Concept: Palliative Care - Data Sources and Method of Identification

Introduction

Palliative Care involves care and services for persons who have an incurable illness and are at the end stages of their life. This concept identifies the types of palliative care services available, the data sources related to these services, and describes the methods of identifying palliative care from these sources in the MCHP Data Repository.

There are two main types of palliative care services:


1. hospital based palliative care, and
   
2. community based palliative care, including:
   
   • Home Care;
     
   • medications provided through the Drug Program Information Network (DPIN); and
     
   • the Winnipeg Regional Health Authority (WRHA) Palliative Care Program.

Palliative Care Data Sources

There are several data sources in the MCHP Data Repository that contain palliative care information. The following sections identify each data source and describe the methods that can be used to identify palliative care information.

1. Hospital Palliative Care

Hospital palliative care can be identified either through diagnoses codes or through hospital service codes and is time dependent. From 1997/98 to 2003/2004, palliative care information can be found in the Hospital Abstract User Manual (HAUM) data and from 2004/2005 to present in the Discharge Abstract Database (DAD) data.

From the HAUM data, palliative care can be identified using:


• ICD-9-CM diagnosis code V66.7 (Encounter for palliative care) or
  
• hospital service code = "06" - either as a main patient service code or service transfer code.

From the DAD data, palliative care can be identified using:


• ICD-10-CA diagnosis code Z51.5 (palliative care) or
  
• hospital service code = "58" - either as a main patient service code or service transfer code.

NOTES:

1. Palliative diagnoses codes are never recorded as the "most responsible diagnosis", so all diagnoses codes should be reviewed.
   
2. In the DAD, many, but not all palliative care patients will be designated as alternate level of care (ALC) patients.

2. Home Care Palliative Care

Home Care provides services to palliative care patients. Palliative care service data is available in two different Home Care data sources:


• In the MSSP Home Care data, palliative care is identified by the program code = "PL" in any of the program variables: "Program1" - "Program5", in the client registry files; OR in the variable "Program" in the client history files. This data is available from 2000/2001 onward.
  
• In the MDS Home Care data, palliative care is identified by a value of "95A" in the variable "mds_openfacilityid" in an open Home Care case. This data is available from 2005/2006 onward.

3. Drug Program Information Network (DPIN) Palliative Care

Palliative care patients may also be receiving medications through the Palliative Care Drug Access Program, identified in the DPIN data with claims that have the variable "CARRIER" = "04". This data is available from 2002/2003 onward.

4. WRHA Palliative Care Program Registry

The WRHA Palliative Care Program provides coordinated services to palliative care patients who are registered with the WHRA Palliative Care Program. The Registry dates back to 2000/2001.

NOTE: This data is not currently available in the MCHP Data Repository, but is being acquired as part of a project related to palliative care.

For more information on the WRHA Palliative Care Program, please visit the WRHA Palliative Care Program Web Site.

SAS Code - Palliative Care

This concept contains an example SAS code program related to identifying palliative care in the MCHP Data Repository. This code is only available internally.

Please see the file "SAS Code - Palliative Care Identification" in the SAS code and formats section below.