Annex C

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Undercoverage in the New Brunswick health care registration file

Despite these large differences in in-migrant figures, if one were to measure the overall coverage of all health care registrations from New Brunswick and compare it with Demography Division's total population estimates, the coverage ratio is between 0.98 and 0.99.¹⁵ (See Table 2). This fact leads us to believe that the problem may lie in how New Brunswick defines a new resident to the province and leads to a coverage, completeness and consistency problem.

As stated earlier, the New Brunswick in-migrant figures are consistently below our own estimates. After several e-mails, phone calls and face-to-face contact with our New Brunswick contact over several months to try and find out why the New Brunswick numbers are always so much lower, we received the answer that they had found that we were not getting accurate information. They would be able to provide us with the correct information.¹⁶

New Brunswick needed to make a few changes to their batch processing of the new/returning residents in order to get the system to provide us with the correct data which would start with the March 2007 figures.

In looking at old batch processing documents, there were 2 separate systems – one for new residents and one for returning residents.¹⁷ Though we were not specifically told what the problem was, given what we had found, it could be that we were only getting the new residents and not the returning residents. We wanted to have both new and returning residents.

We recently received the adjusted figures for March 2007 from the New Brunswick Department of Health. When we compare our preliminary March numbers for the 0 to 17 age group to New Brunswick's figures we have a ratio of 0.55. This figure is better than the 0.22 ratio of March 2006 or the 0.31 and 0.49 ratio for respectively January and February 2007. This March 2007 ratio is still on the low side. We will have to wait for future months to see whether the New Brunswick Medicare figures are closer to our estimates of the 0 to 17 cohort.

We were also given starting in March 2007 a quarterly report of "Adjusted New Brunswick Residents by Age Group and Sex by Region of Residence Registered with Medicare". Unfortunately, at this stage, we do not know how this second report of total registered relates to the monthly in-migrant report as they are 2 different populations. Therefore at this time, we will not be using this second report.

¹⁵ . The New Brunswick health card registration numbers were obtained from information that New Brunswick supplied to Health Canada under the Canada Health Act and from New Brunswick's own Annual Report on Health (the latter source for 2005 and 2006).

¹⁶ . E-mail from the New Brunswick Department of Health.

¹⁷ . The New Brunswick Medicare application for registration form has the following categories to be checked off: New resident and returning resident. The form also asks for one's New Brunswick Medicare number for returning residents (See Annex H).