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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| Dat Tran, Thanh Nguyen, Dawn Opgenorth, Xiaoming Wang, Danny Zuege, David A. Zygun, Henry T. Stelfox, Sean M. Bagshaw
This study, published in the Journal of Critical Care, explores the association between strained ICU capacity and healthcare costs, and demonstrates the admissions to ICUs experiencing strain incur incremental costs, attributed to longer hospitalization and physician services.
| Dat Tran, Robert Welsh, Arto Ohinmaa, Thanh Nguyen, Padma Kaul
Little is known about the resource use and cost burden of acute myocardial infarction (AMI) beyond the index event. We examined resource use and care costs during the first and each subsequent year, among patients with incident AMI.
This environmental scan describes existing initiatives that aim to accelerate the diagnostic phase of cancer care in Alberta, Canada, and internationally. Specifically, it describes their development and implementation, structure and functioning, intended outcomes and effectiveness, costs and cost savings, and enablers and barriers.
| Bing Guo, Paula Corabian, Charles Yan, Lisa Tjosvold
This evidence-based report examines expanding the role of paramedics in the community. It summarizes the various types of community paramedicine programs (characteristics, implementation, and funding sources in other jurisdictions) as well as the safety, effectiveness, and economic outcomes of these paramedic programs towards providing patients with alternate, non-emergency health…
| 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.
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…
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…
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.
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…
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…
PDF of a PowerPoint Presentation by Mr. Anyk Glussich, Program Lead, Canadian Patient Cost Database (CPCD); Canadian Institute for Health Information (CIHI).
On the State of the Art in Costing Methods Workshop.
| 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…
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.
| 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…
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.
INTRODUCTION: Varicella vaccine was introduced to the infant immunization schedule in each province or territory between 2000 and 2007 as a result of the Canadian ImmunizationStrategy. The impact of vaccinating children against this disease is potentially far reaching, asimmunization may also benefit those segments of the population not immunized. The objective of this paper…
Abstract: Medical wait time is a top health policy issue in Canada. Reliable data on the referral wait time from primary to specialty care are limited. Existing data on referral wait times are generally self-reported by specialists. In 2008, the Edmonton North Primary Care Network (PCN) developed a Centralized Referral Program, including a specialist database that contains…
| Sherilyn Houle, Finlay McAlister, Cynthia Jackevicius, Anderson Chuck, Ross Tsuyuki
BACKGROUND: Pay-for-performance (P4P) is increasingly touted as a means to improve health care quality.
PURPOSE: To evaluate the effect of P4P remuneration targeting individual health careproviders.
| Logan McLeod, JoAnn Kingston-Riechers, Egon Jonsson
Abstract: The potential risks to patient safety in a primary care setting are different than the risks to patient safety in an acute care setting. The main differences arise from the organisational structures of primary care delivery and the greater involvement of patients in their care. To account for these differences, we present the Patient Safety in Primary Care Framework…
For which strategies of suicide prevention is there evidence of effectiveness? This report aims to synthesize research findings from existing systematic reviews to address two questions: What types of preventive interventions have been evaluated in the published literature? Which strategies have good-quality evidence to support them? Limited evidence - as well as variability by…
| Anne-Marie Boström, Susan E Slaughter, Dagmara Chojecki, Carole Estabrooks
OBJECTIVES: The recent emphasis on knowledge translation (KT) in health care is based on the premise that quality of care improves when research findings are translated into practice. This study aimed to identify the extent, nature, and settings of KT research pertaining to the care of older adults.
| 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…
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…
PDF of a PowerPoint presentation by Dr. Axel Meisen, Chair of Foresight, Alberta Innovates – Technology Futures.
Alberta Health Services - Becoming the Best: Building a Sustainable Health System - Game Changing Health Innovations Conference
The IHE has produced a book of the proceedings from the Consensus Development Conference: FASD - Across the Lifespan. Hardcover copies are available for purchase at a unit cost of $25.00 CAD plus $2.50 shipping and handling. Click on the Add to Cart button at the bottom of this page to proceed with your purchase. In followup to the conference, the Institute has produced two…
Reflecting the recent increased public awareness of the topic, this is the first and most comprehensive resource for over a decade on the molecular basis, prevalence, treatment options, socioeconomic impact, and prevention strategies of FASD. Edited by world-renowned experts, this compendium includes the latest research results to provide new insights and realistic estimations…
The economic impact of mental illness and addictions is felt throughout society - in the health care system, the social services system, education, criminal justice, and the workplace. In this booklet we conducted a provincial and national level analysis of the expenditures on mental health and addictions in Canada.
