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Accuracy of Canadian health administrative databases in identifying patients with rheumatoid arthritis: a validation study using the medical records of rheumatologists.

https://arctichealth.org/en/permalink/ahliterature114676
Source
Arthritis Care Res (Hoboken). 2013 Oct;65(10):1582-91
Publication Type
Article
Date
Oct-2013
Author
Jessica Widdifield
Sasha Bernatsky
J Michael Paterson
Karen Tu
Ryan Ng
J Carter Thorne
Janet E Pope
Claire Bombardier
Author Affiliation
University of Toronto, Toronto, Ontario, Canada.
Source
Arthritis Care Res (Hoboken). 2013 Oct;65(10):1582-91
Date
Oct-2013
Language
English
Publication Type
Article
Keywords
Adult
Aged
Algorithms
Arthritis, Rheumatoid - diagnosis - epidemiology
Data Mining - statistics & numerical data
Databases, Factual - statistics & numerical data
Drug Prescriptions - statistics & numerical data
Fees and Charges - statistics & numerical data
Female
Hospitalization - statistics & numerical data
Humans
Male
Medical Records Systems, Computerized - statistics & numerical data
Middle Aged
Ontario - epidemiology
Reproducibility of Results
Retrospective Studies
Rheumatology - statistics & numerical data
Single-Payer System - statistics & numerical data
Abstract
Health administrative data can be a valuable tool for disease surveillance and research. Few studies have rigorously evaluated the accuracy of administrative databases for identifying rheumatoid arthritis (RA) patients. Our aim was to validate administrative data algorithms to identify RA patients in Ontario, Canada.
We performed a retrospective review of a random sample of 450 patients from 18 rheumatology clinics. Using rheumatologist-reported diagnosis as the reference standard, we tested and validated different combinations of physician billing, hospitalization, and pharmacy data.
One hundred forty-nine rheumatology patients were classified as having RA and 301 were classified as not having RA based on our reference standard definition (study RA prevalence 33%). Overall, algorithms that included physician billings had excellent sensitivity (range 94-100%). Specificity and positive predictive value (PPV) were modest to excellent and increased when algorithms included multiple physician claims or specialist claims. The addition of RA medications did not significantly improve algorithm performance. The algorithm of "(1 hospitalization RA code ever) OR (3 physician RA diagnosis codes [claims] with =1 by a specialist in a 2-year period)" had a sensitivity of 97%, specificity of 85%, PPV of 76%, and negative predictive value of 98%. Most RA patients (84%) had an RA diagnosis code present in the administrative data within ±1 year of a rheumatologist's documented diagnosis date.
We demonstrated that administrative data can be used to identify RA patients with a high degree of accuracy. RA diagnosis date and disease duration are fairly well estimated from administrative data in jurisdictions of universal health care insurance.
PubMed ID
23592598 View in PubMed
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A comparison between a Canadian regional trauma unit and an American level I trauma center.

https://arctichealth.org/en/permalink/ahliterature220579
Source
J Trauma. 1993 Aug;35(2):261-6
Publication Type
Article
Date
Aug-1993
Author
B R Boulanger
B A McLellan
P W Sharkey
S. Rizoli
K. Mitchell
A. Rodriguez
Author Affiliation
Department of Surgery, Sunnybrook Health Sciences Centre, Toronto, Canada.
Source
J Trauma. 1993 Aug;35(2):261-6
Date
Aug-1993
Language
English
Publication Type
Article
Keywords
Accidents, Traffic - economics - mortality - statistics & numerical data
Adolescent
Adult
Baltimore - epidemiology
Fees and Charges - statistics & numerical data
Female
Glasgow Coma Scale
Health Care Costs - statistics & numerical data
Health Resources - economics - utilization
Health Services Research
Hospital Mortality
Humans
Injury Severity Score
Intensive Care Units - utilization
Length of Stay - statistics & numerical data
Male
Middle Aged
Multiple Trauma - diagnosis - economics - epidemiology - etiology - therapy
Ontario - epidemiology
Outcome Assessment (Health Care)
Patient Admission - statistics & numerical data
Patient Discharge - statistics & numerical data
Trauma Centers - economics - standards - statistics & numerical data - utilization
Abstract
Although there has been recent comparison of the Canadian and American health care systems, the issue of trauma has received little attention. Data were collected on all adult motor vehicle crash (MVC) victims admitted to the Sunnybrook Trauma Unit (CAN), Toronto, Canada, and the R Adams Cowley Shock Trauma Center (USA), Baltimore, Maryland from July 1986 through July 1990. Similar MVC victims at CAN and USA had equivalent mortality rates with similar discharge dispositions (p = NS), but patients at USA were twice as likely to be admitted to the ICU and had longer ICU stays (p
PubMed ID
8355306 View in PubMed
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[Diaskintest for children and teenagers screening on the tuberculous infection: accesses to pricing and analysis charges--effectiveness].

