Orthopedic and ophthalmology surgical service forecast modelling in Manitoba: Research approach for a data linkage study.

Background: The healthcare system in Manitoba, Canada has faced long wait times for many surgical procedures and investigations, including orthopedic and ophthalmology surgeries. Wait times for surgical procedures is considered a significant barrier to accessing healthcare in Canada and can have negative health outcomes for patients. We developed models to forecast anticipated surgical procedure demands up to 2027.

Annual trends of hepatitis C virus infection in Manitoba between 1998 and 2018: A focus on special populations.

Background: Hepatitis C virus (HCV) infection is a major cause of liver-related morbidity and mortality worldwide. Epidemiological data of HCV infection in the Canadian province of Manitoba are limited.

Methods: A population-based retrospective study was conducted using data from the Manitoba Centre for Health Policy repository.

Declining Comprehensiveness of Services Delivered by Canadian Family Physicians Is Not Driven by Early-Career Physicians.

We describe changes in the comprehensiveness of services delivered by family physicians in 4 Canadian provinces (British Columbia, Manitoba, Ontario, Nova Scotia) during the periods 1999-2000 and 2017-2018 and explore if changes differ by years in practice. We measured comprehensiveness using province-wide billing data across 7 settings (home, long-term care, emergency department, hospital, obstetrics, surgical assistance, anesthesiology) and 7 service areas (pre/postnatal care, Papanicolaou [Pap] testing, mental health, substance use, cancer care, minor surgery, palliative home visits). Comprehensiveness declined in all provinces, with greater changes in number of service settings than service areas.

Changes over time in patient visits and continuity of care among graduating cohorts of family physicians in 4 Canadian provinces.

Background: Lack of patient access to family physicians in Canada is a concern. The role of recent physician graduates in this problem of supply of primary care services has not been established. We sought to establish whether career stage or graduation cohort were related to family physician practice volume and continuity of care over time.

Patterns of prescription opioid dispensing among Red River Métis in Manitoba, Canada: a retrospective longitudinal cross-sectional study.

Background: Amid rising concern about opioid use across Canada, Métis leaders in Manitoba are seeking information on prescription opioid dispensing in Red River Métis populations to assist with planning and implementing appropriate evidence-based harm-reduction strategies in their communities. We examined patterns of prescription opioid dispensing among Red River Métis and compared them to those among other residents of Manitoba.

Methods: We conducted a population-based retrospective cross-sectional study for fiscal years 2006/07-2018/19 using administrative data from the Manitoba Population Research Data Repository and a study designed in partnership with researchers from the Manitoba Métis Federation.

Changes in health indicator gaps between First Nations and other residents of Manitoba.

Background: The Truth and Reconciliation Commission of Canada has called for better reporting of health disparities between First Nations people and other Canadians to close gaps in health outcomes. We sought to evaluate changes in these disparities using indicators of health and health care use over the last 2 decades.

Methods: We used linked, whole-population, administrative claims data from the Manitoba Centre for Health Policy for fiscal years 1994/95 to 1998/99 and 2012/13 to 2016/17.

Barriers and enablers to the implementation of evidence-based practice in pressure ulcer prevention and management in an integrated community care setting: A qualitative study informed by the theoretical domains framework.

Pressure ulcer reduction is a healthcare priority. Good clinical guidelines have the potential to transform pressure ulcer prevention and management practices. However, evidence suggests these guidelines are inconsistently utilised.

Identifying people with multiple sclerosis in the Canadian Primary Care Sentinel Surveillance Network.

Background: We validated a case definition for multiple sclerosis using a clinical cohort linked with the Manitoba Primary Care Research Network of the Canadian Primary Care Sentinel Surveillance Network, and applied this definition to describe multiple sclerosis epidemiology using the Canadian Primary Care Sentinel Surveillance Network repository.

Methods: We developed candidate case definitions for multiple sclerosis in the Manitoba Primary Care Research Network using diagnoses and medications. We compared these case definitions to multiple sclerosis diagnoses identified by applying a validated definition to population-based administrative data (reference standard 1) and multiple sclerosis diagnoses recorded by the provincial Multiple Sclerosis Clinic (reference standard 2) using sensitivity, specificity, positive predictive value and negative predictive value.

Comparing cancer incidence, stage at diagnosis and outcomes of First Nations and all other Manitobans: a retrospective analysis.

Background: Globally, epidemiological evidence suggests cancer incidence and outcomes among Indigenous peoples are a growing concern. Although historically cancer among First Nations (FN) peoples in Canada was relatively unknown, recent epidemiological evidence reveals a widening of cancer related disparities. However evidence at the population level is limited.

Challenges Associated with Cross-Jurisdictional Analyses using Administrative Health Data and Primary Care Electronic Medical Records in Canada.

Over the last 30 years, public investments in Canada and many other countries have created clinical and administrative health data repositories to support research on health and social services, population health and health policy. However, there is limited capacity to share and use data across jurisdictional boundaries, in part because of inefficient and cumbersome procedures to access these data and gain approval for their use in research. A lack of harmonization among variables and indicators makes it difficult to compare research among jurisdictions.

