title: An Algorithm Using Administrative Data to Identify Patient Attachment to a Family Physician.
abstract: Background. Commonly self-reported questions in population health surveys, such as "do you have a family physician?", represent one of the best-known sources of information about patients' attachment to family physicians. Is it possible to find a proxy for this information in administrative data? Objective. To identify the type of patient attachment to a family physician using administrative data. Methods. Using physician fee-for-service database and patients enrolment registries (Quebec, Canada, 2008-2010), we developed a step-by-step algorithm including three dimensions of the physician-patient relationship: patient enrolment with a physician, complete annual medical examinations (CME), and concentration of visits to a physician. Results. 68.1% of users were attached to a family physician; for 34.4% of them, attachment was defined by enrolment with a physician, for 31.5%, by CME without enrolment, and, for 34.1%, by concentration of visits to a physician without enrolment or CME. Eight types of patient attachment were described. Conclusion. When compared to findings with survey data, our measure comes out as a solid conceptual framework to identify patient attachment to a family physician in administrative databases. This measure could be of great value for physician/patient-based cohort development and impact assessment of different types of patient attachment on health services utilization.
authors.affiliation: Direction de Santé Publique du Centre Intégré Universitaire de Santé et Services Sociaux du Centre-Est-de-l'Île-de-Montréal, 1301 rue Sherbrooke E., Montréal, QC, Canada H2L 1M3 ; Centre de Recherche du Centre Hospitalier de l'Université de Montréal, 3480 rue Saint-Urbain, Hôtel-Dieu (Pavillon Masson), Montréal, QC, Canada H4W 1Y1 ; Institut de Recherche en Santé Publique de l'Université de Montréal, 7101 avenue du Parc, Montréal, QC, Canada H3N 1X9.
authors.forename: Sylvie
authors.initials: S
authors.lastname: Provost
authors.affiliation: Direction de Santé Publique du Centre Intégré Universitaire de Santé et Services Sociaux du Centre-Est-de-l'Île-de-Montréal, 1301 rue Sherbrooke E., Montréal, QC, Canada H2L 1M3 ; Centre de Recherche du Centre Hospitalier de l'Université de Montréal, 3480 rue Saint-Urbain, Hôtel-Dieu (Pavillon Masson), Montréal, QC, Canada H4W 1Y1.
authors.forename: José
authors.initials: J
authors.lastname: Pérez
authors.affiliation: Direction de Santé Publique du Centre Intégré Universitaire de Santé et Services Sociaux du Centre-Est-de-l'Île-de-Montréal, 1301 rue Sherbrooke E., Montréal, QC, Canada H2L 1M3 ; Centre de Recherche du Centre Hospitalier de l'Université de Montréal, 3480 rue Saint-Urbain, Hôtel-Dieu (Pavillon Masson), Montréal, QC, Canada H4W 1Y1 ; Institut de Recherche en Santé Publique de l'Université de Montréal, 7101 avenue du Parc, Montréal, QC, Canada H3N 1X9 ; Institut National de Santé Publique du Québec, 945 avenue Wolfe, Québec, QC, Canada G1V 5B3.
authors.forename: Raynald
authors.initials: R
authors.lastname: Pineault
authors.affiliation: Direction de Santé Publique du Centre Intégré Universitaire de Santé et Services Sociaux du Centre-Est-de-l'Île-de-Montréal, 1301 rue Sherbrooke E., Montréal, QC, Canada H2L 1M3 ; Institut de Recherche en Santé Publique de l'Université de Montréal, 7101 avenue du Parc, Montréal, QC, Canada H3N 1X9 ; Faculté des Sciences Infirmières, Université de Montréal (Pavillon Marguerite d'Youville), C.P. 6128, succursale Centre-ville, Montréal, QC, Canada H3C 3J7.
authors.forename: Roxane
authors.initials: R
authors.lastname: Borgès Da Silva
authors.affiliation: Direction de Santé Publique du Centre Intégré Universitaire de Santé et Services Sociaux du Centre-Est-de-l'Île-de-Montréal, 1301 rue Sherbrooke E., Montréal, QC, Canada H2L 1M3 ; Centre de Recherche du Centre Hospitalier de l'Université de Montréal, 3480 rue Saint-Urbain, Hôtel-Dieu (Pavillon Masson), Montréal, QC, Canada H4W 1Y1 ; Institut de Recherche en Santé Publique de l'Université de Montréal, 7101 avenue du Parc, Montréal, QC, Canada H3N 1X9 ; Department of Epidemiology, Biostatistics and Occupational Health, McGill University, 1020 Avenue des Pins Ouest, Montreal, QC, Canada H3A 1A2.
authors.forename: Pierre
authors.initials: P
authors.lastname: Tousignant