Allocation of health resources
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* Hude Quan
* Rene Lafreniere
* David Johnson

We agree with Dr. Gross’s assessment (*Can J Surg* 2002; 45[1]:8) that administrative database information is limited in clinical detail and only partially describes how a patient receives health services. In essence we take licence to paraphrase Dr. Gross in saying that better information should lead to better decisions (spanning the spectrum from patient care to health system organization). The practical difficulty in implementing this improvement is that more complete data and the ability to translate data into information and intelligence is very expensive. Obtaining additional resources for infomatics competes with the need to provide actual patient care (to diminish waiting lists for example). In such a situation, administrative data, including physician claims have been increasingly employed by health care services researchers in studies of outcomes, effectiveness, appropriateness and utilization of health care services. The use of administrative data has been facilitated by improved understanding of their features and advantages, including their readiness to be analyzed, their low cost for obtaining a large volume of historical data, their wide geographic coverage and their relatively complete and accurate capture of episodes of patient contact with the health system.

We in the medical community can start by recognizing that clinicians make daily decisions based on partial and sometimes quite poor information. As such, both in daily practice and when reviewing studies such as ours about the health system, waiting for the perfect, complete set of data before making decisions is not practical. Making required decisions based on incomplete information, stating the limitations to the available information and promoting specific improvements required to make better decisions may be a preferable strategy for improving medical information systems. This approach is neither novel nor revolutionary. The medical community has used this approach for decades in patient care and will continue its use in the future.