Part of the successful Institute of Health Economics (IHE) book series, this handbook and ready reference adopts a unique approach in combining policy recommendations with specific treatment options for Parkinson patients. The first part of the book deals with the clinical medical, social and economical aspects of Parkinson Disease. These ten chapters include the latest diagnosis…
| Deborah Marshall, Paul Rogers, Thomas Rohleder, Sonia Vanderby
This booklet provides an overview of the System Dynamics (SD) approach and its potential applications in improving access to health services and quality of care. The specific application addressed here is the improvement of care of patients with hip and knee osteoarthritis (OA), as this is a pressing issue in Canada today. The specific health system and population addressed here…
PURPOSE: A study was undertaken to evaluate the utilization rates of routine preoperativeelectrocardiogram (ECG) and chest x-ray (CXR) by sex, age, and most frequent surgery type, and to estimate the total cost of these screening tests.
The Consensus Statement on Fetal Alcohol Spectrum Disorder (FASD) - Across the Lifespan was produced by a panel of experts led by the Hon. Anne McLellan, former Deputy Prime Minister of Canada. This consensus statement on fetal alcohol spectrum disorder is the product of a unique conference: The IHE Consensus Development Conference on Fetal Alcohol Spectrum Disorder - Across the…
Le présent énoncé consensuel a été préparé par un panel indépendant de professionnels de la santé et de représentants du milieu universitaire et du public en se fondant sur: les études publiées pertinentes réunies par le Comité scientifique de la conférence pour l’établissement…
Written by health policy experts, the book gives a comprehensive overview of 8 different national health care systems and focuses in particular on the different approaches to maintain efficiency and to contain overall healthcare costs. Each chapter identifies the 4-5 specific policies with the highest impact for the respective country over the past 20-30 years and the current policy…
Alberta STE Report written under contract with the Alberta Health Technologies Decision Process (AHTDP). This report is about testing for Human Papillomavirus (HPV). HPV is one of the most common sexually transmitted infections and can also cause cervical cancer. Cervical screening aims to reduce cervical cancer incidence and mortality by detecting precancerous lesions early. Until…
| Charles Yan, JoAnn Kingston-Riechers, Anderson Chuck
This report provides information regarding the impact of physician reimbursement models on five dimensions specified in the Provincial Alternate Relationship Plan Program Evaluation. The impact of physician reimbursement models were assessed on the following five dimensions: Health service utilization Access to care Quality of services Patient satisfaction Physician satisfaction…
This report presents summary information on computed tomography (CT) and magnetic resonance imaging (MRI) in Alberta, with comparison to the use of these diagnostic imaging technologies in other jurisdictions. The aims of the report are to: illustrate the capacity in Alberta to diagnose and manage health problems with the help of these important technolgies compare the numbers,…
L’honorable Michael Kirby (président de la Commission de la santé mentale du Canada) a présidé un éminent panel de citoyens et d’experts pour formuler des recommandations pratiques sur la façon d’améliorer la prévention, le diagnostic et le traitement des troubles dépressifs chez…
The Consensus Statement on Depression in Adults: How to Improve Prevention, Diagnosis and Treatment was produced by a panel of experts led by the Hon. Michael Kirby Chair, Mental Health Commission of Canada. This consensus statement was prepared by an independent panel of health professionals, academics, and public representatives based on: presentations by and questioning of experts…
This rapid assessment addressed a request to assess the published research evidence on how the Actim™ Partus test compares to the TliIQ® System in terms of diagnostic accuracy, clinical utility, and costs when added to preterm labour management in symptomatic women with intact membranes.
Air ambulance transportation with capabilities to provide advanced life support. The objective of this report is to present and synthesize the available published research evidence on the efficacy/effectiveness, safety, and efficiency of air ambulance transportation (helicopters) with on-board capabilities of advanced life support (ALS). The intent is to use this evidence to inform…
The role of rapid fetal fibronectin assay in the management of spontaneous preterm labour The objective of this report is to evaluate the added value of using fetal fibronectin (Rapid fFN for the TLi™ System, referred to here as the rapid fFN assay) to diagnose spontaneous preterm labour (PTL) in symptomatic women, which is the only fFN detection modality currently available…
Evidence of benefit from telemental health applications: a systematic review.
