Validation of ICD-9 diagnostic codes for bronchopulmonary dysplasia in Quebec's provincial health care databases

2012 ◽  
Vol 33 (1) ◽  
pp. 47-52 ◽  
Author(s):  
JS Landry ◽  
D Croitoru ◽  
D Menzies
Keyword(s):  
Health Care ◽  
Health Care Utilization ◽  
Preterm Infants ◽  
Bronchopulmonary Dysplasia ◽  
Gestational Age ◽  
Administrative Databases ◽  
Medical Services ◽  
Care Utilization ◽  
Lower Sensitivity ◽  
Diagnostic Codes

Introduction Bronchopulmonary dysplasia (BPD) is a chronic respiratory disease caused by neonatal lung injury. The aim of this study was to validate the use of ICD-9 diagnostic codes for BPD in administrative databases to allow for their use in health care utilization analyses. Methods The validation process used a retrospective cohort composed of preterm infants, with or without respiratory complications, admitted to the Montréal Children's Hospital, Montréal, Quebec, between 1983 and 1992. BPD subjects were identified using ICD-9 diagnostic codes in the provincial administrative databases (medical services and MED-ECHO) and then matched with subjects with confirmed BPD from the validation cohort. We examined concordance and estimated sensitivity and specificity associated with the use of these diagnostic codes for BPD. Results True positive and false negative BPD subjects did not differ significantly according to gestational age, birth weight and Apgar scores. False positive BPD subjects were found to have significantly lower gestational age than true negative subjects. The use of the ICD-9 diagnostic codes for BPD was associated with a specificity between 97.6% and 98.0%. The sensitivity was lower at 45.0% and 52.4% for the medical services and MED-ECHO databases, respectively. Milder cases of BPD tended to be missed more frequently than more severe cases. Conclusion The specificity of the use of ICD-9 diagnostic codes for BPD in the Quebec provincial health care databases is adequate to allow its routine use. Its lower sensitivity for milder cases will likely result in an underestimation of the impacts of BPD on the long-term health care utilization of preterm infants.

scholarly journals Health Care Utilization by Preterm Infants with Respiratory Complications in Quebec

2012 ◽  
Vol 19 (4) ◽  
pp. 255-260 ◽  
Author(s):  
Jennifer S Landry ◽  
Dan Croitoru ◽  
Yulan Jin ◽  
Kevin Schwartzman ◽  
Andrea Benedetti ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Utilization ◽  
Preterm Infants ◽  
Hospital Admissions ◽  
Preterm Births ◽  
Administrative Databases ◽  
Care Utilization ◽  
Respiratory Complications ◽  
Health Services Use ◽  
Psychiatric Complications

INTRODUCTION: Despite notable advances in prenatal and neonatal care, respiratory distress syndrome (RDS) and bronchopulmonary dysplasia (BPD) remain important complications of preterm births, and their long-term sequelae are poorly understood.OBJECTIVE: To describe health care utilization and costs over a 16- to 25-year follow-up period in a cohort of preterm infants with respiratory complications.METHODS: Using provincial health administrative databases from Quebec, a cohort of individuals who were born prematurely with complications of RDS and/or BPD between 1983 and 1992 were identified. From these databases, which cover all Quebec residents, health services use, medication prescriptions, associated diagnoses and costs were tabulated.RESULTS: A total of 3442 subjects with respiratory complications following preterm birth were identified, of whom 773 had been diagnosed with BPD and 2669 had RDS without BPD. Asthma was diagnosed twice as frequently (1.7 to 2.4 times) in the BPD group compared with the RDS group, with more frequent hospital readmission, and outpatient and emergency room visits. Although respiratory causes remained the main reason for consultation in both groups, 3.7% and 3.4% of the outpatient visits were for mental or psychological ailments, such as depression, attention deficit hyperactivity disorder or dysthymia for the BPD and RDS groups, respectively.CONCLUSION: BPD patients experienced more hospital admissions, outpatient and emergency rooms visits, and were more likely to suffer from respiratory illnesses and to use respiratory drugs than RDS patients. Neurological and psychiatric complications occurred at a high frequency in both RDS and BPD subjects, and were associated with significant use of antipsychotic and antidepressant medications.

scholarly journals Health-care utilization and respiratory morbidities in preterm infants with pulmonary hypertension

2013 ◽  
Vol 33 (7) ◽  
pp. 543-547 ◽  
Author(s):  
B D Stuart ◽  
P Sekar ◽  
J D Coulson ◽  
S E J Choi ◽  
S A McGrath-Morrow ◽  
...  
Keyword(s):  
Health Care ◽  
Pulmonary Hypertension ◽  
Health Care Utilization ◽  
Preterm Infants ◽  
Care Utilization

scholarly journals Access to Health Insurance and Health Care for Hispanic Children in the United States

2021 ◽  
Vol 696 (1) ◽  
pp. 223-244
Author(s):  
Krista M. Perreira ◽  
Chenoa D. Allen ◽  
Jonathan Oberlander
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Health Care Utilization ◽  
Health Care Access ◽  
Preventive Health Services ◽  
The United States ◽  
Medical Services ◽  
Care Utilization ◽  
Hispanic Children ◽  
Medical Needs

Health insurance gives families access to medical services and protects them against the costs of illness and medical treatment. Insured children are more likely than their uninsured peers to use medical services, preventive health services, have a usual source of care, and have fewer unmet medical needs. In this article, we review trends in health insurance coverage for Hispanic children and the factors that influence their coverage. We then discuss health care utilization among Hispanic children and barriers to health care utilization. We conclude with a discussion of strategies to improve Hispanic children’s health care access in the age of COVID-19.

