Abstract Background Electronic consultation (eConsult) services are secure online applications facilitating provider-to-provider communication. They have been found to improve access to specialist care. However, little […]

Abstract Operationalization of the fundamental building blocks of primary care (i.e. empanelment, team-based care and population management) within the context of Community Health Centers requires […]

Abstract   Objectives To assess two models for the prediction of health utilization and functions using standardized in-person assessments of frailty and administrative claims-based geriatric […]

Abstract Objective In this study, we investigated the incremental 1-year direct costs of health care associated with frailty among home care recipients in Ontario with and without […]

Abstract   A majority of Americans have health care insurance through their employers, the cost for which is rising at an alarming rate. Unfortunately, higher […]

Abstract   BACKGROUND Induced abortion is a common procedure performed by physicians with varying degrees of clinical experience. We aimed to determine whether a physician’s […]

Abstract   Background Clinical guidelines caution against nonsteroidal anti-inflammatory drug (NSAID) use in older adults. The study objective was to quantify the 30-day risk of […]

Abstract The aim of the present study is to use the ACG (Adjusted Clinical Groups) System to create an impactibility model by identifying homogeneous clinical […]

Abstract Context The end-of-life period is characterized by increased hospital utilization despite patients’ preferences to receive care and die at home. Objectives To evaluate the […]

Abstract   Objectives The Healthy Kids Community Challenge is a large-scale, centrally-coordinated, community-based intervention in Ontario, Canada that promotes healthy behaviours towards improving healthy weights […]

Abstract   This study is conducted to investigate the association between major depressive disorder and the subsequent development of Alzheimer disease (AD) in elderly patients […]

Abstract   PURPOSE Providing care in alternative (non-office) locations and outside office hours are important elements of access and comprehensiveness of primary care. We examined […]

Abstract Aim To assess the association between allopurinol and mortality and cardiovascular outcomes in an allopurinol‐treated diabetes cohort. Materials and Methods We conducted a population‐based […]

Abstract Dialysis prior to kidney transplantation may have a detrimental effect on post-transplant Outcomes. However, prior studies have not fully characterized the nature of this […]

Abstract Purpose Studies examining symptom differences between surgeries for breast cancer patients rarely incorporate the effects of adjuvant treatment choice. We sought to understand differences […]

Abstract There is growing recognition that social and behavioral risk factors impact population health outcomes. Interventions that target these risk factors can improve health outcomes. […]

Abstract   Purpose This study is conducted to explore the association between potentially inappropriate medication (PIM) and Alzheimer’s disease (AD) among the elderly. Methods We […]

ABSTRACT The effects of high-deductible health plans (HDHPs) on breast cancer diagnosis and treatment among vulnerable populations are unknown. We examined time to first breast […]

ABSTRACT   PURPOSE: Quality end-of-life care (EoLC) is a key aspect of oncology. Days at home in the last 6 months of life represents a […]

Abstract   Background Payers and providers still primarily use ordinary least squares (OLS) to estimate expected economic and clinical outcomes for risk adjustment purposes. Penalized […]

ABSTRACT   AIM To investigate whether hyperdense areas (HDAs) observed after endovascular treatment on multisection computed tomography (CT) are related to outcome. MATERIALS AND METHODS Data on […]

Abstract   Background Pain is more common among people living with HIV (PLWH) than their counterparts; however, it is unclear whether analgesic use differs by […]

Abstract Background It is not known whether the neurotoxicity produced by anaesthetics administered to young animals can also occur in children. Exposure of infant macaques […]

Abstract   Purpose To examine the association of all-cause and premature mortality with four modifiable lifestyle behaviors and quantify the burden of behavioral-related premature death in Ontario, […]

Abstract   Objectives The aims of this study were to assess variation in revascularization of asymptomatic patients with stable ischemic heart disease, identify the predictors of variation, and […]

Abstract Background The rapidly growing population of elderly subjects with multimorbidity is at risk of receiving fragmented and uncoordinated care, and have frequent hospitalizations and […]

Abstract Background The prescribing of psychotropic drugs, i.e. antidepressants, sedatives (anxiolytics, hypnotics), and antipsychotics is considerable and a large proportion is prescribed by general practitioners […]

