title: Using administrative data to measure ambulatory mental health service provision in primary care.
abstract: OBJECTIVE
  We sought to determine the accuracy of administrative data for identifying mental health service provision in primary care.
  
  
  METHODS
  This was a chart abstraction study measuring agreement between billing data and clinical data on the binary variable "mental health visit." Data were collected from the charts and billing records of 5 academic family practice clinics in Toronto, Ontario (1999 to 2000). Billing claims (n = 952) were selected from the billings for all visits by a stratified random sampling technique. A blinded data abstractor reviewed the clinical charts and assigned diagnostic codes for each patient visit associated with the selected claims. Any visit with at least 1 abstracted mental health diagnostic code was defined as a mental health visit. The test characteristics of 4 administrative measures of mental health service provision, based on different combinations of billing codes, were calculated.
  
  
  RESULTS
  The accuracy of the administrative data was 86.8% when compared with clinical data. The sensitivity of the 4 administrative measures ranged from 22.3% to 80.7%. The specificity ranged from 97.0% to 99.5%.
  
  
  CONCLUSIONS
  This is the first study to establish the performance of administrative data in measuring mental health service provision in a primary care setting. In our setting, broadly defined administrative measures of mental health have excellent specificity and adequate sensitivity for exploring and understanding mental health service utilization.
authors.affiliation: Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada. leah.steele@utoronto.ca
authors.forename: Leah S
authors.initials: LS
authors.lastname: Steele
authors.forename: Richard H
authors.initials: RH
authors.lastname: Glazier
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Lin
authors.forename: Michael
authors.initials: M
authors.lastname: Evans
mesh_terms: D000328:Adult; D000553:Ambulatory Care; D016001:Confidence Intervals; D019992:Databases as Topic; D006302:Health Services Research; D006801:Humans; D001523:Mental Disorders / Q000175:diagnosis; D008605:Mental Health Services / Q000706:statistics & numerical data*; D009819:Office Visits; D009864:Ontario; D011320:Primary Health Care; D012494:Sampling Studies; D012680:Sensitivity and Specificity