Code Was Written for the Virtual Health Information Network Catalyst Project With

Code Was Written for the Virtual Health Information Network Catalyst Project With

************************************************************************************************************************************************

**** -This code was written in May 2016 by Sheree Gibb with edits from June Atkinson; ****

**** -Code was written for the Virtual Health Information Network catalyst project with ****

**** Tony Blakely, June Atkinson and Giorgi Khvinzinadze from University of Otago Wellington. ****

**** -The code is the first in a series of programs used to estimate the costs of cardiovascular disease in NZ. The other ****

**** programs were written by June Atkinson. ****

**** -This program extracts all the relevant data from IDI and organises it in preparation for June's programs. ****

**** Several output files are created for use in June's programs. ****

************************************************************************************************************************************************;

%let basepath=\\wprdfs08\Datalab-MA\MAA2015-53 BODE3 and HIRP-led VHIN Research in the IDI;

libname dlab "&basepath\CVD catalyst project";

libname june "&basepath\CVD catalyst project\First run results";

libname moh ODBC dsn=idi_clean_archive_srvprd schema=moh_clean;

libname data ODBC dsn=idi_clean_archive_srvprd schema=data;

libname sandmoh ODBC dsn=idi_sandpit_srvprd schema="clean_read_MOH_Health_Tracker";

libname sand ODBC dsn=idi_sandpit_srvprd schema="DL-MAA2015-53";

libname metadata ODBC dsn=idi_metadata_srvprd schema=clean_read_classifications;

%include "&basepath\CVD catalyst project\SAS formats\SASforHTCancer.sas";

%include "&basepath\CVD catalyst project\SAS formats\SASFormatsforUOWBODE.sas";

%include "&basepath\CVD catalyst project\SAS formats\HealthDataFormats.sas";

%include "&basepath\CVD catalyst project\SAS formats\ifinyr format for datetime.sas";

*********************************************************

*** Extract all relevant health data from IDI ***

*********************************************************;

*Rename all relevant dates as 'visit date' os it is easier for merging later;

*NOTE FROM SHEREE: COULD DELETE UNNECESSARY VARIABLES IN SOME OF THESE TO REDUCE SIZE;

*First, extract datasets that will be used to identify CVD events, we need those data back to 2001;

*NMDS events;

proc sql;

connect to odbc(dsn="idi_clean_archive_srvprd");

create table work.nmds_event_raw as

select * from connection to odbc

(select CAST(moh_evt_even_date as DATETIME) as visit_datedt, CAST(moh_evt_evst_date as DATETIME) as evstdatedt, moh_evt_event_id_nbr as event_id, *

from moh_clean.pub_fund_hosp_discharges_event

WHERE moh_evt_even_date>='01JUN1996'

order by event_id);

disconnect from odbc;

quit;

*NMDS diagnosis;

*Can't use user-defined formats in the passthrough, so need to extract all diagnoses and then restrict to the ones that match the CVD codes;

proc sql;

connect to odbc(dsn="idi_clean_archive_srvprd");

create table work.nmds_diag_all as

select * from connection to odbc

(select moh_dia_event_id_nbr as event_id, CAST(moh_dia_diag_sequence_code as INT) as moh_dia_diag_sequence_code, moh_dia_clinical_sys_code, moh_dia_submitted_system_code,

moh_dia_diagnosis_type_code, moh_dia_clinical_code

from moh_clean.pub_fund_hosp_discharges_diag

where moh_dia_diagnosis_type_code='A'

order by event_id);

disconnect from odbc;

quit;

*Restrict to diagnoses that match a CVD code. We aren't interested in the others;

data nmds_diag_raw;

set nmds_diag_all;

cvd_code_any=input(substr(moh_dia_clinical_code,1,5),$ianycvd.);

cvd_code_4=input(substr(moh_dia_clinical_code,1,4),$i4cvd.);

if strip(cvd_code_4) eq '???' then cvd_code_4=input(substr(moh_dia_clinical_code,1,5),$iothcvd.);

if cvd_code_any='???' and cvd_code_4='???' then delete;

run;