Abstract Background Rapid growth in transcatheter aortic valve replacement (TAVR) demand has translated to inadequate access, reflected by prolonged wait times. Increasing wait times are […]

Abstract Objective The objective of this work was to assess the effectiveness of a population‐level patient‐centered intervention for multimorbid patients based on risk stratification for […]

Background Esophageal adenocarcinoma (EAC) incidence is increasing rapidly. Esophageal cancer has the second lowest 5-year survival rate of people diagnosed with cancer in Canada. Given […]

Abstract BACKGROUND: Using electronic health records (EHRs) for population risk stratification has gained attention in recent years. Compared with insurance claims, EHRs offer novel data […]

Abstract Women with intellectual disability have low screening rates for breast and cervical cancer. This population-based cohort study examined the association between the level of […]

Abstract Background Access to primary care is an important determinant of health, and data are sparse on primary care utilization for people who experience imprisonment. […]

Abstract BACKGROUND AND AIMS Methadone maintenance therapy (MMT) is associated with improved outcomes for children exposed to maternal opioid dependence in utero. We examined Ontario’s […]

Abstract Introduction and hypothesis Vaginal apical suspension is essential for the surgical treatment of pelvic organ prolapse (POP). We aim to evaluate whether the method […]

Abstract Introduction: Recently, in Dutch health care the focus is shifting from a disease oriented approach to a more population based approach. Since in The […]

Abstract Background: Several different indices summarize patient comorbidity using health care data. An accurate index can be used to describe the risk profile of patients, […]

Abstract Objectives. To examine the impact of the dissemination of guidelines to physicians and of a population-level health communication intervention on the percentage of adults […]

Abstract Background Chronic kidney disease is a recognized independent risk factor for cardiovascular disease, but whether the risks of ST‐segment–elevation myocardial infarction (STEMI) and non–ST‐segment–elevation […]

Background: Transitioning low-risk cancer survivors back to their primary care provider (PCP) has been shown to be safe but the effect on health system resources […]

ABSTRACT Recent changes to US reimbursement policies are increasingly holding providers financially accountable for patients’ health. Providing nonmedical services in conjunction with primary care—known as […]

Abstract Although individuals with intellectual and developmental disabilities (IDD) and psychiatric concerns are more likely than others to visit hospital emergency departments (EDs), the frequency […]

Abstract Background The identification of contextual factors that modify associations between client frailty and their health and service use outcomes is essential for informed home […]

Abstract Objectives To quantify health service utilization including assessment, monitoring, and treatment of respiratory complications of children with neuromuscular disease (NMD), identifying practice variation and […]

Abstract   BACKGROUND Rapid repeat pregnancy within 12 months of a live birth is associated with adverse perinatal outcomes. We evaluated the risk for rapid […]

ABSTRACT Objectives: This exploratory study used outpatient laboratory test results from electronic health records (EHRs) for patient risk assessment and evaluated whether risk markers based on […]

Background: Many patients who receive chronic hemodialysis have a limited life expectancy comparable to that of patients with metastatic cancer. However, patterns of home palliative […]

Abstract Study design Retrospective cohort study. Objectives The objectives for this study were to examine the prevalence of polypharmacy for people with traumatic spinal cord […]

Abstract Population aging and the increase of chronic conditions incidence and prevalence produce a higher risk of hospitalization or death. This is particularly high for […]

Abstract Aim Breast cancer and its treatment are associated with varying symptoms. The province of Ontario (13.6 million) has implemented a provincial programme to screen for symptoms among […]

Abstract   BACKGROUND Few studies of how exposure of children to anesthesia may affect neurodevelopment employ comprehensive neuropsychological assessments. This study tested the hypothesis that […]

Abstract Objectives To examine the value of unstructured electronic health record (EHR) data (free‐text notes) in identifying a set of geriatric syndromes. Design Retrospective analysis […]

Abstract   Aims To evaluate the association between metformin use and heart failure (HF) exacerbation in people with type 2 diabetes (T2D) and pre‐existing HF […]

Abstract This population-based cohort study examined the relationship between level of continuity of primary care and subsequent emergency department (ED) visits for adults with (n = 66,484) […]

