Can administrative claim file review be used to gather physical therapy, occupational therapy, and psychology payment data and functional independence measure scores? Implications for rehabilitation providers in the private health sector.

Purpose: Rehabilitation costs for spinal-cord injury (SCI) are increasingly borne by Canada's private health system. Because of poor outcomes, payers are questioning the value of their expenditures, but there is a paucity of data informing analysis of rehabilitation costs and outcomes. This study evaluated the feasibility of using administrative claim file review to extract rehabilitation payment data and functional status for a sample of persons with work-related SCI.

A survey of injury claims data after introduction of injury care protocols in Alberta, Canada.

Objective: To monitor the impact of auto insurance regulatory reforms on the no-fault injury claims experience of Alberta auto insurers.

Methods: Retrospective file review and abstraction of data from individual auto insurer claim files.

Results: Reforms were associated with change in diagnostic frequencies as well as higher health utilization, average cost per treatment episode, cost per claimant, claim closure rate, and reduced incidence of disputes.