PRISM :: Browsing by Author "Lu, Mingshan"

Browsing by Author "Lu, Mingshan"

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Open Access
Administrative health data in Canada: lessons from history
(BioMed Central, 2015-08-19) Lucyk, Kelsey; Lu, Mingshan; Sajobi, Tolulope; Quan, Hude
BACKGROUND: Health decision-making requires evidence from high-quality data. As one example, the Discharge Abstract Database (DAD) compiles data from the majority of Canadian hospitals to form one of the most comprehensive and highly regarded administrative databases available for health research, internationally. However, despite the success of this and other administrative health data resources, little is known about their history or the factors that have led to their success. The purpose of this paper is to provide an historical overview of administrative data for health research in Canada to contribute to the institutional memory of this field. METHODS: We conducted a qualitative content analysis of approximately 20 key sources to construct an historical narrative of administrative health data in Canada. Specifically, we searched for content related to key events, individuals, challenges, and successes in this field over time. RESULTS AND DISCUSSION: In Canada, administrative data for health research has developed in tangent with provincial research centres. Interestingly, the lessons learned from this history align with the original recommendations of the 1964 Royal Commission on Health Services: (1) standardization, and (2) centralization of data resources, that is (3) facilitated through governmental financial support. CONCLUSIONS: The overview history provided here illustrates the need for longstanding partnerships between government and academia, for classification and standardization are time-consuming and ever-evolving processes. This paper will be of interest to those who work with administrative health data, and also for countries that are looking to build or improve upon their use of administrative health data for decision-making.
Open Access
Applied Economics and Policy Research in Health, Dairy, and Fishery Industries
(2019-07-02) Ci, Zhaoxue; Gordon, Daniel V.; Lu, Mingshan; Hall, David C.
Chapter 1: With aging populations, policymakers are encouraging people to work longer to sustain the financial stability of social security systems. However, the effect of postponing retirement on mental health remains uncertain. The US Social Security Amendments of 1983 raised the social benefit age by two months each year for those cohorts born after 1937. These amendments provide a unique opportunity to assess the causal effect of retirement age on mental health. Using data from the 1994 to 2012 waves of the US Health and Retirement Survey, this paper instrumented retirement age with the amendments to control for the biases caused by the endogeneity between retirement age and mental health. This instrumental variable estimation showed that a slight gradual rise in retirement age was beneficial to retirees’ mental health. Chapter 2: There has been increasing awareness by policymakers of the need to identify the key factors that affect dairy farmers’ management decisions. This study utilizes a theoretic model to illustrate why Canadian farmers might be hesitant about disease control under the supply management system and how peer pressure can induce farmers to improve their efforts. An experiment based on a Johne’s disease scenario was implemented among Canadian dairy farmers to test the theoretic model conclusions. Both the theoretic model and the pilot experiment suggest that without a strong external monitoring policy, optimal effort level cannot be achieved. Chapter 3: The Norwegian purse seine fishery has employed multiple rights-based regulatory instruments to limit the fishing effort. Following the management reforms, this fleet shrunk substantially while the capital investment in this fleet expanded substantially. The comprehensive efficiency change in an era of revolutions are worth exploring, yet ambiguous. This paper evaluates the production and cost efficiency changes among the Norwegian purse seiners using data on Norwegian purse seiners for the period of 1994-2013. The stochastic frontier analysis shows that the purse seiners could reduce production cost significantly by eliminating inefficiencies. Meanwhile, both technical and allocative efficiencies are improving over time. A further investigation suggests that the transferable quota policies had limited impact on efficiencies.
