Skip header and navigation

Refine By

37 records – page 1 of 4.

Adults' use of health services in the year before death by suicide in Alberta.

https://arctichealth.org/en/permalink/ahliterature129450
Source
Health Rep. 2011 Sep;22(3):15-22
Publication Type
Article
Date
Sep-2011
Author
Kenneth B Morrison
Lory Laing
Author Affiliation
Alberta Children and Youth Services, Edmonton, Alberta, T5K 2N2. ken.morrison@gov.ab.ca
Source
Health Rep. 2011 Sep;22(3):15-22
Date
Sep-2011
Language
English
Publication Type
Article
Keywords
Adult
Age Factors
Alberta - epidemiology
Case-Control Studies
Female
Health Services - utilization
Humans
Insurance Claim Review - statistics & numerical data
Male
Mental Disorders - complications - diagnosis
Middle Aged
Residence Characteristics - statistics & numerical data
Risk factors
Sex Factors
Socioeconomic Factors
Suicide - statistics & numerical data
Abstract
The suicide rate in Alberta is consistently above the Canadian average. Health care use profiles of those who die by suicide in Alberta are currently unknown.
Death records were selected for people aged 25 to 64 with suicide coded as the underlying cause of death from April 1, 2003 to March 31, 2006. The death records were linked to administrative records pertaining to physician visits, emergency department visits, inpatient hospital separations, and community mental health visits. The control group was the Alberta population aged 25 to 64 who did not die by suicide. Frequency estimates were produced to determine the characteristics of the study population. Odds ratios relating to demographics, exposure to health care services, and case-control status were estimated with logistic regression.
Almost 90% of suicides had a health service in the year before their death. Suicides averaged 16.6 visits per person, compared with 7.7 visits for non-suicides. Much of the health service use among people who died by suicide appears to have been driven by mental disorders.
Information about health service delivery to those who die by suicide can guide prevention and intervention efforts.
PubMed ID
22106785 View in PubMed
Less detail

Determining the test characteristics of claims-based diagnostic codes for the diagnosis of venous thromboembolism in a medical service claims database.

https://arctichealth.org/en/permalink/ahliterature136715
Source
Pharmacoepidemiol Drug Saf. 2011 Mar;20(3):304-7
Publication Type
Article
Date
Mar-2011
Author
Vicky Tagalakis
Susan R Kahn
Author Affiliation
Centre for Clinical Epidemiology and Community Studies, Jewish General Hospital, McGill University, Montréal, Québec, Canada. vicky.tagalakis@mcgill.ca
Source
Pharmacoepidemiol Drug Saf. 2011 Mar;20(3):304-7
Date
Mar-2011
Language
English
Publication Type
Article
Keywords
Canada
Clinical Coding
Cohort Studies
Databases, Factual - statistics & numerical data
Female
Humans
Insurance Claim Review - statistics & numerical data
International Classification of Diseases
Male
Middle Aged
Pulmonary Embolism - diagnosis
Quality Assurance, Health Care - methods
Venous Thrombosis - diagnosis
Abstract
To determine the test characteristics of diagnostic codes within a medical service claims database for deep vein thrombosis (DVT) and pulmonary embolism (PE).
The Regie de l' Assurance Maladie du Québec (RAMQ) administers the health insurance program in Québec, Canada. RAMQ claims data were obtained for subjects with objectively diagnosed DVT with or without PE who were participants in the Venous Thrombosis Outcomes (VETO) Study from April 2001 to July 2002. Using the date of DVT and PE diagnosis in the VETO record as the reference standard, the proportion of subjects correctly classified by RAMQ diagnostic codes was determined for the exact date of DVT and PE occurrence and for four expanded time windows around this date.
In all, 355 VETO patients were included, 301 with DVT alone and 54 with DVT and PE. Overall, 97% of VETO cases had a RAMQ diagnostic code for DVT and 82% of VETO cases with PE had a RAMQ diagnostic code for PE. Sensitivity for DVT and PE was 52% (95% confidence interval (CI), 47-57) and 35% (95% CI, 23-49), respectively for the exact date of diagnosis, and 87% (95% CI, 83-90) and 78% (95% CI, 64-88), respectively for a 60-day window around this date. As all VETO participants had DVT, specificity for the diagnosis of DVT could not be determined.
Diagnostic codes within a medical service claims database are relatively sensitive indicators for DVT and PE, and use of claims data for VTE research purposes can be considered.
PubMed ID
21351312 View in PubMed
Less detail

