Can the quality of care in family practice be measured using administrative data?
OBJECTIVE
To explore the feasibility of using administrative data to develop process indicators for measuring quality in primary care.


METHODS
The Population Health Research Data Repository (Repository) housed at the Manitoba Centre for Health Policy which includes physician claims, hospital discharge abstracts, pharmaceutical use (Drug Program Information Network (DPIN)), and the Manitoba Immunization Monitoring Program (MIMS) for all residents of Manitoba, Canada who used the health care system during the 2001/02 fiscal year. Family physicians were identified from the Physician Resource Database. Indicators were developed based on a literature review and focus group validation.


METHODS
Data files were extracted from administrative data available in the Repository. We extracted data based on the ICD-9-CM codes and ATC-class drugs prescribed and then linked them to the Physician Resource Database. Physician practices were defined by allocating patients to their most responsible physician. Every family physician in Manitoba that met the inclusion criteria (having either 5 or 10 eligible patients depending on the indicator) was 'scored' on each indicator. Physicians were then grouped according to the proportion of the patients allocated to their practice who received the recommended care for the specific indicator.


RESULTS
Using administrative health data we were able to develop and measure eight indicators of quality of care covering both preventive care services and chronic disease management. The number of eligible physicians and patients varied for each indicator as did the percent of patients with recommended care, per physician. For example, the childhood immunization indicator included 544 physicians who, on average, provided immunization for 65 percent of their patients.


CONCLUSIONS
Quality of care provided by family physicians can be measured using administrative data. Despite the limitations addressed in this paper, this work establishes a practical methodology to measure quality of care provided by family physicians that can be used for quality improvement initiatives.
Katz
Alan
A
Manitoba Centre for Health Policy, Department of Community Health Sciences, Faculty of Medicine, University of Manitoba, Winnipeg, Manitoba, R3E 3P5, Canada.
Soodeen
Ruth-Ann
RA
Bogdanovic
Bogdan
B
De Coster
Carolyn
C
Chateau
Dan
D
D003625:Data Collection; D005194:Family Practice / Q000592:standards*; D005240:Feasibility Studies; D005260:Female; D017144:Focus Groups; D006291:Health Policy; D006302:Health Services Research / Q000379:methods*; D006801:Humans; D008297:Male; D008350:Manitoba; D010818:Practice Patterns, Physicians'; D019984:Quality Indicators, Health Care