7 results match your criteria: "H.C.W.) Li Ka Shing Knowledge Institute of St. Michael's Hospital[Affiliation]"
Association of Neighborhood-Level Marginalization With Health Care Use and Clinical Outcomes Following Hospital Discharge in Patients Who Underwent Coronary Catheterization for Acute Myocardial Infarction in a Single-Payer Health Care System.
Circ Cardiovasc Qual Outcomes
December 2023
Department of Medicine (L.E.A., H.A.-Q., D.A.A., C.L.A., R.S.B., I.D., A.C.T.H., C.A.J., M.K.K., D.S.L., C.D.M., I.R., M.J.S., J.A.U., H.C.W., D.T.K.), University of Toronto, ON, Canada.
Background: Canadian data suggest that patients of lower socioeconomic status with acute myocardial infarction receive less beneficial therapy and have worse clinical outcomes, raising questions regarding care disparities even in universal health care systems. We assessed the contemporary association of marginalization with clinical outcomes and health services use.
Methods: Using clinical and administrative databases in Ontario, Canada, we conducted a population-based study of patients aged ≥65 years hospitalized for their first acute myocardial infarction between April 1, 2010 and March 1, 2019.
Association of Neighborhood-Level Material Deprivation With Atrial Fibrillation Care in a Single-Payer Health Care System: A Population-Based Cohort Study.
Circulation
July 2022
University Health Network, Toronto, Canada (H.A.-Q., A.C.T.H., C.A.J., D.A.A., R.S.B., M.K.K., K.T., J.A.U., D.S.L.).
Background: There are limited data on the association of material deprivation with clinical care and outcomes after atrial fibrillation (AF) diagnosis in jurisdictions with universal health care.
Methods: This was a population-based cohort study of individuals ≥66 years of age with first diagnosis of AF between April 1, 2007, and March 31, 2019, in the Canadian province of Ontario, which provides public funding and prohibits private payment for medically necessary physician and hospital services. Prescription medications are subsidized for residents >65 years of age.
Population-Based Study on Patterns of Cardiac Stress Testing After Percutaneous Coronary Intervention.
Circ Cardiovasc Qual Outcomes
October 2017
From the Li Ka Shing Knowledge Institute of St. Michael's Hospital, Toronto, Ontario, Canada (A.B.); Terrence Donnelly Heart Center, St. Michael's Hospital, University of Toronto, Ontario, Canada (A.B., A.N.C., A.T.Y., A.D., S.G.G.); Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada (M.E., M.K., H.C.W., D.T.K.); Division of Cardiology, Scripps Clinic and Research Institute, San Diego, CA (S.P.B.); Schulich Heart Centre, Sunnybrook Health Sciences Centre, University of Toronto, Ontario, Canada (H.C.W., D.T.K.); Peter Munk Cardiac Center of the University Health Network, University of Toronto, Ontario, Canada (S.B.); Women's College Hospital Institute for Health Systems Solutions and Virtual Care, Toronto, Ontario, Canada (S.B.); and Canadian VIGOUR Centre, University of Alberta, Edmonton, Canada (P.K., S.G.G.).
Background: The appropriate use criteria considers cardiac stress testing within 2 years after percutaneous coronary intervention (PCI) to be rarely appropriate, unless prompted by symptoms or change in clinical status. Little is known about the patterns of cardiac stress testing after PCI in the single-payer Canadian healthcare system, where mechanisms for reimbursement are different from the United States.
Methods And Results: Frequency and timing of cardiac stress testing within 2 years of PCI performed between April 2004 and March 2013 in Ontario, Canada, was determined from linked provincial databases.
Predictors of Initial Revascularization Versus Medical Therapy Alone in Patients With Non-ST-Segment-Elevation Acute Coronary Syndrome Undergoing an Invasive Strategy.
Circ Cardiovasc Interv
July 2016
From the Schulich Heart Centre, Division of Cardiology, Sunnybrook Health Sciences Centre (H.C.W., M.C.B., D.T.K., J.V.T.) and Institute of Health Policy, Management and Evaluation (H.C.W., D.T.K., J.V.T.), University of Toronto, Ontario, Canada; Institute for Clinical Evaluative Sciences, Ontario, Canada (H.C.W., F.Q., D.T.K., J.V.T.); Li Ka Shing Knowledge Institute of St. Michael's Hospital, Toronto, Ontario, Canada (H.C.W.); Samuel S. Stratton VA Medical Center, Albany Medical Center, Albany Medical College, New York (M.S.S., W.E.B.); and Foothills Hospital, University of Calgary, Alberta, Canada (M.L.K.).
