Estimating the completeness of physician billing claims for diabetes case ascertainment using population-based prescription drug data
Introduction: Changes in physician reimbursement policies may hinder the collection of billing claims in administrative data; this can result in biased estimates of disease prevalence and incidence. However, the magnitude of data loss is largely unknown. The purpose of this study was to estimate com...
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| Format: | Article |
| Language: | English |
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Public Health Agency of Canada
2016-03-01
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| Series: | Health Promotion and Chronic Disease Prevention in Canada |
| Subjects: | |
| Online Access: | https://www.canada.ca/en/public-health/services/reports-publications/health-promotion-chronic-disease-prevention-canada-research-policy-practice/vol-36-no-3-2016/estimating-completeness-physician-billing-claims-diabetes-case-ascertainment-using-population-based-prescription-drug-data.html |
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| author | L. M. Lix J. P. Kuwornu K. Kroeker G. Kephart K. C. Sikdar M. Smith H. Quan |
| author_facet | L. M. Lix J. P. Kuwornu K. Kroeker G. Kephart K. C. Sikdar M. Smith H. Quan |
| author_sort | L. M. Lix |
| collection | DOAJ |
| description | Introduction: Changes in physician reimbursement policies may hinder the collection of billing claims in administrative data; this can result in biased estimates of disease prevalence and incidence. However, the magnitude of data loss is largely unknown. The purpose of this study was to estimate completeness of capture of disease cases for Manitoba physicians paid by fee-for-service (FFS) and non-fee-for-service (NFFS) methods. Methods: Manitoba’s administrative data were used to identify a cohort (Z 20 years) with a new diabetes medication between 1 April, 2007, and 31 March, 2009. Cohort members were classified by payment method of the prescribing physician (i.e. FFS vs. NFFS). The cohort was then classified as missing or not missing a diabetes diagnosis using physician claims and hospital records. Then, w2 statistics were used to test for differences in the characteristics of the two groups. Results: The cohort consisted of 12 394 individuals; 86.4% had a prescription for a diabetes medication from an FFS physician. A total of 1172 physicians (81.8% FFS) prescribed these medications for the cohort. Cohort members with a prescription from an FFS physician were older and more likely to reside in the urban Winnipeg health region than those with a prescription from a NFFS physician. A greater percentage of NFFS physicians’ cases were missing a diabetes diagnosis (18.7%vs. 14.9%for FFS physicians). Conclusion: The results suggest minimal loss of physician claims associated with remuneration policies in Manitoba. This method of assessing data completeness could be applied to other chronic diseases and jurisdictions to estimate completeness. |
| first_indexed | 2024-12-23T20:41:27Z |
| format | Article |
| id | doaj.art-a8e110b5b3e040a8aabd019858038512 |
| institution | Directory Open Access Journal |
| issn | 2368-738X |
| language | English |
| last_indexed | 2024-12-23T20:41:27Z |
| publishDate | 2016-03-01 |
| publisher | Public Health Agency of Canada |
| record_format | Article |
| series | Health Promotion and Chronic Disease Prevention in Canada |
| spelling | doaj.art-a8e110b5b3e040a8aabd0198580385122022-12-21T17:31:55ZengPublic Health Agency of CanadaHealth Promotion and Chronic Disease Prevention in Canada2368-738X2016-03-01363546010.24095/hpcdp.36.3.02stringEstimating the completeness of physician billing claims for diabetes case ascertainment using population-based prescription drug dataL. M. Lix0J. P. Kuwornu1K. Kroeker2G. Kephart3K. C. Sikdar4M. Smith5H. Quan6Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, CanadaDepartment of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, CanadaDepartment of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, CanadaDepartment of Community Health and Epidemiology, Dalhousie University, Halifax, Nova Scotia, CanadaLibin Cardiovascular Institute of Alberta, University of Calgary, Calgary, Alberta, CanadaManitoba Centre for Health Policy, University of Manitoba, Winnipeg, Manitoba, CanadaLibin Cardiovascular Institute of Alberta, University of Calgary, Calgary, Alberta, Canada; Department of Community Health Sciences, University of Calgary, Calgary, Alberta, CanadaIntroduction: Changes in physician reimbursement policies may hinder the collection of billing claims in administrative data; this can result in biased estimates of disease prevalence and incidence. However, the magnitude of data loss is largely unknown. The purpose of this study was to estimate completeness of capture of disease cases for Manitoba physicians paid by fee-for-service (FFS) and non-fee-for-service (NFFS) methods. Methods: Manitoba’s administrative data were used to identify a cohort (Z 20 years) with a new diabetes medication between 1 April, 2007, and 31 March, 2009. Cohort members were classified by payment method of the prescribing physician (i.e. FFS vs. NFFS). The cohort was then classified as missing or not missing a diabetes diagnosis using physician claims and hospital records. Then, w2 statistics were used to test for differences in the characteristics of the two groups. Results: The cohort consisted of 12 394 individuals; 86.4% had a prescription for a diabetes medication from an FFS physician. A total of 1172 physicians (81.8% FFS) prescribed these medications for the cohort. Cohort members with a prescription from an FFS physician were older and more likely to reside in the urban Winnipeg health region than those with a prescription from a NFFS physician. A greater percentage of NFFS physicians’ cases were missing a diabetes diagnosis (18.7%vs. 14.9%for FFS physicians). Conclusion: The results suggest minimal loss of physician claims associated with remuneration policies in Manitoba. This method of assessing data completeness could be applied to other chronic diseases and jurisdictions to estimate completeness.https://www.canada.ca/en/public-health/services/reports-publications/health-promotion-chronic-disease-prevention-canada-research-policy-practice/vol-36-no-3-2016/estimating-completeness-physician-billing-claims-diabetes-case-ascertainment-using-population-based-prescription-drug-data.htmlchronic disease, medical records, surveillance, data quality |
| spellingShingle | L. M. Lix J. P. Kuwornu K. Kroeker G. Kephart K. C. Sikdar M. Smith H. Quan Estimating the completeness of physician billing claims for diabetes case ascertainment using population-based prescription drug data Health Promotion and Chronic Disease Prevention in Canada chronic disease, medical records, surveillance, data quality |
| title | Estimating the completeness of physician billing claims for diabetes case ascertainment using population-based prescription drug data |
| title_full | Estimating the completeness of physician billing claims for diabetes case ascertainment using population-based prescription drug data |
| title_fullStr | Estimating the completeness of physician billing claims for diabetes case ascertainment using population-based prescription drug data |
| title_full_unstemmed | Estimating the completeness of physician billing claims for diabetes case ascertainment using population-based prescription drug data |
| title_short | Estimating the completeness of physician billing claims for diabetes case ascertainment using population-based prescription drug data |
| title_sort | estimating the completeness of physician billing claims for diabetes case ascertainment using population based prescription drug data |
| topic | chronic disease, medical records, surveillance, data quality |
| url | https://www.canada.ca/en/public-health/services/reports-publications/health-promotion-chronic-disease-prevention-canada-research-policy-practice/vol-36-no-3-2016/estimating-completeness-physician-billing-claims-diabetes-case-ascertainment-using-population-based-prescription-drug-data.html |
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