The outcome of IHE initiatives is providing better information for developing health policy and best medical practices. IHE disseminates information in many ways. In addition to publications in peer-reviewed journals, IHE produces books and a variety of reports synthesizing information in a particular field.
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| Angus Thompson, Maria Ospina, Liz Dennett, Arianna Waye, Philip Jacobs
Presenteeism, reduced productivity while working, has come into consideration as a major occupational health problem in many countries with serious consequences for both organizations and employees. Increasing evidence shows that presenteeism represents a significant source of productivity losses that can cost organizations much more than does absenteeism, and it can lead to an…
This report is from an Alberta Strategic Clinical Networks (SCN) exchange meeting with Mr. Neil Fraser. This event brought together SCNs and related health system stakeholders, and a leader in the Canadian medical technology industry, and recent member of a Federal Advisory Panel on Healthcare Innovation. The meeting had the objectives to help the SCNs to understand the Advisory…
Background: Significant gaps in the evidence base on costs in rural communities in Canada and elsewhere are reported in the literature, particularly regarding costs to families. However, it remains unclear whether the costs related to all resources used by palliative care patients in rural areas differ to those resources used in urban areas.
The Institute of Health Economics held a roundtable on June 4, 2015, entitled Innovative Funding Models: Kidney Care Policy Options for the Future, to identify and discuss key issues in kidney care policy options. Prior to the roundtable, an Innovative Funding Models: Kidney Care Policy Options for the Future Steering Committee teleconference refined project objectives, and the…
The Institute of Health Economics (IHE), in partnership with Boehringer Ingelheim (Canada) Ltd./Ltée held an invitational forum on October 3, 2015, in Edmonton, Alberta. The purpose of this discussion was to bring together multiple stakeholders from across Canada to investigate the current state of evidence and information regarding idiopathic pulmonary fibrosis (IPF) and…
Objective: In this study, we estimate the impact of the new PCV13 immunization program on the burden of disease and related healthcare costs in Alberta.
OBJECTIVES: To examine differences in health services utilization (HSU) costs in the first year of life between low birth weight (LBW) and normal birth weight (NBW) infants, identify maternal and child characteristics associated with HSU costs, and estimate annual HSU cost of LBW infants for the province of Alberta, Canada.
| Bing Guo, Carmen Moga, Christa Harstall, Don Schopflocher
Objective: Because of a lack of a control group, a case-series study is considered one of the weaker study designs from which to obtain evidence on treatment effectiveness. Under certain circumstances, however, this is the only available evidence to inform health-care decisions. This study's intent was to develop and validate a quality appraisal checklist specifically for…
| Werner J Becker, Ted Findlay, Carmen Moga, Ann Scott, Christa Harstall, Paul Taenzer
Objective: To increase the use of evidence-informed approaches to diagnosis, investigation, and treatment of headache for patients in primary care.
Note: This is an Alberta Ambassador Guideline Adaptation Program related publication.
Alberta Health Services (AHS) has recently established a number of Strategic Clinical Networks (SCNs) in the province around specific health care topics (e.g., Cardiovascular Health & Stroke) and within areas where care is delivered (e.g., Surgery). The SCNs are the engines of innovation in the health system and have a mandate to find new and innovative ways of delivering care…
| Don Husereau, Larry Arshoff, Shahira Bhimani, Nicola Allen
This document describes the entry of new medical devices into the Canadian health system. It is intended to provide an accurate description of new medical device entry in Canada, and is intended to give patients, the public, private and public sector health system researchers, medical device companies, and private and public coverage bodies a general understanding of what regulatory,…
Written under contract with the Alberta Health Technologies Decision Process (AHTDP). This report provides an assessment of how the adoption of fFN testing in Alberta impacted the clinical management of preterm labour and healty system resources. This was also an opportunity to retroactively use the Post Policy Implementation Framework to evaluate a specific policy developed within…
We reviewed literature to estimate the costs of Fetal Alcohol Spectrum Disorder (FASD) in the Canadian Criminal Justice System (CJS), and to update the total costs of FASD in Canada. The results suggest FASD is costlier than previous estimates. The costs of FASD associated with the CJS are estimated at $3.9 billion a year, with $1.2 billion for police, $0.4 billion for court,…
| Julie Polisena, John Lavis, Don Juzwishin, Pam McLean-Veysey, Ian Graham, Christa Harstall, Janet Martin
A perceived gap exists in how well Canadian health technology assessment (HTA) producers are supporting the use of their HTAs by decision-makers. The authors propose that the newly released HTA Database Canadian search interface incorporate structured decision-relevant summaries of HTAs that would be developed by participating Canadian HTA organizations. The registry would…
| Ann Scott, Dion Pasichnyk, Christa Harstall, Dagmara Chojecki
This Information Paper is an inventory and broad summary of factors affecting the adoption and diffusion of health technologies and of available models, strategies, tools, and processes for optimizing health technology diffusion.