Article Synopsis
- The study examined factors influencing the decision to revascularize versus treat medically in patients with non-ST-segment elevation acute coronary syndrome who underwent early angiography.
- A total of 50,302 patients were analyzed, with about 68.2% receiving revascularization, showing significant variations across hospitals based on the patient's risk level and the interventionist's expertise.
- Revascularization led to better survival rates compared to medical therapy alone, emphasizing the importance of an invasive strategy in improving patient outcomes.
Identifying predictors of cumulative healthcare costs in incident atrial fibrillation: a population-based study.
J Am Heart Assoc
April 2015
Division of Cardiology, Schulich Heart Centre and Department of Medicine, Sunnybrook Health Sciences Centre, University of Toronto, Ontario, Canada (M.C.B., D.T.K., S.M.S., H.C.W.) Institute for Clinical Evaluative Sciences (ICES), Toronto, Ontario, Canada (F.Q., D.T.K., H.C.W.) Li Ka Shing Knowledge Institute of St Michael's Hospital, Toronto, Ontario, Canada (D.T.K., P.D., H.C.W.) Institute of Health Policy, Management and Evaluation, University of Toronto, Ontario, Canada (C.L.A., H.C.W.).
Background: Atrial fibrillation (AF) has substantial impacts on healthcare resource utilization. Our objective was to understand the pattern and predictors of cumulative healthcare costs in AF patients after incident diagnosis in an emergency department (ED).
Methods And Results: Patients discharged after a first presentation of AF to an ED in Ontario, Canada, were identified from April 1, 2005, through March 31, 2010.
Identifying future research priorities using value of information analyses: left atrial appendage occlusion devices in atrial fibrillation.
J Am Heart Assoc
September 2014
Division of Cardiology, Schulich Heart Centre and Department of Medicine, Sunnybrook Health Sciences Centre, University of Toronto, Ontario, Canada (M.C.B., S.M.S., H.C.W.) Institute of Health Policy, Management and Evaluation, University of Toronto, Ontario, Canada (M.K., H.C.W.) Toronto Health Economics and Technology Assessment Collaborative, Toronto, Ontario, Canada (B.P., M.K., H.C.W.) Institute for Clinical Evaluative Sciences (ICES), TorontoOntario, Canada (M.K., H.C.W.) Li Ka Shing Knowledge Institute of St. Michael's Hospital, Toronto, Ontario, Canada (H.C.W.).
Background: Left atrial appendage occlusion devices are cost effective for stroke prophylaxis in atrial fibrillation when compared with dabigatran or warfarin. We illustrate the use of value-of-information analyses to quantify the degree and consequences of decisional uncertainty and to identify future research priorities.
Methods And Results: A microsimulation decision-analytic model compared left atrial appendage occlusion devices to dabigatran or warfarin in atrial fibrillation.
Impact of system and physician factors on the detection of obstructive coronary disease with diagnostic angiography in stable ischemic heart disease.
Circ Cardiovasc Qual Outcomes
September 2014
From the Schulich Heart Centre, Division of Cardiology, Sunnybrook Health Sciences Centre (H.C.W, M.C.B., D.T.K.) and Institute of Health Policy, Management, and Evaluation (H.C.W., D.T.K.), University of Toronto, Toronto, Ontario, Canada; Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada (H.C.W., F.Q., D.T.K.); Li Ka Shing Knowledge Institute of St. Michael's Hospital, Toronto, Ontario, Canada (H.C.W.); Hamilton Health Sciences Centre, Hamilton, Ontario, Canada (M.K.N.); Southlake Regional Health Centre, Newmarket, Ontario, Canada (W.J.C.); St Mary's Hospital, Kitchener, Ontario, Canada (S.S.); and Cardiac Care Network of Ontario, North York, Ontario, Canada (K.J.K.).
Background: Wide variation exists in the detection rate of obstructive coronary artery disease (CAD) with elective coronary angiography for suspected stable ischemic heart disease. We sought to understand the incremental impact of nonclinical factors on this variation.
Methods And Results: We included all patients who underwent coronary angiography for possible suspected stable ischemic heart disease, from October 1, 2008, to September 30, 2011, in Ontario, Canada.