control and Prevention Adverse Childhood Experiences (ACE) Study, we examined our administrative data to test if psychiatric disorder is associated with a higher level of somatic disorder.
A dataset containing registration data for 205,281 patients younger than age 18 years was randomly selected from administrative data based on these patients never having received any specialized, publicly funded ambulatory, emergency or inpatient admission for treatment of a psychiatric disorder. All physician billing records (8,724,714) from the 16 fiscal years April 1993 to March 2009 were collected and grouped on the basis of presence or absence of any International Classification of Diseases (ICD) psychiatric disorder.
We compared 2 groups (with or without any psychiatric disorder: dependent variable) on the cumulative 16-year mean cost for somatic (biomedical, nonpsychiatric) ICD diagnoses (independent variable).
Billing costs related to somatic and biomedical disorders (nonpsychiatric costs) were 1.8 times greater for those with psychiatric disorders than for those without psychiatric disorders. Somatic costs peaked before the age of 6 years and remained higher than the groupings without psychiatric disorders in each age range.
In support of the ACE study, ICD psychiatric disorders (as an index of developmental adversity) are associated with substantially greater ICD somatic disorders. The findings have implications for health care practice.
Notes
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PubMed ID
22745612 View in PubMed
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Association of mental health with health care use and cost: a population study.

https://arctichealth.org/en/permalink/ahliterature131780
Source
Can J Psychiatry. 2011 Aug;56(8):490-4
Publication Type
Article
Date
Aug-2011
Author
David Cawthorpe
Thomas C R Wilkes
Lindsay Guyn
Bing Li
Mingshan Lu
Author Affiliation
Child and Adolescent Mental Health and Addictions Program, Alberta Health Services, Calgary Zone, Calgary, Alberta. cawthord@ucalgary.ca
Source
Can J Psychiatry. 2011 Aug;56(8):490-4
Date
Aug-2011
Language
English
Publication Type
Article
Keywords
Alberta
Case-Control Studies
Female
Health Care Costs - statistics & numerical data
Health Expenditures - statistics & numerical data
Humans
Male
Mental Disorders - economics - therapy
Mental Health - economics - statistics & numerical data
Mental Health Services - economics - utilization
Abstract
To compare the health costs of groups with and without psychiatric diagnoses (PDs) using 9 years of physician billing data.
A dataset containing registration data for all patients receiving public mental health service was constructed and subsequently matched, on age and sex, in a final patient to comparison patient ratio of 1:8, with health care users who did not receive treatment in the mental health system. Three groups emerged: a patient PD group-patients with psychiatric disorders treated in public mental health care (n = 76 677); a comparison patient PD group-comparison patients with PDs treated in physicians only (n = 277 627); and a patient- comparison patient non-PD group-patients (treated in specialized publicly funded care or by their physician) without PDs (n = 329 177). Examining over 42 million billing records for all of these patients, we compared the average number of visits and the average health only (nonpsychiatric) billing cost per each patient during the 9-year study period across the groups.
Among all health care users in the data, the health costs (Total Costs - Mental Health Costs) were greater on average for the patients with PD group ($3437) and the comparison patient PD group ($3265), compared with patient-comparison patient non-PD group ($1345). Forty-six percent of the comparison sample had a PD.
Having a mental health problem is related to greater health-related expenditures. This has important policy implications on how mental health resources are constructed and rationed within the health care system.
PubMed ID
21878160 View in PubMed
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Emergency department visits for acetaminophen overdose: a Canadian population-based epidemiologic study (1997-2002).

