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INDICATOR NAME
Name
Follow-up with a doctor within 7 days of discharge following hospitalization for congestive heart failure (CHF)
Alternate Name
Percentage of patients who saw a family doctor or specialist within 7 days of discharge after hospitalization for congestive heart failure (CHF)
 
INDICATOR DESCRIPTION
Description
Percentage of follow-up visits with a doctor within 7 days of discharge after hospitalization for congestive heart failure (CHF) among patients aged 40 and older. A higher percentage is better.
Indicator Status
Active
HQO Reporting tool/product
Public reporting
Dimension
Effective, Timely
Type
Process
 
DEFINITION AND SOURCE INFORMATION
Unit of Measurement
Percentage
Calculation Methods
The percentage is calculated as: numerator divided by the denominator times 100
Numerator including inclusion/exclusion

The number of patients in the denominator discharged from acute care hospitals after an admission for congestive heart failure (CHF) who had at least one physician visit within 7 days after discharge.

The follow-up data are received in the following subcategories:

  • By any health care provider
  • By primary care physician (GP/FP)
  • By specialist (cardiologist)

Inclusions:

  1. Ontario physician visits taking place in office, home or long-term care (includes most of the follow-up (planned) emergency department visits).
  2. Physician visits occurring between days 0 to 7 post-discharge (i.e., includes date of discharge).*

*If a patient’s discharge time was before 8 am, the OHIP visit was counted on day 0, otherwise the visit was not counted on the same day as it is impossible to distinguish if the visit happened before or after the discharge.

Exclusions:

  1. Negated OHIP claims, duplicate claims and lab claims.
  2. Records with missing or invalid data on discharge/admission date, health number, age and gender.
Denominator including inclusion/exclusion

The number of patients aged 40 and older discharged from hospital after an admission for congestive heart failure (CHF).

Inclusions:

  • Discharges from acute care hospitals with discharge date in the reporting period
  • Admission for congestive heart failure (CHF) (ICD10 codes I500, I501, I509)
  • Diagnosis type = "M" (main)
  • Discharged home

Exclusions:

  • Patients under age 40
  • Deaths, acute transfers, patient sign-outs against medical advice
  • Records with missing or invalid data on discharge/admission date, health number, age and sex
  • Transfers to hospital or other care settings (palliative care/hospice, addiction treatment centre...) as defined by discharge disposition ‘01’, ‘03’
Adjustment (risk, age/sex standardization)- detailed

Direct age and sex adjusted using 2011 Canadian census population

Age groups are: 40-64, 65-79, 80+

Data Source
Discharge Abstract Database (DAD), Ontario Health Insurance Plan (OHIP) Claims History Database, Physician Database (IPDB), Registered Persons Database (RPDB)
Data provided to HQO by
Institute for Clinical Evaluative Sciences (ICES)
Reported Levels of comparability /stratifications (defined)
Region, Time
 
RESULT UPDATES
Indicator Results
NA
 
OTHER RELEVANT INFORMATION
Caveats and Limitations
The indicator captures a visit with a doctor for any reason and may not necessarily have the same reason as the hospitalization. Follow up by non-physician providers (i.e., nurse practitioners in family health teams) or providers that do not provide billing or shadow billing will not be captured. It is hard to interpret the results as there is some variation in recommended time period for the follow-up (ranging from one week to one month).
Comments Detailed
The admissions are unique by episode (one patient can have more than one admission during the fiscal year).
Footnotes
N/A
 
TAGS
Sector
Primary Care
Type
Process
Topic
Access, Chronic Disease, Integration
Dimension
Effective, Timely
Source
Discharge Abstract Database (DAD), Ontario Health Insurance Plan (OHIP) Claims History Database, Physician Database (IPDB), Registered Persons Database (RPDB)
 
PUBLISH
Publish Datetime
20/11/2018 15:19:00