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Documents

Documents

Metformin use is associated with lower cervical cancer specific mortality

Radiation Oncology 93:S10. University of Toronto, Toronto, ON, Canada; Women’s College Hospital, Toronto, ON, Canada Purpose/Objective(s): While meta-analysis has shown metformin use in diabetic patients […]

Impact of physician and center case volume on the adequacy of cardiac monitoring during adjuvant trastuzumab in breast cancer

2013 Breast Cancer Symposium. Abstract 128. J Clin Oncol 31 (suppl 26; abstr 128). University of Toronto, Toronto, ON, Canada; St. Michael’s Hospital, Toronto, ON, […]

Ambulatory Care Groups as a primary care patient classification system

Cuadernos de Gestión 6:19-24. Published in Spanish. Fundació Jordi Gol i Gurina, Barcelona, Spain No abstract

Adjusted Clinical Groups – an instrument to predict resource use: a population-based healthcare management tool

Gesundheits- und Sozialpolitik 1-2:8-15. Published in German. Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA Advances in information technology, electronic billing, and diagnostic […]

Applicability of predictive risk groupers to MHS data model. Deliverable 8: interim analysis of results

Reston, VA, USA: AdvanceMed Corp. AdvanceMed Corp., Reston, VA, USA AdvanceMed Corporation, a DynCorp company, is supporting the TRICARE Management Activity (TMA) and its health […]

Risk adjustment for asthma: variations by methodology and implications for providers

Working paper: Informed Purchasing Series. Hamilton, NJ, USA: Center for Health Care Strategies. Center for Health Programs Development and Management, University of Maryland, Baltimore County, […]

From theory to application: the implementation of risk adjustment for Minnesota Medicaid

Minneapolis, MN, USA: Park Nicollet Institute, Minnesota Department of Health, Minnesota Department of Human Services. Park Nicollet Institute and Minnesota Department of Health, Minneapolis, MN, […]

Impact of continuity of care and provider factors on medication adherence in patients with hypertension

Baltimore, MD, USA: Johns Hopkins University (doctoral dissertation). Johns Hopkins University, Baltimore, MD, USA STATEMENT OF THE PROBLEM: Hypertension is one of the most common […]

Understanding approaches to case-mix assessment and case-mix adjustment

JHQ Online :W5-24 – W5-29. McKesson Medical Management Group, Newton, MA. Rising healthcare costs coupled with diminishing financial  resources are stimulating changes in the organization […]

Diabetes, gender and neighbourhood ethnicity: inequalities in healthcare resource utilization

Canadian Journal of Diabetes 33:281. Provincial Health Services Authority, Vancouver, BC, Canada AIMS: Lower utilization of medical resources by immigrants are often observed in self-reported […]

Mortalidad por cualquier causa e incidencia de enfermedad cardiovascular en hipertensos con perfil tipo Anglo-Scandinavian Cardiac Outcomes Trial en un ambito poblacional espanol

Aten Primaria 42:420-430. Published in Spanish. Dirección de Planificación, Badalona Serveis Assistencials S.A., Badalona, Barcelona, Spain OBJECTIVES: Mediterranean populations are traditionally considered to be associated […]

Development of a Medical Productivity Index for health insurance beneficiaries

Insurance Markets and Companies: Analyses and Actuarial Computations 2:7-15. University of Minnesota, Minneapolis, MN, USA In this paper, a Medical Productivity Index (MPI) is proposed […]

Des indicateurs de qualité à l’intention des professionnels et des gestionnaires des services de première ligne

Institut national d’excellence en santé et en services sociaux (INESSS). Rapport rédigé par Marie-Dominique Beaulieu, Marie‐Pascale Pomey, Brigitte Côté, Claudio Del Grande, Monia Ghorbel, Phuong […]

Social Housing in Manitoba

Winnipeg, MB, Canada: Manitoba Centre for Health Policy. Manitoba Centre for Health Policy, Winnipeg, MB, Canada The Manitoba Centre for Health Policy (MCHP) in conjunction […]

Clinical integration of the chronic patient

Enfermeria Clnica 24:35-43. Published in Spanish. Gerencia del Servicio de Salud de Castilla-La Mancha (SESCAM), Toledo, Spain Castilla-La Mancha Health Service is developing the integration […]

Risk Stratification – An introduction to the basics

This document provides a high-level overview of what risk stratification is its relevance to the health service and some things to consider when using risk […]