Open Access
The association between 'compliance with colonoscopy surveillance' after primary treatment and healthcare utilization
(2020-09-23) Qaedi, Atena; Lu, Mingshan; Yuan, Lasheng; Xu, Yuan
Choosing Wisely Canada recommends surveillance with colonoscopy for colorectal cancer patients undergoing curative-intent treatment. Although surveillance with colonoscopy after surgery is beneficial in terms of early detection of recurrence and survival, there is limited real-world evidence on the compliance of recommended colonoscopy surveillance, and the health utilization and costs associated with it. This retrospective study uses existing administrative data sets from Alberta Health Services and Alberta Health, which includes 7120 observations for the 2004-2015 period. The study sample consisted of colorectal cancer patients at stages I and II, who underwent curative-intent surgery. This project compared healthcare utilization (measured by cost) and health outcomes (measured by survival) for patients who complied with colonoscopy surveillance, versus those who did not comply. Cost and survival analysis were conducted, employing multivariate analyses via COX and logistic regressions. For the purposes of this study, cost data was calculated using the physician claims or the physician’s payment. In total, 6,962 patients were eligible for analysis. The median age was 67 (range: 18-104) years old. The proportion of patients with stage Ⅰ and Ⅱ colorectal cancer was 42.46% and 57.54%, respectively. A total of 2,812 (40.39%) patients had a one-year compliance, and 275 patients (3.95%) had two-to-five-year compliance. The average healthcare utilization of one-year and two-to-five-year compliance per person was 3,762 and 4,758 in CAD dollars, respectively. Compliance with colonoscopy surveillance after a primary treatment was associated with lower age, earlier cancer stage (stage Ⅰ), lower cancer grade (grade 1), lower CCI, and higher income. In addition, the overall death ratio and cancer-related death ratio was lower for those patients with compliance in each category (one-year and two-five-year follow-up), compared to those with no compliance. The results of this study suggest that colonoscopy surveillance compliance following primary treatment for early-stage colorectal cancer is associated with lower healthcare utilization and better cancer-specific survival.
Open Access
Child health insurance coverage: a survey among temporary and permanent residents in Shanghai
(BioMed Central, 2008-11-17) Lu, Mingshan; Zhang, Jing; Ma, Jin; Li, Bing; Quan, Hude
Open Access
Comparing public and private hospitals in China: Evidence from Guangdong
(BioMed Central, 2010-03-23) Eggleston, Karen; Lu, Mingshan; Li, Congdong; Wang, Jian; Yang, Zhe; Zhang, Jing; Quan, Hude
Open Access
Comparison of risk adjustment methods in patients with liver disease using electronic medical record data
(2017-01-07) Xu, Yuan; Li, Ning; Lu, Mingshan; Dixon, Elijah; Myers, Robert P; Jolley, Rachel J; Quan, Hude
Abstract Background Risk adjustment is essential for valid comparison of patients’ health outcomes or performances of health care providers. Several risk adjustment methods for liver diseases are commonly used but the optimal approach is unknown. This study aimed to compare the common risk adjustment methods for predicting in-hospital mortality in cirrhosis patients using electronic medical record (EMR) data. Methods The sample was derived from Beijing YouAn hospital between 2010 and 2014. Previously validated EMR extraction methods were applied to define liver disease conditions, Charlson comorbidity index (CCI), Elixhauser comorbidity index (ECI), Child-Turcotte-Pugh (CTP), model for end-stage liver disease (MELD), MELD sodium (MELDNa), and five-variable MELD (5vMELD). The performance of the common risk adjustment models as well as models combining disease severity and comorbidity indexes for predicting in-hospital mortality was compared using c-statistic. Results Of 11,121 cirrhotic patients, 69.9% were males and 15.8% age 65 or older. The c-statistics across compared models ranged from 0.785 to 0.887. All models significantly outperformed the baseline model with age, sex, and admission status (c-statistic: 0.628). The c-statistics for the CCI, ECI, MELDNa, and CTP were 0.808, 0.825, 0.849, and 0.851, respectively. The c-statistic was 0.887 for combination of CTP and ECI, and 0.882 for combination of MELDNa score and ECI. Conclusions The liver disease severity indexes (i.e., CTP and MELDNa score) outperformed the CCI and ECI for predicting in-hospital mortality among cirrhosis patients using Chinese EMRs. Combining liver disease severity and comorbidities indexes could improve the discrimination power of predicting in-hospital mortality.
Open Access
Direct economic burden of hepatitis B virus related diseases: evidence from Shandong, China
(BioMed Central, 2013-01-31) Lu, Jingjing; Xu, Aiqiang; Wang, Jian; Zhang, Li; Song, Lizhi; Li, Renpeng; Zhang, Shunxiang; Zhuang, Guihua; Lu, Mingshan
Open Access
Does the new cooperative medical scheme reduce inequality in catastrophic health expenditure in rural China?
