Administrative data accurately identified intensive care unit admissions in Ontario

Abstract

Background and objectives: To evaluate the accuracy of Ontario administrative health data for identifying intensive care unit (ICU) patients.

Materials and methods: Records from the Critical Care Research Network patient registry (CCR-Net) were linked to the Ontario Health Insurance Program (OHIP) database and the Canadian Institute for Health Information (CIHI) database. The CCR-Net was considered the criterion standard for assessing the accuracy of different OHIP or CIHI codes for identifying ICU admission.

Results: The highest positive predictive value (PPV) for ICU admission (91%) was obtained using a CIHI special care unit (SCU) code, but its sensitivity was poor (26%). A strategy based on a combination of CIHI SCU codes yielded a lower PPV (84%) but a higher sensitivity (92%). A strategy based purely on OHIP claims yielded further reductions in PPV (73%), gains in specificity (99%), and moderate sensitivity (56%). The highest sensitivity (100%) was obtained using a combination of CIHI and OHIP codes in exchange for poor PPV (32%).

Conclusions: Administrative databases can be used to identify ICU patients, but no single strategy simultaneously provided high sensitivity, specificity, and PPV. Researchers should consider the study purpose when selecting a strategy for health services research on ICU patients.