| Braden Manns, Anderson Chuck, Eddy Nason, Lianne Barnieh, John Sproule, Jasmine Brown
This work, conducted by the Institute for Health Economics (IHE) and the University of Calgary (Health Economics group), was performed to better understand the unmet educational needs and health economics products that could support people in the province, and to determine the current capacity for conducting health economics in Alberta. This paper seeks to understand the needs…
Objectives: Economic evaluations, although not formally used in purchasing decisions for medical devices in Canada, are still being conducted and published. The aim of this study was to examine the way that prices have been included in Canadian economic evaluations of medical devices.
Economic surveillance and economic assessments are important sources of information to help administrators and policy makers to track current trends and evaluate policies and care patterns. The Institute of Health Economics, in partnership with Alberta Health, held a two-day Costing Methods Workshop which helped to review costing practices by bringing together economists and other…
| Deborah Marshall, Egon Jonsson, Liam Martin, Diane Mosher, Karen V. MacDonald
This White Paper discusses the concept of developing a comprehensive rheumatoid arthritis registry in Alberta, and the important health, social, and economic gains such a resource would generate for Alberta.
The Federal Minister of Health, the Honourable Rona Ambrose, announced the creation of the Advisory Panel on Healthcare Innovation (Panel) on June 24, 2014, to examine innovative health care ideas and approaches that exist in Canada and internationally. The Panel’s mandate is to identify promising innovations, here and internationally, which could help Canada reduce growth…
This book includes the plenary presentations made at the first international conference on prevention of FASD, which was attended by about 700 people from 35 countries around the globe. The issues addressed are FASD as a priority in health policy making; its prevalence and incidence; strategies for prevention; current applied and basic research in the field; the role of the medical…
Fetal alcohol spectrum disorder (FASD) is of growing concern around the world. A range of disabilities caused by prenatal exposure to alcohol, FASD is estimated to affect 2% to 5% of all newborns in the industrialized countries of Europe and North America, and the rates may be significantly higher in some developing countries and certain defined populations. Epidemiological studies…
| Maria Ospina, Liz Dennett, Arianna Waye, Philip Jacobs, Angus Thompson
Objectives: To assess and compare the measurement properties (ie, validity, reliability, responsiveness) and the quality of the evidence of presenteeism instruments.
| Thanh Nguyen, Egon Jonsson, Jessica Moffatt, Liz Dennett, Anderson Chuck, Shelley Birchard
Abstract: Parent-Child Assistance Program (P-CAP) is a 3-year home visitation/harm reduction intervention to prevent alcohol exposed births, thereby births with fetal alcohol spectrum disorder, among high-risk women. This article used a decision analytic modelling technique to estimate the incremental cost-effectiveness ratio and the net monetary benefit of the P-CAP…
| Lindsay Wodinski, Kate Woodman, Margaret Wanke, Thanh Nguyen, Philip Jacobs
Abstract: Alberta's Primary Care Networks (PCNs) bring together family physicians and other health professionals to provide local, comprehensive, and readily accessible primary care services to patients. The Edmonton North PCN, one of the largest in the province, piloted the Resource in Clinic (RIC) Program with objectives to increase efficiencies in the use of physician…
À titre de président du jury, le Dr Alain Lesage, M.D., FRCPC, M.Phil., DFAPA, professeur au département de psychiatrie de l'Université de Montréal et clinicien à l’Institut universitaire en santé mentale de Montréal, Québec, a dirigé un comité spécial dont le mandat était d'élaborer…
This consensus development conference was commissioned by the Government of Alberta to improve the transition of its system of care for people with severe and persistent mental illness (SPMI) toward the community. The system, previously hospital- and institution-centred, is moving towards becoming a community-centred, patient- and family-led one. The development and deployment…
| Caroline Sheppard, Erica Lester, Anderson Chuck, David Kim, Shahzeer Karmali, Christopher Gara, Daniel Birch
INTRODUCTION: The objective of this study was to determine the short-term cost impact thatmedical tourism for bariatric surgery has on a public healthcare system. Due to long wait times for bariatric surgery services, Canadians are venturing to private clinics in other provinces/countries. Postoperative care in this population not only burdens the provincial health system…
In November 2014, the Institute of Health Economics partnered with Eli Lilly Canada Inc. and the Canadian Institutes of Health Research’s Institute for Health Services and Policy Research to hold a roundtable to discuss the federal role in healthcare innovation. The roundtable aimed to examine the existing state of healthcare innovation, its strengths and weaknesses (or gaps),…
Objectives: To estimate the annual health services utilization (HSU) cost per person with FASD by sex and age; the lifetime HSU cost per person with FASD by sex, and the annual HSU cost of FASD for Alberta by sex.