*Pharmaceutical;

proc sql;

connect to odbc(dsn="idi_clean_archive_srvprd");

create table work.pharms_raw as

select * from connection to odbc

(select snz_uid, CAST(moh_pha_dispensed_date as DATETIME) as visit_datedt, moh_pha_domicile_code, moh_pha_dim_form_pack_code, moh_pha_dose_nbr,

moh_pha_frequency_nbr, moh_pha_daily_dose_nbr, moh_pha_patent_category_code, moh_pha_funding_dhb_code, moh_pha_nss_flag_code,

moh_pha_patient_contrib_exc_gst_amt as moh_pha_patient_contrib_exc_gst, moh_pha_remimburs_cost_exc_gst_amt as moh_pha_remimburs_cost_exc_gst,

moh_pha_csc_holder_code, moh_pha_huhc_holder_code, moh_pha_pha_subsidy_card_ind

from moh_clean.pharmaceutical

order by snz_uid, visit_datedt);

disconnect from odbc;

quit;

*Next, extract datasets that will be used for costings only. We only need those from June 2006 onwards;

*GMS claims;

proc sql;

connect to odbc(dsn="idi_clean_archive_srvprd");

create table work.gms_raw as

select * from connection to odbc

(select snz_uid, CAST(moh_gms_visit_date as DATETIME) as visit_datedt, moh_gms_amount_paid_amt

from moh_clean.gms_claims

WHERE moh_gms_visit_date >= '01JUN2006'

order by snz_uid, visit_datedt);

disconnect from odbc;

quit;

*Mortality;

proc sql;

connect to odbc(dsn="idi_clean_archive_srvprd");

create table work.mort_raw as

select * from connection to odbc

(select cast(b.moh_clean_death_date as DATETIME) as doddt, a.moh_mor_death_year_nbr, a.moh_mor_birth_year_nbr, a.snz_uid, b.snz_uid as snz_uid_full, a.moh_mor_icd_d_code as cause_of_death, a.moh_mor_ethnic_grp2_snz_ind

from moh_clean.mortality as a left join data.full_death_date as b on (a.snz_uid=b.snz_uid and b.moh_clean_death_date>='2006-01-01')

order by snz_uid, doddt);

disconnect from odbc;

quit;

*NNPAC;

proc sql;

connect to odbc(dsn="idi_clean_archive_srvprd");

create table work.nnpac_raw as

select * from connection to odbc

(select snz_uid, CAST(moh_nnp_service_date as DATETIME) as visit_datedt, moh_nnp_attendence_code, moh_nnp_domicile_code, moh_nnp_purchase_unit_code, moh_nnp_volume_amt,

moh_nnp_service_type_code, moh_nnp_purchaser_code, moh_nnp_unit_of_measure_key

from moh_clean.nnpac

WHERE moh_nnp_service_date>='01JUN2006'

order by snz_uid, visit_datedt, moh_nnp_service_type_code);

disconnect from odbc;

quit;

*PHO;

proc sql;

connect to odbc(dsn="idi_clean_archive_srvprd");

create table work.pho_raw as

select * from connection to odbc

(select snz_uid, moh_pho_practice_type_code, moh_pho_domicile_code, moh_pho_year_and_quarter_text,

moh_pho_eth_priority_grp_code, moh_pho_sex_snz_code as sex,

moh_pho_ethnicity_1_code, moh_pho_ethnicity_2_code, moh_pho_ethnicity_3_code

from moh_clean.pho_enrolment

WHERE moh_pho_last_consul_date>='01JUN2006'

order by snz_uid, moh_pho_year_and_quarter_text);

disconnect from odbc;

quit;

*Lab claims;

proc sql;

connect to odbc(dsn="idi_clean_archive_srvprd");

create table work.lab_raw as

select * from connection to odbc

(select snz_uid, CAST(moh_lab_visit_date as DATETIME) as visit_datedt, moh_lab_amount_paid_amt

from moh_clean.lab_claims

WHERE moh_lab_visit_date>='01JUN2006'

order by snz_uid, visit_datedt, moh_lab_test_type_code, moh_lab_test_code);

disconnect from odbc;

quit;

