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…
| 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.
| 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…
This report provides a summary of the proceedings from the IHE roundtable on diabetes care and management in Indigenous populations in Canada, held on November 1, 2017. The roundtable aimed to: discuss and share learnings and promising practices from successful community-led diabetes programs, highlighting approaches to effectively engage communities to co-develop prevention and…
| 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…
This report provides a summary of recently published information (January 2015 to present) regarding the glucose monitoring technologies that are commercially available in North America, as well as those that are emerging within the next five years (up to 2021).
| 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…
Alberta STE Report written under contract with the Alberta Health Technologies Decision Process (AHTDP). This STE report examines the safety, screening accuracy, therapeutic efficacy/effectiveness, cost-effectiveness, budget impact, and health system readiness of newborn screening for seven conditions (galactosemia, tyrosinemia type I, homocystinuria, sickle cell anemia, sickle…
Alberta STE Report written under contract with the Alberta Health Technologies Decision Process (AHTDP). This rapid report has been produced in response to a request from Alberta Health to provide an update on the new published research evidence on the efficacy/effectiveness, efficiency, and safety of hysteroscopic tubal sterilization (HTS) using the Essure® system for permanent…
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…
| 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.
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.
| Don Husereau, Anthony Culyer, Peter Neumann, Philip Jacobs
Abstract: Canadian and US health systems have often been characterized as having vastly different approaches to the financing and delivery of healthcare, with Canada portrayed as more reliant on rationing based on costs. In this article, we examine the similarities and differences between the two countries, the evolution and current role of health economic evaluation, and…
Alberta STE Report written under contract with the Alberta Health Technologies Decision Process (AHTDP). This report is an evidence assessment of the clinical effectiveness and safety of hysteroscopic tubal sterilization, and the value for money associated with adopting hysteroscopic tubal sterilization in Alberta. Section Authors: Section One – Background and Context: Carmen…
Alberta STE Report written under contract with the Alberta Health Technologies Decision Process (AHTDP). This report examines the safety, screening accuracy, therapeutic efficacy, patient outcomes and cost effectiveness of first trimester Quad (1T-Quad) +/- NT and NIPT screening for fetal trisomies. Section Authors: Section One – Technology Effectiveness and Safety: Ken Bond,…
| Carolyn Dewa, Desmond Loong, Sarah Bonato, Thanh Nguyen, Philip Jacobs
BACKGROUND: Interest in the well-being of physicians has increased because of their contributions to the healthcare system quality. There is growing recognition that physicians are exposed to workplace factors that increase the risk of work stress. Long-term exposure to high work stress can result in burnout. Reports from around the world suggest that about one-third to…
Summary of Systematic Reviews, Primary Studies, and Evidence-based Guidelines. The following research questions were addressed in this review: What are the clinical effects of a universal screening strategy for ARO carriage when compared with no screening? What are the clinical effects of a universal screening strategy for ARO carriage when compared with targeted screening (screening…
| Don Husereau, Philip Jacobs, Braden Manns, Ties Hoomans, Deborah Marshall, Robyn Tamblyn
This discussion paper has been produced in response to a request from CIHR Institute of Health Services and Policy Research (CIHR IHSPR). The discussion paper will provide guidance to those tasked with conducting an economic evaluation of complex health system interventions. The guidance will be an elaboration of existing National guidelines for economic evaluation, and serve as…
Antibiotic-Resistant Organisms (AROs) are a serious health problem, though they are more prevalent in some settings than others. We were asked to make findings and develop recommendations on how to address surveillance of and screening for AROs in acute care hospitals. This consensus statement addresses these requests. However, confining the discussion and recommendations to hospitals…
| Carolyn Dewa, Philip Jacobs, Thanh Nguyen, Desmond Loong
BACKGROUND: Interest in the impact of burnout on physicians has been growing because of the possible burden this may have on health care systems. The objective of this study is toestimate the cost of burnout on early retirement and reduction in clinical hours of practicingphysicians in Canada.
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 –…
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…
Transcutaneous Bilirubinometry for the Screening of Hyperbilirubinemia in Neonates ≥35 Weeks’ Gestation This report was prepared for Alberta Health Services (AHS) and focuses on the published evidence about the safety, test accuracy, and clinical impact of the use of transcutaneous bilirubin (TcB) test for the screening of significant hyperbilirubinemia in term or late…
Alberta STE Report written under contract with the Alberta Health Technologies Decision Process (AHTDP). This report is an update of the 2008 report on islet transplantation (IT) for Type 1 diabetes (T1DM). Section One of this analysis was intended to describe the profile of T1DM (definition, progression, epidemiology, and population dynamics of affected adults in Alberta, in Canada,…
| 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.