Thai Health Financing Arrangements

Naresuan University Ambulatory casemix systems and Thai health financing arrangements Supasit Pannarunothai Faculty of Medicine

Tuesday-Utilization-Borgquist

BMC Public Health Co-morbidity and Health Care Utilisation Five Years Prior to Diagnosis for Depression: A Register-Based Study in a Swedish Population David Andersson Henrik […]

Monday-Care Coordination I-Muniz

Johns Hopkins ACG System The Development of a Coordination Risk Measure Patricio Muñiz

Improving Patient Care

Cricket Green Medical Practice, Mitcham, Surrey Improving Patient Care Using Risk Profiling in Primary Care Dr Simon Gilbert, GP

Tuesday(C6)-Bridging the Gap Between Payer Data and EHR Data —Rohan D’Souza

Bridging the Gap Between Payer Data and EHR Data —Rohan D’Souza, eClinicalWorks

Sunday-Overview of Version 11: Enhancements and Features-Salls

OVERVIEW OF VERSION 11: ENHANCEMENTS AND FEATURES  Overview of Version 11: Enhancements and Features —Amy Salls, DST Health Solutions

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Overview of the Johns Hopkins ACG System

Karen Kinder, PhD, MBA, Executive Director, ACG System, gives an overview of the ACG System and its various applications to solve health care challenges worldwide. Dr. Kinder highlights how the different users including health organizations, national and regional health authorities, clinic directors, and practitioners use the ACG System to improve accuracy and fairness in evaluating performance, identifying individuals at high risk, forecasting health care utilization, or setting equitable payment rates.

Relation between primary care physician supply and diabetes care and outcomes: a cross-sectional study

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 […]

Home Palliative Service Utilization and Care Trajectory Among Ontario Residents Dying on Chronic Dialysis

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 […]

Association Between Wait Time for Transcatheter Aortic Valve Replacement and Early Postprocedural Outcomes

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 […]

Variation in Revascularization Practice and Outcomes in Asymptomatic Stable Ischemic Heart Disease

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 […]

Trends in Providing Out-of-Office, Urgent After-Hours, and On-Call Care in British Columbia

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 […]

Impact of Predialysis Psychosocial Conditions on Kidney Transplant Recipient Survival: Evidence Using Propensity Score Matching

Abstract Background: An increased number of end-stage renal disease patients suffer psychosocial conditions and may experience delayed access to transplantation due to listing restrictions. However, […]

Days spent at home in the last 6 months of life: a quality indicator of end of life care in patients with hematologic malignancies

Abstract Despite advances in the management of hematologic malignancies, a significant proportion of patients die of their disease. We used administrative databases in Ontario, Canada […]

Comparison of Cardiovascular Risk Factors and Outcomes Among Practicing Physicians vs the General Population in Ontario, Canada

Abstract IMPORTANCE Although cardiovascular disease is the leading cause of death in most developed countries, little is known about current physicians’ cardiovascular health and outcomes. […]

Overall mortality and causes of death in newly admitted nursing home residents

Abstract Background In spite of a rapidly ageing population, there is a lack of population-based data on mortality among nursing home residents in Southern Europe. […]

The measurement of multimorbidity.

Abstract Overview: The presence of multiple concurrent medical conditions (also known as multimorbidity) is now a common phenomenon, hence the importance of its measurement. Objective: […]

Medication use and its impact on high-cost health care users among older adults: protocol for the population-based matched cohort HiCOSTT study

Abstract Background Health interventions and policies for high-cost health care users (HCUs) who are older adults need to be informed by a better understanding of […]

Overall Health Care Cost During the Year Following Diagnosis of Colorectal Cancer Stratified by History of Colorectal Evaluative Procedures

Abstract Background The cost-effectiveness of colorectal screening has been modeled; however, the cost of health care following the diagnosis of colorectal cancer has not been […]

Association Between Switching to a High-Deductible Health Plan and Major Cardiovascular Outcomes

Abstract Objective To describe the association between enrollment in high-deductible health plans and the risk of major adverse cardiovascular outcomes. Design, Setting, and Participants This […]

Emergency department use in people who experience imprisonment in Ontario, Canada

Abstract Objectives The aims of this study were to describe emergency department (ED) utilization by people in provincial prison and on release, and to compare […]

Healthcare services use and costs for a cohort of high needs elderly diabetic patients

