Methods to develop and maintain a valid physician registry in evolving information environments.

Area of Science:

• Health Services Research
• Public Health Policy
• Health Workforce Analysis

Background:

• The increasing prevalence of alternative funding models for physician services in Canada diminishes the utility of traditional fee-for-service (FFS) payment data for population-based health information.
• This trend necessitates the development of robust methods to track and analyze the physician workforce accurately.

Purpose of the Study:

• To describe the methods for developing and validating an anonymous physician workforce registry.
• To support policy-relevant analyses in contexts with diverse physician payment arrangements.

Main Methods:

• Utilized fee-for-service (FFS) payment data to identify physicians in clinical practice in British Columbia.
• Incorporated hospital discharge abstract data to identify physicians not submitting FFS claims.
• Analyzed the proportion of physician expenditures attributable to FFS payments across different local health areas.

Main Results:

• In 2004, 97% of 8,558 practicing physicians in British Columbia were identifiable via FFS data.
• A stable proportion (65-69%) of physicians not submitting FFS claims were identified using hospital discharge data across multiple years (1996, 2000, 2004).
• Significant variation (0-100%) was observed in the proportion of FFS-attributed physician expenditures across local health areas province-wide in 2004.

Conclusions:

• Combining FFS and hospital data enables the creation of comprehensive physician registries for population-based workforce analysis.
• Integrating FFS and alternative funding payment data can accurately calculate physician income and clinical activity.
• Identifies physicians at high risk of measurement error in areas with substantial non-FFS clinical activity.