Alberta STE Report written under contract with the Alberta Health Technologies Decision Process (AHTDP). This report performs an evaluation of the scientific evidence on the safety, performance, and effectiveness of universal and targeted preschool hearing screening (PHS) to inform the Infant and Preschool Screening Framework being developed by the Community and Public Health (CPH)…
Alberta STE Report written under contract with the Alberta Health Technologies Decision Process (AHTDP). This review focused on the best evidence available on the use of PSVS to detect vision conditions in asymptomatic preschool children (aged from birth to 6 years; not necessarily considered at risk for developing visual impairment) to determine the safety and efficacy/effectiveness…
Alberta STE Report written under contract with the Alberta Health Technologies Decision Process (AHTDP). This report is an update of a 2007 report. Permanent congenital hearing impairment/loss (PCHI/PCHL) is one of the most common congenital anomalies found at birth which can lead to delays and deficits in the development of speech, language, cognition, and learning, as well as…
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…
| 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…
Alberta STE Report written under contract with the Alberta Health Technologies Decision Process (AHTDP). This report provides an epidemiological profile of fetal aneuploidy and open neural tube defects (ONTD); describes the patterns of care, utilization trends, and factors affecting the provision of first and second trimester screening (FASTs) services for fetal aneuploidy and…
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…
Alberta STE Report written under contract with the Alberta Health Technologies Decision Process (AHTDP). This report examines the research evidence on the safety and efficacy of insulin pump therapy, as compared to multiple daily insulin injections, in the treatment of children, adults, and pregnant women diagnosed with type 1 diabetes. The report also analyses the economic impact…
| 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.
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…
| Carissa Escober-Doran, Philip Jacobs, Carolyn Dewa
This study measures the return on investment for parent training at the pre- or early childhood stage. The purpose is to prevent conduct disorders in childhood, and mental health problems in adolescence and adulthood. The program studied is the Triple P program. The context is a one year birth cohort in Alberta. The costs are for a universal parental training program. The downstream…
The Alberta Diabetes Surveillance System (ADSS) was created in 2006 in partnership with Alberta Health and Wellness (AHW) and the Institute of Health Economics (IHE). The purpose of the ADSS is to provide information about diabetes within the province of Alberta. This information includes the incidence, prevalence and use of health care services for people with diabetes, along…
| 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
| 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.
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.
| 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…
The Alberta Diabetes Surveillance System (ADSS) was created in 2006 in a partnership between Alberta Health and Wellness (AHW) and the Institute of Health Economics (IHE). The purpose of the ADSS is to provide information about diabetes within the province of Alberta. This information includes the incidence, prevalence and use of health care services for people with diabetes, along…
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…
The objective of this report is to assess research evidence on the safety and prognostic value of exercise testing (including electrocardiogram exercise testing and cardiopulmonary exercise testing) for the prediction of cardiac events in patients with chronic diseases including diabetes, chronic obstructive pulmonary disease (COPD), and arthritis. Information Specialist: Trish…
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 on assisted reproductive technologies (ARTs) is a literature review and secondary analyses of administrative health data conducted to provide information on the direct health care costs associated with multiple pregnancies and the potential cost impact of ARTs in Alberta. It examines the impact of multiple pregnancies and Assistive Reproductive Technologies on health…
The Institute of Health Economics sponsored Dr. Arne Ohlsson and Dr. Prakeshkumar Shah to write this book to inform the May 2007 Consensus Development Conference on Healthy Mothers Healthy Babies: How to Prevent Low Birth Weight. The book provides a synopsis of the research evidence on the determinants and prevention of preterm/low birth weight births. This book is a synopsis (an…
The purpose of this report is to update an earlier HTA report published in 2003. This report examines the newly published clinical research evidence on the safety and efficacy/effectiveness of islet transplantation in type 1 diabetic patients who have severe hypoglycemia episodes or hyperglycemia unawareness but are without kidney failure. The main clinical efficacy/effectiveness…
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,…
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
The Alberta Diabetes Surveillance System (ADSS) was created in 2006 in a partnership between Alberta Health and Wellness (AHW) and the Institute of Health Economics (IHE). The purpose of the ADSS is to provide information on diabetes in the province of Alberta. This information includes the incidence, prevalence and use of health care services for people with diabetes, along with…
This consensus statement on how to prevent low birth weight was developed to inform patients, health policy, and practice. It is a product of the IHE Consensus Development Conference on Healthy Mothers - Healthy Babies: How to Prevent Low Birth Weight held April 23 to 25, 2007
| Philip Jacobs, Rita Yim, Arto Ohinmaa, Janice Varney, Anita Hanrahan, Joy Loewen, Laura Mashinter, Bev Baptiste, Margaret Russell
This booklet is a compendium of existing statistics related to the economic aspect of childhood immunizations in Canada. It brings together, in one document, data obtained from a wide range of sources. It covers topics related to the economic and epidemiological burden of childhood diseases, resources used, and system performance from provincial, national, and international viewpoints.
