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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Guidelines for health technology assessments typically require that uncertainty be accounted for in economic evaluations, but the parameter uncertainty of the regression model used in the valuation study of the health instrument is often tacitly ignored. This study considered UK valuation study of the EQ-5D-3L and constructed a Bayesian model that accounts for layers of uncertainty…
| Ashleigh Tuite, Victoria Ng, Raphael Ximenes, Alan Diener, Ellen Rafferty, Nicholas Ogden, Matthew Tunis
Vaccination has been a key part of Canada’s coronavirus disease 2019 (COVID-19) pandemic response. Although the clinical benefits of vaccination are clear, an understanding of the population-level benefits of vaccination relative to the programmatic costs is of value. The objective of this article is to quantify the economic impact of COVID-19 vaccination in the Canadian…
| Ilke Akpinar, Erin Kirwin, Lisa Tjosvold, Dagmara Chojecki, Jeff Round
Many publicly funded health systems use a mix of privately and publicly operated providers of care to deliver elective surgical services. The aim of this systematic review was to assess the role of privately operated but publicly funded provision of surgical services for adult patients who had cataract or orthopedic surgery within publicly funded health systems in high-income countries.…
| Wendy Sligl, Justin Chen, Xiaoming Wang, Cheyanne Boehm, Karen Fong, Katelynn Crick, Míriam Clua, Cassidy Codan, Tanis Dingle, Daniel Gregson, Connie Prosser, Hossein Sadrzadeh, Charles Yan, Guanmin Chen, Alena Tse-Chang, Daniel Garros, Christopher Doig, David Zygun, Dawn Opgenorth, John Conly, Sean Bagshaw
Sepsis is a leading cause of hospital mortality, particularly in the intensive care unit (ICU) , and the related financial costs to healthcare systems are substantial. Antimicrobial use in ICUs is considerable; early, and effective antimicrobial therapy has been associated with improved sepsis outcomes. However, up to 50% of antimicrobials are sub-optimally prescribed,…
| Lucy Mosquera, Khaled El Emam, Lei Ding, Vishal Sharma, Xue Hua Zhang, Samer El Kababji, Chris Carvalho, Brian Hamilton, Dan Palfrey, Linglong Kong, Bei Jiang, Dean Eurich
Getting access to administrative health data for research purposes is a difficult and time-consuming process due to increasingly demanding privacy regulations. An alternative method for sharing administrative health data would be to share synthetic datasets where the records do not correspond to real individuals, but the patterns and relationships seen in the data are reproduced.…
| Charles Yan, Jeff Round, Ilke Akpinar, Chantal Atwood, Lesly Deuchar, Mohit Bhutani, Richard Leigh, Michael Stickland
Appropriate management of chronic obstructive pulmonary disease (COPD) patients following acute exacerbations can reduce the risk of future exacerbations, improve health status, and lower care costs. While a transition care bundle (TCB) was associated with lower readmissions to hospitals than usual care (UC), it remains unclear whether the TCB was associated with cost savings.…
| Bruce Ritchie, Karen J. B. Martins, Dat Tran, Heather Blain, Lawrence Richer, Scott Klarenbach
Self-administered subcutaneous immunoglobulin G (SCIg) reduces nursing time and eliminates the need for treatment at ambulatory care clinics, as compared with clinic-based intravenously administered IgG (IVIg), and are therapeutically equivalent. Using administrative health data in Alberta, this population-based cohort study examined the costs of IgG administration (SCIg versus…
| Thomas Vilches, Ellen Rafferty, Chad Wells, Alison Galvani, Seyed Moghadas
Diagnostic testing has been pivotal in detecting SARS-CoV-2 infections and reducing transmission through the isolation of positive cases. This study quantified the value of implementing frequent, rapid antigen (RA) testing in the workplace to identify screening programs that are cost-effective. The findings provide important insights which can inform testing strategies. The modeling…
| Charles Yan, Nathan McClure, Sean Dukelow, Balraj Mann, Jeff Round
Increasing demand for provision of care to stroke survivors creates challenges for health care planners. A key concern is the optimal alignment of health care resources between provision of acute care, rehabilitation, and among different segments of rehabilitation, including inpatient rehabilitation, early supported discharge (ESD), and outpatient rehabilitation (OPR). In this…
This commentary clarifies and reinforces recommendations provided in a recently published article on the second edition of the practical guide for evidence-informed deliberative processes (EDPs): “Evidence-Informed Deliberative Processes for Health Benefit Package Design – Part II: A Practical Guide”. While the practical guide draws on an extensive amount of information…
| Erin Kirwin, Rachel Meacock, Jeff Round, Matt Sutton
The diagonal approach is a health system funding concept wherein vertical approaches targeting specific diseases are combined with horizontal approaches intended to strengthen health systems broadly. This paper aims to develop a theoretical framework for the diagonal approach. It allows concurrent evaluation of three different types of horizontal interventions, those: (i)…