https://arctichealth.org/en/permalink/ahliterature162487
Source
CJEM. 2007 Jul;9(4):267-74
Publication Type
Article
Date
Jul-2007
Author
Robert P Myers
Bing Li
Abdel Aziz M Shaheen
Author Affiliation
Liver Unit, Division of Gastroenterology, Department of Medicine, University of Calgary, Alberta. rpmyers@ucalgary.ca
Source
CJEM. 2007 Jul;9(4):267-74
Date
Jul-2007
Language
English
Publication Type
Article
Keywords
Accidents - statistics & numerical data
Acetaminophen - poisoning
Adolescent
Adult
Age Distribution
Aged
Alberta - epidemiology
Analgesics, Non-Narcotic - poisoning
Child
Child, Preschool
Drug Overdose - epidemiology
Female
Hospitalization - statistics & numerical data - trends
Humans
Male
Middle Aged
Population Surveillance
Registries
Risk assessment
Risk factors
Sex Distribution
Socioeconomic Factors
Suicide, Attempted - statistics & numerical data
Abstract
We describe the epidemiology of emergency department (ED) visits for acetaminophen overdose in a large Canadian health region, with a focus on sociodemographic risk factors and temporal trends.
Patients presenting to an ED in the Calgary Health Region (population approximately 1.1 million) for acetaminophen overdose between 1997 and 2002 were identified using regional administrative data.
A total of 2699 patients made 3015 ED visits for acetaminophen overdose between 1997 and 2002, corresponding to an age- and sex-adjusted incidence of 45.7 per 100,000 population. Alcohol-related disorders were common (19%) and overdose rates were higher in females, younger patients, Aboriginals and social assistance recipients. The incidence decreased from 52.6 per 100,000 in 1997 to 35.1 per 100,000 in 2002 (34% relative reduction; p
PubMed ID
17626691 View in PubMed
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Follow-through after calling a nurse telephone advice line: a population-based study.

https://arctichealth.org/en/permalink/ahliterature144980
Source
Fam Pract. 2010 Jun;27(3):271-8
Publication Type
Article
Date
Jun-2010
Author
Carolyn De Coster
Hude Quan
Rod Elford
Bing Li
Lara Mazzei
Scott Zimmer
Author Affiliation
Data Integration, Measurement and Reporting, Alberta Health Services, Calgary, Alberta. carolyn.decoster@albertahealthservices.ca
Source
Fam Pract. 2010 Jun;27(3):271-8
Date
Jun-2010
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Alberta
Child
Child, Preschool
Continuity of Patient Care
Databases, Factual
Emergency Medicine
Family Practice
Female
Hotlines
Humans
Male
Middle Aged
Nurse-Patient Relations
Remote Consultation
Young Adult
Abstract
Nurse telephone advice (NTA) lines, a major initiative in primary health care reform, provide symptom triage and health information. Compliance studies utilizing database analysis are frequently limited to a defined population, such as children or Emergency Department (ED) users.
To explore caller characteristics associated with following NTA advice to go to the ED, see a health care professional or self-care for Calgary, Canada (population 1 million).
NTA data were linked with utilization data to assess ED and physician visits following a call. Four nurse advice categories were defined: go to ED, health care provider in 24 hours, health care provider in 72 hours if symptoms persist and self-care. Follow-through was defined based on health care utilization within specified time periods following the call. Logistic regression identified characteristics associated with follow-through of NTA nurse advice; characteristics included age, sex, neighbourhood income, health status, time of call and type of care protocol.
Follow-through was highest for self-care advice (83.7%), followed by ED advice (52.3%) and then 24-hour advice (43.2%). Lower follow-through on ED or 24-hour advice was associated with age
Notes
Comment In: Fam Pract. 2011 Jun;28(3):35021177745
PubMed ID
20215333 View in PubMed
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Health resource use in epilepsy: Significant disparities by age, gender, and aboriginal status.