(2016-11-14) Guo, Na; Iversen, Tor; Lu, Mingshan; Wang, Jian; Shi, Luwen
Abstract Background In 2003, the New Cooperative Medical Scheme (NCMS) was introduced in China to re-establish health insurance for the country’s vast rural population. In addition, the coverage of NCMS has been expanding after the new health care reform launched in 2009. This study aims to examine whether the NCMS and its recent expansion have reached the goal of reducing the risk and inequality of catastrophic health spending for rural residents in China. Methods We conducted a face-to-face household survey in three counties of the Shandong province in 2009 and 2012. Using this unique panel data, we examined the changes in the incidence and intensity of catastrophic health expenditures (CHEs) before and after NCMS reimbursement. We used concentration index (CI) and decomposition method to study the changes in inequality in CHEs. Results We found that NCMS reimbursement played a role of reducing both the incidence and intensity of CHEs, and that this impact was stronger after the new health care reform was launched. After reimbursement, the concentration indices for CHEs were 0.073 and 0.021 in 2009 and 2012, indicating that the rich had a greater tendency to incur CHEs and there existed less inequality in the incidence of CHEs after reimbursement in 2012 compared with 2009. The decomposition analysis results suggested that changes in CHE inequality between 2009 and 2012 were attributed to changes in economic status and household size rather than reimbursement levels. Conclusions Our results indicated that inequality was shrinking from 2009 to 2012, which could be a result of fewer rich people having CHEs in 2012 compared with 2009. The impact of NCMS in alleviating the financial burden of rural residents was still limited, especially among the poor. Health care reform policies in China that aim to reduce CHEs must continue to place an emphasis on improving reimbursement, cost containment, and reducing income inequalities.
Open Access
Economic Analysis of Near-Patient Testing for C. difficile Implemented in a Large Hospital in Calgary, Canada
(2020-06-19) Sharma, Anuj; Hollis, Aidan; Lu, Mingshan; Walls, William David; Laliberté, Jean William P.
Clostridium difficile infection (CDI) is the main source for onset of antibiotic-associated diarrhea in patients and is thus an important cause of morbidity and mortality in Canadian hospitals. CDI typically results from the augmented and needless use of potent broad-spectrum antibiotics. All patients suspected of CDI are put under mandatory pre-emptive contact precautions even before patients are tested for CDI. The contact precautions involve use of fresh gown and gloves for each entry into a patient room. Most patients with a suspected diagnosis of CDI ultimately test negative. The existing centralized testing takes about 24 hours for test result confirmation. Consequently, hospitals are burdened with unnecessary cost of putting such patients under contact precautions and patients who test positive face a delay in appropriate therapy initiation. There is a rapid test available for diagnosing CDI which gives results within a few hours, but it is more expensive than the centralized testing. This thesis offers an economic analysis of rapid testing for CDI in Calgary, Alberta. Existing literature on implementation of rapid testing lack accurate cost-benefit analysis. In my thesis, I have focused only on patients who test negative. The hypothesis is that for patients with a negative diagnosis, rapid testing may enable early removal from contact precautions for patients who do not have any other diseases which requires contact precautions, saving the hospital the cost of contact precautions. The analysis in this thesis suggests that by implementing rapid testing for diagnosing CDI, Foothills Medical Center in Calgary, Canada can save approximately $20,000 annually.
Open Access
Economics of innovation in the pharmaceutical industry
(2020-07-06) Moradpour Taleshi, Javad; Hollis, Aidan; Lu, Mingshan; Magesan, Arvind; Laliberté, Jean William P.; Devlin, Rose Anne
This thesis is a collection of three essays which investigate the economics of innovation in the healthcare industry. In Chapter 2 I use a global data set to measure the effect of health losses and average patient income on innovation in different therapeutic areas. I show that the average patient income is a strong predictor of the number of clinical trials, and I demonstrate how this can be used to identify diseases that are underfunded relative to their harm to human health. Chapter 3 presents a theoretical model of health markets with public health insurance. The model describes the operation of the cost-effectiveness threshold frequently employed by public insurers to decide which health products to cover. I show that having two different thresholds for products with and without patents can increase efficiency. Chapter 4 introduces a structural model of pharmaceutical innovation. Estimates from this model show that the net effect of a firm's innovation on their rivals' decision to innovate in the same therapeutic area is negative. The model demonstrates that previous firm-specific experience in a therapeutic area is a key factor in the decision to invest in that therapeutic area.