| Victoria Ung, Thanh Nguyen, Karen Wong, Karen Kroeker, Thomas Lee, Haili Wang, Arto Ohinmaa, Philip Jacobs, Richard Fedorak
BACKGROUND & AIMS: Infliximab is effective for induction and maintenance of response in patients with moderate to moderately severe ulcerative colitis. Previous cost analyses of infliximab treatment for ulcerative colitis used models of colectomy vs infliximab and response rates derived from early clinical trials. In real life, therapeutic options are more complex; patients…
Real World Evidence: System Readiness – Are we ready to use routinely collected data to improve health system performance? Summary Report Real World Evidence: Priority Setting for Action was an invitational roundtable discussion organized by the Institute of Health Economics (IHE) and supported by and developed in partnership with Strategy for Patient Oriented Research Support…
| Don Husereau, Anthony Culyer, Peter Neumann, Philip Jacobs
Abstract: Canadian and US health systems have often been characterized as having vastly different approaches to the financing and delivery of healthcare, with Canada portrayed as more reliant on rationing based on costs. In this article, we examine the similarities and differences between the two countries, the evolution and current role of health economic evaluation, and…
Alberta STE Report written under contract with the Alberta Health Technologies Decision Process (AHTDP). This report is an evidence assessment of the clinical effectiveness and safety of hysteroscopic tubal sterilization, and the value for money associated with adopting hysteroscopic tubal sterilization in Alberta. Section Authors: Section One – Background and Context: Carmen…
Alberta STE Report written under contract with the Alberta Health Technologies Decision Process (AHTDP). This report is an evidence assessment of the best available research evidence on the safety and effectiveness, cost effectiveness and budget impact of using Endovenous Laser Ablation (EVLA) or Endovenous Radiofrequency Ablation (RFA) in the management of symptomatic varicose…
| Arto Ohinmaa, Thanh Nguyen, Cheryl Barnabe, Liam Martin, Anthony Russell, Susan G Barr, Walter Maksymowych
OBJECTIVE: To provide Canadian estimates of health care utilization costs associated withrheumatoid arthritis (RA)-related and non-RA-related care within 4 treatment strategies and in different physical functioning categories.
Alberta STE Report written under contract with the Alberta Health Technologies Decision Process (AHTDP). This report examines the safety, screening accuracy, therapeutic efficacy, patient outcomes and cost effectiveness of first trimester Quad (1T-Quad) +/- NT and NIPT screening for fetal trisomies. Section Authors: Section One – Technology Effectiveness and Safety: Ken Bond,…
| Cheryl Barnabe, Thanh Nguyen, Arto Ohinmaa, Joanne Homik, Susan G Barr, Liam Martin, Walter Maksymowych
OBJECTIVE: Sustained remission in rheumatoid arthritis (RA) results in healthcare utilizationcost savings. We evaluated the variation in estimates of savings when different definitions ofremission [2011 American College of Rheumatology/European League Against Rheumatism Boolean Definition, Simplified Disease Activity Index (SDAI) ≤ 3.3, Clinical Disease Activity Index…
| Carolyn Dewa, Desmond Loong, Sarah Bonato, Thanh Nguyen, Philip Jacobs
BACKGROUND: Interest in the well-being of physicians has increased because of their contributions to the healthcare system quality. There is growing recognition that physicians are exposed to workplace factors that increase the risk of work stress. Long-term exposure to high work stress can result in burnout. Reports from around the world suggest that about one-third to…
Summary of Systematic Reviews, Primary Studies, and Evidence-based Guidelines. The following research questions were addressed in this review: What are the clinical effects of a universal screening strategy for ARO carriage when compared with no screening? What are the clinical effects of a universal screening strategy for ARO carriage when compared with targeted screening (screening…
| Don Husereau, Philip Jacobs, Braden Manns, Ties Hoomans, Deborah Marshall, Robyn Tamblyn
This discussion paper has been produced in response to a request from CIHR Institute of Health Services and Policy Research (CIHR IHSPR). The discussion paper will provide guidance to those tasked with conducting an economic evaluation of complex health system interventions. The guidance will be an elaboration of existing National guidelines for economic evaluation, and serve as…
Antibiotic-Resistant Organisms (AROs) are a serious health problem, though they are more prevalent in some settings than others. We were asked to make findings and develop recommendations on how to address surveillance of and screening for AROs in acute care hospitals. This consensus statement addresses these requests. However, confining the discussion and recommendations to hospitals…
| Carolyn Dewa, Philip Jacobs, Thanh Nguyen, Desmond Loong
BACKGROUND: Interest in the impact of burnout on physicians has been growing because of the possible burden this may have on health care systems. The objective of this study is toestimate the cost of burnout on early retirement and reduction in clinical hours of practicingphysicians in Canada.