Abstract Background The worldwide prevalence of diabetes mellitus is increasing, which especially involves people aged >65 years. A recent study also found that almost 75% […]

Individual and social determinants of SARS-CoV-2 testing and positivity in Ontario, Canada: a population-wide study

ABSTRACT Background Optimizing the public health response to reduce the burden of COVID-19 necessitates characterizing population-level heterogeneity of risks for the disease. However, heterogeneity in […]

The influence of frailty on postoperative complications in geriatric patients receiving single-level lumbar fusion surgery

Abstract Purpose This study evaluates the influence of patient frailty status on postoperative complications in those receiving single-level lumbar fusion surgery. Methods The nationwide readmission […]

Medical use of cocaine and perioperative morbidity following sinonasal surgery—A population study

Abstract Background Topical cocaine is favoured by many surgeons for sinonasal surgery due to its superior vasoconstrictive and anesthetic properties. However, historical reports suggesting cocaine […]

Risk Factors and Outcomes of Early Hospital Readmission in Canadian Kidney Transplant Recipients: A PopulationBased Multi-Center Cohort Study

Abstract Background Early hospital readmissions (EHRs) occur commonly in kidney transplant recipients. Conflicting evidence exists regarding risk factors and outcomes of EHRs. Objective To determine […]

Understanding Deductible and Reimbursement Maximum:A Study of Rural China’s Tiered Medical System

Abstract A high-deductible coverage is shown to reduce inappropriate health care, while little is known about its effect on social welfare under a reimbursement limit. […]

Claims-based pharmacy markers for comprehensive medication management program case identification: Validation against concurrent and prospective healthcare costs and utilization

Abstract Background Three claims-based pharmacy markers (complex, costly and risky medications) were developed to help automatically identify patients for comprehensive medication management. Objective To evaluate […]

Estimating The Marginal Productivity Of Health Technology Adoption

Abstract Decisions to adopt health technologies rely, in part, on judgements about cost effectiveness. Cost effectiveness is commonly assessed against a willingness-to-pay threshold for health […]

Care Coordination Engagement Patterns in Long-Term Patients

Abstract OBJECTIVE: Health care networks are increasingly turning to programs that provide office-based care coordination to high-cost, high-need patients to control preventable health care costs. […]

More Employers Offer Preventive Drug Lists Over Time

ABSTRACT Objective: To describe trends in employer preventive drug list (PDL) offerings and associations of employer PDL offerings with employer and workforce characteristics. Study Design: […]

Percutaneous Endoscopic Gastrostomy (PEG) Tube Placement in Frail Patients: Exploring Postprocedural Outcomes and Readmissions Using the National Readmission Database, 2018–2020

Abstract Objective Percutaneous endoscopic gastrostomy (PEG) tube placement is a common gastrointestinal procedure that provides nutrition, fluids, and medications to patients with inadequate oral intake. […]

Frailty and body composition as predictors of postoperative outcomes in patients with epithelial ovarian cancer undergoing neoadjuvant chemotherapy

Abstract Objective To assess whether the five-factor modified frailty index (mFI5) can predict adverse post-operative outcomes in patients with epithelial ovarian cancer (EOC) undergoing interval […]

Predicting Return Home After Moderate-to-Severe Traumatic Brain Injury

Abstract Background and Objectives Days alive and at home (DAH) is a validated outcome measure that captures health care transitions between time spent at home […]

Review of Risk Factors for Opioid Misuse and Addiction Following Traumatic Injury

Abstract Traumatic injuries represent a significant public health challenge, affecting millions worldwide annually and necessitating acute pain management that frequently involves the use of opioid […]

Regional variation in healthcare spending and mortality among senior high-cost healthcare users in Ontario, Canada: a retrospective matched cohort study

Abstract Background Senior high cost health care users (HCU) are a priority for many governments. Little research has addressed regional variation of HCU incidence and […]

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Seven Quick Wins (International Version)

Are you a provider, payor or population health organization looking for a quick tune-up to your existing strategy and planning? Then look no further. We […]

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Visualization & Use of the ACG System in the Military Health System

Presented by:David H. Carnahan, Colonel, USAF, MD, MSCE

Relation between surgeon volume and risk of complications after total hip arthroplasty: propensity score matched cohort study

BMJ 348:g3284. University of Toronto, Toronto, ON, Canada; Institute for Clinical Evaluative Sciences, Toronto, ON, Canada OBJECTIVES: To identify a cut point in annual surgeon […]

