Features of physician services databases in Canada.

Area of Science:

• Health Services Research
• Public Health Surveillance
• Health Informatics

Background:

• Physician services databases (PSDs) are crucial for Canadian health research and surveillance.
• Existing provincial and territorial PSDs lack standardized data elements, posing challenges for data integration.
• Variations in data collection and maintenance across jurisdictions necessitate a comparative analysis.

Purpose of the Study:

• To compare the major features of physician services databases across Canadian provinces and territories.
• To identify inconsistencies in data elements, coding practices, and coverage.
• To inform future efforts towards data standardization for pan-Canadian research.

Main Methods:

• A survey of key informants was conducted to gather information on database characteristics.
• Data included years of records, patient/provider demographics, inclusions/exclusions, and coding of diagnoses, procedures, and service locations.
• Canadian Institute for Health Information's National Physician Database data were analyzed to assess physician remuneration methods and PSD completeness.

Main Results:

• Most PSDs contain records from after 1990, with diagnoses frequently coded using ICD-9.
• Coding systems for diagnoses and procedures varied significantly across jurisdictions and over time.
• All PSDs identified in-hospital services and differentiated family medicine, but capture of non-fee-for-service records varied.

Conclusions:

• Significant differences exist in the features and data elements of Canadian physician services databases.
• These variations may impact the comparability of findings from pan-Canadian studies.
• Further research is recommended to address the implications of these data disparities for national health research.