The objective of this paper is to estimate the additional costs to the criminal justice system associated with people with mental illness who go through the system. The focus of the report is on costs in Alberta.
Alberta STE Report written under contract with the Alberta Health Technologies Decision Process (AHTDP). This report examines the potential role of low dose computed tomography (LDCT) in screening for lung cancer in adults aged 50 years or older in Alberta. Section Authors: Section One – Social and System Demographics Analysis: Bing Guo, Dagmara Chojecki Section Two –…
Should vitamin B12 tablets be included in more Canadian drug formularies? An economic model of the cost-saving potential from increased utilisation of oral versus intramuscular vitamin B12 maintenance therapy for Alberta seniors. OBJECTIVE: The aim of this study was to estimate the cost-savings attainable if all patients aged ≥65 years in Alberta, Canada, currently on…
OBJECTIVES: The objective of this study was to explore the degree to which databases otherthan MEDLINE contribute studies relevant for inclusion in rapid health technology assessments (HTA).
This report has been produced in response to a request from Alberta Health (AH). The objective was to perform a review of practices of engaging committees composed of lay people or members of the general public at international, national, provincial, and regional levels. The review attempts to address the following questions: What scientific evidence is available about committees…
The International Charter on Prevention of FASD has been published in The Lancet Global Health, one of the world’s most influential public-health journals. The Charter – also known as the “Edmonton Charter” – was endorsed at the First International Conference on Prevention of FASD in September 2013.The Edmonton Charter was drafted by senior…
The International Charter on Prevention of FASD has been published in The Lancet Global Health, one of the world’s most influential public-health journals. The Charter – also known as the “Edmonton Charter” – was endorsed at the First International Conference on Prevention of FASD in September 2013.The Edmonton Charter was drafted by senior staff of…
The International Charter on Prevention of FASD has been published in The Lancet Global Health, one of the world’s most influential public-health journals. The Charter – also known as the “Edmonton Charter” – was endorsed at the First International Conference on Prevention of FASD in September 2013.The Edmonton Charter was drafted by senior staff of…
The International Charter on Prevention of FASD has been published in The Lancet Global Health, one of the world’s most influential public-health journals. The Charter – also known as the “Edmonton Charter” – was endorsed at the First International Conference on Prevention of FASD in September 2013.The Edmonton Charter was drafted by senior staff of…
The International Charter on Prevention of FASD has been published in The Lancet Global Health, one of the world’s most influential public-health journals. The Charter – also known as the “Edmonton Charter” – was endorsed at the First International Conference on Prevention of FASD in September 2013.The Edmonton Charter was drafted by senior staff of…
The International Charter on Prevention of FASD has been published in The Lancet Global Health, one of the world’s most influential public-health journals. The Charter – also known as the “Edmonton Charter” – was endorsed at the First International Conference on Prevention of FASD in September 2013.The Edmonton Charter was drafted by senior staff of…
The International Charter on Prevention of FASD has been published in The Lancet Global Health, one of the world’s most influential public-health journals. The Charter – also known as the “Edmonton Charter” – was endorsed at the First International Conference on Prevention of FASD in September 2013.The Edmonton Charter was drafted by senior staff of…
| Lianne Barnieh, Braden Manns, Anthony Harris, Marja Blom, Cam Donaldson, Scott Klarenbach, Don Husereau, Diane Lorenzetti, Fiona Clement
BACKGROUND: The use of a restrictive formulary, with placement determined through a drug-reimbursement decision-making process, is one approach to managing drug expenditures.
IHE In Your Pocket 2014 – a handbook of health economic statistics includes the most currently available data, presented in separate sections on the economic burden of illness, health care resources, health behaviours, health status and demographics, and health system performance. IHE In Your Pocket was designed to provide a compact, comprehensive, and comparative overview…
| Philip Jacobs, Jessica Moffatt, Arto Ohinmaa, Egon Jonsson
Background: To address public health risk factors, governments conduct interventions in many different ministries, including non-health ministries. In order to understand the scope and cost of public health in Alberta, we developed a survey of government public health interventions. We included any government ministry or public organization, which includes health as a stated…
OBJECTIVE: About one-third of the annual $51 billion cost of mental illnesses is related to productivity losses. However, few studies have examined the association of treatment and productivity. The purpose of our research is to examine the association of depression and its treatment and work productivity.