| Samantha Pollard, Dierdre Weymann, Brandon Chan, Morgan Ehman, Sarah Wordsworth, James Buchanan, Timothy P. Hanna, Cheryl Ho, Howard J Lim, Paula Lorgelly, Adam Raymakers, Christopher McCabe, Dean Regier
This study defines a core data set to facilitate economic evaluations of precision oncology. Precision oncology is generating vast amounts of multiomic data to improve human health and accelerate research. Existing clinical study designs and attendant data are unable to provide comparative evidence for economic evaluations. This lack of evidence can cause inconsistent and inappropriate…
| Melanie McPhail, Christopher McCabe, Dean Regier, Tania Bubela
Regulatory and reimbursement decisions for drugs and vaccines are increasingly based on limited safety and efficacy evidence. In this environment, life-cycle approaches to evaluation are needed. A life-cycle approach grants market approval and/or positive reimbursement decisions based on an undertaking to conduct post-market clinical trials that address evidentiary uncertainties,…
| Erin Kirwin, Jeff Round, Ken Bond, Christopher McCabe
This paper presents a Life-Cycle Health Technology Assessment (HTA) framework designed to address three challenges faced by standard HTA: uncertainty, evolving evidence and health system sustainability. The LC-HTA framework is built around on-market evidence generation and risk-based pricing strategies. Where…
Previous reports have examined predictors for inpatient stroke rehabilitation length of stay (LOS) and home discharge. However, none of them has provided a validation benchmark for predictability of identified risk factors. Accordingly, we examined temporal trends, geographic variations, and predicted inpatient rehabilitation LOS and home discharge for stroke patients in Alberta…
| Ellen Rafferty, Laura Reifferscheid, Lawrence Svenson, Margaret Russell, Shannon Macdonald, Stephanie Booth
The impact of universal varicella vaccination on herpes zoster (HZ) risk in unvaccinated and vaccinated children, and its long-term influence on HZ epidemiology, remains unknown. This retrospective cohort study used population-based administrative health data for children born between 1993 and 2018. A universal varicella vaccination programme implementation corresponded to decreased…
| Erin Kirwin, Ellen Rafferty, Kate Harback, Jeff Round, Christopher McCabe
The objective of this study was to implement a model-based approach to identify the optimal allocation of a coronavirus disease 2019 (COVID-19) vaccine in the province of Alberta Canada. The results have three important policy implications: (i) optimal vaccine allocation will depend on the public health policies in place at the time of allocation and the impact of those policies…
Little is currently known about the overall health service utilization and cost burden in patients with high risk for cardiovascular disease (HRCVD) who are recommended to start a statin to control dyslipidemia to prevent CVD events and mortality in short- and long-term care. We assessed the resource use and healthcare cost burden in this HRCVD patient population in Alberta, Canada,…
| Sean M. Bagshaw, Dat Tran, Dawn Opgenorth, Xiaoming Wang, Danny Zuege, Armann Ingolfsson, Henry T. Stelfox, Thanh Nguyen
Delay in transfer from intensive care unit (ICU) may contribute to strained capacity. Using a population-based patient cohort in 17 ICUs in Alberta between 2012 and 2016, this paper describes the epidemiologic features and healthcare costs attributable to potentially avoidable delays in ICU discharge. Potentially avoidable discharge delay occurred in approximately 70% of ICU patients…
Summary: We examined the association between optimal control of dyslipidemia and mortality and healthcare costs in patients with high risk for cardiovascular disease (HRCVD) between 2012-2016 in Alberta, Canada. HRCVD patients who were optimally controlled had lower mortality and incurred modestly higher costs, compared to those who were not. Secondary prevention patients with…
| Dat Tran, Ilke Akpinar, Irvin Mayers, Tatiana Makhinova, Philip Jacobs
The objective of this study, published in the International Journal of Chronic Obstructive Pulmonary Disease, was to describe the trends in pharmacologic treatment for patients newly diagnosed with chronic obstructive pulmonary disease (COPD) in Alberta, Canada.
| Charles Yan, Katherine Rittenbach, Sepideh Souri, Peter H. Silverstone
This analysis, published in BMC Psychiatry, aimed to determine cost-effectiveness of a stepped-care pathway for depression in adults in primary care versus standard care (SC), treatment-as-usual (TAU), and online cognitive behavioural therapy (CBT).
| Samuel N. Frempong, Andrew J. Sutton, Clare Davenport, Pelham Barton
The aim of this study, published in PharmacoEconomics – Open, was to conduct an early economic analysis of a hypothetical rapid test for typhoid fever diagnosis in Ghana and identify the necessary characteristics of the test for it to be cost effective in Ghana.