Abstract Primary Health Networks (PHNs) are tasked to enhance the efficiency and effectiveness of general practice. Gold Coast Primary Health Network (GCPHN) has been collecting […]

Abstract   Background Data are limited on risk factors for vancomycin-resistant Enterococcus (VRE) bacteremia. Methods All patients with a confirmed VRE bacteremia in Ontario, Canada, between January […]

Abstract Background Previous studies on high-risk opioid use have only focused on patients diagnosed with an opioid disorder. This study evaluates the impact of various […]

BACKGROUND:  Primary care clinicians know that case-mix varies between different physician practices and geographical areas. Leicester City Clinical Commissioning Group (CCG) is now able to quantify […]

Health Innovation Program, the University of Wisconsin School of Medicine and Public Health from The Wisconsin Partnership Program, and the Community–Academic Partnerships core of the […]

Abstract Background The Italian National Health Service (NHS) provides universal coverage to all citizens, granting primary and hospital care with a copayment system for outpatient […]

Abstract Background: Hidradenitis suppurativa (HS) is a chronic debilitating disease with long-lasting comorbidities that impose direct and indirect costs on the health care system. However, […]

Abstract Background: Using electronic health records (EHRs), in addition to claims, to systematically identify patients with factors associated with adverse outcomes (geriatric risk) among older […]

Abstract Purpose: A recent regulatory warning and case reports have described the development of muscle complications with the use of 5‐α reductase inhibitors (5ARIs). We […]

Risk adjustment models are traditionally derived from administrative claims. Prescription fill rates—extracted by comparing electronic health record prescriptions and pharmacy claims fills —represent a novel […]

In the United States kidney transplant rates vary significantly across end-stage renal disease (ESRD) networks. We conducted a population-based cohort study to determine whether there […]

Department of Health Policy and Management, Johns Hopkins School of Public Health, Center for Population Health Information Technology, Baltimore, MD HealthPartners, Health Informatics Division, Bloomington, […]

Abstract The increasing challenge of multiple chronic diseases (multimorbidity) requires more evidence-based knowledge and effective practice. In order to better understand the existing evidence on […]

BACKGROUND: Older patients undergoing emergency general surgery (EGS) experience high rates of postoperative morbidity and mortality. Studies focused primarily on elective surgery indicate that frailty […]

OBJECTIVES: To determine the extent of agreement between four commonly used definitions of multiple chronic conditions (MCCs) and compare each definition’s ability to predict 30-day […]

Background: Frailty is a risk factor for adverse postoperative outcomes. Hospitals that perform higher volumes of surgery have better outcomes than low-volume providers. We hypothesized […]

IMPORTANCE There have been concerns raised by patients and regulatory agencies regarding serious psychiatric adverse effects associated with 5α-reductase inhibitors. OBJECTIVE To determine if there […]

This study explored the utility of the Johns Hopkins Aggregated Diagnostic Groups (ADGs) as a noncategorical measure of child health in administrative health data. Canadian […]

Objective To determine how to best measure the provision of comprehensive preventive care assessment to adults with IDD. Design Cross-sectional. Setting Ontario. Participants Adults with […]

Abstract To address the challenging health care needs of the population served by an urban academic medical center, we developed the Johns Hopkins Community Health […]

BACKGROUND The prognostic importance of high-density lipoprotein cholesterol (HDL-C) as a specific risk factor for cardiovascular (CV) disease has been challenged by recent clinical trials […]

Objective: In 2001, the province of Ontario expanded cancer genetic testing eligibility to include all women with high-grade serous ovarian carcinoma (HGSC) of the ovary, […]

Working Paper 150004. Toronto, ON, Canada: Canadian Centre for Health Economics. Canadian Centre for Health Economics, Toronto, ON, Canada Objective: to examine the extent of […]

Background: A small number of people with chronic obstructive pulmonary disease (COPD) receive pulmonary function testing around the time of diagnosis. Because omitting testing increases […]

Introduction: Active surveillance (AS) is a strategy for the management of low-risk prostate cancer (PCa). However, few studies have assessed the uptake of AS at […]

Background: Over the past decade, annual heath exams have been de-emphasized for the general population but emphasized for adults with intellectual and developmental disabilities (IDD). […]

