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DAD Research Analytic Files. A collaboration b etween CIHI and Statistics Canada’s Data Liberation Initiative (DLI) April 2013. Canadian Institute for Health Information (CIHI) - Overview.
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DAD Research Analytic Files A collaboration between CIHI and Statistics Canada’s Data Liberation Initiative (DLI) April 2013
Canadian Institute for Health Information (CIHI) - Overview • Mandate: To provide accurate and timely information required for sound health policy, effective management of the health system and to increase public awareness about factors affecting good health • 27 databases of linkable health information • Health care services: primary health care, hospital care, specialized services, community and pharmaceutical care • Health spending: by geography and by category • Health workforce: physicians, nurses, and other health care providers
Collaboration between CIHI and Statistics Canada’s Data Liberation Initiative (DLI) CIHI’s Data Access Strategy • Purpose: To improve timeliness and accessibility of data to users such as system planners, policy makers, and researchers by • Streamlining CIHI’s existing data dissemination channels • Exploring new, trusted data dissemination channels • Collaboration with Statistics Canada to make CIHI data more accessible to academic researchers using the DLI • Pilot project ending March 31 2014: provide CIHI data to be part of the DLI collection, along with complete documentation
What is the DAD? • The Discharge Abstract Database (DAD) captures administrative, clinical, and demographic information on hospital discharges (including deaths, sign-outs, and transfers). Some provinces/territories capture day surgery. • More than 3 million records submitted to DAD annually • Data are received from all acute care facilities across Canada (except Quebec: data received from Quebec ministry of health added to a different database: Hospital Morbidity Database (HMDB) • Select chronic care, rehabilitation, and psychiatric facilities also submit data to DAD.
DAD data elements • Some DAD data elements groupings: • Length of hospital stay • Patient demographics (age, gender, province of residence,…) • Admission and discharge information • Patient services while in hospital • Service provider information • Diagnosis, special care and intervention information Only select data elements from the above are included in the DAD DLI Sample Files.
Facts about the DAD DLI Sample Files • DAD sample data files for the DLI include acute inpatient cases from all provinces/territories except Quebec and British Columbia • Files are designed to maintain balance between patient privacy and usefulness of data • 10% sample ensures privacy, and combining two years of data enhances richness • 2 DAD-DLI files: one with more clinical detail, one with more geographic detail • Documentation accompanies the data files
DAD’s Patient-oriented Approach • DAD-DLI sample files allow for greater analysis potential when the sequence of care for an individual can be followed over time • All discharge records belonging to these patients over a two-year period are included in the DAD-DLI files • Separate, non-overlapping 10% samples of persons are created for the ‘clinical’ and ‘geographic’ files
Contents of DAD DLI Sample Files • To protect patient privacy: • Less clinical detail in the geographic file • Less geographic detail in the clinical file • Collapsed data for privacy protection • Age in years (not birth date) • Length of stay (in days not date of stays) • Newborn weights by size groupings • Gestation weeks at delivery in four categories
Common DAD DLI Sample Data Elements • Person identifier (meaningless except to identify discharge records for the same person within the files) • Facility province (territories are combined) • Discharge information (relative to reference date) • Admission information (relative to confidential reference day based on collapsed total length of stay • Gender • Age groups (newborn, less than 1 year, 1-7, 8-12, etc.) • Admission/discharge information
Clinical detail file (DAD DLI Sample File) • Clinical details: • Diagnoses based on ICD–CA classification codes and type • Interventions: CCI codes, type, status, location, anaesthetic techniques • Special care unit visits: type/number and hours • Length of stay in days • Newborn weights by size groupings • Gestation weeks at delivery in four categories
Geographic detail file (DAD DLI Sample File) • Health Region • Resource Utilization by diagnosis and use of health care services • Length of Stay: three categories (0, 1-2, 3+ days)
Documentation for DAD DLI Sample Files • File specifications containing methodological notes • Data layout with definitions and values • Data quality documentation • DAD Abstracting Manual • International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, Canada (ICD-10-CA) • Canadian Classification of Health Interventions (CCI) • CMG+ Directory 2011 • Available in both English and French
Key Uses of the DAD DLI Sample Files • Researchers can become familiar with the structure and content of data • Researchers can explore relationships among data elements (e.g. diagnoses and interventions) • Researchers can perform preliminary analyses and data mining, and test hypotheses Provides researchers with an opportunity to work with the data and clarify data requirements before making a formal data request to CIHI
For your information – Other ways of accessing data from CIHI
Accessing data from CIHI • CIHI website • Free, pre-formatted, aggregate-level data including “Quick Stats” (data tables) and Analytic Reports • Customized data requests • Aggregate-level • Record-level • Graduate Student Data Access Program
Graduate Student Data Access Program • CIHI provides data to qualifying graduate students at no cost through the GSDAP (please visit www.CIHI.ca) • Objectives: • To build the capacity of graduate students to undertake health service research; and • To increase awareness of CIHI and CIHI’s data holdings, and the importance of data quality and privacy, as graduate students pursue health services research careers • Criteria: • Data used by the student to fulfill graduate requirements • The research project was reviewed by a research ethics boardand will support CIHI’s mandate
Customized Data Requests Aggregate • Groups or summaries of data (e.g. counts, means, median) • Data table • Small cell sizes may be suppressed (counts<5) Person-level • De-identified data on patients, who may have more than one record in the database • De-identified data limited to meeting the project’s needs • Format (SAS, comma-delimited)
Accessing data from CIHI 1) Determining your own data requirement • Are the data required available elsewhere on CIHI website?If not, contact CIHI for a customized data request 2) Contact CIHI • Complete Online Data Inquiry Form 3) CIHI’s initial assessment of data request • Forwarded to appropriate database area and request evaluated based on the requirements provided on the form 4) Further documentation • Signed Request Form, Specifications approval, data extraction and verification, and data release Note: all data from CIHI are released to the users as per CIHI Privacy Policy (available on CIHI website)
For more information • Explore CIHI’s website at www.cihi.ca for existing sources of data and information • For more information on the STC-DLI, please contact Statistics Canada at dli-idd@statcan.gc.ca