This review considers the evidence of benefit from use of telemental health (TMH) in studies that had clinical, economic, or administrative outcomes. The review also includes studies that provided information on the accuracy or feasibility of TMH.
Information Specialist: Janice Varney
Routine Preoperative Tests - Are They Necessary? is about routine preoperative testing on otherwise healthy patients who are scheduled for elective surgery. This report is a synopsis of the findings from some of the major health technology assessments and systematic reviews on preoperative testing published during the last two decades. The implications of these results for Alberta…
| Anderson Chuck, Philip Jacobs, Thanh Nguyen, Arto Ohinmaa, Janice Varney
Evaluation of enzyme immunoassay and immunoblot testing for the diagnosis of syphilis in Alberta. A new protocol for testing and diagnosing syphilis has been proposed in Alberta. The protocol proposes replacing rapid plasma reagin (RPR) with enzyme immunoassay (EIA) as the standard initial test and replacing Treponema pallidum (T. pallidum) particle agglutination assay (TPPA) and…
| Sheri Pohar, Sumit Majumdar, Philip Jacobs, Jeffrey Johnson
Institute of Health Economics Working Paper WP 06-04. The purpose of this analysis was to compare health care utilization as well as costs and mortality of individuals with diabetes in the province of Saskatchewan from 1999 to 2001, according to residential location. NOTE: In 2006 the Alberta Heritage Foundation for Medical Research HTA unit moved to IHE. Documents produced in…
Alberta Heritage Foundation for Medical Research (AHFMR) HTA Report #38. This report aims to identify strategies that have been evaluated and reported in the literature and to assess their effectiveness in reducing emergency department overcrowding. Information Specialists: Seana Collins, Liz Dennett NOTE: In 2006 the Alberta Heritage Foundation for Medical Research HTA unit moved…
| David Cooke, Meina Dubetz, Rahim Heshmati, Sandra Iftody, Erin McKimmon, Jodi Powers, Robert Lee, Peter Dunscombe
Alberta Heritage Foundation for Medical Research (AHFMR) HTA Initiative #22. We present a model process that will assist health care organizations in developing and implementing a formal management system for learning from incidens. Developed specifically for the Radiation Treatment (RT) Program at the Tom Baker Cancer Centre, a major cancer treatment centre in Calgary, Alberta,…
| Anita Simon, Robert Lee, David Cooke, Diane Lorenzetti
Alberta Heritage Foundation for Medical Research (AHFMR) HTA Initiative #17. This paper focuses on incident reporting systems relevant to the hospital and efforts to improve patient safety and clinical outcomes. Costs associated with incident reporting systems are included wherever possible. This paper aims to assess the effectiveness of hospital incident reporting systems in improving…
Alberta Heritage Foundation for Medical Research (AHFMR) HTA Report #16. This report has been prepared in view of the continuing interest in positron emission tomography and other functional diagnostic imaging (FDI) methods within the Alberta health care system. It also continues the work at the Alberta Heritage Foundation for Medical Research in developing approaches to assessment…
Alberta Heritage Foundation for Medical Research (AHFMR) HTA Report #16. This is the second volume of an assessment of functional diagnostic imaging methods in imaging of the myocardium. Volume 1 included an overview of the assessment findings and provided comments on the place of the FDI techniques in this application. In this volume, further details are given of the assessment…
Alberta Heritage Foundation for Medical Research (AHFMR) HTA Report #12. This report has been prepared following a request from the provincial Clinical Practice Guidelines Program for information on the accuracy of diagnostic tests for the detection of bacterial vaginosis (BV), vulvovaginal candidiasis (VVC) and trichomoniasis in females of reproductive age. The intention of this…
Alberta Heritage Foundation for Medical Research (AHFMR) HTA Report #11. This report has been prepared in view of the increasing interest in ultrasound technology for diagnosis of osteoporosis. Until recently, quantitative ultrasound (QUS) was mainly being used in research settings. This procedure is still not covered by provincial fee schedules. The recent FDA pre-marketing approvals…
Alberta Heritage Foundation for Medical Research (AHFMR) HTA Report #10. This report has been prepared as part of a project to assess the role of high cost functional diagnostic imaging (FDI) and related methods in routine health care. In the present paper, the potential application of four FDI methods to the management of epilepsy is considered. The assessment considered the current…