This study, published in PharmacoEconomics – Open, reports exploratory analysis of the provincial and nationwide costs of industry-sponsored drug clinical trials (CTs) in Canada. The costs of industry-sponsored drug CTs completed in 2016 were Can$2.1 billion. In addition to the creation of knowledge, these trials play an important role in alleviating the healthcare cost burden…
| Dat Tran, Thanh Nguyen, Arto Ohinmaa, Irvin Mayers, Philip Jacobs
OBJECTIVES: To examine the resource use and healthcare costs for chronic obstructive pulmonary disease (COPD) in Alberta, Canada between 2008 and 2016 and model the future costs to 2030.
Clinical research is funded by industry, governments, charities, and hospitals. It is important to know the economic commitment of the various funding bodies, but until now there has been no national source available which provides these data. We surveyed the major funders to provide such a measure. There is evidence that government and charity funding of medical research is a…
| Helena M Earl, Louise Hiller, Anne-Laure Vallier, Shrushma Loi, Karen McAdam, Luke Hughes-Davies, Adrian N Harnett, Mei-Lin Ah-See, Richard Simcock, Daniel Rea, Sanjay Raj, Pamela Woodings, Mark Harries, Donna Howe, Kerry Raynes, Helen B Higgins, Maggie Wilcox, Chris Plummer, Janine Mansi, Ioannis Gounaris, Betania Mahler–Araujo, Elena Provenzano, Anita Chhabra, Jean E Abraham, Carlos Caldas, Peter S Hall, Christopher McCabe, Claire Hulme, David Miles, Andrew M Wardley, David A Cameron
Adjuvant trastuzumab significantly improves outcomes for patients with HER2-positive early breast cancer. The standard treatment duration is 12 months but shorter treatment could provide similar efficacy while reducing toxicities and cost. We aimed to investigate whether 6-month adjuvant trastuzumab treatment is non-inferior to the standard 12-month treatment regarding disease-free…
| Timothy Caulfield, Alessandro R Marcon, Blake Murdoch, Jasmine Brown, Sarah Tinker Perrault, Jonathan Jarry, Jeremy Snyder, Samantha J Anthony, Stephanie Brooks, Zubin Master, Christen Rachul, Ubaka Ogbogu, Joshua Greenberg, Amy Zarzeczny, Robyn Hyde-Lay
Abstract: Numerous social, economic and academic pressures can have a negative impact on representations of biomedical research. We review several of the forces playing an increasingly pernicious role in how health and science information is interpreted, shared and used, drawing discussions towards the role of narrative. In turn, we explore how aspects of narrative are used in…
| 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.
| Paula Corabian, Bing Guo, Carmen Moga, Ann Scott
This article retrospectively examines the evolution of rapid assessments (RAs) produced by the Health Technology Assessment (HTA) Program at the Institute of Health Economics over its 25-year relationship with a single requester, the Alberta Health Ministry (AHM).
On November 23rd in Calgary and November 30th in Edmonton, the Institute of Health Economics (IHE) hosted an educational workshop designed to support both early and late stage organizations in developing an understanding of when, where, and how health economics can be used to strengthen product and business planning, and satisfy requirements of purchasers of technology. Participants…
| 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.
On October 21, 2018, Health Canada, the Canadian Agency for Drugs and Technologies in Health (CADTH), the Institute of Health Economics (IHE), and the Canadian Association for Population Therapeutics (CAPT) collaborated on Defining Decision-Grade Real-World Evidence and its Role in the Canadian Context: A Design Sprint. Held as a satellite to the 2018 CAPT conference in Toronto,…
Realistic Medicine is the 18th IHE Innovation Forum, a semi-annual event bringing together senior public- and private-sector experts and decision-makers to address health care policy issues.