Development and validation of a predictive algorithm to identify adult asthmatics from medical services and pharmacy claims databases.

https://arctichealth.org/en/permalink/ahliterature137505
Source
Health Serv Res. 2011 Jun;46(3):939-63
Publication Type
Article
Date
Jun-2011
Author
Yuko Kawasumi
Michal Abrahamowicz
Pierre Ernst
Robyn Tamblyn
Author Affiliation
Centre for Health Services and Policy Research, University of British Columbia, 201-2206 East Mall, Vancouver, BC, Canada. ykawasumi@chspr.ubc.ca
Source
Health Serv Res. 2011 Jun;46(3):939-63
Date
Jun-2011
Language
English
Publication Type
Article
Keywords
Adult
Aged
Algorithms
Asthma - epidemiology - prevention & control
Drug Prescriptions - statistics & numerical data
Female
Health Status Indicators
Humans
Insurance Claim Review - statistics & numerical data
Logistic Models
Male
Management Information Systems - statistics & numerical data
Mass Screening - methods
Middle Aged
Multivariate Analysis
Quebec - epidemiology
Reproducibility of Results
Sensitivity and specificity
Severity of Illness Index
Abstract
To develop and validate the accuracy of a predictive model to identify adult asthmatics from administrative health care databases.
An existing electronic medical record project in Montreal, Quebec.
One thousand four hundred and thirty-one patients with confirmed asthma status were identified from primary care physician's electronic medical record.
Therapeutic indication of asthma in an electronic prescription and/or confirmed asthma from an automated problem list were used as the gold standard. Five groups of asthma-specific markers were identified from administrative health care databases to estimate the probability of the presence of asthma. Cross-validation evaluated the diagnostic ability of each predictive model using 50 percent of sample.
The best performance in discriminating between the patients with asthma and those without it included indicators from medical service and prescription claims databases. The best-fitting algorithm had a sensitivity of 70 percent, a specificity of 94 percent, and positive predictive value of 65 percent. The prescriptions claims-specific algorithm demonstrated a nearly equal performance to the model with medical services and prescription claims combined.
Our algorithm using asthma-specific markers from administrative claims databases provided moderate sensitivity and high specificity.
Notes
Cites: Postgrad Med J. 2000 Jul;76(897):413-410878200
Cites: Pharmacoepidemiol Drug Saf. 2006 Apr;15(4):245-5216374899
Cites: Can Respir J. 2001 Mar-Apr;8 Suppl A:5A-27A11360044
Cites: J Asthma. 2001 Jun;38(4):363-7311456390
Cites: Pediatrics. 2001 Aug;108(2):432-711483811
Cites: Am J Med. 2002 Jan;112(1):44-811812406
Cites: Arch Pediatr Adolesc Med. 2002 Feb;156(2):141-611814375
Cites: Eur J Clin Pharmacol. 2002 Jan;57(11):819-2511871384
Cites: Curr Opin Allergy Clin Immunol. 2002 Jun;2(3):189-9412045413
Cites: J Clin Epidemiol. 2002 Sep;55(9):938-4412393083
Cites: J Asthma. 2003 Sep;40(6):683-9014580000
Cites: Am J Manag Care. 2004 Jan;10(1):25-3214738184
Cites: Ann Allergy Asthma Immunol. 2004 Jan;92(1):40-614756463
Cites: Can Respir J. 2004 Mar;11(2):141-515045045
Cites: J Clin Epidemiol. 2004 Feb;57(2):131-4115125622
Cites: J Clin Epidemiol. 2004 Apr;57(4):392-715135841
Cites: Radiology. 1982 Apr;143(1):29-367063747
Cites: Am J Manag Care. 2006 Aug;12(8):478-8416886890
Cites: Can Respir J. 2006 Jul-Aug;13(5):253-916896426
Cites: J Clin Epidemiol. 2007 Jun;60(6):600-917493519
Cites: Thorax. 2007 Jul;62(7):581-717287299
Cites: Thorax. 1986 Nov;41(11):833-93824270
Cites: Biometrics. 1988 Sep;44(3):837-453203132
Cites: Health Serv Res. 1991 Apr;26(1):53-741901841
Cites: J Clin Epidemiol. 1995 Nov;48(11):1393-77490602
Cites: J Allergy Clin Immunol. 1996 Dec;98(6 Pt 1):1016-88977499
Cites: Aust Fam Physician. 1997 Jan;26 Suppl 1:S4-69009028
Cites: Arch Intern Med. 1997 Jun 9;157(11):1201-89183231
Cites: Am J Respir Crit Care Med. 1998 Jan;157(1):123-89445289
Cites: J Clin Epidemiol. 2005 Feb;58(2):206-815680756
Cites: Pediatr Pulmonol. 2004 Dec;38(6):443-5015690559
Cites: Psychosom Med. 2005 Jul-Aug;67(4):596-60116046373
Cites: Chest. 2005 Aug;128(2):602-816100144
Cites: Eur J Epidemiol. 2005;20(11):947-5616284873
Cites: Can Respir J. 2005 Nov-Dec;12(8):435-616331315
Cites: J Am Med Inform Assoc. 2006 Mar-Apr;13(2):148-5916357357
Cites: Pediatrics. 2000 Oct;106(4 Suppl):886-9611044140
PubMed ID
21275988 View in PubMed
Less detail