Association of the Social Determinants of Health With Quality of Primary Care.

Purpose: In primary care, there is increasing recognition of the difficulty of treating patients' immediate health concerns when their overall well-being is shaped by underlying social determinants of health. We assessed the association of social complexity factors with the quality of care patients received in primary care settings.

Methods: Eleven social complexity factors were defined using administrative data on poverty, mental health, newcomer status, and justice system involvement from the Manitoba Population Research Data Repository.

An Unconditional Prenatal Income Supplement Reduces Population Inequities In Birth Outcomes.

The Commission on Social Determinants of Health, sponsored by the World Health Organization, has identified measuring health inequities and evaluating interventions to reduce them as important priorities. We examined whether an unconditional prenatal income supplement for low-income women was associated with reduced population-level inequities in birth outcomes. We identified all mother-newborn pairs from the period 2003-10 in Manitoba, Canada, and divided them into the following three groups: low income exposed (received the supplement); low income unexposed (did not receive the supplement); and not low income unexposed (ineligible for the supplement).

Families First Home Visiting programme reduces population-level child health and social inequities.

Background: Home visiting has been shown to reduce child maltreatment and improve child health outcomes. In this observational study, we explored whether Families First, a home visiting programme in Manitoba, Canada, decreased population-level inequities in children being taken into care of child welfare and receiving complete childhood immunisations.

Methods: De-identified administrative health and social services data for children born 2003-2009 in Manitoba were linked to home visiting programme data.

Increasing medication adherence and income assistance access for first-episode psychosis patients.

Background: Assertive community treatment for first-episode psychosis programs have been shown to improve symptoms and reduce service use. There is little or no evidence on whether these programs can increase access to income assistance and improve medication adherence in first episode psychosis patients. This research examines the impact of the Early Psychosis Prevention and Intervention Service (EPPIS) on these outcomes.

Is the Families First Home Visiting Program Effective in Reducing Child Maltreatment and Improving Child Development?

While home visiting programs are among the most widespread interventions to support at-risk families, there is a paucity of research investigating these programs under real-world conditions. The effectiveness of Families First home visiting (FFHV) was examined for decreasing rates of being in care of child welfare, decreasing hospitalizations for maltreatment-related injuries, and improving child development at school entry. Data for 4,562 children from home visiting and 5,184 comparison children were linked to deidentified administrative health, social services, and education data.

A Multimodal Intervention for Children with ADHD Reduces Inequity in Health and Education Outcomes.

Objective: To evaluate whether a multimodal intervention for children with attention-deficit hyperactivity disorder (ADHD) resulted in better long-term health and education outcomes and reduced inequity across the socioeconomic gradient.

Method: We analyzed administrative data held in the Manitoba Population Research Data Repository describing recipients of a combined pharmacological/behavioural intervention for ADHD. The study cohort included children aged 5 to 17 years who visited the Manitoba Adolescent Treatment Centre's ADHD intervention service at least 3 times (2007-2012).

Teen clinics: missing the mark? Comparing pregnancy and sexually transmitted infections rates among enrolled and non-enrolled adolescents.

Background: In Manitoba, Canada, school-based clinics providing sexual and reproductive health services for adolescents have been implemented to address high rates of sexually transmitted infections (STIs) and pregnancies.

Methods: The objectives of this population-based study were to compare pregnancy and STI rates between adolescents enrolled in schools with school-based clinics, those in schools without clinics, and those not enrolled in school. Data were from the PATHS Data Resource held in the Population Health Research Data Repository housed at the Manitoba Centre for Health Policy.

Unconditional Prenatal Income Supplement and Birth Outcomes.

Background And Objectives: Perinatal outcomes have improved in developed countries but remain poor for disadvantaged populations. We examined whether an unconditional income supplement to low-income pregnant women was associated with improved birth outcomes.

Methods: This study included all mother-newborn pairs (2003-2010) in Manitoba, Canada, where the mother received prenatal social assistance, the infant was born in the hospital, and the pair had a risk screen (N = 14 591).

Does a pay-for-performance program for primary care physicians alleviate health inequity in childhood vaccination rates?

Introduction: Childhood vaccination rates in Manitoba populations with low socioeconomic status (SES) fall significantly below the provincial average. This study examined the impact of a pay-for-performance (P4P) program called the Physician Integrated Network (PIN) on health inequity in childhood vaccination rates.

Methods: The study used administrative data housed at the Manitoba Centre for Health Policy.

Can opportunities be enhanced for vaccinating children in home visiting programs? A population-based cohort study.

Background: Home visiting programs focused on improving early childhood environments are commonplace in North America. A goal of many of these programs is to improve the overall health of children, including promotion of age appropriate vaccination. In this study, population-based data are used to examine the effect of a home visiting program on vaccination rates in children.