*Change all datetimes to dates;

*I couldn't manage to extract these in correct date format using the passthrough;

%macro datechange(dataset, dtvar);

data &dataset;

set &dataset;

format &dtvar ddmmyy10.;

&dtvar=datepart(&dtvar.dt);

drop &dtvar.dt;

run;

%mend datechange;

%datechange(lab_raw, visit_date);

%datechange(nmds_event_raw, visit_date);

%datechange(nmds_event_raw, evstdate);

%datechange(gms_raw, visit_date);

%datechange(mort_raw, dod);

%datechange(pharms_raw, visit_date);

%datechange(nnpac_raw, visit_date);

****************************************************

*** Get population and demographic information ***

****************************************************;

*Create table with health tracker flags and sex, dob for everyone in health tracker;

proc sql;

connect to odbc(dsn="idi_clean_archive_srvprd");

create table work.uids as

select * from connection to odbc

(select distinct snz_uid, snz_moh_uid

from security.concordance

where snz_moh_uid IS NOT NULL

order by snz_uid);

disconnect from odbc;

quit;

proc sql;

create table with_snzuid as

select b.snz_uid, input(a.pop2006_2007,3.) as pop200607, input(a.pop2007_2008,3.) as pop200708, input(a.pop2008_2009,3.) as pop200809,

input(a.pop2009_2010,3.) as pop200910, input(a.pop2010_2011,3.) as pop201011, input(a.pop2011_2012,3.) as pop201112, input(a.pop2012_2013,3.) as pop201213,

input(a.pop2013_2014,3.) as pop201314, input(a.pop2014_2015,3.) as pop201415

from sand.Health_Tracker_pop_201603 as a left join work.uids as b on a.snz_moh_uid=b.snz_moh_uid

order by b.snz_uid;

quit;

*Select the final value from the sets of duplicates;

*Rules we have decided on are:

- 1 (resident) vs 0 (no health records) = 1

- 2 (non-resident) vs 0 (no health records) = 2

- 1 (resident) vs 2 (non-resident) = 1

- 0 vs 1 vs 2 = 1;

*As we are going to recode '2' to '0' anyway, we can just start by recoding '2' to '0' and then take the max value;

data with_snzuid_recode;

set with_snzuid;

*Recode '2' to '0';

if pop200607=2 then pop200607=0; if pop200708=2 then pop200708=0; if pop200809=2 then pop200809=0; if pop200910=2 then pop200910=0;

if pop201011=2 then pop201011=0; if pop201112=2 then pop201112=0; if pop201213=2 then pop201213=0; if pop201314=2 then pop201314=0;

if pop201415=2 then pop201415=0;

*There are a few records with no snz_uid (snz_moh_uid in health tracker does not match to a record in IDI);

*Delete them;

if snz_uid=. then delete;

*Delete people who are not residents in any year;

if sum(of pop200607--pop201415) eq 0 then delete;

run;

*Take the maximum;

proc summary nway data=with_snzuid_recode;

class snz_uid;

var pop200607 pop200708 pop200809 pop200910 pop201011 pop201112 pop201213 pop201314 pop201415;

output out=ht_final (drop=_type_ _freq_) max=;

quit;

*Get sex and ethnicity from personal detail table;

proc sql;

create table demog_v1 as

select b.snz_sex_code, b.snz_ethnicity_grp2_nbr as snz_eth_maori, a.*

from ht_final as a left join data.personal_detail as b on a.snz_uid=b.snz_uid

order by snz_uid;

quit;

*Get full date of birth from full birth date table;

proc sql;

create table demog as

select b.moh_clean_birth_date as dob, a.*

from demog_v1 as a left join data.full_birth_date as b on a.snz_uid=b.snz_uid

order by snz_uid;

quit;

*Couple of hundred are missing sex in PD table, and don't have it recorded in NHI either. Drop them;

data demog_final;

set demog;

if snz_sex_code='' then delete;

run;

*Get ethnicity, dod, cause of death from mortality for those who have died;

proc sql;

create table with_mort_eth as

select a.*, b.moh_mor_ethnic_grp2_snz_ind as mort_eth_maori, b.dod, b.cause_of_death

from demog as a left join mort_raw as b

on a.snz_uid=b.snz_uid;

quit;