https://arctichealth.org/en/permalink/ahliterature147611
Source
Probl Tuberk Bolezn Legk. 2009;(9):41-6
Publication Type
Article
Date
2009

Payment and attendance at general practice preventive health examinations.

https://arctichealth.org/en/permalink/ahliterature54744
Source
Fam Med. 1995 Sep;27(8):531-4
Publication Type
Article
Date
Sep-1995
Author
B. Christensen
Author Affiliation
Institute of General Practice, University of Aarhus, Denmark.
Source
Fam Med. 1995 Sep;27(8):531-4
Date
Sep-1995
Language
English
Publication Type
Article
Keywords
Adult
Coronary Disease - prevention & control
Denmark
Family Practice - economics - statistics & numerical data
Fees and Charges - statistics & numerical data
Humans
Male
Mass Screening - economics - statistics & numerical data - utilization
Middle Aged
Patient Acceptance of Health Care - statistics & numerical data
Preventive Health Services - economics - statistics & numerical data - utilization
Risk factors
Abstract
BACKGROUND AND OBJECTIVES: This study's purpose was to determine how conditions of payment influence attendance at preventive health examinations. METHODS: A multi-practice study of 65 general practitioners (GPs) was conducted in two areas in the county of Aarhus, Denmark. The GPs invited 2,452 men aged 40-49 to a preventive health examination for coronary heart disease (CHD). The examination was free in one area but cost $40 in the other area. A risk profile was estimated, based on a summation of points for risk factors for CHD, including blood pressure, serum cholesterol, smoking behavior, body mass index, and family history of CHD. RESULTS: Attendance at the examinations was 37% in the required payment area and 66% in the free area. Of the total attenders, 13% had an increased risk of CHD. A slight but significant tendency, a lower risk for developing CHD, existed among attenders who paid for the examination. CONCLUSION: A requirement for payment for health examination leads to fewer patients obtaining examinations.
PubMed ID
8522084 View in PubMed
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Public payments to physicians in Ontario adjusted for overhead costs.

https://arctichealth.org/en/permalink/ahliterature107875
Source
Healthc Policy. 2012 Nov;8(2):30-6
Publication Type
Article
Date
Nov-2012
Author
Jeremy Petch
Irfan A Dhalla
David A Henry
Susan E Schultz
Richard H Glazier
Sacha Bhatia
Andreas Laupacis
Author Affiliation
Keenan Research Centre, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON. petchj@shm.ca
Source
Healthc Policy. 2012 Nov;8(2):30-6
Date
Nov-2012
Language
English
Publication Type
Article
Keywords
Fees and Charges - statistics & numerical data
Financing, Government - economics - statistics & numerical data
Humans
Income - statistics & numerical data
Long-Term Care - economics
Medicine - statistics & numerical data
Ontario
Physicians - economics
Reimbursement Mechanisms - economics
Abstract
We used data collected in the 2010 National Physician Survey and public payment data published in the Institute for Clinical and Evaluative Sciences report Payments to Ontario Physicians from Ministry of Health and Long-Term Care Sources 1992/93 to 2009/10 to estimate 2009/2010 net physician income from public payments for Ontario physicians by specialty. Incorporating overhead substantially affects estimates of physician income and changes relative position. For example, ophthalmologists were ranked second when only public payments were considered but eighth when overhead was included. Conversely, hospital-based specialties such as anaesthesia, radiation oncology and emergency medicine rank significantly higher after overhead is included.
Notes
Cites: CMAJ. 2004 Mar 2;170(5):77614993162
Cites: CMAJ. 2002 Sep 3;167(5):53512240831
Cites: Health Aff (Millwood). 2011 Sep;30(9):1647-5621900654
Cites: Am J Public Health. 2011 Jul;101(7):1198-20821566029
Cites: N Engl J Med. 1990 Sep 27;323(13):884-902118594
PubMed ID
23968613 View in PubMed
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The recommodification of healthcare? A case study of user charges and inequalities in access to healthcare in Sweden 1980-2005.