Open Access
The Effect of Environmental Regulations on Health and Labor Supply
(2021-06-09) Adibnia, Elham; Staubli Muehlenbachs, Stephan; Lu, Mingshan; Muehlenbachs, Lucija; Gordon, Daniel Vernon; Gunes, Pinar Mine
The title of this thesis is ``The Effect of Environmental Regulations on Health and Labor Supply: Evidence from Ontario's Coal Phase-out". It explores the effect of environmental regulations on a wide range of health, and economic outcomes. I use coal phase-out in Ontario, Canada, as a quasi-experimental setting in my study. The first chapter of my thesis is introduction. Then, I explore related works, and conduct a literature review on papers that have studied the effect of pollution on air quality, infant health, adult health, environmental justice, labor supply, income, and productivity. In the third chapter, I present the historical background, and discuss implementation of coal phase-out in Ontario, in detail. In the fourth chapter, I use data from pollution monitoring networks to estimate the impact of Ontario's coal phase-out on the local air quality. I apply a difference-in-differences strategy comparing air pollution concentrations within 20 miles of power plants relative to 20-40 miles before and after their shutdowns. I find that applying this policy decreases O3, and SO2 levels by 6, and 19 percent, respectively. However, the results do not show a statistically significant effect on PM2.5, NOx, NO2, and NO levels. In the fifth chapter, I study the effect of Ontario's coal phase-out on infant, and adult health outcomes such as, birth weight, low birth weight incidence, preterm birth, adult's respiratory, and cardiovascular diseases. I use Canadian Vital Statistics-Birth and Death Databases, and a difference-in-differences strategy. My findings show that coal-fired power plant closures do not significantly change infant, and adult health outcomes. The final chapter, investigates the effect of coal phase-out in Ontario on local migration, labor supply, and income. I use a large-scale panel dataset, Longitudinal Administrative Databank (LAD), and a difference-in-differences method to find the causal relationships. I find that closure of coal-fired power plants in Ontario does not have any significant effect on local migration, and labor supply, on the extensive margin. However, it is associated with a 2.6-3 percent increase in employment income, and a 0.7-0.8 percent increase in market income in the short-, and the long-run, respectively.
Open Access
Growing old before growing rich: inequality in health service utilization among the mid-aged and elderly in Gansu and Zhejiang Provinces, China
(BioMed Central, 2012-09-04) Wang, Yang; Wang, Jian; Maitland, Elizabeth; Zhao, Yaohui; Nicholas, Stephen; Lu, Mingshan
Open Access
Identifying cost-based quality and performance indicators for home care: a modified delphi method study
(2024-07-24) Jajszczok, Max; Eastwood, Cathy A.; Lu, Mingshan; Cunningham, Ceara; Southern, Danielle A.; Quan, Hude
Abstract Background This study, part of a multi-study program, aimed to identify a core set of cost-based quality and performance indicators using a modified Delphi research approach. Conceptually, this core set of cost-based indicators is intended for use within a broader health system performance framework for evaluating home care programming in Canada. Methods This study used findings from a recently published scoping review identifying 34 cost-focused home care program PQIs. A purposive and snowball technique was employed to recruit a national panel of system-level operational and content experts in home care. We collected data through progressive surveys and engagement sessions. In the first round of surveying, the panel scored each indicator on Importance, Actionable, and Interpretable criteria. The panel set the second round of ranking the remaining indicators’ consensus criteria. The panel ranked by importance their top five indicators from operational and system perspectives. Indicators selected by over 50% of the panel were accepted as consensus. Results We identified 13 panellists. 12 completed the first round which identified that 30 met the predetermined inclusion criteria. Eight completed the ranking exercise, with one of the eight completing one of two components. The second round resulted in three PQIs meeting the consensus criteria: one operational and two systems-policy-focused. The PQIs: “Average cost per day per home care client,” “Home care service cost (mean) per home care client 1y, 3y and 7y per health authority and provincially and nationally”, and “Home care funding as a percent of overall health care expenditures.” Conclusions The findings from this study offer a crucial foundation for assessing operational and health system outcomes. Notably, this research pioneers identifying key cost-based PQIs through a national expert panel and modified Delphi methodology. This study contributes to the literature on PQIs for home care and provides a basis for future research and practice. These selected PQIs should be applied to future research to test their applicability and validity within home care programming and outcomes. Researchers should apply these selected PQIs in future studies to evaluate their applicability and validity within home care programming and outcomes.
