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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| John Paul Ekwaru, Arto Ohinmaa, Sarah Loehr, Solmaz Setayeshgar, Thanh Nguyen, Paul J Veugelers
Objective: Public health decision makers not only consider health benefits but also economic implications when articulating and issuing lifestyle recommendations. Whereas various estimates exist for the economic burden of physical inactivity, excess body weight and smoking, estimates of the economic burden associated with our diet are rare. In the present study, we estimated the…
This overview report provides a summary of the published information on the oxygen therapy issues studied in the past 10 years in the acute care settings. The report includes a summary of audit studies that aimed to address appropriate/inappropriate use of oxygen, and explores the safety and quality issues identified in the literature about oxygen prescription, administration,…
This report provides a summary of the IHE Biosimilars Forum engagement exercise that took place on October 6, 2016 in Edmonton. The intent of the forum was to inform Alberta biosimilar reimbursement policy by sharing international experiences in this area, and the perspectives of key stakeholders.
This rapid report provides a summary of current evidence on the application of gainsharing shared savings strategies in healthcare systems and the barriers and facilitators related to their implementation.
Economic evaluation helps policy makers and healthcare payers make decisions on drug listing, coverage, and reimbursement. When economic evaluations are conducted before a product launch, the prices of the pharmaceuticals have to be forecast.
The Institute of Health Economics (IHE), in partnership with the Canadian Pulmonary Fibrosis Foundation (CPFF), held a forum on April 25th, 2016 in Toronto, Ontario, entitled Optimizing access to care for patients with idiopathic pulmonary fibrosis: A multi-stakeholder national forum, to discuss the need for patient-led policy recommendations and a patient charter for idiopathic…
| Thanh Nguyen, Anderson Chuck, Tracy Wasylak, Jeannette Lawrence, Peter Faris, Olle Ljungqvist, Gregg Nelson, Leah Gramlich
BACKGROUND: In February 2013, Alberta Health Services established an Enhanced Recovery After Surgery (ERAS) implementation program for adopting the ERAS Society colorectal guidelines into 6 sites (initial phase) that perform more than 75% of all colorectal surgeries in the province. We conducted an economic evaluation of this initiative to not only determine its cost-effectiveness,…
This white paper follows on from the 2016 IHE report, Economic surveillance for chronic obstructive pulmonary disease (COPD) in Alberta. It provides a summary of main gaps in COPD care across Canada and, in the context of a broad economic framework, it surveys important examples of programs and policies designed to address these gaps.
| Arto Ohinmaa, Yufei Zheng, Thomas Jeerakathil, Scott Klarenbach, Unto Häkkinen, Thanh Nguyen, Dan Friesen, Jane Ruseski, Padma Kaul, Ruolz Ariste, Philip Jacobs
OBJECTIVES: This study aimed to evaluate the trends and regional variation of stroke hospital care in 30-day in-hospital mortality, hospital length of stay (LOS), and 1-year total hospitalization cost after implementation of the Alberta Provincial Stroke Strategy.
| Thanh Nguyen, Justin Ezekowitz, Dat Tran, Padma Kaul
BACKGROUND: Eplerenone has been demonstrated as being cost effective for the treatment of patients with systolic heart failure (HF) and mild symptoms in several jurisdictions; however, its cost effectiveness is unknown in the context of Alberta, Canada.
Objective: The objective of this paper is to estimate the additional mental health service costs incurred within the criminal justice system that are incurred because of people with mental illnesses who go through the system. Our focus is on costs in Alberta.
The Institute of Health Economics (IHE) together with the O’Brien Institute for Public Health (O’Brien Institute) held a policy forum on February 8th, 2016, entitled Physicians as Stewards of Resources: Roles, Responsibilities, and Remuneration to inform decision-making regarding the fiscal sustainability of theprovincial healthcare system, with a specific…
| Anderson Chuck, Thanh Nguyen, James Wesenberg, Rhada Chari, Robert Wilson, Selikke Janes-Kelley
Objectives: In 2006, the Alberta Ministry of Health issued a policy to implement fetal fibronectin (fFN) testing as a publicly funded service for pregnant women. The goals were to reduce maternity health care utilization and unnecessary treatment, which would result in cost-savings for the health system by more accurately diagnosing false preterm labour. We conducted a post-policy…
This guide has been developed by the information specialists at the Institute of Health Economics in Edmonton Alberta and is intended to facilitate searching for health technology assessments (HTAs) or systematic reviews by providing the list of current and reliable internet-based resources that we regularly use in our work. We have tried as much as possible to match this guide…
| Arianna Waye, Philip Jacobs, Maria Ospina, Michael Stickland, Irvin Mayers
This report provides the results of an economic surveillance analysis on the components of the Alberta healthcare system that are devoted to COPD prevention and treatment. It focuses on epidemiology (prevalence and incidence), service use, and cost indicators, and identifies gaps in the system that presumably add to the overall economic burden of COPD. PDF of the above image: IHE…
Alberta STE Report written under contract with the Alberta Health Technologies Decision Process (AHTDP). This STE report examines the safety, screening accuracy, therapeutic efficacy/effectiveness, cost-effectiveness, budget impact, and health system readiness of newborn screening for seven conditions (galactosemia, tyrosinemia type I, homocystinuria, sickle cell anemia, sickle…
Objectives: To estimate the life expectancy and specify the causes of death among people with fetal alcohol syndrome (FAS). Methods: Included were all patients recorded in Alberta provincial databases of inpatients, outpatients, or practitioner claims from 2003 to 2012. People with FAS were identified by ICD-9 code 760.71 and ICD-10 codes Q86.0 and P04.3, and were linked…
Alberta STE Report written under contract with the Alberta Health Technologies Decision Process (AHTDP). This rapid report has been produced in response to a request from Alberta Health to provide an update on the new published research evidence on the efficacy/effectiveness, efficiency, and safety of hysteroscopic tubal sterilization (HTS) using the Essure® system for permanent…
Alberta STE Report written under contract with the Alberta Health Technologies Decision Process (AHTDP). This report is an update of the “Technological efficacy/effectiveness analysis” (T) section of the 2014 Alberta STE report, which was an evidence assessment of the clinical effectiveness and safety of endovenous ablation interventions for symptomatic varicose veins…
Abstract: Canada having a universal health insurance plan that provides hospital and physician benefits offers a natural experiment of whether continuity ofcare actually provides lower or higher utilization of services. The question we are evaluating is whether Canadians, who have a regular physician, use more health resources than those who do not have one? Using two statistical…
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