| S.P. Bisch, T. Wells, L. Gramlich, P. Faris, X. Wang, Dat Tran, Thanh Nguyen, S. Glaze, P. Chu, P. Ghatage, J. Nation, V. Capstick, H. Steed, J. Sabourin, G. Nelson
The Institute of Health Economics has contributed to a study published in the Journal Gynecologic Oncology. The study described the effects of Enhanced Recovery After Surgery (ERAS) guideline implementation in gynecologic oncology on length of stay, patient outcomes, and economic impact in Alberta. The study compared pre-and post-guideline implementation outcomes at two centers…
| Jasmine Brown, Roger Bland, Egon Jonsson, Andrew Greenshaw
Objective: Fetal alcohol spectrum disorder (FASD) is a medical term used to describe a range of mental and physical disabilities caused by maternal alcohol consumption. The role of alcohol as a teratogen and its effects on the cellular growth of the embryo and the fetus were not determined on scientific grounds until the late 1960s. However, the link between alcohol use during…
| Jasmine Brown, Roger Bland, Egon Jonsson, Andrew Greenshaw
Objective: Fetal Alcohol Spectrum Disorder (FASD) is a preventable disorder caused by maternal alcohol consumption and marked by a range of physical and mental disabilities. Although recognized by the scientific and medical community as a clinical disorder, no internationally standardized diagnostic tool yet exists for FASD. Methods and Results: This review seeks to analyse the…
| Charles Yan, Yufei Zheng, Michael D. Hill, Balraj Mann, Thomas Jeerakathil, Noreen Kamal, Shy Amlani, Anderson Chuck
Abstract: We present a conceptual approach to determine the optimal solution to delivering a health technology, consistent with the objective of maximizing patient outcomes subject to resources available to a publicly funded health system. The article addresses two key policy questions: 1) adding system values through appropriate planning of health services delivery and 2) considering…
Objective: The aim of this study was to analyze the health care costs and savings associated with quality improvement (QI) interventions initiated and implemented utilizing the National Surgical Quality Improvement Program (NSQIP). Background: Five acute care facilities of Alberta Health Services (AHS) adopted NSQIP in 2015 for a pilot project. Methods: The cost-savings of NSQIP…
Since 2000, 5 studies have been published that each purported to estimate aggregate national mental health costs in Canada. Each of these studies used a different method. Our aim was to compare the studies, and we created a framework for the different elements used to assess mental health costs (direct costs, indirect costs, transfer payments, and “human” costs). In…
Presenteeism (reduced productivity at work) is thought to be responsible for large economic costs. Nevertheless, much of the research supporting this is based on self-report questionnaires that have not been adequately evaluated.
| Dat Tran, Ilke Akpinar, Richard Fedorak, Egon Jonsson, John Mackey, Lawrence Richer, Philip Jacobs
Purpose: In pharmaceutical clinical trials, industrial sponsors pay for study drugs and related healthcare services. We conducted a study to determine industry’s economic contribution of these trials to the Alberta healthcare system. Authors and Affiliations: Dat T. Tran1,2; Ilke Akpinar2 ; Richard N. Fedorak3 ; Egon Jonsson2 ; John R. Mackey4 ; Lawrence Richer5 ; Philip…
On November 1st, 2017, the Institute of Health Economics (IHE) hosted a pan-Canadian roundtable discussion regarding diabetes care and management in indigenous populations in Canada. This event was sponsored through an educational grant from Boehringer Ingelheim Canada, and was developed in consultation with an advisory committee including: Mr. Mehmood Alibhai (Boehringer Ingelheim…
On October 22, 2017, in conjunction with the 2017 Annual CAPT Conference, the Institute of Health Economics (IHE) and the Canadian Association for Population Therapeutics (CAPT) co-hosted the IHE/CAPT Precision Health Workshop. Precision Health (PH) has potential to provide a wide range of solutions such as enhanced R&D efficiency, earlier diagnosis and time to treatment,…
This paper reviews implementation of enhanced recovery after surgery (ERAS) and its financial implications. Literature on clinical outcomes and financial implications were reviewed. Reports from many different surgery types shows that implementation of ERAS reduces complications and shortens hospital stay. These improvements have major impacts on reducing the cost of care even…
| Thanh Nguyen, Ilke Akpinar, Jennifer Gratrix, Sabrina Plitt, Petra Smyczek, Ron Read, Philip Jacobs, Tom Wong, Ameeta E Singh
Adding universal rectal screening to urogenital screening should positively impact rectal Chlamydia trachomatis (CT) incidence in affected populations. A dynamic Markov model was used to evaluate costs and outcomes of three rectal CT screening strategies among women attending sexually transmitted infection clinics in Alberta, Canada: universal urogenital-only screening (UG-only),…
Building a Community-Based Health System: Lessons for a Path Forward is the 17th IHE Innovation Forum, a semi-annual event bringing together senior public- and private-sector experts and decision-makers to address health care policy issues.
This IHE Biosimilars Invitational Forum provided the perspective of international, national, and Alberta speakers and panellists who described the biosimilar reimbursement approach taken and outcomes achieved by other jurisdictions, guiding principles and policy options for Alberta, and key performance indicators and targets for reimbursement policy going forward. Towards a Framework…
This symposium addressed the importance of integrated health information as a necessary foundation for improved patient and system outcomes. The focus of the symposium was to discuss the benefits and challenges of shared health information and to better understand the role that health care providers play individually and collectively in achieving more person-centred and integrated…
The Value in Health Invitational Forum provided an overview from provincial, national, and international leaders around key issues to consider and address from a system perspective when developing an approach to extract value from a complex health system. The concept of system organization for a) development of standards, b) accountability arrangements and roles, and c) approaches…
| Alain Lesage, Roger Bland, Ian Musgrave, Egon Jonsson, Mike Kirby, Helen-Maria Vasiliadis
The Liberal government committed to making mental health services more accessible. Housing funding was increased in the last budget, but now commitment to comprehensive home care for the severely mentally ill and access to primary care treatments for common mental disorders are needed.
| 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…
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.
