Failure of Administrative Data to Guide Asthma Care

Abstract

Rationale: Asthma is a chronic inflammatory disease of the airways that is very common (7.9% of Canadians over the age of 12). Despite numerous clinical guidelines, education events and administrative data reviews, there has been little change to the way asthma is managed in the Canadian health care system for nearly 30 years. We evaluated, through the Physician Learning Program (PLP) in Alberta, possible reasons why administrative datasets have not been able to provide meaningful information to adjust health policy. Methods: Provincial data was attained through Alberta Health Service and Alberta Health on pulmonary function testing from 2005-2011 (through the PLP). The number of asthma diagnosis made during the same time frame were then compared. Results: The preliminary results of the PLP found that spirometry was billed for roughly half as often as the asthma diagnostic codes were utilized during the same time frame. However, the review also revealed inconsistencies in how administrative data are captured, making it difficult to determine whether spirometry is being underutilized by physicians in making asthma diagnoses. Conclusions: Inconsistencies in how administrative data are captured in Alberta may be contributing to an incomplete picture of the rates of asthma diagnosis and physiological testing, and may explain, in part, the limited influence of administrative datasets on guiding meaningful change within the healthcare system.