Surveillance of ischemic heart disease should include physician billing claims: population-based evidence from administrative health data across seven Canadian provinces
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Key result
The addition of physician billing claims to hospital discharge data revealed that the incidence and prevalence of diagnosed ischemic heart disease are underestimated by as much as 50% when using inpatient data alone.
Population
Canadian adults aged 20 years and older in seven provinces
Comparison
Surveillance using hospital discharge abstracts… vs Surveillance using hospital discharge abstracts…
Design
Cohort
Follow-up
1995/96 to 2006/07
Authors
Discussion
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Member takes
Implication
Ischemic heart disease surveillance may underestimate burden by half using inpatient data alone; leaves open optimal integration across other populations and outcomes.
Study Design
Type
Observational
Multicenter
Yes
Structured PICO
P
Population
Population-based cohort of adults aged 20 years and older across seven Canadian provinces, evaluated using administrative health databases from 1995 to 2007 to estimate ischemic heart disease burden.
E
Exposure
Surveillance using hospital discharge abstracts combined with physician billing claims (1H2P or 1H3P algorithms)
C
Comparator
Surveillance using hospital discharge abstracts alone (1H algorithm)
O
Outcome
Prevalence and incidence of diagnosed ischemic heart disease (IHD)
Population-based surveillance of ischemic heart disease requires the inclusion of physician billing claims alongside hospital discharge data to avoid underestimating disease burden by up to 50%.
Limitations
- Does not capture undiagnosed cases or individuals who die of IHD prior to receiving a diagnosis due to lack of linkage to vital statistics.
- Incidence and prevalence indicators may be sensitive to changes in rules for reimbursement of health insurance schemes over time and across provinces.
- Limited historical information (12 years) may lead to overestimation of incidence due to previously diagnosed cases being misclassified as incident.
- Does not capture undiagnosed cases or individuals who die of IHD prior to receiving a diagnosis
- Incidence and prevalence indicators may be sensitive to changes in rules for reimbursement over time and across provinces
- Some cases identified as incident may have been previously diagnosed due to limited historical information (12 years)
Cite This Study
Robitaille et al. (2013) conducted an observational in Ischemic heart disease. Addition of physician billing claims to hospital discharge data (1H2P or 1H3P) vs. Hospital discharge data alone (1H) was evaluated on Prevalence and incidence of diagnosed ischemic heart disease. The addition of physician billing claims to hospital discharge data revealed that the incidence and prevalence of diagnosed ischemic heart disease are underestimated by as much as 50% when using inpatient data alone.
Topics
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