Home and Community Care data set

Description

Information on transactions for individuals receiving services paid by the Continuing Care Division, BC Ministry of Health Services. Transactions relate to clients who are publicly-funded residents of long-term care facilities, assisted living facilities, family care homes and group homes, clients in adult daycare programs, and clients receiving home care and home support services.

Population Data BC receives data from the Continuing Care Data Warehouse (CCDW) tables of the Ministry of Health Services. The CCDW system was implemented in 1990.

Fields available

Client Master Record

Field Name	Description
Client Number**	Unique number which identifies the client receiving services. [Replaced by a project-specific identification number.]
Birth Date**
Death Date**
Last Update Date	Indicates the last date the client record was updated.
Client Status	Indicates the status of the client (used for referral clients only), e.g. active, inactive, etc.
Sex
Health Unit of Assessment**	The health unit used as indicated on the latest assessment form.
Assessment Date	Effective date of latest assessment.
Care Advice Date	Effective date of latest LTC care advice.
Health Unit of Care Advice**	Health unit as coded on the latest care advice form processed.
Care Facility ID	Identifies facility where client is currently receiving care. [Replaced by a project-specific identification number.]
Indicator of Homemaker Care payment rate category
Health Unit Responsible for Client**
Review Date	For LTC use only. Bring-forward date set and controlled by the health unit on which the client must be re-assessed or reviewed.
Veterans' Allowance Flag	Indicates if client qualifies for war veteran's allowance.
Absence from Facility Flag	Indicates if person is currently absent from facility care.
Guaranteed Annual Income Flag	Indicates if client is receiving Guaranteed Annual Income for Need (GAIN).

Assessment Record

Field Name	Description
Date of Assessment	The date the case manager assessed the client.
Location of Assessment	Location where the assessment was performed, e.g. client's home, facility, acute hospital, etc.
Care Recommended by Assessor	Possible values are: not eligible, homemaker, care in facility, home care program, mental health, and day care.
Care Approved by Administrator	Same as above. This field is now redundant, as the assessor has the authority to approve the recommend the care type.
Assessment Type	Possible values are: new assessment (first time assessed by CCD, to be used once ever), review -- no change in assessed care level, re-assessment -- change in assessed care level, appeal -- client or provider appeal a previous assessment, correction to a previous assessment, and undefined.
Approved Level of Care	Approved level of care for a client. Possible values are: mental health resources, personal care, intermediate care 1, intermediate care 2, intermediate care 3, extended care, undefined or not applicable.
Recommended Level of Care
Assessor Number**	Specifies the case manager who performed the assessment. [Replaced by a project-specific identification number.]
Health Unit of Assessment**	Health unit for which the assessment was performed.

Care Advice for LTC Record

Field Name	Description
Effective Date	Date and sequence number that LTC care advice is to become effective.
Transaction Number	This field is no longer available.
Removal Date	The date the care or fee advice became inactive because of a correction or a deletion.
Financial Activation Date	The date the care advice became financially active. NOTE: This is a redundant field, as this will be the same as the 'Effective Date'.
Maximum time Authorized	The maximum hours or days of service for which provider can bill - applies to non-facility care only.
Assessor Number**	ID of assessor who completed care advice form. [Replaced by a project-specific identification number.]
Health Unit Number**	Number identifying the health unit from which this care advice originates.
Type of Care Advice	Possible values are: start service, change of service, end service, correction to a start service, correction to a change of service, correction to an end service, deletion of a start service, deletion of a change of service, and deletion of an end service.
Status of Care Advice	Status of the care or fee advice. Verified and unverified are active, corrected and deleted are inactive. Used to determine what is to be paid for and which care advices need verification.
Paid Flag	Indicates whether the care is to be paid or unpaid.
Client Contribution Rate	Contribution paid by client per day for care received (only applies to non-facility care).
Reference Transaction Number	This field is no longer available.
Level of Care	The reason for a start, change or end of service (according to 'type of care advice'). This is not consistently recorded for people in extended care units prior to 1987, and is not recorded at all after that date.
Reason Code	The reason for a start, change or end of service (according to 'type of care advice'). This is not consistently recorded for people in extended care units prior to 1987, and is not recorded at all after that date.
Provider Category	Indicates which provider category this service event applies to.
Provider Health Unit	Health unit number in which provider provides services.
Provider Class	Indicates the type of payment the provider receives. Possible values includes: per diem claims, hourly claims, per diem facility payments, no payment.
Provider Number	Unique number, internal to Continuing Care Division. [Replaced by a project-specific identification number.]