*Get NHI ethnicity for everyone;

proc sql;

create table with_nhi_eth as

select a.*, b.moh_pop_ethnic_grp2_snz_ind as nhi_eth_maori

from with_mort_eth as a left join moh.pop_cohort_demographics as b

on a.snz_uid=b.snz_uid;

quit;

*Create final ethnicity: use mortality if available, then NHI, then personal detail;

data june.corepop;

set with_nhi_eth;

if mort_eth_maori ne '' then UseEthMaori=mort_eth_maori;

else if nhi_eth_maori ne '' then UseEthMaori=nhi_eth_maori;

else if snz_eth_maori ne '' then UseEthMaori=snz_eth_maori;

else UseEthMaori='';

drop mort_eth_maori snz_eth_maori nhi_eth_maori;

rename snz_sex_code=UseSex;

format dob2 ddmmyy10.;

dob2=input(dob,anydtdte10.);

drop dob;

rename dob2=UseDOB;

rename dod=UseDOD;

if dob2='' or snz_sex_code='' or useethmaori='' then delete;

run;

***************************************************************************************************

*** Calculate total cost per day per person for labs, GMS, pharmaceutical, and NNPAC combined ***

***************************************************************************************************

* NNPAC costs ;

*Import spreadsheet with PUCs for each year;

PROC IMPORT

OUT= WORK.PUCPricetouse

DATAFILE= "&basepath\CVD catalyst project\0102 - 1617 Price HistorytoUse.csv"

DBMS=CSV REPLACE;

GETNAMES=YES;

DATAROW=2;

guessingrows=max;

RUN;

data pucpricetouse2001_2016;

set pucpricetouse(keep=pu price2001 price2002 price2003 price2004 price2005

price2006 price2007 price2008 price2009 price2010

price2011 price2012 price2013 price2014 price2015 price2016);

if substr(pu,1,2) eq 'MH' then delete;

run;

/*Make a informat of puccode and finyear to produce price*/

data pucfinyr(keep=puc finyr pucprice puc_finyr);

set pucpricetouse2001_2016(rename=(pu=PUC));

array PUCpricearray {*} price2006 price2007 price2008 price2009 price2010

price2011 price2012 price2013 price2014 price2015 price2016;

array finarr {11} _temporary_ (200607 200708 200809 200910 201011 201112

201213 201314 201415 201516 201617);

length FinYr 8 puc_finyr $15;

meanprice=mean(price2006, price2007, price2008, price2009, price2010,

price2011, price2012, price2013, price2014, price2015, price2016);

meanall=mean(price2001, price2002, price2003, price2004, price2005,

price2006, price2007, price2008, price2009, price2010,

price2011, price2012, price2013, price2014, price2015, price2016);

do i=1 to dim(PUCpricearray);

FinYr=finarr{i};

puc_finyr=put(puc,8.)||'_'||put(finyr,6.);

PUCPrice=PUCpricearray{i};

if pucprice eq 0 and meanprice ne 0 then pucprince=-10; /*If price for that year is zero but

there is a price for other years then estimate value from inflation or deflation*/

else if pucprice eq . and meanprice ne . then pucprice=-20; /*This will mean that there are prices for

others in the time range. Estiamte value*/

else if pucprice eq . and meanall ne . then pucprice=-30; /*This will mean that there are prices for

others in earlier years. Estimate value*/

else if pucprice eq . then pucprice=-99; /*Have no price*/

output;

end;

run;

data dlab.pucfinyrformat(keep=fmtname start end label type min max length default fuzz sexcl eexcl hlo

DateFMade puc finyr pucprice puc_finyr);

length fmtname $8 start end $15 label $16 min max default length 3 fuzz 8

type sexcl eexcl $1 hlo $2;

set pucfinyr;

retain DateFMade;

format datefmade datetime.;

if _n_ eq 1 then DateFMade=datetime();

type='I';fuzz=0;sexcl='N';hlo=' ';eexcl='N';

min=1;max=15;default=15;length=15;

start=puc_finyr;end=start;

fmtname='ipucfy';

label=put(pucprice,16.5);

output;

run;

options fmtsearch=(fmtlib work library);

proc sort data=dlab.pucfinyrformat nodupkey;

by type fmtname start sexcl eexcl;

run;

proc format cntlin=dlab.pucfinyrformat;

run;