Controlling Health Care Costs – Wisely is the 16th IHE Innovation Forum, a semi-annual event bringing together senior public- and private-sector experts and decision-makers to address health care policy issues.
| 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 IHE Invitational Forum provided the perspective of international, national, and Alberta speakers and panellists who described the biosimilar reimbursement approach taken and outcomes achieved by other jurisdictions, guiding principles and policy options for Alberta, and key performance indicators and targets for reimbursement policy going forward.
| 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.
High Needs & High Cost Patients in Healthcare – How do we improve outcomes for these patients? is the 15th IHE Innovation Forum, a semi-annual event bringing together senior public- and private-sector experts and decision-makers to address health care policy issues.
| 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.
| 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…
On April 25th, The Institute of Health Economics (IHE), in partnership with the Canadian Foundation for Pulmonary Fibrosis (CPFF) and supported by an unrestricted grant from Boehringer Ingelheim (Canada) Ltd. (BI), held a national, multi-stakeholder roundtable forum to discuss policy recommendations on idiopathic pulmonary fibrosis (IPF) care.
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…
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…
The IHE/O’Brien Physicians as Stewards of Resources: Roles, Responsibilities and Remuneration Policy Forum aims to inform decision-making regarding the fiscal sustainability of the provincial healthcare system, with a specific focus on physicians as stewards of public resources. The forum, which will also be attended by Health Minister Sarah Hoffman as lunch keynote speaker,…
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.
Strengthening Mental Health Services for Children and Families is the 14th IHE Innovation Forum, a semi-annual event bringing together senior public- and private-sector experts and decision-makers to address health care policy issues.
The purpose of this workshop was to examine COPD management in Canada through presentation of analyses and examples of system supports to action best practices to a select group of clinical leaders and relevant public sector decision makers. The group deliberated, and key themes and policy recommendations from discusssion were captured to form the basis of the final COPD Policy…
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.
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…
Better Information - Better Health: Accessing Health and Health-Related Data in Alberta is the 13th IHE Innovation Forum, a semi-annual event bringing together senior public- and private-sector experts and decision-makers to address health care policy issues.
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.
| 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…
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…
| 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…
| 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…
Health System Standards: From Good Intent to Real World Application is the 12th IHE Innovation Forum, a semi-annual event bringing together senior public- and private-sector experts and decision-makers to address health care policy issues.
This free forum for primary care clinicians was held in conjunction with the annual Accelerating Primary Care conference in Edmonton, Alberta, November 23, 2014. The forum saw three physician leaders review the latest developments in the continuously advancing field of stroke prevention and care, with a particular focus on the role of primary care. The forum was…
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…
The Institute of Health Economics, in collaboration with the Government of Alberta and with support from Alberta Health Services (AHS) hosted the Consensus Development Conference on Improving Mental Health Transitions in Edmonton, Alberta, from November 4 - 6, 2014.
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 Unit (Ontario) and AstraZeneca Canada. It was held in conjunction with the annual Canadian Association for Population Therapeutics (CAPT).…
| 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…
| 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.
| 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…
The 3-day Canadian Consensus Development Conference on Surveillance & Screening for Antimicrobial-Resistant Organisms (AROs) held in Calgary, Alberta from June 18 - 20, 2014, was the first event of its kind to look at issues in the field of AROs.
| 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.
Meeting the Challenge: Dementia and Continuing Care is the 11th IHE Innovation Forum, a semi-annual event bringing together senior public- and private-sector experts and decision-makers to address health care policy issues.
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).
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.
Abstract: The cost of drug development is commonly cited between US$800 and US$1.8 billion. A similar statistic for vaccines is yet to be estimated, and it is unclear whether the cost of vaccines is similar to drug development. Financial and regulatory policy significantly impacts the extent and cost of pharmaceutical development, and as such it is important that…
| Thanh Nguyen, Anderson Chuck, Arto Ohinmaa, Philip Jacobs
Objectives: To estimate the monetary benefits of ramipril and its distribution over time among four beneficiaries in Canada: the drug developing manufacturer, generic manufacturers, the healthcare sector and employment sectors.
