Faculty of Medicine, University of British Columbia, Vancouver, Canada.
Can J Psychiatry. 2012 Jun;57(6):366-74. doi: 10.1177/070674371205700606.
Estimates from Canada's first national mental health surveillance initiative-which is based on diagnostic codes in administrative health care utilization databases-indicate that the proportion of Canadians who receive mental health care is more than twice as high as reported in Canada's national mental health survey. Our study examines and clarifies the nature and extent of differences between 2 predominant types of data that are used for mental health services research and planning.
A person-by-person data linkage was conducted between the Canadian Community Health Survey: Mental Health and Well-Being and administrative health care utilization records (British Columbia Ministry of Health Services-Medical Services Plan, and Hospital Discharge Abstract Database) within a universal-access, publically funded health care system, to examine the level of agreement between the data sources and respondent characteristics associated with agreement (N = 2378).
The prevalence of mental health care from general practitioners (GPs) was higher in administrative data (19.3%; 95% CI 17.7% to 20.9%) than survey data (8.5%; 95% CI 7.5% to 9.8%). Agreement between prevalence estimates from the 2 data sources was associated with age, mental health characteristics, and the number of GP visits. The median number of visits per person was significantly higher in the survey data.
GPs saw more than twice as many patients for mental health issues according to administrative data, compared with survey data; however, the number of visits per patient was higher in survey data.
加拿大首次全国性精神健康监测活动的评估结果——该活动基于医疗保健管理使用数据库中的诊断代码——表明,接受精神保健的加拿大人比例比加拿大全国性精神健康调查所报告的比例高出两倍以上。本研究检验并阐明了两种主要数据类型之间的差异的性质和程度,这两种数据类型用于精神保健服务研究和规划。
在全民享有、公共资助的医疗保健系统内,对加拿大社区健康调查:精神健康和幸福感与医疗保健管理使用记录(不列颠哥伦比亚省卫生部医疗服务计划和医院出院摘要数据库)进行逐个对象的数据链接,以检验数据源之间的一致性以及与一致性相关的应答者特征(N=2378)。
在行政数据中(19.3%;95%CI 17.7%至 20.9%),全科医生(GP)提供的精神保健治疗的流行率高于调查数据(8.5%;95%CI 7.5%至 9.8%)。这两个数据源的流行率估计值之间的一致性与年龄、精神健康特征和 GP 就诊次数有关。调查数据中人均就诊次数中位数明显较高。
根据行政数据,全科医生看诊的精神健康问题患者比调查数据多两倍以上;然而,调查数据中的每位患者就诊次数更高。