Mothers of children diagnosed with attention-deficit/hyperactivity disorder: health conditions and medical care utilization in periods before and after birth of the child

Med Care 47:105-114. Division of Research, Kaiser Permanente Medical Care Program, Northern California Region, Oakland, CA, USA BACKGROUND: Analyzing health conditions and medical utilization of […]

Elective, major noncardiac surgery on the weekend: a population-based cohort study of 30-day mortality

Med Care 52:557-564. University of Ottawa, Ottawa, ON, Canada; Ottawa Hospital Research Institute, Ottawa, ON, Canada IMPORTANCE: Previous research has demonstrated that patients undergoing elective […]

Multimorbidity in people with type 2 diabetes in the Basque Country (Spain): Prevalence, comorbidity clusters and comparison with other chronic patients

Eur J Intern Med 26:197-202. Basque Institute for Healthcare Innovation, Barakaldo, Spain; Osakidetza (Basque Health Service), Erandio, Spain; Department of Health, Vitoria-Gasteiz, Spain; World Health […]

Predictors of hospital stay and home care services use: A population-based, retrospective cohort study in stage IV gastric cancer

Palliat Med 29:147-156. Queen’s University, Kingston, ON, Canada; University of Toronto, Toronto, ON, Canada; Institute for Clinical Evaluative Sciences, Toronto, ON, Canada; Queen’s University, Kingston, […]

How profitable is risk selection? A comparison of four risk adjustment models

Health Econ 11:165-174. Department of Health Services, Boston University School of Public Health, Boston, MA, USA To mitigate selection triggered by capitation payments, risk-adjustment models […]

Macrolide antibiotics and the risk of ventricular arrhythmia in older adults

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 […]

A cross-sectional, population-based study of HIV physicians and outpatient health care use by people with HIV in Ontario

BMC Health Serv Res 15:63. Bruyère Research Institute, Ottawa, ON, Canada; University of Ottawa, Ottawa, ON, Canada; McGill University, Montreal, QC, Canada; Ottawa Hospital Research […]

Improved Survival in Patients with Viral Hepatitis-Induced Hepatocellular Carcinoma Undergoing Recommended Abdominal Ultrasound Surveillance in Ontario: A Population-Based Retrospective Cohort Study

PLoS One 10:e0138907. University of Toronto, Toronto, ON, Canada; Ontario Institute for Cancer Research/Cancer Care Ontario, Toronto, ON, Canada; Institute for Clinical Evaluative  Sciences, Toronto, ON, […]

What, if anything, does amenable mortality tell us about regional health system performance?

Healthc Policy 8:79-90. University of British Columbia, Vancouver, BC, Canada OBJECTIVES: Amenable mortality is proposed as a health system performance measure, and has been used […]

A chronic disease score with empirically derived weights

Med Care 33:783-795. Indiana University Department of Medicine, Indianapolis, IN, USA. Different types of medication prescribed during a 6-month period for the treatment and management […]

Assessing socioeconomic health care utilization inequity in Israel: impact of alternative approaches to morbidity adjustment

BMC Public Health 11:609. Faculty of Social Welfare and Health Sciences, University of Haifa, Mount Carmel, Israel BACKGROUND: The ability to accurately detect differential resource […]

Capitation and enhanced fee-for-service models for primary care reform: a population-based evaluation

CMAJ 180:E72-E81. Institute for Clinical Evaluative Sciences, Toronto, ON, Canada BACKGROUND: Primary care reform in Ontario, Canada, included the initiation of a blended capitation model […]

Variability in prescription drug expenditures explained by Adjusted Clinical Groups (ACG) case-mix: a cross-sectional study of patient electronic records in primary care

BMC Health Serv Res 8:53. Catalan Institute of Oncology, IDIBELL, L’Hospitalet, Barcelona, Spain BACKGROUND: In view of rapidly increasing prescription costs, case-mix adjustment should be […]

The importance of comorbidity in analysing patient costs in Swedish primary care

BMC Public Health 6:36. Ryd Primary Health Care Centre, Linköping, Sweden BACKGROUND: The objective was to explore the usefulness of the morbidity risk adjustment system […]

Designing and using measures of quality based on physician office records.