*Apply format to NNPAC file to get costs;

data nap_pucs(keep=finyr puc volume moh_nnp_unit_of_measure_key purchaser_code visit_date

snz_uid possdelflag pucprice costexcl);

set nnpac_raw (rename=(moh_nnp_purchase_unit_code=purchase_unit moh_nnp_volume_amt=volume moh_nnp_purchaser_code=purchaser_code));

length PUC $8 possdelflag 3;

PUC=substr(left(purchase_unit),1,8);

FinYr=input(visit_date,ifinyr.);

possdelflag=.;

if substr(puc,1,2) eq 'MH' then possdelflag=1;

else if substr(right(puc),8,1) eq 'A' then possdelflag=2;

else if volume eq 0 then possdelflag=3; /*Check - there may be some that need counting once per year or month*/

else if purchaser_code in ('06','08','10','17','19','98','A0','A1','A2','A3','A4','A5','A6','A7')

then possdelflag=10; /*Need to check if we want to exclude all of these or not*/

else possdelflag=0;

pucprice=input(put(puc,8.)||'_'||put(finyr,6.),?? ipucfy.);

if pucprice eq . then pucprice=-99;

if pucprice lt 0 then costexcl=.; else costexcl=pucprice*volume;

format purchaser_code $fpurch.;

run;

data nap_costs;

set nap_pucs(rename=(costexcl=CostexclActYrNNPAC));

label CostExclActYrNNPAC="Cost ExGST Actual Year (and not cpi adjusted) dollars (from PUC)";

run;

data nap_CostsUse(keep=finyr visit_date snz_uid costexclactyrNNPAC);

set nap_Costs;

where finyr ne . and finyr ge 200607 and finyr le 201314;

run;

/*End of dealing with NNPAC costs, back to rest of program*/

*Sum GMS costs per person per day;

proc summary data=gms_raw chartype nway;

class snz_uid visit_date;

vars moh_gms_amount_paid_amt;

output out=gms_daily_sum (drop=_type_) sum=GMSTotal_amount_paid;

run;

*Sum lab costs per person per day;

proc summary data=lab_raw chartype nway;

class snz_uid visit_date;

vars moh_lab_amount_paid_amt;

output out=lab_daily_sum (drop=_type_) sum=LABTotal_amount_paid ;

run;

*Sum pharmaceutical costs per person per day;

proc summary data=pharms_raw chartype nway;

class snz_uid visit_date;

vars moh_pha_patient_contrib_exc_gst moh_pha_remimburs_cost_exc_gst;

output out=pharms_daily_totals (drop=_type_) sum(moh_pha_patient_contrib_exc_gst moh_pha_remimburs_cost_exc_gst)=PHARMTotal_Patient PHARMTotal_reimburse;

run;

*Create final file with total cost from NNPAC, labs, pharmaceutical and GMS per person per day;

data daily_totals;

merge pharms_daily_totals lab_daily_sum gms_daily_sum nap_CostsUse (drop=finyr);

by snz_uid visit_date;

CostExclEndYr=SUM(PHARMTotal_Patient, PHARMTotal_reimburse, GMSTotal_amount_paid, LABTotal_amount_paid, costexclactyrNNPAC);

FinYr=input(visit_date,ifinyr.);

drop PHARMTotal_Patient PHARMTotal_reimburse GMSTotal_amount_paid LABTotal_amount_paid costexclactyrnnpac _freq_;

CostExclRefYr=CostExclEndYr*1000/input(finyr,icpi11b.);

run;

*Add demographics to the daily cost file;

proc sql;

create table june.combined4sourcecosts as

select a.*, b.usedod, b.usedob, b.useethmaori, b.usesex

from daily_totals as a left join june.corepop as b

on a.snz_uid=b.snz_uid;

delete from june.combined4sourcecosts where (usedob is null or usesex is null or useethmaori is null);

quit;