Open Access
Impacts of Increased Home Care Investments on Health System Service Utilization
(2024-07-24) Jajszczok, Max; Quan, Hude; Eastwood, Catherine A.; Lu, Mingshan; Cunningham, Ceara
Introduction: A Canadian home care performance measurement framework does not exist. This research examined the impact of Federal and Provincial investments in home care programs in Alberta. We identified the need for financially focused home care system indicators, refined indicators through a modified Delphi approach, and applied selected indicators within the Alberta context. Methods: We conducted a three-phase multistage, mixed-methods study. 1.) Through a scoping review, we identified measures, frameworks and related evaluation tools specific to the IHI Quadruple Aim as applied to home care programs. 2.) We identified core financially focused measurement indicators using a modified Delphi process and a Content Analysis approach. 3.) We applied the newly identified indicators to Alberta Health Services data for home care clients from 2015 to 2020. The identified indicators were examined through trend analyses and a cost-effectiveness analysis economic evaluation. Results: In the first study, we reviewed 3,475 potential documents, leading to 105 articles for performance and quality indicator (PQI) extraction, identifying 829 unique PQIs. Under the IHI Quadruple Aim, 661 PQIs were Clinical Outcomes, 35 Healthcare Provider Satisfaction, 99 Patient Experience, and 34 Financial. In our second phase, 12 panellists comprised the first round and selected 30 PQIs. The second round, comprising eight panellists, resulted in consensus on three PQIs: “Average cost per day per home care client,” “Home care service cost per client over time,” and “Home care funding as a percentage of health care expenditures.” In our third phase, trend analyses identified that enhanced home care investments per client and overall expenditures in Alberta led to a decrease in acute care usage. Over five years, the model estimated a reduction of 346,200 patient days in acute care. An additional $240.3M in home care investments yielded a Cost Effectiveness Ratio of 694:1 in acute care beds days avoided. Conclusions: Our research identified and applied new cost-based indicators effectively portraying how targeted funding affects utilization, revealing that enhancing home care programs improves system cost-effectiveness. Policymakers are encouraged to incorporate these novel indicators into their measurement frameworks to gauge the effects of home care investments on the overall health system.
Open Access
Measuring Catastrophic Health Expenditure: Innovation and Validation
(2019-10-04) Jiang, Jing; Lu, Mingshan; Yuan, Lasheng; Spackman, David Eldon
This research attempts to provide an innovative approach to measuring Catastrophic Health Expenditure (CHE) that captures the dynamics of household assets globally. CHE is a major cause that pushes households into poverty or forces households already in poverty into even deeper poverty. The study estimates how dynamically measured CHE affects a household’s assets by exploiting a panel dataset with a plethora of household financial information. The innovative approach is then validated by comparing the accuracies of future CHE incidence prediction, using the CHE indicators in the current period along with other household characteristics, fitted into a machine-learning classification algorithm.
Open Access
New method for determining breast cancer recurrence-free survival using routinely collected real-world health data
(2022-03-16) Jung, Hyunmin; Lu, Mingshan; Quan, May L.; Cheung, Winson Y.; Kong, Shiying; Lupichuk, Sasha; Feng, Yuanchao; Xu, Yuan
Abstract Background In cancer survival analyses using population-based data, researchers face the challenge of ascertaining the timing of recurrence. We previously developed algorithms to identify recurrence of breast cancer. This is a follow-up study to detect the timing of recurrence. Methods Health events that signified recurrence and timing were obtained from routinely collected administrative data. The timing of recurrence was estimated by finding the timing of key indicator events using three different algorithms, respectively. For validation, we compared algorithm-estimated timing of recurrence with that obtained from chart-reviewed data. We further compared the results of cox regressions models (modeling recurrence-free survival) based on the algorithms versus chart review. Results In total, 598 breast cancer patients were included. 121 (20.2%) had recurrence after a median follow-up of 4 years. Based on the high accuracy algorithm for identifying the presence of recurrence (with 94.2% sensitivity and 79.2% positive predictive value), the majority (64.5%) of the algorithm-estimated recurrence dates fell within 3 months of the corresponding chart review determined recurrence dates. The algorithm estimated and chart-reviewed data generated Kaplan–Meier (K-M) curves and Cox regression results for recurrence-free survival (hazard ratios and P-values) were very similar. Conclusion The proposed algorithms for identifying the timing of breast cancer recurrence achieved similar results to the chart review data and were potentially useful in survival analysis.