https://arctichealth.org/en/permalink/ahliterature285706
Source
Health Policy. 2017 Jan;121(1):42-49
Publication Type
Article
Date
Jan-2017
Author
Kristin Farrants
Clare Bambra
Lotta Nylen
Adetayo Kasim
Bo Burström
David Hunter
Source
Health Policy. 2017 Jan;121(1):42-49
Date
Jan-2017
Language
English
Publication Type
Article
Keywords
Cross-Sectional Studies
Educational Status
Fees and Charges - statistics & numerical data - trends
Health Services Accessibility - statistics & numerical data
Health Status Disparities
Healthcare Disparities
Humans
Organizational Case Studies
Surveys and Questionnaires
Sweden
Abstract
User charges in Swedish healthcare have increased during recent decades. This can be seen in terms of the recommodification of healthcare: making healthcare access more dependent on market position. This study investigates whether the increase in user charges had an impact on educational inequalities in access to healthcare in Sweden between 1980 and 2005.
Data from the Swedish Living Conditions Survey were used to calculate the odds ratios of access to healthcare for the low and higher educated in Sweden, and the results were stratified by health status (Good and Not good health) for each year 1980-2005. These odds ratios were correlated with the average user charge for healthcare.
There were no educational differences in healthcare access in the group with Good health. In the group with Not good health, the higher educated had higher rates of healthcare access than the lower educated. Inequalities in access to healthcare were relatively stable over time, with a slight increase among those with Not good health.
Recommodification has had only a small association with access to healthcare in Sweden. The Swedish system has integral protections that protect the vulnerable against rising healthcare costs. This is an important caveat for other countries that are considering introducing or raising user charges.
PubMed ID
27890395 View in PubMed
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Use rates under President Clinton's health reform plan.

https://arctichealth.org/en/permalink/ahliterature222210
Source
Health Care Manage Rev. 1993;18(2):27-37
Publication Type
Article
Date
1993
Author
T P Weil
Author Affiliation
Bedford Health Associates, Inc., Asheville, NC.
Source
Health Care Manage Rev. 1993;18(2):27-37
Date
1993
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Canada
Child
Child Health Services - economics
Continental Population Groups
Employment - statistics & numerical data
Fees and Charges - statistics & numerical data
Forecasting
Germany
Health services needs and demand
Hospitals - utilization
Humans
Length of Stay - economics - statistics & numerical data
Managed Care Programs - economics - trends
Maternal Health Services - economics
Medically Uninsured - statistics & numerical data
Middle Aged
National Health Insurance, United States - economics - trends
Physicians - utilization
United States
Abstract
During the 1992 presidential debates there was considerable rhetoric on health reform. Based on the broad principles now available concerning President Clinton's plan, this article compares differences in hospital and physician use rates of the now uninsured, who would be covered by his proposal, to those who have been traditionally enrolled in health insurance plans. Numerous studies illustrate that these new insurees have historically needed more and received less health care than the insured. Hospitals and physicians will be under pressure to provide a greater volume of benefits. It is predicted that these future estimated use rates will be more akin to the Canadian single-payor rather than the German multipayor national health insurance plan.
PubMed ID
8320104 View in PubMed
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8 records – page 1 of 1.