Choosing Wisely® in Health Care: A Canadian Perspective is the tenth IHE Innovation Forum, a semi-annual event bringing together senior public- and private-sector decision-makers to address policy issues of importance in the healthcare system in Alberta, Canada, and internationally. Choosing Wisely® is an initiative of the ABIM Foundation to improve health care in the United…
| Christa Harstall, Paul Taenzer, Nancy Zuck, Donna Angus, Carmen Moga, Ann Scott
Rationale, Aims, and Objectives: The Alberta Ambassador Program (AAP) adapted seven clinical practice guidelines on low back pain (LBP) into a single guideline spanning the continuum of care from prevention and diagnosis through to treatment. The Ambassador adaptation process was evaluated to 1 Identify the major challenges encountered and successful strategies utilized;…
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…
IHE hosted the First International Conference on Prevention of FASD, September 23 - 25, 2013 in Edmonton, Alberta. More than 800 people were in attendance, including global experts and leaders in the health system, government, and the academic and business communities. Well-known speakers from around the world presented facts and findings from research, and described innovative…
Alcohol can hurt the brain and body of an unborn baby and cause Fetal Alcohol Spectrum Disorder (FASD), a serious lifelong condition that impacts both the individual and their family. A child with FASD becomes an adult with FASD, facing birth defects, developmental and learning delays and social, educational, and employment challenges.
| Thanh Nguyen, Jessica Moffatt, Philip Jacobs, Anderson Chuck, Egon Jonsson
Objectives: To estimate the break-even effectiveness of the Alberta Fetal Alcohol Spectrum Disorder (FASD) Service Networks in reducing occurrences of secondary disabilities associated with FASD.
Early Childhood Development: Advancing Children’s Health is the ninth IHE Innovation Forum, a semi-annual event bringing together senior public- and private-sector decision-makers to address policy issues of importance in the healthcare system in Alberta, Canada, and internationally.
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…
The Provincial Industry Payer Agreements in an Era of National Purchasing Strategies half-day invitational roundtable was part of the IHE's ongoing Methodology Forum series supported by the Institute of Health Economics, the Alberta government, and industry partners, AstraZeneca, Merck, and Eli Lilly. The event brought together academic experts, industry leaders and senior decision…
| Thanh Nguyen, Egon Jonsson, Jessica Moffatt, Liz Dennett
From the Introduction: In this paper, we report a discussion of available evidence regarding the association between poverty and FASD, and regarding the economic consequences of FASD on individuals and families which may materialize an FASD - poverty trap.
| Ian Colman, Yasmin Garad, Yiye Zeng, Kiyuri Naicker, Murray Weeks, Scott Patten, Peter Jones, Angus Thompson, T. Cameron Wild
Purpose: Studies suggest that childhood trauma is linked to both depression and heavy drinking in adulthood, and may create a lifelong vulnerability to stress. Few studies have explored the effects of stress sensitization on the development of depression or heavy drinking among those who have experienced traumatic childhood events. This study aimed to determine the effect…
| 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.
Value for Money in the Health System was the eighth in the series of Innovation Forums. The keynote speaker, Mr. Don Drummond, Matthews Fellow and Distinguished Visiting Scholar in the School of Policy Studies at Queens University, and a former Associate Deputy Minister of Finance in the Government of Canada, as well as a former Senior Vice President and Chief Economics at TD Financial…
Stroke Update 2012 was a free forum for primary care clinicians, held in conjunction with the annual Accelerating Primary Care conference in Banff, Alberta, November 18, 2012. The forum brought together 5 physician leaders to review the current “state of the art” in the rapidly advancing field of stroke prevention and care, with an emphasis on the role of primary care.…
Background: The aim of this study was to extend an earlier retrospective cohort study of schizophrenia via a prospective study to a follow-up of 34 years, with an emphasis on describing the life-course of the illness.
| Thanh Nguyen, Anderson Chuck, Arto Ohinmaa, Philip Jacobs
Background: The benefits of pharmaceutical innovations are widely diffused; they accrue to the healthcare providers, patients, employers, and manufacturers. We estimate the societal monetary benefits of simvastatin in Canada and its distribution among different beneficiaries overtime.
| Mel Slomp, Philip Jacobs, Arto Ohinmaa, Roger Bland, Ray Block, Carolyn Dewa, Carina Wang
OBJECTIVES: In Canada, most mental health services are embedded in the publichealth care system. Little is known of the cost distribution within the mental healthpopulation. Our study aims to estimate the depression care costs of patients with adepression diagnosis, ranking them by the increasing total depression health carecosts.