Health Care Utilization in the First Year of Life among Small- and Large- for-Gestational Age Term Infants

2012 ◽  
Vol 17 (6) ◽  
pp. 1016-1024 ◽  
Author(s):  
Patricia M. Dietz ◽  
Joanne H. Rizzo ◽  
Lucinda J. England ◽  
William M. Callaghan ◽  
Kimberly K. Vesco ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Utilization ◽  
Gestational Age ◽  
Large For Gestational Age ◽  
Care Utilization ◽  
First Year ◽  
Term Infants ◽  
First Year Of Life

Health Care Utilization after NICU Discharge and Neurodevelopmental Outcome in the First 2 Years of Life in Preterm Infants

2017 ◽  
Vol 35 (05) ◽  
pp. 441-447 ◽  
Author(s):  
Michelle Greene ◽  
Kousiki Patra
Keyword(s):  
Health Care ◽  
Health Care Utilization ◽  
Preterm Infants ◽  
Neonatal Intensive Care ◽  
Neurodevelopmental Outcome ◽  
Health Care Use ◽  
High Rate ◽  
Care Utilization ◽  
Abnormal Head

Objective The objective of this study was to determine predictors of health care utilization and its association with neurodevelopmental outcome in a recent cohort of preterm infants. Study Design A total of 405 infants (born 2008–2011) seen in neonatal intensive care unit (NICU) follow-up were compared for use of hospitalizations (hosps), emergency room (ER), subspecialties (SS), and results of the Bayley-III. High rate of use was defined as having >1 hosp, ER, or SS. Multiple regression adjusted for the effect of risk factors on high health care use. Results High hosp rate was associated with public health insurance (PHI; p = 0.021), severely abnormal head ultrasound (SAHUS; p = 0.04) at 1 year, and PHI (p = 0.011), younger gestational age (GA) (p = 0.029) at 2 years. High ER use was associated with PHI, younger GA at 1 year (p = 0.007 and 0.012) and 2 years (p = 0.010 and 0.005). High SS was associated with NICU morbidities including small for GA (p = 0.005), retinopathy of prematurity (p = 0.001), necrotizing enterocolitis (p = 0.03), and SAHUS (p = 0.045). At 20 months, infants with high hosp and SS had higher rates of cerebral palsy and significantly lower mean cognitive, language, and motor scores. Conclusion Health care utilization is high among preterm infants in recent years and significantly associated with worse neurodevelopmental outcome. Further research is needed to determine if health care utilization after NICU discharge is an independent predictor of poor outcome.

The Role of Pulmonary Follow-up in Reducing Health Care Utilization in Infants With Bronchopulmonary Dysplasia

2012 ◽  
Vol 51 (7) ◽  
pp. 645-650 ◽  
Author(s):  
Lawrence M. Rhein ◽  
Liza Konnikova ◽  
Amanda McGeachey ◽  
Michelle Pruchniewski ◽  
Vincent C. Smith
Keyword(s):  
Health Care ◽  
Health Care Utilization ◽  
Bronchopulmonary Dysplasia ◽  
Care Utilization

Late Preterm Infants: Birth Outcomes and Health Care Utilization in the First Year

PEDIATRICS ◽  
2010 ◽  
Vol 126 (2) ◽  
pp. e311-e319 ◽  
Author(s):  
T. M. Bird ◽  
J. M. Bronstein ◽  
R. W. Hall ◽  
C. L. Lowery ◽  
R. Nugent ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Utilization ◽  
Preterm Infants ◽  
Birth Outcomes ◽  
Late Preterm ◽  
Care Utilization ◽  
First Year ◽  
Late Preterm Infants

Linkage of the Canadian Study of Health and Aging to Provincial Administrative Health Care Databases in Nova Scotia

2001 ◽  
Vol 13 (S1) ◽  
pp. 147-158 ◽  
Author(s):  
Alexandra M. Yip ◽  
George Kephart ◽  
Kenneth Rockwood
Keyword(s):  
Health Care ◽  
Health Status ◽  
Nova Scotia ◽  
Health Services ◽  
Health Care Utilization ◽  
Community Dwelling ◽  
Medical Services ◽  
Care Utilization ◽  
Canadian Study ◽  
Health Card

The Canadian Study of Health and Aging (CSHA) was a cohort study that included 528 Nova Scotian community-dwelling participants. Linkage of CSHA and provincial Medical Services Insurance (MSI) data enabled examination of health care utilization in this subsample. This article discusses methodological and ethical issues of database linkage and explores variation in the use of health services by demographic variables and health status. Utilization over 24 months following baseline was extracted from MSI's physician claims, hospital discharge abstracts, and Pharmacare claims databases. Twenty-nine subjects refused consent for access to their MSI file; health card numbers for three others could not be retrieved. A significant difference in healthcare use by age and self-rated health was revealed. Linkage of population-based data with provincial administrative health care databases has the potential to guide health care planning and resource allocation. This process must include steps to ensure protection of confidentiality. Standard practices for linkage consent and routine follow-up should be adopted. The Canadian Study of Health and Aging (CSHA) began in 1991-92 to explore dementia, frailty, and adverse health outcomes (Canadian Study of Health and Aging Working Group, 1994). The original CSHA proposal included linkage to provincial administrative health care databases by the individual CSHA study centers to enhance information on health care utilization and outcomes of study participants. In Nova Scotia, the Medical Services Insurance (MSI) administration, which drew the sampling frame for the original CSHA, did not retain the list of corresponding health card numbers. Furthermore, consent for this access was not asked of participants at the time of the first interview. The objectives of this study reported here were to examine the feasibility and ethical considerations of linking data from the CSHA to MSI utilization data, and to explore variation in health services use by demographic and health status characteristics in the Nova Scotia community cohort.

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