Care Advice for Direct Care Service Record

Field Name	Description
Transaction Number	This field is no longer available.
Financial Activation Date	Date the care advice became financially active.
Referring Physician Number	Unique number identifying referring physician. [Replaced by a project-specific identification number.]
Maximum time Authorized	NOT USED BY DIRECT CARE.
Hospital of Referral	ID of hospital where patient was previously receiving care.
Ward of Referral	ID of the hospital ward where the patient was previously receiving care.
Care Group Type	Code classifying the type of care the client is receiving.
Referral Source	Used by OT, PT and QRT only. Possible values include: undefined, LTC, HNC, preventive, direct, CC nursing or PT.OT program, physician, and emergency-hospital.
Type of Care Advice	Indicates whether it is the start or end of a care episode.
Status of Care Advice	Values will always indicate 'verified'. Not useful for research purposes.
Paid Flag	Values will always indicate 'unpaid'. Not useful for research purposes.
Effective Date of Care Advice
Level of Care	Possible values include: HNC, PT, OT, and QRT (use organization code to distinguish between OT and QRT).
Expected Length of Time in Program	Code indicating the expected length of time the patient will be in the program. Except for QRT, possible values are: =<2 weeks, 3-4 weeks, 5-14 weeks, 3-6 months, and 6+ mths. For QRT, possible values are: 1 day, 2 days, 3 days, 4 days, and 5+days.
Reason Code	Reason for patient's discharge.
PT or HNC Visits	Total of either PT or home nursing care visits for this care episode. Entered on discharge, or every 6 mos for long term patients.
OT or PHN visits	Total of either OT or public health nurse visits for this care episode. Entered on discharge, or every 6 mos for long term patients.
Primary Diagnosis	ICD-9 codes. Not used since approximately 1991.
Secondary diagnosis	ICD-9 codes. Not used since approximately 1991.
Operation/Surgery Code	Procedure codes. Not used since approximately 1991.
Projected Treatment Type	Type of care to be provided. For all except QRT, possible values include: full rehabilitation, partial rehabilitation, maintenance, palliative care, and undefined. For QRT, possible values include: crisis intervention, respite care giver, early hospital discharge, and emergency care diversion.
Client Outcome at Discharge	Indicates patient outcome at discharge.
Last Visit Update Date	Date on which the visit totals were last entered.

** Data field which could potentially identify an individual, and which therefore is only released only to researchers having a clear need for the data in order to accomplish their research project.

Inclusions

• Service transactions for clients who are publicly-funded residents of long-term care facilities, assisted living facilities, family care homes and group homes, clients in adult daycare programs, and clients receiving home care and home support services.

Exclusions

• Health authorities provide some services that they do not report to the CCDW.
• Community-based agencies do not report to the Ministry on the support services they provide.

Data changes over time

• Population Data BC now receives data from the Continuing Care Data Warehouse (CCDW) tables at the BC Ministry of Health Services. However, the current DAR/RA checklist (2003 July version) corresponds to the old format of Continuing Care data from the Continuing Care Information Management System (CCIMS). Until a revised checklist is in use, we map the original data file and field checklist against a new file and field checklist and provide researchers with the cross-walked data.
  The current CCDW data differs from the former CCIMS data (available from 1985 to1989), and the continuity between the data is problematic to work with. Therefore, we generally only provide researchers with the CCDW data from 1990 forward.

Quality/accuracy of information/field coding source

• Health Authorities are slowly changing their reporting mechanism from CCIMS to a new Minimum Reporting Requirement (MRR). In the process, data quality in the CCIMS system, which feeds the CCDW, appears to have suffered. Researchers interested in using these data will want to consult with Population Data BC staff about limitations and potential solutions. We expect data quality to improve again over time.

Important additional information

• The LTC Service Plan table (Care Advice for LTC on the DAR/RA) captures services provided to residents of a facility and home support services provided to community-based residents. The Direct Care table (Care Advice for Direct Care Service Record on the DAR/RA) captures home care services such as home nursing, home physiotherapy and home occupational therapy provided to community-based residents. The division between these two files is an historical artefact related to the development of publicly-funded services (Hollander and Pallan 1995).
• A Service Event is a period of service that a patient has with a service provider. Each service event begins with a ‘Start Date' or service change (‘Start Type Code'), and the event is either open or ended by a service change (‘Start Type Code') or an ‘End Date'.
• Project-specific client numbers are provided unless otherwise authorized. This allows the grouping of service records within a single care episode.

References

• McGrail KM, Broemeling AM,McGregor MJ, Salomons K, Ronald LA, McKendry R. Home Health Services in British Columbia: A Portrait of Users and Trends Over Time. Vancouver (BC): UBC Centre for Health Services and Policy Research; October 2008.
• Hollander, M. J. & Pallan, P. The British Columbia Continuing Care System: Service Delivery and Resource Planning. Aging (Milano.) 1995;7:94-109.