| 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…
| Sherilyn Houle, Anderson Chuck, Finlay McAlister, Ross Tsuyuki
STUDY OBJECTIVE: To quantify the potential cost savings of a community pharmacy-basedhypertension management program based on the results of the Study of Cardiovascular Risk Intervention by Pharmacists-Hypertension (SCRIP-HTN) study in terms of avoided cardiovascular events-myocardial infarction, stroke, and heart failure hospitalization, and to compare these cost savings…
Social Determinants of Health is the seventh IHE Innovation Forum, a semi-annual event bringing together senior public- and private-sector experts and decision-makers to address health care policy issues.
| Bach Tran, Arto Ohinmaa, Anh Duong, Nhan Do, Long Nguyen, Quoc Nguyen, Steve Mills, Philip Jacobs, Stan Houston
PURPOSE: This longitudinal study assessed the changes in drug use patterns and health-related quality of life (HRQL) among HIV-positive drug users in the first methadonemaintenance treatment (MMT) cohort in Vietnam.
| 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.
| Bing Guo, Christa Harstall, Thomas Louie, Sander Veldhuyzen van Zanten, Levinus Dieleman
Aim: To critically appraise the clinical research evidence on the safety and effectiveness of FT compared with standard care in the treatment of patients with CDAD.
From the Introduction: Until four or five decades ago, the clinical consensus about childhood depression was that it did not, and perhaps could not, occur (Lefkowitz & Burton, 1978; Rie, 1966; Rochlin, 1965; Wolfenstein, 1966). In fact, prior to 1960, childhood depression was rarely mentioned in the literature (Cytryn, 2003; Tisher, 2007). A number of studies and conceptualizations…
| 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.
Maximizing Health System Performance—Assisted by Evidence, Science, and Information Systems is the sixth of the IHE’s Innovation Forums, a semi-annual series brings together senior public- and private-sector decision-makers to address policy issues of importance in the healthcare system, not just in Alberta, but to all of Canada and the international community, as well.
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…
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…
| 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…
As part of Alberta Health Services (AHS) Strategic Health Needs Assessment and Service Design 2030 project, the Institute of Health Economics was commissioned to conduct three Knowledge Exchange events. The third event – Population Health Innovations – was held May 2nd, 2011. The event was supported by Alberta Health Services in collaboration with Alberta Health and…
As part of Alberta Health Services (AHS) Strategic Health Needs Assessment and Service Design 2030 project, the Institute of Health Economics was commissioned to conduct three Knowledge Exchange events. The second event – High Performing Health Systems – was held April 15th, 2011. The event was supported by Alberta Health Services in collaboration with Alberta Health…
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 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.
As part of Alberta Health Services (AHS) Strategic Health Needs Assessment and Service Design 2030 project, the Institute of Health Economics was commissioned to conduct three Knowledge Exchange events. The first of the Knowledge Exchange events – Becoming the Best: Building Sustainability – Game Changing Health Innovations – was held on February 24th, 2011.
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
Objective: To ascertain knowledge gaps in the diagnosis and treatment of acute and chronic low back pain (LBP) in the primary care setting to prepare a scoping survey for identifying knowledge gaps in LBP management among Alberta's primary care practitioners, and to identify potential barriers to implementing a multidisciplinary LBP guideline. Note: This is an Alberta Ambassador…
| Angus Thompson, Stephen Newman, Helene Orn, Roger Bland
OBJECTIVE: Life course studies of schizophrenia that have used a 3-phase model (onset,course, and outcome) have had their use restricted owing to differences in definition and methodology. The purpose of this investigation was to describe life course data in mathematical terms and to compare the results with the findings from other life course studies.
Abstract: Within the school system, children with mental illness receive a variety of services that arise because of their conditions, and that require resources that exceed those provided to other students. Some of these services fall into the category of "specialized mental health" services, while others are additional services provided by teachers as part of their routine activities.…
On October 26 & 27, 2010, the Institute of Health Economics (IHE) conducted an invitational workshop on the optimal use of diagnostic imaging (CT and MRI) based on the recommendations from the low back pain guideline.
Diagnostic Imaging Workshop – as part of the Alberta Ambassador Guideline Adaptation Program
| Carissa Escober-Doran, Philip Jacobs, Carolyn Dewa
Objective: In Canada charitable or nonprofit organizations provide government-contracted mental health and addictions services, and they augment government funding by raising charitable revenues. This study estimated by source the revenues of nonprofit mental health and addictions organizations in Canada.
Advancements in methodological approaches in the evaluation of health technologies are important for ensuring ongoing improvement in the comprehensiveness and quality of assessments. On September 23 and 24th, 2010, The Institute of Health Economics (IHE) conducted an invitational methodology forum addressing the economic evaluation of medicines in Canada. Delegates from academia,…
| Thanh Nguyen, Philip Jacobs, Margaret Wanke, Ann Hense, Reg Sauve
OBJECTIVE: In 2004, the three-module, three-year long patient safety program, Managing Obstetrical Risk Efficiently (MOREOB), was introduced to all clinicians providing obstetrical services in Alberta. We report on an outcomes evaluation of this initiative.
