To advance and promote the discipline and professional practice
of public health epidemiology in Ontario

Medical Services

Medical services information is obtained from the Ontario Health Insurance Plan (OHIP) Approved Claims files. The Approved Claims contains service and payment information for both fee-for-service claims submitted by physicians and other licensed health professionals and some of the "shadow billings" by providers in organization covered by alternate payment arrangements.  


Original Source:

Ontario Health Insurance Plan (OHIP) Approved Claims files
Distributed By:

Provincial Health Planning Database (PHPDB), Ontario MOHLTC
Suggested Citation:

Medical Services [years], Provincial Health Planning Database (PHPDB) Extracted: [date], Ontario MOHLTC

See Data Citation Notes.

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Related OPHS Standards

Chronic Disease Prevention and Well-Being Food Safety Healthy Environments Healthy Growth and Development Immunization Infectious and Communicable Diseases Prevention and Control Safe Water School Health Substance Use and Injury Prevention
 

Data Notes

Background
  • Medical services represents is a newly available source of morbidity information. Other components of morbidity include hospitalizations and ambulatory care visits. Both are also available through the Provincial Health Planning Database (PHPDB).
  • Medical services information is obtained from the Ontario Health Insurance Plan (OHIP) Approved Claims files.
  • The Approved Claims contains service and payment information for both fee-for-service claims submitted by physicians and other licensed health professionals and some of the "shadow billings" by providers in organization covered by alternate payment arrangements. Included in a typical claim is information about the patient, provider, Fee Schedule Code/procedure preformed, number of services/units delivered and some "diagnostic" information.


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Copy-Pasted Data Notes from old website
  • Since only some of the claims from the MOHLTC's various alternate payment programs or "shadow billers" are included there may be undercounting of total volume of certain services.
  • OHIP had developed a unique coding system for diagnosis. Although some of the codes do bear a resemblance to equivalent International Classification of Disease codes, they should not be confused with any other diagnostic coding system.
  • Some diagnosis codes may have completely different meanings depending on the specialty of the provider and should therefore always be used in conjunction with the diagnosis type field.
  • Approximately 50% of diagnosis codes are missing from the medical claims data since there is no requirement to include them.
  • Geographic information for residence of patient must be interpreted with extreme caution. OHIP does not collect any geographic information on either the patient or the provider as part of the claim. The location of the patient in the PHPDB is based on the address of the person recorded in the Registered Persons Database. Many of these addresses have never been updated since they were first entered in the early 1990's.
  • Rates and proportions based on counts less than 5 must be suppressed. This is specified in the Ontario Provincial Health Planning Database User Agreement.



Analysis Checklist

[General Checklist for All Associated Indicators]
  • The following instructions are designed to be overwritten when drafting a data source web page:  
  • This is where analysis details and coding idiosyncrasies are noted.
  • The order of the points should should reflect relevance: list more important point earlier for higher visibility.
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Associated Indicators

One Two Three Four Five

  

One Two Three Four Five

  

One Two Three Four Five

  

One Two Three Four Five
 

References

Cited References
  1. Cited references are numbered and refer to square-bracketed [1] numbers in the indicator text.
  2. Provide references following the Vancouver Citation Method, as used by the Canadian Public Health Association.  
  3. Column numbers in the right-hand column don't update in the web editor, but will update on the published webpage.  
  4. Similarly, the column lengths will balance on the published webpage; but try to keep the left column longer in the web editor.
  5. Delete these instructions as well as the examples which follow, when drafting an indicator. 
  1. Single E, Rehm J, Robson L, Van Truong M.  The relative risk and etiologic fractions of different cause of death and disease attributable to alcohol, tobacco and illicit drug use in Canada.  CMAJ 2000; 162(12): 1669-1675
  2. Appendix: A Summary of Studies on the Quality of Health Care Administrative Databases in Canda. In: Goel V, Williams JI, Anderson GM, Blackstien-Hirsch P, Foodks C, Naylor CD, editors. Patterns of Health Care in Ontario. The ICES Practice Atlas, 2nd edition. Ottawa: Canadian Medical Association; 1996. p. 339-45.
General References

Acknowledgements

Lead Authors

The acknowledgements section lists all individuals who have contributed to this indicator.  Individuals should provide permission before their names are added to the webpage.  Delete instructions and overwrite the templates when drafting an indicator.  

Name, Organization (at time of contribution)

Contributing Authors

Where possible, list each contributing author rather than a subgroup name.

Name, Organization (at time of contribution)

Reviewers

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Name, Organization (at time of contribution)

Other Acknowledgements

Name, Organization (at time of contribution)

Revision History

 This Core Indicator Product webpage is maintained by the [Insert SUBGROUP name here and link it to the subgroup webpage].  
Date Review Type Author Changes PDF
May 8, 2008 Date of Last Revision    

[September 7, 2019]
Website Update:
No Content Review
Sherri[Caitlyn Paget],
on behalf of the CIWG
    Migrated to new website structure and format, including:
  • Replaced references from PHPDB (SPELL IT OUT) to IntelliHEALTH.
  • Reorganized content to provide high-level information at a glance, and move in-depth analytic information into dedicated sections for users to access when needed.  
  • Added short data source description in header.  
  • Moved data-specific Analysis Checklist items from the indicator pages to reduce duplication.  
  • Crosslinked to relevant Core Indicators webpages including OPHS program standard(s) and associated indicator(s).
  • Added Revision History table, with PDF copy of previous version for reference.  
     
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to provide standardized methodology for population health assessment, to measure complex concepts of individual and community health.
Please contact core.indicators@apheo.ca for further information.  
   
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