*************************************

**** Estimate PHO costs ***

*************************************;

/*Estimate PHO costs in 2011/12 dollars*/

/*Modification of June's basic code for old PHO extracts. IDI doesn't have all the variables we need so */

/* we are just using domicile code, practice type, age, sex and ethnicity. */

/*No age on PHO dataset so we need to transfer age from NHI file before starting*/

/*Note from June - ideally the next extract will have all the other variables so you can calculate the costs correctly*/

*Add ages to PHO file;

proc sql;

create table pho_with_age as

select a.*, b.usedob, b.usesex, b.useethmaori, b.usedod

from pho_raw as a left join june.corepop as b on a.snz_uid=b.snz_uid;

delete from pho_with_age where (usedob is null or usesex is null or useethmaori is null);

quit;

*Estimate PHO costs;

*Multipliers come from June's previous work;

data june.pho_costsuse (keep= snz_uid finyr visit_date costexclpermth_refyr costexclpermth_actyr usedob usesex useethmaori usedod);

set pho_with_age;

format visit_date ddmmyy10.;

visit_date=input(compress(moh_pho_year_and_quarter_text),yyq6.);

FinYr=input(visit_date,ifinyr.);

if strip(moh_pho_practice_type_code) eq 'ACCESS' then pract=1; else pract=0; /*1=Access, 0=Interim*/

if strip(sex)='2' then fem=1; else fem=0; /*1=female, 0=Not Female*/

if substr(moh_pho_ethnicity_1_code,1,1) in ('2','3') or substr(moh_pho_ethnicity_2_code,1,1) in ('2','3') or substr(moh_pho_ethnicity_3_code,1,1) in ('2','3')

then MaoriPac=1; else MaoriPac=0;

if usedob ne . then age_quart=yrdif(usedob,visit_date,'AGE'); /*Age at start of quarter*/

else age_quart=.;

*Assuming not HUHC and only calculating First Contact not other costs.

Costs are capitation rates from 1 July 2011, rates excl GST and are annualised so need dividing by 12 to get monthly;

CostExclpermth_RefYr=.;CostexclperMth_ActYr=.;

if age_quart ge 0 and age_quart lt 5 then CostExclpermth_RefYr=( pract*(379.4228*fem+399.4788*(1-fem)) +

(1-pract)*(370.2764*fem+394.0248*(1-fem)) + maoripac*(72.9380*fem+76.7928*(1-fem)) )/12;

else if age_quart ge 5 and age_quart lt 15 then CostExclpermth_RefYr=( pract*(120.1000*fem+112.4156*(1-fem)) +

(1-pract)*(95.3308*fem+90.3508*(1-fem)) + maoripac*(23.0868*fem+21.6104*(1-fem)) )/12;

else if age_quart ge 15 and age_quart lt 25 then CostExclpermth_RefYr=( 110.8208*fem+60.9928*(1-fem) + maoripac*(21.3032*fem+11.7248*(1-fem)) )/12;

else if age_quart ge 25 and age_quart lt 45 then CostExclpermth_RefYr=( 97.3828*fem+62.9500*(1-fem) + maoripac*(18.7200*fem+12.1012*(1-fem)) )/12;

else if age_quart ge 45 and age_quart lt 65 then CostExclpermth_RefYr=( 133.3836*fem+99.6236*(1-fem) + maoripac*(25.6404*fem+19.1512*(1-fem)) )/12;

else if age_quart ge 65 then CostExclpermth_RefYr=( 229.8604*fem+198.2284*(1-fem) + maoripac*(44.1868*fem+38.1068*(1-fem)) )/12;

CostExclperMth_ActYr=CostExclpermth_RefYr*input(finyr,icpi11b.)/1000;

label CostexclperMth_RefYr="Cost ExGST Per Month Ref Year (2011/12) dollars (estimate)"; /*Note Reference year*/

label CostexclperMth_ActYr="Cost ExGST Per Month Actual Year dollars (estimate converted back from RefYr)"; /*Note Actual year*/

label visit_date="Date of start of Year Quarter";

run;