Background: Hip fractures among older adults are one of the leading causes of hospitalization and result in significant morbidity, mortality, and health care use. Guidelines […]

Thomas E. Kottke, MD, MSPH; Jason M. Gallagher, MBA; Sachin Rauri, MS; Juliana O. Tillema, MPA; Nicolaas P. Pronk, PhD, FACSM; Susan M. Knudson, MA […]

JAMA Surg. University of Ottawa, Ottawa, ON, Canada; Institute for Clinical Evaluative Sciences, Ottawa, ON, Canada; Ottawa Hospital, Ottawa, ON, Canada; Ottawa Hospital Research Institute, […]

Santelices C E, Muñoz P F, Muñiz P, Rojas J. BACKGROUND: Health care must be provided with strong primary health care models, emphasizing prevention and a […]

Med Care 54:277-286. University of Ottawa, Ottawa, ON, Canada; Institute of Clinical Evaluative Sciences, Ottawa, ON, Canada; Queen’s University, Kingston, ON, Canada; Monash University, Clayton, […]

Santelices C E, Muñoz P F, Muñiz P, Rojas J. BACKGROUND: Health care must be provided with strong primary health care models, emphasizing prevention and a […]

J Am Board Fam Med 29:116-125. University of Maryland School of Medicine, Baltimore, MD, USA; University of Maryland School of Pharmacy, Baltimore, MD, USA; Department […]

Am J Hypertens University of Wisconsin School of Medicine and Public Health, Madison, WI, USA; Veterans Affairs Pittsburgh Healthcare System , Pittsburgh, PA, USA; University […]

CMAJ Western University, London, ON, Canada; London Health Sciences Centre, London, ON, Canada; Institute for Clinical Evaluative Sciences (ICES) Western, London, ON, Canada BACKGROUND: Many […]

Ann Intern Med 164:395-405. Weill Cornell Medical College, New York, NY, USA BACKGROUND: Effects of the patient-centered medical home (PCMH) are unclear. Previous studies had […]

JAMA Pediatr 170:148-154. Children’s Hospitals and Clinics of Minnesota, Minneapolis, MN, USA IMPORTANCE: Little is known about the effect of pediatric accountable care organizations (ACOs) […]

Can J Diabetes 40:35-42. University of Alberta, Edmonton, AB, Canada; Institute for Clinical Evaluative Sciences, Toronto, ON, Canada; Women’s College Hospital, Toronto, ON, Canada; McMaster […]

Background: Higher primary care physician supply is associated with lower mortality due to heart disease, cancer and stroke, but its relation to diabetes care and […]

OBJECTIVES: To evaluate the effects of postoperative rehabilitation on the outcomes of older adults with dementia who experienced hip fracture. DESIGN: Retrospective cohort study. SETTING: […]

Ann Fam Med 14:26-33. University of Ottawa, Ottawa, ON, Canada; Institute for Clinical Evaluative Sciences, Ottawa, ON, Canada; Institute for Clinical Evaluative Sciences, Toronto, ON, […]

Cancer Epidemiol Biomarkers Prev 25:507-512. University Health Network, Toronto, ON, Canada; University of Toronto, Toronto, ON, Canada; Women’s College Hospital, Toronto, ON, Canada; Institute of […]

Circ Cardiovasc Qual Outcomes 9:23-30. Johns Hopkins University Baltimore, MD, USA; Yale School of Medicine, New Haven, CT, USA; University of Colorado, Aurora, CO, USA; […]

PLoS One 10:e0145233. University of Bergen, Bergen, Norway; Norwegian Centre for Minority Health Research, Oslo, Norway; Aragón Health Sciences Institute (IACS), Zaragoza, Spain; Carlos III […]

Ann Neurol 79:32-41. University of Toronto, Toronto, ON, Canada; Sunnybrook Health Sciences Centre, Toronot, ON, Canada; Institute of Health Policy, Management and Evaluation at the […]

Scand J Public Health Blekinge Institute of Technology, Karlskrona, Sweden; Lund University, Lund, Sweden; Linnaeus University, Växjö, Sweden BACKGROUND AND AIMS: Pain is common in […]