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…
A successful screening program for cystic fibrosis (CF) refers to the ability of the program to appropriately identify and refer for care those with CF, while meeting the needs of those who do not have CF, particularly those infants identified by the screening program as carriers (individuals unaffected by CF but have a mutation in one of their CFTR genes). Some measures of success…
The use of the automated auditory brainstem response and otoacoustic emissions tests for newborn hearing screening. Permanent congenital hearing impairment/loss (PCHI) is one of the most common congenital anomalies found at birth which can be expected to lead to delays and deficits in the development of speech, language, cognition and learning, as well as secondary effects on the…
| 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…
The objective of this statement was to develop a consensus statement on the benefits and costs of testing supplies for self-monitoring of blood glucose in diabetes, to inform patients, health policy and practice.
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…
| 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,…
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 Report #36. The objective of this report is to identify the most appropriate investigative protocol, or component of a protocol, for determining the cause(s) of stillbirth and to identify protocols that have been recommended by health authorities and professional associations both within Canada and worldwide. Information…
| Sheri Pohar, Scot Simpson, Sumit Majumdar, Philip Jacobs, Arto Ohinmaa, William Osei, Mary Rose Stang, Winanne Downey, Jeffrey Johnson
Institute of Health Economics Working Paper WP 05-06. The purpose of this study was to analyze epidemiologic and cost trends from 1991 to 2001 in the province of Saskatchewan for a cohort of individuals identified as having diabetes and for a randomly selected control cohort. The objectives were to: explore epidemiologic trends (i.e., prevalence, incidence and mortality) in diabetes…
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…
| Sheri Maddigan, David Feeny, Sumit Majumdar, Karen Farris, Jeffrey Johnson
Institute of Health Economics Working Paper WP 05-02. The purpose of this report was to assess the cross-sectional construct validity of the Health Utilities Mark 3 (HUI3) in type 2 diabetes using population-health survey data. 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;…
| 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…
| Sheri Maddigan, David Feeny, Sumit Majumdar, Karen Farris, Jeffrey Johnson
Institute of Health Economics Working Paper WP 05-01. The objective of this paper is to assess a broad range of determinants of health to determine which are most strongly associated with health-related quality of life (HRQL) in people with type 2 diabetes. NOTE: In 2006 the Alberta Heritage Foundation for Medical Research HTA unit moved to IHE. Documents produced in and prior…
| 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 #33. This report is a systematic review and critical appraisal of the evidence on the use of ovulation induction (OI) drug therapy to manage anovulatory infertility associated with polycystic ovary syndrome (PCOS) in women of reproductive age. The aim was to provide the current published scientific evidence about…
Alberta Heritage Foundation for Medical Research (AHFMR) HTA Report #31. This report was prepared in response to a request from Alberta Health and Wellness (AHW) for information about the use of islet cell transplantation for patients with type 1 diabetes. AHW was specifically interested in the current status of islet cell transplantation using the Edmonton protocol for a sub-population…
Alberta Heritage Foundation for Medical Research (AHFMR) HTA Report #23. This report is a systematic review and critical appraisal of the literature on the use of formal outpatient diabetes education as a therapeutic tool for self-management in adult patients with type 2 diatetes. It has been prepared to provide information to the Capital Health Authority in Alberta, Canada and…
| Sue Ludwig, Patricia Leggett Tait, Christa Harstall
Alberta Heritage Foundation for Medical Research (AHFMR) HTA Report #22. This review was requested to determine whether conductive education as a learning approach or therapeutic intervention is safe and efficacious for children with disabilities such as cerebral palsy that impact neuromotor functioning. The review also addresses the profile of the child who would benefit from…
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…
Alberta Heritage Foundation for Medical Research (AHFMR) HTA Report #3. The intent of this report is to inform medical practitioners and the public on the current status of in vitro fertilization and embryo transfer (IVF-ET) as a treatment for various types of infertility, and on its use and coverage in Canada. The report has been prepared because of the interest and debate regarding…