Panel Paper:
Harmonizing Health Administrative Data across Canadian Provinces in the Context of Medication Management Among the Elderly
*Names in bold indicate Presenter
Approach: We identified key indicators, including counts of potentially inappropriate medications according to the Beer’s List criteria (and separately for STOPP/START), indicators for adverse drug reactions, measures of polypharmacy, and individual drugs that are generally contraindicated among the elderly. We describe variation in medication management within and across provinces for 2017-18.
Results: Different drug classification systems and area-level measures of socioeconomic status are typically used in the two provinces. Differences in formal patient rostering across provinces, including how rostering and physicians’ team affiliation appear in the data, also required attention. Among more than 1.5 million patients age 66+ in each province, 55% are women and the average age is 76 years. While only about 1% experience an adverse drug event in a year, more than one quarter visit the emergency department. Important variation exists in these measures across family physicians, (standard deviations exceed the mean), and across primary care teams (standard deviations are 65-75% of the mean).
Conclusion: Close collaboration and attention to detail allowed us to create harmonized indicators using administrative health data in Canada’s two largest provinces. Variation in these measures and how provincial primary care policies impact them will be the subject of future research.
