Validity of Physician Billing Claims to Identify Deceased Organ Donors in Large Healthcare Databases

Alvin Ho-ting Li, S Joseph Kim, Jagadish Rangrej, Damon C Scales, Salimah Shariff, Donald A Redelmeier, Greg Knoll, Ann Young and Amit X Garg

PLOS ONE, 2013, vol. 8, issue 8, 1-6

Abstract: Objective: We evaluated the validity of physician billing claims to identify deceased organ donors in large provincial healthcare databases. Methods: We conducted a population-based retrospective validation study of all deceased donors in Ontario, Canada from 2006 to 2011 (n = 988). We included all registered deaths during the same period (n = 458,074). Our main outcome measures included sensitivity, specificity, positive predictive value, and negative predictive value of various algorithms consisting of physician billing claims to identify deceased organ donors and organ-specific donors compared to a reference standard of medical chart abstraction. Results: The best performing algorithm consisted of any one of 10 different physician billing claims. This algorithm had a sensitivity of 75.4% (95% CI: 72.6% to 78.0%) and a positive predictive value of 77.4% (95% CI: 74.7% to 80.0%) for the identification of deceased organ donors. As expected, specificity and negative predictive value were near 100%. The number of organ donors identified by the algorithm each year was similar to the expected value, and this included the pre-validation period (1991 to 2005). Algorithms to identify organ–specific donors performed poorly (e.g. sensitivity ranged from 0% for small intestine to 67% for heart; positive predictive values ranged from 0% for small intestine to 37% for heart). Interpretation: Primary data abstraction to identify deceased organ donors should be used whenever possible, particularly for the detection of organ-specific donations. The limitations of physician billing claims should be considered whenever they are used.

Date: 2013
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Persistent link: https://EconPapers.repec.org/RePEc:plo:pone00:0070825

DOI: 10.1371/journal.pone.0070825

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