Reporting a regular medical doctor index: A new measure of patient-physician affiliation for health administrative data.

Having a regular medical doctor is associated with better process of care and health outcomes. The goal of this study was to harness the richness in health administrative data to create a measure which accurately predicted whether patients self-identified as having a regular medical doctor. The Canadian Community Health Survey (2007-2012) was linked with health administrative data (HAD) (2002-2012) from Quebec, Canada's second largest province.

Probabilistic bias analysis for exposure misclassification of household income by neighbourhood in a cohort of individuals with colorectal cancer.

Introduction: Despite poor agreement, neighbourhood income is used as a proxy for household income, due to a lack of data availability. We quantified misclassification between household and neighbourhood income and demonstrate quantitative bias analysis (QBA) in scenarios where only neighbourhood income is available in assessing income inequalities on colorectal cancer mortality.

Methods: This was a retrospective study of adults with colorectal cancer diagnosed 2006-14 from Statistics Canada's Canadian Census Health and Environment Cohort.

Paid Family Leave and Prevention of Acute Respiratory Infections in Young Infants.

Importance: Acute respiratory tract infections are the leading cause of emergency department visits and hospitalizations in US children, with highest risks in the first 2 months after birth. Out-of-home childcare settings increase the spread of respiratory tract infections. The study team hypothesized that access to state-paid family leave could reduce acute care encounters (hospital admissions or emergency department visits) for respiratory tract infections in young infants by reducing out-of-home childcare transmissions.

Income differences in time to colon cancer diagnosis.

Introduction: People with low income have worse outcomes throughout the cancer care continuum; however, little is known about income and the diagnostic interval. We described diagnostic pathways by neighborhood income and investigated the association between income and the diagnostic interval.

Methods: This was a retrospective cohort study of colon cancer patients diagnosed 2007-2019 in Ontario using routinely collected data.

Agreement between individual and neighborhood income measures in patients with colorectal cancer in Canada.

Introduction: With increasing interest in income-related differences in cancer outcomes, accurate measurement of income is imperative. Misclassification of income can result in wrong conclusions as to the presence of income inequalities. We determined misclassification between individual- and neighborhood-level income and their association with overall survival among colorectal cancer (CRC) patients.

Health care services use, stillbirth, and neonatal and infant survival following implementation of the Maternal Health Voucher Scheme in Bangladesh: A difference-in-differences analysis of Bangladesh Demographic and Health Survey data, 2000 to 2016.

Background: Starting in 2006 to 2007, the Government of Bangladesh implemented the Maternal Health Voucher Scheme (MHVS). This program provides pregnant women with vouchers that can be exchanged for health services from eligible public and private sector providers. In this study, we examined whether access to the MHVS was associated with maternal health services utilization, stillbirth, and neonatal and infant mortality.

Antenatal corticosteroid administration and attention-deficit/hyperactivity disorder in childhood: a regression discontinuity study.

Background: Antenatal corticosteroids reduce respiratory morbidity in preterm infants, but their use during late preterm gestation (34-36 weeks) is limited because their safety for longer-term child neurodevelopment is unclear. We sought to determine if fetuses with higher probability of exposure to antenatal corticosteroids had increased rates of prescriptions for attention-deficit/hyperactivity disorder (ADHD) medication in childhood, using a quasiexperimental design that better controls for confounding than existing observational studies.

Methods: We identified 16 358 children whose birthing parents were admitted for delivery between 31 + 0 (31 weeks, 0 days) and 36 + 6 weeks' gestation in 2000-2013, using a perinatal data registry from British Columbia, Canada, and linked their records with population-based child ADHD medication data (2000-2018).

The effects of early pregnancy loss on health outcomes and health care utilization and costs.

Objective: To evaluate the effects of early pregnancy loss on subsequent health care use and costs.

Data Sources: Linked administrative health databases from Manitoba, Canada.

Study Design: This was a population-based cohort study.

