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Med Care. 2004 Oct;42(10):960-5.

Using administrative data to measure ambulatory mental health service provision in primary care.

Author information

1
Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada. leah.steele@utoronto.ca

Abstract

OBJECTIVE:

We sought to determine the accuracy of administrative data for identifying mental health service provision in primary care.

STUDY DESIGN:

This was a chart abstraction study measuring agreement between billing data and clinical data on the binary variable "mental health visit." Data were collected from the charts and billing records of 5 academic family practice clinics in Toronto, Ontario (1999 to 2000). Billing claims (n = 952) were selected from the billings for all visits by a stratified random sampling technique. A blinded data abstractor reviewed the clinical charts and assigned diagnostic codes for each patient visit associated with the selected claims. Any visit with at least 1 abstracted mental health diagnostic code was defined as a mental health visit. The test characteristics of 4 administrative measures of mental health service provision, based on different combinations of billing codes, were calculated.

RESULTS:

The accuracy of the administrative data was 86.8% when compared with clinical data. The sensitivity of the 4 administrative measures ranged from 22.3% to 80.7%. The specificity ranged from 97.0% to 99.5%.

CONCLUSIONS:

This is the first study to establish the performance of administrative data in measuring mental health service provision in a primary care setting. In our setting, broadly defined administrative measures of mental health have excellent specificity and adequate sensitivity for exploring and understanding mental health service utilization.

[Indexed for MEDLINE]

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