Overlap between child protection services and the youth justice system: protocol for a retrospective population-based cohort study using linked administrative data in Manitoba, Canada.

Introduction: Children who have a history of involvement in child protection services (CPS) are over-represented in the youth and adult criminal justice systems. There are significant health and socioeconomic implications for individuals involved in either or both CPS and the justice system. Understanding the 'overlap' between these two systems would provide insight into the health and social needs of this population.

The Intersection between Criminal Accusations, Victimization, and Mental Disorders: A Canadian Population-Based Study.

Objective: Understand the relationship between criminal accusations, victimization, and mental disorders at a population level using administrative data from Manitoba, Canada.

Method: Residents aged 18 to 64 between April 1, 2007, and March 31, 2012 ( = 793,024) with hospital- and physician-diagnosed mental disorders were compared to those without. Overall and per-person rates of criminal accusations and reported victimization in the 2011/2012 fiscal year were examined.

Prevalence of mental disorders among all justice-involved: A population-level study in Canada.

More than 10 million people are imprisoned around the world, with many more who encounter the justice system. However, most studies examining the mental health burden in the justice system have examined only incarcerated individuals, with few looking at both criminal offending and victimization at the population-level. This study aimed to describe the population-level prevalence of mental disorders among the entirety of justice-involved individuals in a Canadian sample.

Risk and associated factors for a future schizophrenia diagnosis after an index diagnosis of unspecified psychotic disorder: A population-based study.

A significant minority of unspecified psychosis presentations progress to schizophrenia. Clinical risk factors can inform targeted referral to specialized treatment programs, but few population studies have examined this. In this study, we used health administrative data for a population-based cohort from Manitoba, Canada to characterize the risk and identify vulnerable subgroups for a future diagnosis of schizophrenia after a diagnosis of unspecified psychotic disorder.

Health, Social, Education, and Justice Outcomes of Manitoba First Nations Children Diagnosed with Fetal Alcohol Spectrum Disorder: A Population-Based Cohort Study of Linked Administrative Data.

Objective: To examine health services, social services, education, and justice system outcomes among First Nations children and youth with fetal alcohol spectrum disorder (FASD).

Methods: In this retrospective cohort study, health and social services, education, and justice data were linked with clinical records on First Nations (FN) individuals aged 1 to 25 and diagnosed with FASD between 1999 and 2010 ( = 743). We compared the FN FASD group to non-FN individuals with FASD (non-FN FASD; = 315) and to First Nations individuals (matched on age, sex, and income) not diagnosed with FASD (FN non-FASD; = 2229).

Admission to hospital for pneumonia and influenza attributable to 2009 pandemic A/H1N1 influenza in First Nations communities in three provinces of Canada.

Background: Early reports of the 2009 A/H1N1 influenza pandemic (pH1N1) indicated that a disproportionate burden of illness fell on First Nations reserve communities. In addition, the impact of the pandemic on different communities may have been influenced by differing provincial policies. We compared hospitalization rates for pneumonia and influenza (P&I) attributable to pH1N1 influenza between residents of First Nations reserve communities and the general population in three Canadian provinces.

Use of health, education, and social services by individuals with fetal alcohol spectrum disorder.

Background: Fetal Alcohol Spectrum Disorder (FASD) is the leading cause of intellectual disability in western society, presenting a significant burden on health, education and social services. Quantifying the burden of FASD is important for service planning and policy and program development.

Objective: To describe the health, education and social service use of individuals with FASD to provide an indication of the burden of service use of the disorder.

The ripples of adolescent motherhood: social, educational, and medical outcomes for children of teen and prior teen mothers.

Objective: We examined medical, educational and social risks to children of teen mothers and children of nonadolescent mothers with a history of teen birth (prior teen mothers) and considered these risks at both the individual and societal level.

Methods: A population-based, retrospective cohort study tracked outcomes through young adulthood for children born in Manitoba, Canada (n = 32 179). chi(2) and logistic regression analyses examined risk of childhood death or hospitalization, failure to graduate high school, intervention by child protective services, becoming a teen mother, and welfare receipt as a young adult.

From health research to social research: privacy, methods, approaches.

Information-rich environments in Canada, Australia, and the United Kingdom have been built using record linkage techniques with population-based health insurance systems and longitudinal administrative data. This paper discusses the issues in extending population-based administrative data from health to additional topics more generally connected with well being. The scope of work associated with a multi-faceted American survey, the Panel Study in Income Dynamics (PSID), is compared with that of the administrative data in Manitoba, Canada.

The effect of socioeconomic status on bone density testing in a public health-care system.

Introduction And Hypothesis: An inverse relationship exists between socio-economic status (SES) and osteoporotic fractures. In publicly funded health-care systems there should be no barriers to accessing bone mineral density (BMD) testing, especially for those at increased fracture risk. Our hypothesis was that there would be a positive association between SES and BMD utilization (i.

Socioeconomic status and the utilization of diagnostic imaging in an urban setting.

Background: In publicly funded health care systems, the utilization of health care services should be equitable, irrespective of socioeconomic status (SES). Although the association between SES and health care utilization has been examined in Canada relative to surgical, cardiac and preventive health care services, no published studies have specifically explored the association between SES and diagnostic imaging.

Methods: We examined over 300,000 diagnostic imaging claims made in the Winnipeg Regional Health Authority between Apr.

Trends in the health status of older Manitobans, 1985 to 1999.

