Data surveillance on the clinical data used for health system funding in Ontario
Articles and reports: 11-522-X201700014758Description: Several Canadian jurisdictions including Ontario are using patient-based healthcare data in their funding models. These initiatives can influence the quality of this data both positively and negatively as people tend to pay more attention to the data and its quality when financial decisions are based upon it. Ontario’s funding formula uses data from several national databases housed at the Canadian Institute for Health Information (CIHI). These databases provide information on patient activity and clinical status across the continuum of care. As funding models may influence coding behaviour, CIHI is collaborating with the Ontario Ministry of Health and Long-Term Care to assess and monitor the quality of this data. CIHI is using data mining software and modelling techniques (that are often associated with “big data”) to identify data anomalies across multiple factors. The models identify what the “typical” clinical coding patterns are for key patient groups (for example, patients seen in special care units or discharged to home care), so that outliers can be identified, where patients do not fit the expected pattern. A key component of the modelling is segmenting the data based on patient, provider and hospital characteristics to take into account key differences in the delivery of health care and patient populations across the province. CIHI’s analysis identified several hospitals with coding practices that appear to be changing or significantly different from their peer group. Further investigation is required to understand why these differences exist and to develop appropriate strategies to mitigate variations.Issue Number: 2017000Author(s): Kelly, Maureen; Kirby, LoriMain Product:Statistics Canada International Symposium Series: Proceedings