***************************

**** NMDS costs ***

***************************;

data NMDS_costs (keep= snz_uid visit_date totallos misscostwgt CostExclEndYr CostPerDayActYr Totallos CostExclRefYr CostExclEndYr CostPerDayRefYr CostPerDayEndYr

CostExclEndYrCasemx CostPerDayEndYrCasemx evstdate finyr finyrstart finyrend);

set nmds_event_raw (rename=(moh_evt_cost_weight_amt=cost_weight));

where visit_date ge '01Jun2006'd;

FinYr=input(visit_date,ifinyr.);

length TotalLOS 4;

TotalLOS=moh_evt_los_nbr;

if cost_weight eq . then MissCostWgt=1; else MissCostWgt=0;

FinYrEnd=input(visit_date,ifinyr.);

FinYrStart=input(evstdate,ifinyr.);

cpiadjust=1000/input(FinYrEnd,icpi11b.);

CostExclEndYr=cost_weight*input(finyrend,imedsurpu.)*cpiadjust; /*Use finyrend dollar values and CPI adjust*/

CostExclActYr=cost_weight*input(finyr,imedsurpu.); /*Use actual finyr dollar values for the analyses*/

CostExclRefYr=cost_weight*input(201112,imedsurpu.); /*If use 2011/12 finyr dollar values for all years*/

if TotalLOS in (.,0,1) then CostPerDayRefYr=CostExclRefYr; else CostPerDayRefYr=CostExclRefYr/totallos;

if TotalLOS in (.,0,1) then CostPerDayEndYr=CostExclEndYr; else CostPerDayEndYr=CostExclEndYr/totallos;

if TotalLOS in (.,0,1) then CostPerDayActYr=CostExclActYr; else CostPerDayActYr=CostExclActYr/totallos;

CostExclEndYrCasemx=CostExclEndYr; CostPerDayEndYrCasemx=CostPerDayEndYr;

if upcase(pur_unit) eq 'EXCLU' then do; CostExclEndYrCasemx=0; CostPerDayEndYrCasemx=0; end;

label CostExclRefYr="Cost ExGST Ref Year (2011/12) dollars (From CostWeights)"

CostExclEndYr="Cost ExGST Each Year dollars (From CostWeights) CPI adjusted"

CostPerDayRefYr="Cost ExGST Per Day Ref Year (2011/12) dollars"

CostPerDayEndYr="Cost ExGST Per Day FinYrEnd Year dollars CPI adjusted" /*Use these as alternative costs*/

CostExclEndYrCasemx="Cost ExGST Each Year dollars (From CostWeights) CPI adj. (Casemix Costs Only)"

CostPerDayEndYrCasemx="Cost ExGST Per Day FinYrEnd Year dollars CPI adj (Casemix Costs Only)" /*Use these as main costs*/

FinYrEnd="Financial Year of End of event"

FinYrStart="Financial Year of Start of event";

run;

*Add demographics to NMDS costs file;

proc sql;

create table june.nmds_CostsUse as

select a.snz_uid, a.visit_date, a.costexclrefyr, a.costexclendyr, a.costperdayrefyr, a.costperdayactyr, a.costexclendyrcasemx,

a.costperdayendyrcasemx, a.totallos, a.evstdate, a.costperdayendyr, a.finyrend, a.finyrstart, b.usedod, b.usedob, b.useethmaori, b.usesex

from nmds_costs as a left join june.corepop as b

on a.snz_uid=b.snz_uid

where finyrend ne . and finyrend ge 200607 and finyrstart le 201314;

delete from june.nmds_CostsUse where (usedob is null or usesex is null or useethmaori is null);

quit;

*There are some people with two entries (with different costs) for the same start and end dates.

