Using administrative data to measure the extent to which practitioners work together: "interconnected" care is common in a large cohort of family physicians.

Background: Health care practitioners in jurisdictions around the world are encouraged to work in groups. The extent to which they actually do so, however, is not often measured. The purpose of this paper is to demonstrate the potential for administrative data to measure how practitioners are interconnected through their care of patients.

Financial and work satisfaction: impacts of participation in primary care reform on physicians in ontario.

Governments in Ontario have promised family physicians (FPs) that participation in primary care reform would be financially as well as professionally rewarding. We compared work satisfaction, incomes and work patterns of FPs practising in different models to determine whether the predicted benefits to physicians really materialized. Study participants included 332 FPs in Ontario practising in five models of care.

Predictors of universal influenza vaccination uptake in grades 1 and 2 Toronto school children: effective vaccination strategies should not end with at risk children.

The first population-based survey to determine predictors of influenza vaccination among children in a major metropolitan city with access to publicly funded health care and a universal influenza immunization program (UIIP). Previously collected demographic and health related data from 5619 school children aged 5-9 in Toronto, in 2006 were used to predict influenza vaccination. Vaccination was more likely in children with current asthma (OR 1.

School-based influenza vaccine delivery, vaccination rates, and healthcare use in the context of a universal influenza immunization program: an ecological study.

Influenza vaccines are universally funded in Ontario, Canada. Some public health units (PHUs) vaccinate children in schools. We examined the impact of school-based delivery on vaccination rates and healthcare use of the entire population over seven influenza seasons (2000-2007) using population-based survey and health administrative data.

The effect of universal influenza immunization on antibiotic prescriptions: an ecological study.

The Canadian province of Ontario introduced universal influenza immunization in 2000, offering free vaccines to the entire population. We compared changes in rates of influenza-associated respiratory antibiotic prescriptions before and after universal immunization in Ontario with corresponding changes in other provinces. Universal influenza immunization is associated with reduced influenza-associated antibiotic prescriptions.

Influenza vaccination rates in Ontario children: implications for universal childhood vaccination policy.

The aims of this study were to estimate influenza vaccination coverage for children during the 2006-2007 influenza season in Ontario, Canada, where universal vaccination is available, and to compare the rate among children aged 6-23 months with corresponding rates from other Canadian provinces that specifically target this high-risk group. We conducted a telephone survey of caregivers of children aged 6 months-11 years that included 4854 children from 3029 households. Ontario's vaccination rate (complete and partial coverage combined) for children aged 2-11 years was 28.

Chronic disease risk factors associated with health service use in the elderly.

Background: To examine the association between number and combination of chronic disease risk factors on health service use.

Methods: Data from the 1995 Nova Scotia Health Survey (n = 2,653) was linked to provincial health services administrative databases. Multivariate regression models were developed that included important interactions between risk factors and were stratified by sex and at age 50.

The 2006 Canadian dyslipidemia guidelines will prevent more deaths while treating fewer people--but should they be further modified?

Background: When clinical guidelines affect large numbers of individuals or substantial resources, it is important to understand their benefits, harms and costs from a population perspective. Many countries' dyslipidemia guidelines include these perspectives.

Objective: To compare the effectiveness and efficiency of the 2003 and 2006 Canadian dyslipidemia guidelines for statin treatment in reducing deaths from coronary artery disease (CAD) in the Canadian population.

Inequitable access for mentally ill patients to some medically necessary procedures.

Background: Although universal health care aims for equity in service delivery, socioeconomic status still affects death rates from ischemic heart disease and stroke as well as access to revascularization procedures. We investigated whether psychiatric status is associated with a similar pattern of increased mortality but reduced access to procedures. We measured the associations between mental illness, death, hospital admissions and specialized or revascularization procedures for circulatory disease (including ischemic heart disease and stroke) for all patients in contact with psychiatric services and primary care across Nova Scotia.

Mortality in individuals who have had psychiatric treatment: population-based study in Nova Scotia.

Background: Most studies of mortality in psychiatric patients have investigated in-patients rather than those attending out-patient clinics or primary care, where most receive treatment.

Aims: To evaluate the mortality risk in mental illness for patients in contact with psychiatric services or primary care (n=221 048) across Nova Scotia (population 936 025).

Method: A population-based record-linkage analysis was made of the period 1995-2000, using an inception cohort to calculate mortality rate ratios.