Evaluating Montréal's harm reduction interventions for people who inject drugs: protocol for observational study and cost-effectiveness analysis.

Introduction: The main harm reduction interventions for people who inject drugs (PWID) are supervised injection facilities, needle and syringe programmes and opioid agonist treatment. Current evidence supporting their implementation and operation underestimates their usefulness by excluding skin, soft tissue and vascular infections (SSTVIs) and anoxic/toxicity-related brain injury from cost-effectiveness analyses (CEA). Our goal is to conduct a comprehensive CEA of harm reduction interventions in a setting with a large, dispersed, heterogeneous population of PWID, and include prevention of SSTVIs and anoxic/toxicity-related brain injury as measures of benefit in addition to HIV, hepatitis C and overdose morbidity and mortalities averted.

Antenatal corticosteroid administration and early school age child development: A regression discontinuity study in British Columbia, Canada.

Background: There are growing concerns that antenatal corticosteroid administration may harm children's neurodevelopment. We investigated the safety of antenatal corticosteroid administration practices for children's overall developmental health (skills and behaviors) at early school age.

Methods And Findings: We linked population health and education databases from British Columbia (BC), Canada to identify a cohort of births admitted to hospital between 31 weeks, 0 days gestation (31+0 weeks), and 36+6 weeks, 2000 to 2013, with routine early school age child development testing.

Evaluating the intended and unintended consequences of opioid-prescribing interventions on primary care in British Columbia, Canada: protocol for a retrospective population-based cohort study.

Introduction: Between 2015 and 2018, there were over 40 000 opioid-related overdose events and 4551 deaths among residents in British Columbia (BC). During this time the province mobilised a variety of policy levers to encourage physicians to expand access to opioid agonist treatment and the College of Physicians and Surgeons of British Columbia (CPSBC) released a practice standard establishing legally enforceable minimum thresholds of professional behaviour in the hopes of curtailing overdose events. Our goal is to conduct a comprehensive investigation of the intended and unintended consequences of these policy changes.

Public health investments: neglect or wilful omission? Historical trends in Quebec and implications for Canada.

This commentary explores public health (PH) investments in Quebec and underlines the challenge of tracking PH resources across Canada. We analyzed governmental data to compare investments across all health and social programs in Quebec from 2004-2005 to 2017-2018. The province's PH budgets suffered from disproportionately low investments and abrupt cuts.

The Impact of Team-Based Primary Care on Guideline-Recommended Disease Screening.

Introduction: Family Medicine Groups, implemented in Quebec in 2002, are interprofessional primary care teams designed to improve timely access to high-quality primary care. This study investigates whether Family Medicine Groups increased rates of guideline-recommended screenings for 3 chronic diseases: colorectal cancer (colonoscopy/sigmoidoscopy), breast cancer (mammography), and osteoporosis (bone mineral density testing).

Methods: Using population-based administrative health data from the provincial insurer (2000-2010), the authors examined elderly and chronically ill patients who registered with a general practitioner in the first 15 months of the Family Medicine Group policy.

The Impact of Parental and Medical Leave Policies on Socioeconomic and Health Outcomes in OECD Countries: A Systematic Review of the Empirical Literature.

Unlabelled: Policy Points: Historically, reforms that have increased the duration of job-protected paid parental leave have improved women's economic outcomes. By targeting the period around childbirth, access to paid parental leave also appears to reduce rates of infant mortality, with breastfeeding representing one potential mechanism. The provision of more generous paid leave entitlements in countries that offer unpaid or short durations of paid leave could help families strike a balance between the competing demands of earning income and attending to personal and family well-being.

Effect of a conditional cash transfer program on length-for-age and weight-for-age in Brazilian infants at 24 months using doubly-robust, targeted estimation.