Effect of ambiguous hemochromatosis gene test results on physician utilization.

https://arctichealth.org/en/permalink/ahliterature128154
Source
Med Care. 2012 May;50(5):394-8
Publication Type
Article
Date
May-2012
Author
Mark Speechley
David Alter
Helen Guo
Helen Harrison
Paul C Adams
Author Affiliation
Department of Epidemiology, University of Western Ontario, London, Canada.
Source
Med Care. 2012 May;50(5):394-8
Date
May-2012
Language
English
Publication Type
Article
Keywords
Adult
Cohort Studies
Female
Ferritins - blood
Genetic Counseling - statistics & numerical data
Genetic Testing - statistics & numerical data
Histocompatibility Antigens Class I - genetics
Humans
Insurance Claim Review - statistics & numerical data
Iron Overload - blood
Male
Membrane Proteins - genetics
Middle Aged
Mutation
Ontario
Physicians - utilization
Primary Health Care - utilization
Transferrin - analysis
Abstract
Genetic test results may be available to greater numbers of people through genetic screening projects and other means. The effects of widespread genetic testing and notification of genetic test results, particularly added costs through increased physician utilization, have not been clearly established.
A primary care-based cohort of 20,306 participants (Hemochromatosis and Iron Overload Study, Ontario site) were tested for the C282Y and H63D mutations of the HFE gene and for abnormal serum ferritin (SF) and transferrin saturation levels. The primary outcome variable was the total number of physician claims per patient after genetic test notification by mail. Multiple Poisson regression was used to adjust for age, sex, baseline SF, diagnoses of arthritis, diabetes, heart failure and impotence, self-rated health, and the number of claims during the 12 months before notification of results. The reference group had no HFE mutations (wild type) and normal transferrin saturation/SF values.
Participants with an ambiguous hemochromatosis gene test and normal iron levels had statistically significantly higher average physician utilization of 3.0%. Participants with HFE mutations (excluding C282Y homozygotes) and elevated iron values showed a 6% increase in physician utilization.
The health effects, if any, of increased utilization in heterozygotes or those with mild ferritin elevations are unknown but are unlikely to be large at the population level. Ambiguous genetic test results are associated with increased physician service use and should be considered when assessing the complete societal costs of widespread genetic testing.
Notes
Cites: Milbank Mem Fund Q Health Soc. 1978 Fall;56(4):426-62104191
Cites: Genet Med. 2005 Mar;7(3):191-715775755
Cites: N Engl J Med. 2005 Apr 28;352(17):1769-7815858186
Cites: Am J Med Sci. 2003 Feb;325(2):53-6212589228
Cites: Breast Dis. 2006-2007;27:97-10817917142
Cites: Genet Med. 2007 Nov;9(11):778-9118007147
Cites: Genet Test. 2008 Dec;12(4):491-50018939938
Cites: Genet Med. 2006 Nov;8(11):681-717108759
PubMed ID
22228247 View in PubMed
Less detail

