Multimorbidity measures from health administrative data using ICD system codes: a systematic review

Author(s):  
Marc Simard ◽  
Elham Rahme ◽  
Alexandre Campeau Calfat ◽  
Caroline Sirois
2014 ◽  
Vol 28 (10) ◽  
pp. 1167-1196 ◽  
Author(s):  
Julia M Langton ◽  
Bianca Blanch ◽  
Anna K Drew ◽  
Marion Haas ◽  
Jane M Ingham ◽  
...  

2013 ◽  
Vol 31 (31_suppl) ◽  
pp. 111-111
Author(s):  
Julia M. Langton ◽  
Bianca Blanch ◽  
Annabelle Drew ◽  
Marion Haas ◽  
Jane M. Ingham ◽  
...  

111 Background: The last year of life is one of the most resource intensive periods in cancer care. The aim of this systematic review is to synthesize retrospective observational studies examining resource utilization and costs at the end-of-life period in adult cancer patients. The purpose is to examine study methodology and outcomes, with a particular focus on studies using quality indicators. Methods: We searched Medline, Embase, CINAHL, and York Centre for Research and Dissemination (1990-2011). Two reviewers screened titles and abstracts of 14,424 articles and 835 full-text, potentially relevant articles. Inclusion criteria were: English-language; at least one resource utilization or cost outcome in adult cancer decedents with solid tumors; outcomes derived from health administrative data; and an exclusive end-of-life or palliative focus. Results: We reviewed 78 studies examining end-of-life care in over 3.7 million cancer decedents; 55 were from the North America; and 33 published since 2008. We observed exponential increases in service use and costs as death approached. Hospital services were the main cost driver. Palliative services were relatively underutilized, and associated with lower expenditures than hospital-based care. The 15 studies using quality of care indicators demonstrated significant proportions of up to 33% of patients receive chemotherapy or life sustaining treatments in the last month of life; up to 66% do not receive hospice/palliative services. Conclusions: Observational studies using routinely collected health administrative data have the potential to drive evidence-based palliative care practice and policy. Further refinement of quality of care markers will enhance benchmarking activities across health care jurisdictions, providers, and patient populations.


2018 ◽  
Vol 49 (12) ◽  
pp. 2091-2099 ◽  
Author(s):  
Kelly K. Anderson ◽  
Ross Norman ◽  
Arlene G. MacDougall ◽  
Jordan Edwards ◽  
Lena Palaniyappan ◽  
...  

AbstractBackgroundDiscrepancies between population-based estimates of the incidence of psychotic disorder and the treated incidence reported by early psychosis intervention (EPI) programs suggest additional cases may be receiving services elsewhere in the health system. Our objective was to estimate the incidence of non-affective psychotic disorder in the catchment area of an EPI program, and compare this to EPI-treated incidence estimates.MethodsWe constructed a retrospective cohort (1997–2015) of incident cases of non-affective psychosis aged 16–50 years in an EPI program catchment using population-based linked health administrative data. Cases were identified by either one hospitalization or two outpatient physician billings within a 12-month period with a diagnosis of non-affective psychosis. We estimated the cumulative incidence and EPI-treated incidence of non-affective psychosis using denominator data from the census. We also estimated the incidence of first-episode psychosis (people who would meet the case definition for an EPI program) using a novel approach.ResultsOur case definition identified 3245 cases of incident non-affective psychosis over the 17-year period. We estimate that the incidence of first-episode non-affective psychosis in the program catchment area is 33.3 per 100 000 per year (95% CI 31.4–35.1), which is more than twice as high as the EPI-treated incidence of 18.8 per 100 000 per year (95% CI 17.4–20.3).ConclusionsCase ascertainment strategies limited to specialized psychiatric services may substantially underestimate the incidence of non-affective psychotic disorders, relative to population-based estimates. Accurate information on the epidemiology of first-episode psychosis will enable us to more effectively resource EPI services and evaluate their coverage.


2018 ◽  
Vol 18 (1) ◽  
Author(s):  
Andrea Gruneir ◽  
Candemir Cigsar ◽  
Xuesong Wang ◽  
Alice Newman ◽  
Susan E. Bronskill ◽  
...  

BJPsych Open ◽  
2018 ◽  
Vol 4 (6) ◽  
pp. 447-453 ◽  
Author(s):  
Kelly K. Anderson ◽  
Suzanne Archie ◽  
Richard G. Booth ◽  
Chiachen Cheng ◽  
Daniel Lizotte ◽  
...  

BackgroundThe family physician is key to facilitating access to psychiatric treatment for young people with first-episode psychosis, and this involvement can reduce aversive events in pathways to care. Those who seek help from primary care tend to have longer intervals to psychiatric care, and some people receive ongoing psychiatric treatment from the family physician.AimsOur objective is to understand the role of the family physician in help-seeking, recognition and ongoing management of first-episode psychosis.MethodWe will use a mixed-methods approach, incorporating health administrative data, electronic medical records (EMRs) and qualitative methodologies to study the role of the family physician at three points on the pathway to care. First, help-seeking: we will use health administrative data to examine access to a family physician and patterns of primary care use preceding the first diagnosis of psychosis; second, recognition: we will identify first-onset cases of psychosis in health administrative data, and look back at linked EMRs from primary care to define a risk profile for undetected cases; and third, management: we will examine service provision to identified patients through EMR data, including patterns of contacts, prescriptions and referrals to specialised care. We will then conduct qualitative interviews and focus groups with key stakeholders to better understand the trends observed in the quantitative data.DiscussionThese findings will provide an in-depth description of first-episode psychosis in primary care, informing strategies to build linkages between family physicians and psychiatric services to improve transitions of care during the crucial early stages of psychosis.Declaration of interestNone.


F1000Research ◽  
2020 ◽  
Vol 9 ◽  
pp. 1438
Author(s):  
Suman Budhwani ◽  
Ashlinder Gill ◽  
Mary Scott ◽  
Walter P. Wodchis ◽  
JinHee Kim ◽  
...  

Background: A plethora of performance measurement indicators for palliative and end-of-life care currently exist in the literature. This often leads to confusion, inconsistency and redundancy in efforts by health systems to understand what should be measured and how.  The objective of this study was to conduct a scoping review to provide an inventory of performance measurement indicators that can be measured using population-level health administrative data, and to summarize key concepts for measurement proposed in the literature.  Methods: A scoping review using MEDLINE and EMBASE, as well as grey literature was conducted.  Articles were included if they described performance or quality indicators of palliative and end-of-life care at the population-level using routinely-collected administrative data.  Details on the indicator such as name, description, numerator, and denominator were charted. Results: A total of 339 indicators were extracted.  These indicators were classified into nine health care sectors and one cross-sector category.  Extracted indicators emphasized key measurement themes such as health utilization and cost and excessive, unnecessary, and aggressive care particularly close to the end-of-life.  Many indicators were often measured using the same constructs, but with different specifications, such as varying time periods used to ascribe for end-of-life care, and varying patient populations.  Conclusions: Future work is needed to achieve consensus ‘best’ definitions of these indicators as well as a universal performance measurement framework, similar to other ongoing efforts in population health.  Efforts to monitor palliative and end-of-life care can use this inventory of indicators to select appropriate indicators to measure health system performance.


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