The Institute of Health Economics organized the November 17 roundtable, with funding from Merck and in-kind support from the Canadian Health Services Research Foundation. The roundtable served as an initial gathering of the original partners and invited delegates (see Appendix I for full participant list) to further develop the HCiC partnership and begin planning…
Abstract: In the 1980s, drug prices began rising considerably worldwide, and in the 1990s, countries began incorporating health economics into the scientific review process. Rising prices in vaccines began around the year 2000 and national bodies began to use health economics to review vaccines in the next decade. Health economics is a discipline that evaluates alternative…
The Alberta Diabetes Surveillance System (ADSS) was created in 2006 in partnership with Alberta Health and Wellness (AHW) and the Institute of Health Economics (IHE). The purpose of the ADSS is to provide information about diabetes within the province of Alberta. This information includes the incidence, prevalence and use of health care services for people with diabetes, along…
Purpose: The concept of the suicidal process implies a progression from behaviour of relatively low intent to completed suicide. Evidence from the literature has given rise to the speculation that the age of onset of an early form of the suicidal process may be associated with the ultimate seriousness of suicidal behaviour. This study was designed to test the hypothesis…
| Philip Jacobs, Jessica Moffatt, Egon Jonsson, Arto Ohinmaa, Cathy Gladwin
The Institute of Health Economics (IHE) has completed a scan to determine what public health-related costs are borne by government departments, ministries, and agencies. The final report, Everybody’s Business: The Cost of Multi-Department Involvement in Public Health in Alberta, was funded by Alberta Health Services (AHS) as part of the Project 2030 initiative that saw the…
| Christa Harstall, Paul Taenzer, Donna Angus, Carmen Moga, Ann Scott, Tara Schuller
Rationale, Aims, and Objectives: A collaborative, multidisciplinary guideline adaptation process was developed to construct a single overarching, evidence-based clinical practice guideline (CPG) for all primary care practitioners responsible for the management of low back pain (LBP) to curb the use of ineffective treatments and improve patient outcomes. Note: This is an…
The Alberta Survey of Addictive Behaviours and Mental Health in the Workforce: 2009 is the third such study conducted since 1992. It provides an interesting, comprehensive picture of many issues related to the mental health of workers across all sectors in Alberta. Introduction IHE is pleased to release the final report of The Alberta Survey of Addictive Behaviours and Mental Health…
This report describes the outcomes of a two day workshop that explored options for improving quality and access to diagnostic imaging services for low back pain (LBP) in Alberta through the engagement of stakeholders that are involved in the assessment, diagnosis, treatment, and management of this condition. These include health professionals, health service managers, administrators,…
As part of Alberta Health Services (AHS) Strategic Health Needs Assessment and Service Design 2030 project, “Becoming the Best: Building Sustainability” the Institute of Health Economics (IHE) was commissioned to conduct three Knowledge Exchange events between February and May 2011. These single-day conferences assembled leading international thinkers and experts in…
This one-day, invitational event engaged community experts and senior decision-makers involved in First Nations, Inuit, and Métis health policy in Canada in round-table discussions. Integrated Knowledge Exchange in health requires communities, researchers, and policy-makers utilize evidence from all sources in a culturally relevant way.
This in-depth book contains an introduction to prevention of FASD and to the different methods that are used. There is also a systematic review of the effectiveness of prevention approaches and an overview of reviews on FASD. The book ends with a chapter called “Five perspectives on prevention of FASD” written by professionals in the field who are working to prevent…
| Bing Guo, Christa Harstall, Thanh Nguyen, Arto Ohinmaa
Alberta STE Report written under contract with the Alberta Health Technologies Decision Process (AHTDP). Fecal transplantation for the treatment of Clostridium difficile-associated disease or ulcerative colitis examines the clinical research evidence on the safety and effects of fecal transplantation in the treatment of patients with Clostridium difficile-associated disease…
This article is an overview of systematic reviews reporting on the efficacy/effectiveness of psychotherapy and/or pharmacotherapy interventions delivered within Sex Offender Treatment (SOT) programs to reduce the risk of re-offending in convicted adult male sex offenders.
Related Report:
Treatment for Convicted Adult Male Sex Offenders