Geographical discrepancy in oral food challenge utilization based on Canadian billing data

Allergy, Asthma & Clinical Immunology

Research

Lianne Soller¹  Edmond S. Chan¹  Philippe Begin²  Samira Jeimy³  Harold Kim⁴  Ala El Baba⁵ 

[1]Division of Allergy and Immunology, Department of Pediatrics, University of British Columbia, Vancouver, BC, Canada

[2]BC Children’s Hospital Research Institute, Vancouver, BC, Canada

[3]Division of Allergy, Rheumatology and Immunology, Department of Pediatrics, CHU Sainte-Justine, Montréal, QC, Canada

[4]Division of Allergy and Clinical Immunology, Department of Medicine, Centre Hospitalier de l’Université de Montréal, Montréal, QC, Canada

[5]Division of Clinical Immunology and Allergy, Department of Medicine, Western University, London, ON, Canada

[6]Division of Clinical Immunology and Allergy, Department of Medicine, Western University, London, ON, Canada

[7]Division of Clinical Immunology and Allergy, Department of Medicine, McMaster University, Hamilton, ON, Canada

[8]Division of Internal Medicine, Department of Medicine, Western University, 1151 Richmond St, N6A 3K7, London, ON, Canada

关键词: Oral food challenges;    OFC;    Food allergies;    Canadian allergists;    Barriers;    Québec;    Ontario;    OHIP;    RAMQ;   

DOI  :  10.1186/s13223-022-00751-6

 received in 2022-11-09, accepted in 2022-12-08,  发布年份 2022

来源: Springer

【 摘 要 】

BackgroundOral food challenges (OFC) confer the highest sensitivity and specificity in diagnosis; however, uptake has been variable across clinical settings. Numerous barriers were identified in literature from inadequate training to resource access. OFC utilization patterns using billing data have not been previously studied.ObjectiveThe objective of this study is to explore the geographic differences in utilization of OFCs across Ontario and Québec using anonymized billing data from 2013 to 2017.MethodsAnonymized OFC billing data were obtained between 2013 and 2017 from Ontario Health Insurance Plan (OHIP) and Régie de l'Assurance Maladie du Québec (RAMQ). The number of OFCs was extracted by location, billings, and physician demographics for clinic and hospital-based challenges.ResultsOver the period studied, the number of OFCs increased by 92% and 85% in Ontario clinics and Québec hospitals, respectively. For Ontario hospitals, the number of OFCs increased by 194%. While Québec performed exclusively hospital-based OFCs, after controlling for the population, the number of OFCs per 100,000 residents annually were similar to Ontario at 50 and 49 OFCs, respectively. The number of OFCs varied across the regions studied with an annual rate reaching up to 156 OFCs per 100,000 residents in urban regions and as low as 0.1 in regions furthest from city centers.ConclusionOFC utilization has steadily increased over the last decade. There has been marked geographical discrepancies in OFC utilization which could be driven by the location of allergists and heterogeneity in their practices. More research is needed to identify barriers and propose solutions to them.

【 授权许可】

CC BY   
© The Author(s) 2023

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