*Leave them as two separate entries and they will be costed separately;

****************************************

* Identify and flag CVD events ;

****************************************

*Transfer diagnoses to main NMDS event file;

proc sql;

create table cvd_events as

select evstdate as diagnosis_date format ddmmyy10., *

from nmds_event_raw as a inner join nmds_diag_raw as b on a.event_id=b.event_id;

quit;

*Angina medications;

*Get a list of all dim_form_pack_subsidy_code values for Glyceryl trinitrate (chemical ID 1577), Isosorbide dinitrate (2377),

Isosorbide mononitrate (2836), Nicorandil (1272), Perhexiline maleate (1949);

data angina_codes;

set metadata.moh_dim_form_pack_subsidy_code (where=(chemical_id in(1577 2377 2836 1272 1949)));

*There are two preparations that are not for cardiovascular disease, drop them;

if dim_form_pack_subsidy_key in(79992 79935) then delete;

dim_form_pack_code=strip(put(dim_form_pack_subsidy_key, 8.));

run;

*Extract all prescriptions for those codes;

proc sql;

create table angina_prescriptions as

select b.snz_uid, b.snz_moh_uid, b.moh_pha_dispensed_date, b.moh_pha_quan_presc_nbr, b.moh_pha_quan_disp_nbr, a.*

from angina_codes as a inner join moh.pharmaceutical as b on a.dim_form_pack_code=b.moh_pha_dim_form_pack_code

/*restrict to a sample for testing*/

order by snz_uid, moh_pha_dispensed_date;

quit;

*Flag individuals with 2 or more dispensings in a 12 month period;

*Calculate time between dispensings;

data with_time;

set angina_prescriptions;

by snz_uid;

disp_date=input(moh_pha_dispensed_date, yymmdd10.);

format disp_date ddmmyy10.;

last_date=lag(disp_date);

time_since_last=disp_date-last_date;

if first.snz_uid then time_since_last=.;

if time_since_last le 365 and time_since_last ne . and time_since_last ne 0 then repeat=1;

else repeat=0;

format first_presc ddmmyy10.;

if repeat=1 then first_presc=last_date;

run;

*List all pairs where the gap was less than 12 months;

proc sql;

create table angina_list as

select distinct snz_uid, snz_moh_uid, first_presc

from with_time

where repeat=1

order by snz_uid, first_presc;

quit;

*Select the first instance where the gap was less than 12 months;

data final_angina_list;

set angina_list;

by snz_uid;

if first.snz_uid then keep=1;

if keep ne 1 then delete;

drop keep;

pharms_angina_flag=1;

rename first_presc=diagnosis_date;

*Code all angina cases identified in this way as 'AngM' in the cvd4 codes and 'ACVD' in the any CVD codes;

cvd_code_4='AngM';

cvd_code_any='ACVD';

run;

*Combine angina and CVD events;

data cvd_all;

set cvd_events final_angina_list;

run;

proc sort data=cvd_all;

by snz_uid diagnosis_date;

run;

data cvd_look_back;

set cvd_all;

last_uid=lag(snz_uid);

if snz_uid ne last_uid then diag=1;

*Delete events that aren't a first diagnosis since 2001;

if diag ne 1 then delete;

*Delete events before July 2006;

if diagnosis_date ge '01JUL2006'd then delete;

drop last_uid event_id snz_moh_uid pharms_angina_flag diag;

run;

*Add demographics, date and cvd death flag for people with CVD diagnoses;

proc sql;

create table cvd_cases as

select a.*, b.usedod, b.usedob, b.useethmaori, b.usesex, b.cause_of_death

from cvd_look_back as a left join june.corepop as b

on a.snz_uid=b.snz_uid;

delete from cvd_cases where (usedob is null or usesex is null or useethmaori is null);

quit;

*Convert icd codes for death causes to cvd groups using June's format;

data june.cvd_final_list;

set cvd_cases;

cvd_death_any=input(substr(cause_of_death,1,5),$ianycvd.);

cvd_death_4=input(substr(cause_of_death,1,4),$i4cvd.);

if strip(cvd_death_4) eq '???' then cvd_death_4=input(substr(cause_of_death,1,5),$iothcvd.);

if usedod='' then do;

cvd_death_any='';

cvd_death_4='';

end;

keep snz_uid usesex usedob useethmaori usedod cause_of_death diagnosis_date moh_dia_clinical_code cvd_code_4 cvd_code_any

cvd_death_any cvd_death_4;

run;