Study of patterns of medical care utilization using computer algorithms

• Main Author: Li, Nan
• Format: Thesis
• Language: English
• Published: Memorial University of Newfoundland 2000
• Subjects: Canada; Newfoundland
• Online Access: https://research.library.mun.ca/6607/; https://research.library.mun.ca/6607/1/NanLi.pdf; https://research.library.mun.ca/6607/3/NanLi.pdf

The main purpose of this study is to investigate and characterize patterns of medical care utilization, specifically, to discover if there are associations between patterns of medical care utilization and demographic variables, socioeconomic status, and area of residence for three diagnostic groups (cardiovascular disease, mental disease and chronic respiratory conditions) across three geographical categories which divide the island into three areas by degree of urbanization. This study focuses on ambulatory physician visits which included outpatient, emergency room, and office visits, and excludes physician visits to hospitalized patients and visits to nursing home residents. It uses secondary data generated by the Newfoundland Panel on Health and Medical Care (NPHMC). The NPHMC began with a cross-sectional telephone survey in 1994-95 (random single-stage cluster sample of households selected by RDD); respondents who gave written consent to access medical care databases became the utilization panel. This panel was then linked to utilization databases - hospital separations and physicians' claims - using the provincial health insurance number, for a seven-year period (April 1, 1992 - March 31, 1999). The analysis in this thesis includes 678 subjects for cardiovascular disease, 402 subjects for mental disease, and 942 subjects for chronic respiratory conditions, 20 years or older, residing in the province of Newfoundland, Canada, and followed for four years (April 1, 1992-March 31,1996). -- Patterns of utilization in the three diagnostic groups were investigated by dividing the four-year study period into 16 trimesters and using SAS programs to identify five main patterns of care: non-episodic, isolated episodes, and continuous episodes over 2-5, 6-11, or 12-16 consecutive trimesters. Respondents were assigned to one of three classifications by urbanization level: metropolitan St. John's, other urban, and remote, which acted as a proxy for level of medical care resources. -- The hypothesis that demographic and ...