Dataset Information

Using physician billing claims from the Ontario Health Insurance Plan to determine individual influenza vaccination status: an updated validation study.

ABSTRACT: Owing to the absence of a vaccination registry in Ontario, administrative data are currently the best available source to determine population-based individual-level influenza vaccination status. Our objective was to validate physician billing claims for influenza vaccination in the Ontario Health Insurance Plan database against the Canadian Community Health Survey.We used self-reported seasonal influenza vaccination status of Ontario residents surveyed between 2007 and 2009 as the reference standard. The survey responses were linked to physician claims database records to validate billing codes for influenza vaccination. We calculated sensitivity, specificity, positive predictive value and negative predictive value with 95% confidence intervals (CIs). We stratified the data by several covariates and comorbidities to determine stratum-specific performance characteristics. We used these estimates to adjust an estimate of influenza vaccine effectiveness for the 2010/11 influenza season.For the 47?301 patients included in the analysis, the sensitivity for the billing codes was 49.8% (95% CI 49.0%-50.5%), specificity was 95.7% (95% CI 95.5%-96.0%), positive predictive value was 88.4% (95% CI 87.8%-89.0%) and negative predictive value was 74.5% (95% CI 74.0%-74.9%). Performance measures were optimized in patients aged 65 years and older, particularly those with comorbidities.Although administrative data have limitations for determining influenza vaccination status, owing to the high positive predictive value, they are well suited for self-controlled study designs that are often used to assess vaccine safety. For studies of coverage and effectiveness, restricting the cohort to patients aged 65 years and older will minimize misclassification bias. Performance characteristics from this study can be used to mitigate misclassification bias.

SUBMITTER: Schwartz KL

PROVIDER: S-EPMC5047797 | biostudies-other | 2016 Jul-Sep

REPOSITORIES: biostudies-other

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Using physician billing claims from the Ontario Health Insurance Plan to determine individual influenza vaccination status: an updated validation study.

Schwartz Kevin L KL Jembere Nathaniel N Campitelli Michael A MA Buchan Sarah A SA Chung Hannah H Kwong Jeffrey C JC

CMAJ open 20160701 3

<h4>Background</h4>Owing to the absence of a vaccination registry in Ontario, administrative data are currently the best available source to determine population-based individual-level influenza vaccination status. Our objective was to validate physician billing claims for influenza vaccination in the Ontario Health Insurance Plan database against the Canadian Community Health Survey.<h4>Methods</h4>We used self-reported seasonal influenza vaccination status of Ontario residents surveyed between ...[more]

PMID: 27730110

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Project description:ImportanceMen and women should earn equal pay for equal work. An examination of the magnitude of pay disparities could inform strategies for remediation.ObjectiveTo examine gender-based differences in pay within a large, comprehensive physician population practicing within a variety of payment systems.Design, setting, and participantsThis cross-sectional study used data from the Ontario Health Insurance Plan (OHIP) in the 2017 to 2018 fiscal year to estimate differences in gross payments between men and women physicians in Ontario, Canada. Pay gaps were calculated annually and daily. Regression analyses were used to control for observable practice characteristics that could account for individual differences in daily pay. In Canada's largest province, Ontario, medical services are predominantly provided by self-employed physicians who bill the province's single payer, OHIP. All physicians who submitted claims to OHIP were included. Data were analyzed from January 2020 to July 2021.ExposuresPhysician gender, obtained from the OHIP Corporate Provider Database. Gender is recorded as male or female.Main outcomes and measuresGross clinical payments were tabulated for individual physicians on a daily and annual basis in conjunction with each physician's practice characteristics, setting, and specialty.ResultsA total of 31 481 physicians were included in the study sample (12 604 [40.0%] women; 18 877 [60.0%] men; mean [SD] time since graduation, 23.3 [13.6] years), representing 99% of active physicians in Ontario. The unadjusted differences in clinical payments between male and female physicians were 32.8% (95% CI, 30.8%-34.6%) annually and 22.5% (95% CI, 21.2%-23.8%) daily. After accounting for practice characteristics, region, and specialty, the overall daily payment gap was 13.5% (95% CI, 12.3%-14.8%). The pay gap persisted with differing magnitudes when examined by specialty (ranging from 6.6% to 37.6%), practice setting (8.3% to 17.2%), payment model (13.4% to 22.8% for family medicine; 8.0% to 11.6% for other specialties), and rurality (8.0% to 16.5%).Conclusions and relevanceThis cross-sectional study examined differences in magnitude of annual and daily payment gaps and between unadjusted and adjusted gaps. Comparing the gaps for different specialties, geography, and payment systems illustrated the complexity of the issue by showing that the pay gap varied for physicians in different practice settings. As such, multiple directed interventions will be necessary to ensure that all physicians are paid equally for equal work, regardless of gender.

Dataset Information

Using physician billing claims from the Ontario Health Insurance Plan to determine individual influenza vaccination status: an updated validation study.

Publications

Using physician billing claims from the Ontario Health Insurance Plan to determine individual influenza vaccination status: an updated validation study.

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