Appendix Table A
Application of CSHCN Screener items to administrative health data

Appendix Table A
Application of CSHCN Screener items to administrative health data
Table summary
This table displays the results of Application of CSHCN Screener items to administrative health data CSHCN Screener item and Application of item (appearing as column headers).
  CSHCN Screener item Application of item
1. Does your child currently need or use medicine prescribed by a doctor (other than vitamins)? Data for this item came from the PharmaNet data file.Note 18 A day of medicine use was defined based on the date the prescription was filled and the number of days of medication supplied. A child can have more than one prescription filled on the same day, with different numbers of days supplied for each. Even if prescription dates differed, the days supplied might overlap. It was assumed that the child starts the prescription the day it is filled. A cautionary note is that days of medication prescribed do not necessarily equal to days of medication taken. Three cut-off options were examined: 6 (≥ 183 days), 9 (≥ 274 days), and 12 months (≥ 365 days) of medicine use in any 12-month (365 days) period from January 2005 to December 2007. The three most commonly used prescription drugs were identified. The Anatomical Therapeutic Chemical (ATC) Classification System was used to classify drugs according to the organ or system on which they act and/or their therapeutic and chemical characteristics.Note 32
2. Does your child need or use more medical care, mental health, or educational services than is usual for most children of the same age? Data for this item are from the MSP data file.Note 33 Each unique service date and specialty code for each individual was considered a separate visit. Codes indicating the type of services rendered by a practitioner were counted for each child. The data contained 45 active service codes, for example, regional examinations. (The list is available from the authors.) The age-specific 95th percentile for the number of visits in 2006 was used as a cut-off to identify children who had more than the usual number of medical service visits for children their age.
3. Is your child limited or prevented in any way in his or her ability to do the things most children of the same age can do? The data source was the MSP data file.Note 33 Diagnostic codes from the International Classification of Diseases, Ninth version (ICD-9) were used to identify the condition for which the individual was treated. Two sets of specific diagnostic codes were considered to indicate the presence of functional limitations for which the child was treated: (a) indicators of “disability among youth,”Note 34 using data from the Population Health Research Data Repository at the Manitoba Centre for Health Policy, and (b) a list of the most common ICD-10 codes (converted to ICD-9) for Canadian children with neurologically-based functional limitations/disabilities identified in the 2006 Participation and Activity Limitation Survey dataset.Note 35 The final list of diagnostic codes included: epilepsy, hydrocephalus, spina bifida, developmental delay, hearing loss, cystic fibrosis, emotional problems, cerebral palsy, blindness, motor, speech-language, learning-cognition, social, sensory, and psychological domains. (The complete list is available from the authors.) Children who had one of these diagnostic codes in 2006 and the same code within the following or previous 6- to 18-month period met the criteria for this item.
4. Does your child need or receive special therapy, such as physical, occupational, or speech therapy? The data source was the MSP data file.Note 33 Four specialty codes were used: physical medicine and rehabilitation specialist, physical therapist, occupational therapist, and respiratory therapist. These codes describe a practitioner’s specialty associated with a claim, assigned when the claim was processed. Children who had one of these codes in 2006 and the same code within the following or previous 6- to 18-month period met the criteria for this item.
5. Does your child have any kind of emotional, developmental, or behavioral problem for which he or she needs or receives treatment or counselling? The data source was the MSP data file.Note 33 Specialty and service codes were used. Specialty codes included psychiatrist and counselor/psychologist. Service codes included counselling and counselling psychotherapy. Children who had one of these diagnosis codes in 2006 and the same code within the following or previous 6- to 18-month period met the criteria for this item.
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