Open Access
Psychometric evaluation of a Canadian version of the Seattle Angina Questionnaire (SAQ-CAN)
(2020-12-01) Lawal, Oluwaseyi A; Awosoga, Oluwagbohunmi; Santana, Maria J; James, Matthew T; Southern, Danielle A; Wilton, Stephen B; Graham, Michelle M; Knudtson, Merrill; Lu, Mingshan; Quan, Hude; Ghali, William A; Norris, Colleen M; Sajobi, Tolulope
Abstract Background The Seattle Angina Questionnaire (SAQ) is a widely-used patient-reported outcomes measure in patients with heart disease. This study assesses the validity and reliability of the SAQ in a Canadian cohort of individuals with stable angina. Methods and results Data are from the Alberta Provincial Project for Outcome Assessment in Coronary Heart Disease (APPROACH) registry, a population-based registry of patients who received cardiac catheterization in Alberta, Canada. The cohort consists of 4052 patients undergoing cardiac catheterization for stable angina and completed the SAQ within 2 weeks. Exploratory factor analysis and confirmatory factor analysis (CFA) were used to assess the factorial structure of the SAQ. Internal and test–retest reliabilities of a new measure (i.e., SAQ-CAN) was measured using Cronbach α and intraclass correlation coefficient, respectively. CFA model fit was assessed using the root mean square error of approximation (RMSEA) and comparative fit index (CFI). Construct validity of the SAQ-CAN was assessed in relation to Hospital Anxiety and Depression Scales (HADS), Euro Quality of life 5 dimension (EQ5D), and original SAQ. Of the 4052 patients included in this analysis, 3281 (80.97%) were younger than 75 years old, while 3239 (79.94%) were male. Both exploratory and confirmatory factor analyses revealed a four-factorial structure consisting of 16 items that provided a better fit to the data (RMSEA = 0.049 [90% CI = (0.047, 0.052)]; CFI = 0.975). The 16-item SAQ demonstrated good to excellent internal reliability (Cronbach’s α range from 0.77 to 0.90), moderate to strong correlation with the Original SAQ and EQ5D but negligible correlations with HADS. Conclusion The SAQ-CAN has acceptable psychometric properties that are comparable to the original SAQ. We recommend its use for assessing coronary health outcomes in Canadian patients with Coronary Artery Disease.
Open Access
Supervised consumption site enables cost savings by avoiding emergency services: a cost analysis study
(2022-03-28) Khair, Shahreen; Eastwood, Cathy A.; Lu, Mingshan; Jackson, Jennifer
Abstract Background and aims We report on a cost analysis study, using population level data to determine the emergency service costs avoided from emergency overdose management at supervised consumption services (SCS). Design We completed a cost analysis from a payer’s perspective. In this setting, there is a single-payer model of service delivery. Setting In Calgary, Canada, ‘Safeworks Harm Reduction Program’ was established in late 2017 and offers 24/7 access to SCS. The facility is a nurse-led service, available for client drop-in. We conducted a cost analysis for the entire duration of the program from November 2017 to January 2020, a period of 2 years and 3 months. Methods We assessed costs using the following factors from government health databases: monthly operational costs of providing services for drug consumption, cost of providing ambulance pre-hospital care for clients with overdoses who could not be revived at the facility, cost of initial treatment in an emergency department, and benefit of costs averted from overdoses that were successfully managed at the SCS. Results The proportion of clients who have overdosed at the SCS has decreased steadily for the duration of the program. The number of overdoses that can be managed on site at the SCS has trended upward, currently 98%. Each overdose that is managed at the SCS produces approximately $1600 CAD in cost savings, with a savings of over $2.3 million for the lifetime of the program. Conclusion Overdose management at an SCS creates cost savings by offsetting costs required for managing overdoses using emergency department and pre-hospital ambulance services.
Open Access
A systematic review of interventions to increase breast and cervical cancer screening uptake among Asian women
(BioMed Central, 2012) Lu, Mingshan; Moritz, Sabina; Lorenzetti, Diane; Sykes, Lindsay; Straus, Sharon; Quan, Hude
Funding provided by the Open Access Authors Fund.
Open Access
The Economics of Big Data in Healthcare: A Case Study of the ICD-9 to ICD-10 Transition
(2018-10-23) Khair, Shahreen; Lu, Mingshan; Yuan, Lasheng; Quan, Hude
This thesis attempts to provide a methodological and qualitative analysis of the trend in data usage in the healthcare industry and highlight the importance of economic evaluation in big data for healthcare. The paper explores the need for economic evaluation of the current data usage scenario in Canada via a case study on the ICD-9 to ICD-10 transition and illustrates the gaps in data availability. Detailed formulae for calculating the costs and benefits of the transition is provided, while a comprehensive guideline illustrates how the cost calculations would differ between the different provinces of Alberta, Manitoba, Saskatchewan and British Columbia. The paper also presents an overview of the upcoming ICD-11 transition and provides a framework for conducting an economic evaluation of the ICD-10 to ICD-11 transition. In conclusion, the thesis finds that although considerable progress has been made, significant improvements in data utilization is required to reap the full benefits of health data available and enable efficient economic evaluation.