In order to better understand Mental Health & Addictions in the Workplace, the PNWER Health Care Working Group hosted a half day session in conjunction with the annual PNWER summit. This session brought together key policy experts, decision makers, clinicians, and business leaders, and provided the opportunity for dialogue around this issue.
Abstract: The article presents information on the Health Technology Assessment. Guidance for health care practices in Sweden were documented when Medical Collegium was established in 1663 to distinguish quackery from medicine and control the poisonous drugs. In early 1980s, Sweden established the Swedish Council on Technology Assessment in Healthcare to assess major diseases…
| Amanda Burls, Lorraine Caron, Ghislaine Cleret de Langavant, Wybo Dondorp, Christa Harstall, Ela Pathak-Sen, Bjørn Hofmann
OBJECTIVES: Values are intrinsic to the use of health technology assessments (HTAs) inhealth policy, but neglecting value assumptions in HTA makes their results appear more robust or normatively neutral than may be the case. Results of a 2003 survey by the International Network of Agencies for Health Technology Assessment (INAHTA) revealed the existence of disparate methods…
There is a wealth of theoretical and real-world evidence on the impacts of physician payment system design on physician behavior and health system performance. In order to bring some of that knowledge to Alberta the Institute of Health Economics (IHE) conducted, on behalf of Alberta Health and Wellness, a 1 and ½ day Provider Funding: Performance, Accountability, and Incentives…
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.
| Susan E Brien, Diane Lorenzetti, Steven Lewis, James Kennedy, William A Ghali
BACKGROUND: There is an extensive body of literature on health system quality reporting that has yet to be characterized. Scoping is a novel methodology for systematically assessing the breadth of a body of literature in a particular research area. Our objectives were to showcase the scoping review methodology in the review of health system quality reporting, and to reporton…
Rationale, aims and objectives: The Appraisal of Guidelines Research and Evaluation (AGREE) instrument is a generic tool for assessing guideline quality. This feasibility study aimed to reduce the ambiguity and subjectivity associated with AGREE item scoring, and to augment the tool's capacity to differentiate between good- and poor-quality guidelines. Note: This is an Alberta…
Alcohol can hurt the brain and body of an unborn baby and cause Fetal Alcohol Spectrum Disorder (FASD), a serious lifelong condition that impacts both the individual and their family. A child with FASD becomes an adult with FASD, facing birth defects, developmental and learning delays and social, educational, and employment challenges. The IHE Consensus Development Conference on…
Background: Although many programs targeting fetal alcohol spectrum disorder (FASD) are implemented, the province of Alberta is still lacking information on costs of FASD.
Objectives: To estimate the costs of FASD in Alberta based on available US and Canadian research on costs of FASD, and Alberta data.
The Institute of Health Economics (IHE), in collaboration with the Alberta Depression Initiative Project, Alberta Health and Wellness, the Alberta Mental Health Board and the Mental Health Commission of Canada organized a Consensus development conference on Depression in Adults: How to Improve Prevention, Diagnosis and Treatment in Calgary, Alberta in October 2008. The main objective…
| Ann Scott, Carmen Moga, Christa Harstall, Jacques Magnan
Abstract: Health technology assessments (HTAs) are an as yet unexploited source of comprehensive, systematically generated information that could be used by research funding agencies to formulate researchable questions that are relevant to decision-makers. We describe a process that was developed for distilling evidence gaps identified in HTAs into researchable questions…
| Ann Scott, Carmen Moga, Pamela Barton, Saifee Rashiq, Don Schopflocher, Paul Taenzer, Christa Harstall
Rationale and objective: A research translation strategy for chronic pain was developed that has significant potential to advance the usefulness of systematic reviews (SRs) in clinical practice.
Note: This is an Alberta Ambassador Guideline Adaptation Program related publication.
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…
The Institute of Health Economics (IHE) co-hosted this Calgary conference in April 2007 to consult experts on factors contributing to the low birth weight rate in Alberta, to develop a consensus on the relevant factors, and to tailor interventions to address the contributing factors. The consensus statement on how to prevent low birth weight was developed to inform patients, health…
| Saifee Rashiq, Pamela Barton, Christa Harstall, Don Schopflocher, Paul Taenzer
Background: The purpose of Health Technology Assessment (HTA) is to make the best possible summary of the evidence regarding specific health interventions in order to influence health care and policy decisions. The need for decision makers to find relevant HTA data when it is needed is a barrier to its usefulness. These barriers are highest in rural areas and amongst isolated…