The costs by age group, sector and diagnosis are calculated using a top-down methodology. This means that we start with the total provincial cost in each sector and then divide it up based on visit characteristics. In the case of Physician Claims, the costs are assigned to each person per visit. In the case of Hospital Clinics, Emergency, and Inpatient visits, the cost is assigned based on the individual visit “intensity.” Not included are Continuing Care (Nursing Homes, Supported Living, Home Care), Corporate Administration, Outpatient Radiation Therapy, and Community Pharmacy. These will be included in a future version.
This method allows us to assign costs to each individual and then roll the individuals up into age groups, sectors, and diagnoses groups. With the costs assigned this way, we can now see the cost of various diagnoses based on the age group or sector. By clicking on either chart, we see how the cost is distributed to the other groupings. For example, by clicking on "Infections" we can see that 59% of the $259M occurs in the Inpatient sector.
What costs are included/excluded?
The costs include the Hospitals (Inpatient, Emergency and Clinics) and direct physician billing. Not included are Continuing Care (Nursing Homes, Supported Living, Home Care), Outpatient radiation therapy, Community Pharmacy, and Corporate Administration.
How do I interpret this dashboard?
This dashboard provides a big picture view of the relative costs of various diagnosis categories across sectors and age cohorts. This cost is determined by assigning the cost to each person based on either the direct physician billing or proportionally based on the “resource intensity weight” assigned to each visit. These costs are therefore a top-down approach of assigning costs based on patient/visit characteristics.
Why are there so many diagnosis groups?
The diagnosis groups are based on the ICD-10 codes (International Statistical Classification of Diseases and Related Health Problems), a medical classification list by the World Health Organization (WHO). There are 16,000 ICD-10 codes. We have grouped these into 250 diagnostic groups which we call Aggregate Episode Diagnostic Categories (AEDC).