Trends in the health status of the entire senior population aged 65 years or older in Manitoba were examined over a 14-year period (1985-1999) using administrative data (about 50,000 individuals). Significant health gains were apparent for a number of important indicators, including acute myocardial infarction, stroke, cancer, and hip fractures, although some of these gains were restricted to urban areas. Improvements in these health indicators are significant, as they can have major implications for individuals' need for health services and ability to live independently.

A methodology for estimating hospital bed need in Manitoba in 2020.

A team of health researchers of the Manitoba Centre for Health Policy at the University of Manitoba was asked to forecast the number of acute care hospital beds that will be required to meet the needs of residents of the province of Manitoba by the year 2020. Methodological considerations for this request included identification of factors expected to affect bed use in the future, and how to account for these factors. The objective of this paper is to describe these methodological considerations, how decisions were made, and steps taken in our approach to this problem.

Anticipating change: how many acute care hospital beds will Manitoba regions need in 2020?

Being able to anticipate future needs for health services presents a challenge for health planners. Using existing population projections, two models are presented to estimate the demand for hospital beds in regions of Manitoba in 2020. The first, a current-use projection model, simply projects the average use for a recent 3-year period into the future.

Exploring reasons for bed pressures in Winnipeg acute care hospitals.

Hospital overcrowding has plagued Winnipeg and other Canadian cities for years. This study explored factors related to overcrowding. Hospital files were used to examine patterns of hospital use from fiscal years 1996/1997 to 1999/2000.

Construction and validation of a population-based bone densitometry database.

Utilization of dual-energy X-ray absorptiometry (DXA) for the initial diagnostic assessment of osteoporosis and in monitoring treatment has risen dramatically in recent years. Population-based studies of the impact of DXA and osteoporosis remain challenging because of incomplete and fragmented test data that exist in most regions. Our aim was to create and assess completeness of a database of all clinical DXA services and test results for the province of Manitoba, Canada and to present descriptive data resulting from testing.

Potential savings from reducing inequalities in health.

Background: Numerous studies have established that socio-economic position is positively related to health status, but we know little about the real costs of these differences across an entire population. This paper estimates the potential savings in morbidity and dollars from reducing the inequalities in health among Winnipeg residents.

Methods: We measure excess morbidity by examining rates of premature death, hip fracture, and heart attack according to the relative affluence of the Winnipeg neighbourhood.

A population-based study of osteoporosis testing and treatment following introduction of a new bone densitometry service.

Bone density measurement plays a key role in the initial diagnostic assessment of osteoporosis and in targeting pharmacologic therapies. The impact of access to dual-energy X-ray absorptiometry (DXA) on physician prescribing habits is unclear, however. We were able to directly evaluate the change in physician osteoporosis testing and prescribing following introduction of a DXA testing service in a geographic region that had previously had very limited access.

Does universal comprehensive insurance encourage unnecessary use? Evidence from Manitoba says "no".

Background: Many argue that "free" medical care leads to unnecessary use of health resources. Evidence suggests that user fees do discourage physician use, at least by those of low socioeconomic status. In this study, we compare health care utilization and health among socioeconomic groups to determine whether people of low socioeconomic status see physicians more than would be expected given their health status.

Seasonal patterns of hospital use in Winnipeg: implications for managing winter bed crises.

This study examined whether Winnipeg hospitals experience predictable "high-volume periods" in order to determine whether hospital overcrowding might be anticipated and, therefore, avoided. We found that high-volume periods among medical patients occurred during all but one year between 1987 and 1998. Most high-volume periods occurred during influenza seasons.

The impact of influenza-associated respiratory illnesses on hospitalizations, physician visits, emergency room visits, and mortality.

Objectives: Although the increased risk of hospitalization and mortality during influenza seasons has been documented extensively, there is a relative paucity of research on the impact of influenza-related illnesses on other health care use indicators, such as physician use. The purpose of this study was to examine the impact of influenza-associated respiratory illnesses on the Winnipeg health care system, including hospitalizations, physician visits and emergency room visits. Their impact on mortality was also examined.

Assessing population health care need using a claims-based ACG morbidity measure: a validation analysis in the Province of Manitoba.

Objectives: To assess the ability of an Adjusted Clinical Group (ACG)-based morbidity measure to assess the overall health service needs of populations. Data Sources/Study Setting. Three population-based secondary data sources: registration and health service utilization data from fiscal year 1995-1996; mortality data from vital statistics reports from 1996-1999; and Canadian census data.

Hospitalizations and deaths due to respiratory illnesses during influenza seasons: a comparison of community residents, senior housing residents, and nursing home residents.

Background: Although research indicates that influenza is a major cause of morbidity and mortality among older adults, few studies have tried to identify which seniors are particularly at risk of experiencing complications of influenza. The purpose of this study was to compare hospitalizations and deaths due to respiratory illnesses during influenza seasons among seniors (aged 65+) living in the community, senior residences (apartments reserved for seniors), and nursing homes.

Methods: Using administrative data, all hospital admissions and deaths due to respiratory illnesses (pneumonia and influenza, chronic lung disease, and acute respiratory diseases) were identified for all individuals aged 65 and older living in Winnipeg, Canada (approximately 88,000 individuals) during four influenza seasons (1995-1996 to 1998-1999).

Performance of the ACG case-mix system in two Canadian provinces.

Background: While the adjusted clinical group (ACG) system has been extensively validated in the United States, its use in other developed nations has been limited. This article examines the performance of the system in 2 Canadian provinces and assesses the extent to which ACGs can account for same-year and next-year health care expenditures.

Methods: The study population included all residents of Manitoba and British Columbia who were continuously enrolled in the provincial health plans from April 1, 1995, to March 31, 1997.