Objective: Conditional cash transfer programs are popular internationally and represent a large investment in child health. Evidence of their impact on child nutrition status remains weak and inconsistent, particularly for Bolsa Família, the Brazilian conditional cash transfer program and one of the world's largest. Our objective was to estimate the effect of the Brazilian conditional cash transfer program, Bolsa Família (BF), on child nutritional status as measured by length-for-age z-score (LAZ) and weight-for-age z-score (WAZ) at 24 months.

The impact of eliminating primary school tuition fees on child marriage in sub-Saharan Africa: A quasi-experimental evaluation of policy changes in 8 countries.

Background: Child marriage harms girls' health and hinders progress toward development goals. Randomized studies have shown that providing financial incentives for girls' education can effectively delay marriage, but larger-scale interventions are needed in light of slow progress toward curbing the practice. Many sub-Saharan African countries eliminated primary school tuition fees over the past two decades, resulting in massive increases in enrolment.

Optimal Timing of Physician Visits after Hospital Discharge to Reduce Readmission.

Objective: To identify the optimal timing of in-person physician visit after hospital discharge to yield the largest reduction in readmission among elderly or chronically ill patients.

Data Sources/study Setting/extraction Methods: We extracted insurance billing data on 620,656 admissions for any cause from 2002 to 2009 in Quebec, Canada.

Study Design: We used flexible survival models to estimate inverse probability weights for the precise timing (days) of in-person physician visit after discharge and weighted competing risk outcome models.

Measuring colorectal cancer incidence: the performance of an algorithm using administrative health data.

Background: Certain cancer case ascertainment methods used in Quebec and elsewhere are known to underestimate the burden of cancer, particularly for some subgroups. Algorithms using claims data are a low-cost option to improve the quality of cancer surveillance, but have not frequently been implemented at the population-level. Our objectives were to 1) develop a colorectal cancer (CRC) case ascertainment algorithm using population-level hospitalization and physician billing data, 2) validate the algorithm, and 3) describe the characteristics of cases.

Disparities in direct acting antivirals uptake in HIV-hepatitis C co-infected populations in Canada.

Background: Direct acting antivirals (DAAs) have revolutionized hepatitis C (HCV) treatment with >90% cure rates even in real-world studies, giving hope that HCV can be eliminated. However, for DAAs to have a population-level impact on the burden of HCV disease, treatment uptake needs to be expanded. We investigated temporal trends in HCV treatment uptake and evaluated factors associated with second-generation DAA initiation and efficacy among key HIV-HCV co-infected populations in Canada.

Inter-institutional Variation in Use of Caesarean Delivery for Labour Dystocia.

Objective: To establish the degree of variation across hospitals in the use of Caesarean delivery for the indication of labour dystocia before and after accounting for maternal, fetal, and hospital characteristics.

Methods: This study was a retrospective, population-based cohort study of nulliparous women delivering term singletons in cephalic position following labour. Delivery visits were extracted from three provincial perinatal registries in the Canadian provinces of Ontario, Alberta, and British Columbia, from 2008-2012.

Did the Great Recession affect mortality rates in the metropolitan United States? Effects on mortality by age, gender and cause of death.

Objectives: Mortality rates generally decline during economic recessions in high-income countries, however gaps remain in our understanding of the underlying mechanisms. This study estimates the impacts of increases in unemployment rates on both all-cause and cause-specific mortality across U.S.

Primary Enforcement of Mandatory Seat Belt Laws and Motor Vehicle Crash Deaths.

Introduction: Policies that allow directly citing motorists for seat belt non-use (primary enforcement) have been shown to reduce motor vehicle crash deaths relative to secondary enforcement, but the evidence base is dated and does not account for recent improvements in vehicle designs and road safety. The purpose of this study was to test whether recent upgrades to primary enforcement still reduce motor vehicle crash deaths.

Methods: In 2016, researchers used motor vehicle crash death data from the Fatal Analysis Reporting System for 2000-2014 and calculated rates using both person- and exposure-based denominators.