https://arctichealth.org/en/permalink/ahliterature159472
Source
Epilepsia. 2008 Apr;49(4):586-93
Publication Type
Article
Date
Apr-2008
Author
Nathalie Jetté
Hude Quan
Peter Faris
Stafford Dean
Bing Li
Andrew Fong
Samuel Wiebe
Author Affiliation
Division of Neurology, Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada. njette@ucalgary.ca
Source
Epilepsia. 2008 Apr;49(4):586-93
Date
Apr-2008
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Age Factors
Aged
Aged, 80 and over
Ambulatory Care - economics - utilization
Canada
Child
Child, Preschool
Epilepsy - diagnosis - economics - therapy
Female
Health Care Costs
Health Resources - economics - utilization
Healthcare Disparities - statistics & numerical data
Humans
Indians, North American - statistics & numerical data
Insurance Claim Review - statistics & numerical data
International Classification of Diseases - statistics & numerical data
Male
Middle Aged
Residence Characteristics
Sex Factors
Abstract
Epilepsy imposes a significant burden on society. The objective of this study was to estimate health resource utilization (HRU) over a 1-year period in epilepsy patients, using administrative databases.
Three administrative databases (inpatient, emergency, and physician claims) were used to identify epilepsy cases. HRU variables included general physician (GP) and emergency (ER) visits, physician billings, hospitalizations, and length of stay (LOS). Logistic regression was used to determine the association between demographic variables and HRU variations.
Among the 1,431 patients with a mean age of 37.5 +/- 17.3 years, 56 (4%) were aboriginal. Ninety-six percent of patients saw a GP or a specialist (outpatient visit), 12% were hospitalized, and 8% visited the ER. Younger patients were more likely to see a neurologist (OR = 1.7, 95% CI 1.3-2.3), visit the ER (OR = 4.9, 95% CI 3.2-7.4), or be hospitalized (OR = 2.9, 95% CI 2.0-4.3). Females were less likely to see a GP but more likely to see a neurologist. Aboriginals were more likely than nonaboriginals to visit the ER (OR = 2.3, 95% CI 1.1-5.0) or be hospitalized (OR = 2.8, 95% CI 1.5-5.1) but less likely to see a neurologist (OR = 0.3, 95% CI 0.2-0.6). Welfare status and residence location (urban vs. rural) were not associated with HRU level.
We demonstrated the feasibility of using administrative databases to assess HRU in epilepsy. We also uncovered disparities in HRU by age, gender, and by aboriginal status, suggesting possible internal or external barriers to specialized care in some groups.
PubMed ID
18177361 View in PubMed
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Hospitalizations for acetaminophen overdose: a Canadian population-based study from 1995 to 2004.

https://arctichealth.org/en/permalink/ahliterature162617
Source
BMC Public Health. 2007;7:143
Publication Type
Article
Date
2007
Author
Robert P Myers
Bing Li
Andrew Fong
Abdel Aziz M Shaheen
Hude Quan
Author Affiliation
Liver Unit, Division of Gastroenterology, Department of Medicine, University of Calgary, Calgary, Alberta, Canada. rpmyers@ucalgary.ca
Source
BMC Public Health. 2007;7:143
Date
2007
Language
English
Publication Type
Article
Keywords
Accidents - statistics & numerical data
Acetaminophen - adverse effects
Adolescent
Adult
Age Distribution
Aged
Alberta - epidemiology
Analgesics, Non-Narcotic - adverse effects
Child
Child, Preschool
Drug Overdose - epidemiology - ethnology
Female
Hospitalization - statistics & numerical data - trends
Humans
Male
Middle Aged
Population Surveillance
Registries
Risk assessment
Risk factors
Sex Distribution
Socioeconomic Factors
Suicide, Attempted - ethnology - statistics & numerical data
Abstract
Acetaminophen overdose (AO) is the most common cause of acute liver failure. We examined temporal trends and sociodemographic risk factors for AO in a large Canadian health region.
1,543 patients hospitalized for AO in the Calgary Health Region (population ~1.1 million) between 1995 and 2004 were identified using administrative data.
The age/sex-adjusted hospitalization rate decreased by 41% from 19.6 per 100,000 population in 1995 to 12.1 per 100,000 in 2004 (P /= 50 years. Hospitalization rates for intentional overdoses fell from 16.6 per 100,000 in 1995 to 8.6 per 100,000 in 2004 (2004 vs. 1995: rate ratio [RR] 0.49; P
Notes
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PubMed ID
17615056 View in PubMed
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Risk adjustment performance of Charlson and Elixhauser comorbidities in ICD-9 and ICD-10 administrative databases.

