Number of patients  who had  a primary care physician  visit within 7 days  of discharge after hospitalization for any of the following conditions: pneumonia, diabetes, stroke, gastrointestinal disease, congestive heart failure, chronic obstructive pulmonary disease, heart attack  and other cardiac conditions (selected HBAM Inpatient Grouper (HIG) conditions). .

Inclusions:

1. A physician visit is counted if there is a service claim billed:

a. by any primary care physician in the group in which the patient is enrolled;
b. within 0 to 7 days of their discharge from hospital, and;
c. where the fee schedule code is classified as “Professional”.

Note: These criteria allow for the inclusion of inpatient visits; for example, claims with a fee schedule code C124 (Day of discharge visit – most responsible physician), are eligible to be counted (assuming the claim meets the other criteria listed above). Similarly, claims for visits that take place in the Emergency Department are eligible to be counted (again, assuming the claim meets the other criteria listed above).

Exclusions: 

1. Hospital discharge records with missing or invalid discharge date, admission date, health number, age and gender;

2. Ontario Health Insurance Plan (OHIP) claims that are negated, duplicates, physician claims from laboratory groups, and claims paid by the Workplace Safety and Insurance Board (WSIB).

Number of patients discharged from hospital after hospitalization for any of the following conditions: pneumonia, diabetes, stroke, gastrointestinal disease, congestive heart failure, chronic obstructive pulmonary disease, heart attack and other cardiac conditions (selected HBAM Inpatient Grouper (HIG) conditions).

Inclusions:

1. Acute inpatients in the specified HBAM Inpatient Grouper (HIGs) (see link) enrolled with a primary care physician at the time of discharge;
2. Cases that are typical, transfer in, short stay, long stay or long stay transfer in per the HIG atypical indicator (i.e. the HIG atypical indicator must be ‘00’, ‘01’, ‘09’, ‘10’, ‘11’);
3. Included ages are cohort specific: a. patients ≥ 45 for acute myocardial infarction (AMI), stroke, chronic obstructive pulmonary disease (COPD), congestive heart failure (CHF); b. patients ≥ 40 for cardiac HIGs; c. all ages for pneumonia, diabetes, and gastrointestinal (GI).

Exclusions: 

1. Death in hospital, acute transfers, patient sign-outs against medical advice;

2. Records with missing valid data on discharge/admission date, health number, age and gender;

3. Transfers to other hospital care and to other (palliative care/hospice, addiction treatment centre….) as defined by Discharge disposition ‘01’(for FY 2018 and onwards, discharge disposition ‘10’), ‘03’ (for FY 2018 and onwards, discharge disposition ‘20’, ‘30’, ‘40’, ‘90’) or institution to type '2', '3', '7'.

None