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Developing a method to estimate practice denominators for a national Canadian electronic medical record database
Michelle Greiver1, Tyler Williamson, Terri-Lyn Bennett
1Department of Family and Community Medicine, University of Toronto, Ontario, Canada. mgreiver@rogers.com
Family Practice
|January 12, 2013
Summary
A new method accurately estimates primary care practice denominators using yearly patient contact data. This approach provides a stable and reliable denominator for disease prevalence calculations, even without patient enrollment.
Area of Science:
- Primary care research
- Health services research
- Epidemiology
Background:
- Accurate disease prevalence calculation requires matching numerators (cases) with denominators (population at risk).
- Determining appropriate primary care practice denominators presents a significant challenge in health research.
Purpose of the Study:
- To develop and validate a novel method for calculating primary care practice denominators.
- To assess the reliability and stability of the proposed denominator calculation method.
Main Methods:
- Compared a 'corrected yearly contact group' (practice population) with enrolled patient numbers.
- Utilized electronic medical record visit data and a correction factor based on patient-reported physician contact.
- Data collected from 81 physicians in Toronto and Kingston, Ontario.
Main Results:
- The ratio of practice population to enrolled patients was consistently 1.03 in 2010 and 2011.
- No significant change in the ratio was observed over the two-year study period.
- Ratios showed minimal variation (<10%) across different locations, providers, and practice characteristics, with slight demographic-based estimation differences.
Conclusions:
- The developed method provides a practice denominator closely aligned with the enrolled population.
- The denominator estimation proved stable across time, geographic locations, and provider/practice variations.
- This method offers a viable approach for estimating practice denominators in settings lacking formal patient enrollment.
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