https://arctichealth.org/en/permalink/ahliterature159351
Source
BMC Health Serv Res. 2008;8:12
Publication Type
Article
Date
2008
Author
Bing Li
Dewey Evans
Peter Faris
Stafford Dean
Hude Quan
Author Affiliation
Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada. lib@ucalgary.ca
Source
BMC Health Serv Res. 2008;8:12
Date
2008
Language
English
Publication Type
Article
Keywords
Aged
Algorithms
British Columbia - epidemiology
Comorbidity
Diabetes Mellitus - epidemiology - mortality
Female
Heart Failure - epidemiology - mortality
Hospital Mortality
Humans
International Classification of Diseases
Kidney Failure, Chronic - epidemiology - mortality
Logistic Models
Male
Program Evaluation
ROC Curve
Risk Adjustment - standards
Stroke - epidemiology - mortality
Abstract
The performance of the Charlson and Elixhauser comorbidity measures in predicting patient outcomes have been well validated with ICD-9 data but not with ICD-10 data, especially in disease specific patient cohorts. The objective of this study was to assess the performance of these two comorbidity measures in the prediction of in-hospital and 1 year mortality among patients with congestive heart failure (CHF), diabetes, chronic renal failure (CRF), stroke and patients undergoing coronary artery bypass grafting (CABG).
A Canadian provincial hospital discharge administrative database was used to define 17 Charlson comorbidities and 30 Elixhauser comorbidities. C-statistic values were calculated to evaluate the performance of two measures. One year mortality information was obtained from the provincial Vital Statistics Department.
The absolute difference between ICD-9 and ICD-10 data in C-statistics ranged from 0 to 0.04 across five cohorts for the Charlson and Elixhauser comorbidity measures predicting in-hospital or 1 year mortality. In the models predicting in-hospital mortality using ICD-10 data, the C-statistics ranged from 0.62 (for stroke) - 0.82 (for diabetes) for Charlson measure and 0.62 (for stroke) to 0.83 (for CABG) for Elixhauser measure.
The change in coding algorithms did not influence the performance of either the Charlson or Elixhauser comorbidity measures in the prediction of outcome. Both comorbidity measures were still valid prognostic indicators in the ICD-10 data and had a similar performance in predicting short and long term mortality in the ICD-9 and ICD-10 data.
Notes
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PubMed ID
18194561 View in PubMed
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Temporal associations of early patient transfers and mortality with the implementation of a regional myocardial infarction care model.

https://arctichealth.org/en/permalink/ahliterature130313
Source
Can J Cardiol. 2011 Nov-Dec;27(6):731-8
Publication Type
Article
Author
Alka B Patel
Hude Quan
Peter Faris
Merril L Knudtson
Mouhieddin Traboulsi
Bing Li
William A Ghali
Author Affiliation
Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada.
Source
Can J Cardiol. 2011 Nov-Dec;27(6):731-8
Language
English
Publication Type
Article
Keywords
Aged
Alberta - epidemiology
Angioplasty, Balloon, Coronary
Female
Follow-Up Studies
Hospital Mortality - trends
Hospital Planning
Humans
Length of Stay - trends
Male
Middle Aged
Models, organizational
Myocardial Infarction - mortality - therapy
Odds Ratio
Outcome Assessment (Health Care) - methods
Patient transfer
Retrospective Studies
Time Factors
Abstract
In order to reduce the delays encountered through patient transfer, regional care models have been developed that directly transport subsets of acute myocardial infarction (AMI) patients to hospitals with percutaneous coronary intervention (PCI) facilities. Calgary is a Canadian city that implemented this type of model in 2004.
The study population included 9768 AMI patients admitted to Calgary hospitals between 1997 and 2007. Administrative data were used to define patients who were directly admitted to the PCI hospital and those transferred there after initial admission to a hospital without specialized cardiac care. The differences in clinical characteristics and mortality trends of patients grouped by hospital delivery site and transfer practice are described.
The proportion of patients directly admitted to a PCI hospital has increased with the implementation of a regional care model. Among patients admitted to non-PCI facilities, the patients who are transferred are younger, more likely to be male, have a shorter length of stay, and have lower proportions of several comorbid conditions. The risk-adjusted in-hospital mortality odds ratio for patients who received care at the PCI hospital postmodel relative to those treated at non-PCI hospitals premodel was 0.38 (95% confidence interval, 0.31-0.47). The corresponding adjusted odds ratio was 0.60 (0.47-0.76).
Our results suggest changing care over time and trends toward improved outcomes. Patients' clinical characteristics appear to play a major role in the decision to transfer. Avoidance of the risk treatment paradox through refinement of regional transfer protocols ought to be a priority.
PubMed ID
22014858 View in PubMed
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