The Determinants of the Technical Efficiency of Acute Inpatient Care in Canada.

Objective: To evaluate the technical efficiency of acute inpatient care at the pan-Canadian level and to explore the factors associated with inefficiency-why hospitals are not on their production frontier.

Data Sources/study Setting: Canadian Management Information System (MIS) database (CMDB) and Discharge Abstract Database (DAD) for the fiscal year of 2012-2013.

Study Design: We use a nonparametric approach (data envelopment analysis) applied to three peer groups (teaching, large, and medium hospitals, focusing on their acute inpatient care only).

A Snapshot of Advance Directives in Long-Term Care: How Often Is "Do Not" Done?

Advance directives allow individuals and their families or legal guardians to communicate preferences for interventions and treatments in the event that these individuals are no longer able to make decisions for themselves. This study examines how often do-not-hospitalize (DNH) and do-not-resuscitate (DNR) directives were recorded for residents in 982 reporting Canadian long-term care facilities between 2009-2010 and 2011-2012 and, to the extent possible, whether these directives were followed in acute care settings. It found that three-quarters of long-term care residents had a directive not to resuscitate and that these directives appeared to be well followed across the continuum; only 1 in 2,500 residents with a DNR received resuscitation in hospital.

Compromised wounds in Canada.

Wounds are a serious healthcare issue with profound personal, clinical and economic implications. Using a working definition of compromised wounds, this study examines the prevalence of wounds by type and by healthcare setting using data from hospitals, home care, hospital-based continuing care and long-term care facilities within fiscal year 2011-2012 in Canada. It also evaluates several risk factors associated with wounds, such as diabetes, circulatory disease and age.

Use of case mix tools for utilization management and planning.

An aging population, new technologies and drugs, and tightening constraints on financial and human resources have placed increased demands on hospitals to meet health care needs. Canadian hospitals, health regions, and ministries are placing a high priority on the evaluation of appropriateness and efficiency of medical care and on the proactive and targeted reduction of inefficiencies. The CMG+ grouping methodology is a case mix tool produced by the Canadian Institute for Health Information (CIHI) to analyze the acute-care inpatient population in Canada.

Medication use and risk of falls.

Purpose: Injuries due to falls are an important public health concern, particularly for the elderly, and effective prevention is an ongoing endeavour. The present study has two related objectives: (1) to describe associations between drug use and falls in an institutionalized population, and (2) to identify a high risk subgroup within the larger population.

Methods: The initial analysis was based on a population of 227 residents who were followed over a 1-year period.