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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| 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.…
| Baruch Levi, Stefanie Tan, Husayn Marini, Sara Allin
Emergency and urgent care systems in high-income countries face major challenges related to overcrowding, long wait times, and rising demand. Internationally, and across Canada, healthcare systems have experimented with various policies to promote access to health services for unplanned acute conditions while reducing avoidable visits to hospital emergency departments (EDs). This…
| Don Husereau, John Sproule, Christopher Henshall
Combination therapy is the use of two or more therapies with the intention of improving patient health which are increasingly becoming more prevalent in the health system. Combination therapies can be produced by a single manufacturer but often the various components of the combination are produced by different companies which creates complexities in terms of pricing and reimbursement…
| Stefanie Tan, Julie Farmer, Monika Roerig, Sara Allin
Internationally and across Canada, governments have explored varied approaches to reforming the governance and financing of primary care with the aim of improving access, efficiency, effectiveness, and patient experiences in the health system. This rapid review prepared for the Institute of Health Economics by the North American Observatory on Health Systems and Policies presents…
| Sara Allin, Sierra Campbell, Margaret Jamieson, Fiona Miller, Monika Roerig, John Sproule
The Institute of Health Economics contributed as part of the team authoring the Canada Report for the Partnership for Health Sustainability and Resilience (PHSSR) initiative. https://www.phssr.org/findings The report lead author was Dr. Sara Allin, the Director for the North American Observatory on Health Systems and Policies. https://www.dlsph.utoronto.ca/2022/11/15/strengthening-primary-care-key-to-rebuilding-canadas-crumbling-healthcare-system/…
| 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…
| Carmel Montgomery, John Sproule, Jeff Round, Christopher McCabe
Using the example of frailty care in Canada, this discussion paper was completed in 2021 and presents an adaptation of the WHO Best Buys principles as a tool to support higher-level decision making and priority setting for high-value healthcare investment. Our goal is to support decision-makers to reduce the preventable and avoidable burden of morbidity, mortality and disability…
| John Sproule, Ken Bond, Lindsey Warkentin, Bing Guo, Nancy Zuck
This report is the result of a national consultation and roundtable deliberations conducted by the Institute of Health Economics to support the development of a National Strategy for Heart Valve Disease in Canada. Two virtual policy engagements with clinical leaders, patients and health system managers were conducted in November 2021. These workshops identified 9 thematic areas…
Primary care services after hours in Alberta are limited, and, as a result, emergency departments have long wait times and overcrowding as they accommodate a greater number of low-acuity conditions. In recent decades, various urgent care models have been established to fill the gap between emergency and primary care, with the aim of providing unscheduled services for urgent but…
| 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…
| Michelle Pollock, Ann Scott, Jennifer Seida, Paula Corabian, Andrew J. Sutton, Mike Paulden, Christopher McCabe, Lisa Tjosvold, Bing Guo
The clinical review and economic evaluation aimed to determine how Oncotype DX and Prosigna can be optimally used to determine which patients with early-stage breast cancer will benefit from adjuvant chemotherapy. This report addresses the following research question: For patients with early-stage (I–III), ER+, HER2?, node-negative or node-positive (one to three nodes) breast…
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.
| 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…
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…
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,…
| Deborah Marshall, Egon Jonsson, Liam Martin, Diane Mosher, Karen V. MacDonald
This White Paper discusses the concept of developing a comprehensive rheumatoid arthritis registry in Alberta, and the important health, social, and economic gains such a resource would generate for Alberta.
This book includes the plenary presentations made at the first international conference on prevention of FASD, which was attended by about 700 people from 35 countries around the globe. The issues addressed are FASD as a priority in health policy making; its prevalence and incidence; strategies for prevention; current applied and basic research in the field; the role of the medical…
Fetal alcohol spectrum disorder (FASD) is of growing concern around the world. A range of disabilities caused by prenatal exposure to alcohol, FASD is estimated to affect 2% to 5% of all newborns in the industrialized countries of Europe and North America, and the rates may be significantly higher in some developing countries and certain defined populations. Epidemiological studies…
| 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…
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.
| 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…
| 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…
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 –…
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…
This consensus statement on Legal Issues of Fetal Alcohol Spectrum Disorder (FASD) is the product of a unique IHE Consensus Development Conference held in September 2013. The event was a three-day juried hearing of evidence and scientific findings that allowed for the engagement and collaboration of citizens and decision makers in government and the justice system in addressing…
| 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.
| 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.
This project is concerned with describing a comprehensive set of HTA products, not the methods used to produce them. The report describes various products produced by HTA agencies and provides a summary of the basic elements of these products, but an in-depth analysis of, or comparison between, the various products in terms of their methodology is beyond its scope. Information…
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…
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 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…
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…
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.
| David Hailey, Marie-Josée Paquin, Olga Maciejewski, Linda Harris, Ann Casebeer, Gordon Fick, Patti Taschuk, Anthony Fields
Teleoncology: Applications and associated benefits for the adult population. This report determines the current state of evidence on teleoncology applications to improve access to care closer to home for rural patients and families affected by a diagnosis of cancer. It follows an earlier report by Marie-Josée Paquin prepared as part of her participation in the SEARCH Classic…
Institute of Health Economics Working Paper WP 06-02. The purpose of this report is to examine the economic implications for the province if a supplement to the fee schedule were allowed for vacuum-assisted biopsies. NOTE: In 2006 the Alberta Heritage Foundation for Medical Research HTA unit moved to IHE. Documents produced in and prior to 2006 have different formats; the format…
| 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,…
Alberta Heritage Foundation for Medical Research (AHFMR) HTA Initiative #23. This report is intended as a discussion primer for two challenges increasingly faced by health technology assessment (HTA), health impact assessment (HIA), health needs assessment, parliamentary technology assessment (PTA), participatory technology assessment, policy makers in numerous areas, health care…
Alberta Heritage Foundation for Medical Research (AHFMR) HTA Initiative #18. This paper has two specific objectives: to describe some of the challenges of using research evidence to inform healthcare policy making; and to provide policy makers and researchers with a framework or tool that would identify and facilitate the use of research evidence and other information in healthcare…
| Leanne Kmet, Robert Lee, Linda Cook, Diane Lorenzetti, Glenys Godlovitch, Edna Einsiedel
Alberta Heritage Foundation for Medical Research (AHFMR) HTA Report. In this systematic review, we have critically reviewed the literature addressing the social, legal and ethical issues related to genetic testing for cancer susceptibility, synthesized current information and identified existing gaps in knowledge. We believe the review will prove valuable to policy- and decision-makers…
Alberta Heritage Foundation for Medical Research (AHFMR) HTA Report #21. The three objectives of this assessment are to determine the available scientific evidence on: the effective time interval for mammography screening in asymptomatic women aged 50 to 69 years; the effective screening interval in asymptomatic women between the ages of 40 and 49 years; and the mortality rate…
Alberta Heritage Foundation for Medical Research (AHFMR) HTA Report #18. This report has been prepared following interest by the Alberta Cord Blood Bank in obtaining advice on the comparative effectiveness and costs of different types of stem cell transplantation. Earlier assessments by the Foundation have considered peripheral blood stem cell transplantation and cord blood transplantation.…
Alberta Heritage Foundation for Medical Research (AHFMR) HTA Report #17. The present report has been prepared as a follow up to the previous assessment because of continued interest in the technology by the health ministry and others. It considers studies that have been reported in the literature since completion of the earlier assessment (1997-1999) and focuses on the efficacy…