Healthcare utilization during transition to adult care in patients with spina bifida A population-based, longitudinal study in Ontario, Canada.

Introduction: Individuals with spina bifida (SB) may experience negative health outcomes because of an informal transition from pediatric to adult care that results in using the emergency room (ER ) for non-acute health problems.

Methods: We conducted a retrospective, population-based cohort study of all people with SB in Ontario, Canada turning 18 years old between 2002 and 2011. These patients were followed for five years before and after age 18.

Interprofessional Primary Care and Acute Care Hospital Use by People With Dementia: A Population-Based Study.

Purpose: Interprofessional primary care has the potential to optimize hospital use for acute care among people with dementia. We compared 1-year emergency department (ED) visits and hospitalizations among people with dementia enrolled in a practice having an interprofessional primary care team with those enrolled in a physician-only group practice.

Methods: A population-based, repeated cohort study design was used to extract yearly cohorts of 95,323 community-dwelling people in Ontario, Canada, newly identified in administrative data with dementia between April 1, 2005 and March 31, 2015.

The quality of diabetes care among cancer survivors: a retrospective cohort study.

Background: As cancer survivorship continues to improve, management of co-morbid diabetes has become an increasingly important determinant of health outcomes for people with cancer. This study aimed to compare indicators of diabetes quality of care between people with diabetes and without a history of cancer.

Methods: We used the Electronic Medical Record Administrative data Linked Database (EMRALD), a database of Ontario primary care EMR charts linked to administrative data, to identify people with diabetes and at least 1 year follow-up.

Sex Differences in Dementia Primary Care Performance and Health Service Use: A Population-Based Study.

Objectives: Growing evidence points to underlying sex differences in the risk factors and clinical presentation of dementia. It is unclear, however, whether sex differences also exist in the management and healthcare utilization of persons with dementia. We compared primary care performance and health service use indicators for newly identified men and women with dementia in Ontario, Canada, over a 12-year period.

Interfacility patient sharing and infection incidence in the Ontario hospital system: A 13-year cohort study.

Objective: Interfacility patient movement plays an important role in the dissemination of antimicrobial-resistant organisms throughout healthcare systems. We evaluated how 3 alternative measures of interfacility patient sharing were associated with C. difficile infection incidence in Ontario acute-care facilities.

Predictors and variability of antibiotic prescribing amongst family physicians.

Background: Rising rates of antimicrobial resistance are driven by overuse of antibiotics. Characterizing physician antibiotic prescribing variability can inform interventions to optimize antibiotic use.

Objectives: To describe predictors of overall antibiotic prescribing as well as the inter-physician variability in antibiotic prescribing amongst family physicians.

End-of-Life Strategies among Patients with Advanced Chronic Obstructive Pulmonary Disease.

Rationale: The burden of advanced chronic obstructive pulmonary disease (COPD) is high globally; however, little is known about how often end-of-life strategies are used by this population.

Objectives: To describe trends in the use of end-of-life care strategies by people with advanced COPD in Ontario, Canada.

Methods: A population-based repeated cross-sectional study examining end-of-life care strategies in individuals with advanced COPD was conducted.

Trends in needlestick injury incidence following regulatory change in Ontario, Canada (2004-2012): an observational study.

Background: A number of jurisdictions have used regulation to promote the adoption of safety-engineered needles as a primary solution to reduce the risk of needlestick injuries among healthcare workers. Regulatory change has not been complemented by ongoing efforts to monitor needlestick injury trends which limits opportunities to evaluate the need for additional investment in this area. The objective of this study was to describe trends in the incidence of needlestick injuries in Ontario prior to and following the establishment of regulation to promote the adoption of safety-engineered needles.

Diverging trends in the incidence of occupational and nonoccupational injury in Ontario, 2004-2011.

Objectives: We describe trends in occupational and nonoccupational injury among working-age adults in Ontario.

Methods: We conducted an observational study of adults aged 15 to 64 over the period 2004 through 2011, estimating the incidence of occupational and nonoccupational injury from emergency department (ED) records and, separately, from survey responses to 5 waves of a national health interview survey.

Results: Over the observation period, the annual percentage change (APC) in the incidence of work-related injury was -5.

Time trends in musculoskeletal disorders attributed to work exposures in Ontario using three independent data sources, 2004-2011.

Objective: Work-related musculoskeletal disorders (MSDs) are the leading cause of work disability in the developed economies. The objective of this study was to describe trends in the incidence of MSDs attributed to work exposures in Ontario over the period 2004-2011.

Methods: An observational study of work-related morbidity obtained from three independent sources for a complete population of approximately six million occupationally active adults aged 15-64 in the largest Canadian province.

Work-attributed illness arising from excess heat exposure in Ontario, 2004-2010.

Objective: To describe the incidence of occupational heat illness in Ontario.

Methods: Heat illness events were identified in two population-based data sources: work-related emergency department (ED) records and lost time claims for the period 2004-2010 in Ontario, Canada. Incidence rates were calculated using denominator estimates from national labour market surveys and estimates were adjusted for workers' compensation insurance coverage.

Mortality following unemployment in Canada, 1991-2001.

Background: This study describes the association between unemployment and cause-specific mortality for a cohort of working-age Canadians.

Methods: We conducted a cohort study over an 11-year period among a broadly representative 15% sample of the non-institutionalized population of Canada aged 30-69 at cohort inception in 1991 (888,000 men and 711,600 women who were occupationally active). We used cox proportional hazard models, for six cause of death categories, two consecutive multi-year periods and four age groups, to estimate mortality hazard ratios comparing unemployed to employed men and women.

Overqualification and risk of all-cause and cardiovascular mortality: evidence from the Canadian Census Mortality Follow-up Study (1991-2001).

Objectives: To evaluate whether education, occupation and overqualification (defined as having a level of educational attainment higher than the skill level required for an occupation) are associated with risk of all-cause and cardiovascular disease (CVD) mortality.

Method: A prospective study of the association between overqualification and all-cause and CVD mortality was undertaken in the Canadian Census Mortality Follow-up study (1991-2001), a 15% sample of Canadian adults who completed the 1991 census long-form questionnaire (n=1,091,800, 39% women, baseline age 35-64 years). Education, occupation and all confounders (age, income adequacy, marital status, years since immigration, ethnicity, Aboriginal origins, province of residence, and community size) were measured at study baseline, with subsequent follow-up for mortality.

Avoidable mortality for causes amenable to medical care, by occupation in Canada, 1991-2001.

Objective: To describe the incidence of avoidable mortality for causes amenable to medical care among occupation groups in Canada.

Method: A cohort study over an 11-year period among a representative 15% sample of the non-institutionalized population of Canada aged 30-69 at cohort inception. Age-standardized mortality rates for causes amenable to medical care and all other causes of death were calculated for occupationally-active men and women in five categories of skill level and 80 specific occupational groups as well as for persons not occupationally active.