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…
Healthcare systems and organizations, industry, and the public call for support in navigating digital health technologies (DHTs). The authors critically assessed the regulations for DHTs in the U.S., the U.K., and Canada and the DHT-specific health technology assessment (HTA) guidelines, frameworks, and toolkits to describe the current state of practice and propose considerations…
| 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…
| 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…
| 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…
The Institute of Health Economics conducted an environmental scan to: describe available Alberta data assets to support the identification, surveillance, and management of high-risk patients with known cardiovascular disease; identify preliminary gaps in the available information; and formulate potential strategies to address the gaps identified. This environmental scan represents…
| Bing Guo, Carmen Moga, Charles Yan, Gareth Hopkin, Jeff Round, Jennifer Seida, Lisa Tjosvold, Michelle Pollock
This health evidence review assesses the clinical effectiveness and economic impact of various vascular risk reduction (VRR) initiatives that have been implemented in Alberta, and promising new initiatives, to inform priority-setting decisions regarding risk-reduction initiatives. The assessment also examines the clinical benefit that future projects would need to achieve for them…
| Susan Armijo-Olivo, Bing Guo, Nathan McClure, Carmen Moga, Negar Razavilar, Jeff Round, Lisa Tjosvold, Dat Tran, Charles Yan
This health evidence review assesses strategies for the delivery of high-quality and cost-effective stroke rehabilitation care in Alberta to inform decisions about how the province might increase care capacity for stroke rehabilitation services and maximize the benefits of effective treatment interventions. The review assesses two novel approaches to the delivery of high-quality…
Summary: Deliberative processes are a well-established part of health technology assessment (HTA) programs in a number of high- and middle-income countries, and serve to combine complex sets of evidence, perspectives, and values to support open, transparent, and accountable decision making. Nevertheless, there is little documentation and research to inform the development…
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…
| 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…
| Rodger Craig, Carmen Moga, Bing Guo, Dagmara Chojecki
The Institute of Health Economics (IHE) was commissioned by the Canadian Cardiovascular Society to provide a rapid update of the literature, to compare the impacts of public reporting and external benchmarking on selected outcomes, and to evaluate and describe the applicability of this body of research to non- competitive health systems, emphasizing perspectives and considerations…
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.
| Angus Thompson, Maria Ospina, Liz Dennett, Arianna Waye, Philip Jacobs
Presenteeism, reduced productivity while working, has come into consideration as a major occupational health problem in many countries with serious consequences for both organizations and employees. Increasing evidence shows that presenteeism represents a significant source of productivity losses that can cost organizations much more than does absenteeism, and it can lead to an…
| 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.
| 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.
| 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…
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…
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…
Institute of Health Economics Working Paper WP 05-07. The aim of this paper is to compare health in Canada and the United States using a preference-based measure. 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 was determined by the agency for which the document…
Institute of Health Economics Working Paper WP 05-03. Missing data is a common problem in studies that collect data on patient-reported outcomes data. This paper reports the methods, results, and an evaluation of one method for imputing missince Centre for Epidemiological Studies-Depression (CES-D) data in a study of health-related quality of life (HRQL) in a cohort of patients…
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;…