Effect of eliminating compensation for pain and suffering on the outcome of insurance claims.

https://arctichealth.org/en/permalink/ahliterature196941
Source
N Engl J Med. 2000 Oct 12;343(15):1119-20
Publication Type
Article
Date
Oct-12-2000

Effect of eliminating compensation for pain and suffering on the outcome of insurance claims.

https://arctichealth.org/en/permalink/ahliterature196942
Source
N Engl J Med. 2000 Oct 12;343(15):1119; author reply 1120
Publication Type
Article
Date
Oct-12-2000

Effect of eliminating compensation for pain and suffering on the outcome of insurance claims.

https://arctichealth.org/en/permalink/ahliterature196943
Source
N Engl J Med. 2000 Oct 12;343(15):1119; author reply 1120
Publication Type
Article
Date
Oct-12-2000

Effect of eliminating compensation for pain and suffering on the outcome of insurance claims.

https://arctichealth.org/en/permalink/ahliterature196944
Source
N Engl J Med. 2000 Oct 12;343(15):1118-9; author reply 1120
Publication Type
Article
Date
Oct-12-2000

Effect of eliminating compensation for pain and suffering on the outcome of insurance claims for whiplash injury.

https://arctichealth.org/en/permalink/ahliterature198845
Source
N Engl J Med. 2000 Apr 20;342(16):1179-86
Publication Type
Article
Date
Apr-20-2000
Author
J D Cassidy
L J Carroll
P. Côté
M. Lemstra
A. Berglund
A. Nygren
Author Affiliation
Alberta Centre for Injury Control and Research, Department of Public Health Sciences, University of Alberta, Edmonton, Canada. dcassidy@ualberta.ca
Source
N Engl J Med. 2000 Apr 20;342(16):1179-86
Date
Apr-20-2000
Language
English
Publication Type
Article
Keywords
Accidents, Traffic - economics
Adult
Female
Humans
Incidence
Insurance Claim Reporting - statistics & numerical data
Insurance Claim Review - statistics & numerical data
Insurance, Accident - economics - legislation & jurisprudence - statistics & numerical data - utilization
Insurance, Liability - statistics & numerical data - utilization
Male
Neck Pain - economics - etiology
Prognosis
Saskatchewan
Time Factors
Whiplash Injuries - complications - economics - epidemiology
Abstract
The incidence and prognosis of whiplash injury from motor vehicle collisions may be related to eligibility for compensation for pain and suffering. On January 1, 1995, the tort-compensation system for traffic injuries, which included payments for pain and suffering, in Saskatchewan, Canada, was changed to a no-fault system, which did not include such payments. To determine whether this change was associated with a decrease in claims and improved recovery after whiplash injury, we studied a population-based cohort of persons who filed insurance claims for traffic injuries between July 1, 1994, and December 31, 1995.
Of 9006 potentially eligible claimants, 7462 (83 percent) met our criteria for whiplash injury. The six-month cumulative incidence of claims was 417 per 100,000 persons in the last six months of the tort system, as compared with 302 and 296 per 100,000, respectively, in the first and second six-month periods of the no-fault system. The incidence of claims was higher for women than for men in each period; the incidence decreased by 43 percent for men and by 15 percent for women between the tort period and the two no-fault periods combined. The median time from the date of injury to the closure of a claim decreased from 433 days (95 percent confidence interval, 409 to 457) to 194 days (95 percent confidence interval, 182 to 206) and 203 days (95 percent confidence interval, 193 to 213), respectively. The intensity of neck pain, the level of physical functioning, and the presence or absence of depressive symptoms were strongly associated with the time to claim closure in both systems.
The elimination of compensation for pain and suffering is associated with a decreased incidence and improved prognosis of whiplash injury.
Notes
Comment In: N Engl J Med. 2000 Oct 12;343(15):1118-9; author reply 112011032514
Comment In: N Engl J Med. 2000 Oct 12;343(15):1119-2011032517
Comment In: N Engl J Med. 2000 Oct 12;343(15):1119; author reply 112011032516
Comment In: N Engl J Med. 2000 Apr 20;342(16):1211-310770990
Comment In: N Engl J Med. 2000 Oct 12;343(15):1119; author reply 112011032515
PubMed ID
10770984 View in PubMed
Less detail

37 records – page 1 of 4.