J Ambul Care Manage 18:56-72. Harvard School of Public Health, Harvard University, Boston, MA, USA This article presents our principles for developing performance measures to […]

Impact of managed care on prescription drug use

Health Aff 10:140-154. Johns Hopkins University School of Hygiene and Public Health, Baltimore, MD, USA Differences between the health services utilization patterns of persons enrolled […]

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

CMAJ 173:1173-1177. Radiology, University of Manitoba, Winnipeg, MB, Canada INTRODUCTION AND HYPOTHESIS: An inverse relationship exists between socio-economic status (SES) and osteoporotic fractures. In publicly […]

Rural American Indian Medicaid health care services use and health care costs in California

Am J Public Health 96:363-370. Institute for Health Policy Studies, University of California San Francisco, USA OBJECTIVES: We determined differences in Medicaid service use and […]

Evaluating diagnosis-based risk-adjustment methods in a population with spinal cord dysfunction

Arch Phys Med Rehabil 85:218-226. OBJECTIVE: To examine performance of models in predicting health care utilization for individuals with spinal cord dysfunction.DESIGN: Regression models compared […]

Oil and water? Lessons from Maryland’s effort to protect safety net providers in moving to Medicaid managed care

J Urban Health 77:645-662. Mathematica Policy Research in Washington, DC, USA Studies have highlighted the tensions that can arise between Medicaid managed care organizations and […]

Does community-governed nonprofit primary care improve access to services? Cross-sectional survey of practice characteristics

Int J Health Serv 35:465-478. Department of Public Health, Wellington School of Medicine and Health Sciences, New Zealand This study compared community-governed nonprofit and for-profit […]

Predictors of 1-year change in patient activation in older adults with diabetes mellitus and heart disease

J Am Geriatr Soc 60:1316-1321. Group Health Research Institute, Seattle, Washington, USA OBJECTIVES: To identify patterns and predictors of 1-year change in patient activation in […]

Risk-adjusted resource allocation: using Taiwan’s National Health Insurance as an example

Asia Pac J Public Health 27:NP958-971. Department of Health Policy & Management, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA. OBJECTIVES: To […]

Distance to hospital and socioeconomic status influence secondary health care use

Scand J Prim Health Care 31:83-88. Blekinge Centre of Competence, Karlskrona, Sweden Objective. The aim of this study was to investigate how distance to hospital […]

The effect of the doctor-patient relationship on emergency department use among the elderly

Am JPublic Health 90:97-102. Department of Family Medicine, University of Washington School of Medicine, Seattle, WA, USA OBJECTIVES: This study sought to determine the rate […]

Measurement of relative cost weights as an effect of the retrospective application of Adjusted Clinical Groups in primary care

Gac Sanit 20:132-141. Published in Spanish. Badalona Serveis Assistencials, S.A., Badalona, Barcelona, España OBJECTIVE: The objective of the study is to obtain the cost’s relative […]

Income-related inequities: Cross-sectional analyses of the use of medicare services in British Columbia in 1992 and 2002

Open Med 2:e91. University of British Columbia, Vancouver, BC, Canada BACKGROUND: The primary demonstration of the principle of income-related equity in Canada is the provision […]

Disaster-related injuries in the period of recovery: the effect of prolonged displacement on risk of injury in older adults

JTrauma 67:834-840. Department of Environmental Health Sciences, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA BACKGROUND: Hurricane Katrina, which struck the Gulf Coast […]

Setting health care capitations through diagnosis-based risk adjustment: a suitable model for the English NHS?

Health Policy 101:133-139. Faculty of Health, University of Plymouth, Plymouth, UK The English system of health resource allocation has been described as the apotheosis of […]

Insurance coverage and subsequent utilization of complementary and alternative medicine providers

Am J Manag Care 12:397-404. Department of Health Services, School of Public Health and Community Medicine, University of Washington, Seattle, WA, USA BACKGROUND: Since 1996, […]

Multimorbidity, polypharmacy, referrals, and adverse drug events: are we doing things well?

Br J Gen Pract 62:e821. Aragón Health Sciences Institute (IACS), Miguel Servet University Hospital, University of Zaragoza, Spain BACKGROUND: The consequences of multimorbidity include polypharmacy […]

Costs and associated factors with optimal and suboptimal responses to the treatment of major depressive disorder

Aten Primaria 44:667-675. Published in Spanish. Dirección de Planificación, Badalona Serveis Assistencials, Barcelona, Spain OBJECTIVE: To evaluate the compliance, persistence and costs of the treatment […]

Factors associated with hospitalisations for ambulatory care-sensitive conditions among persons with an intellectual disability: a publicly insured population perspective

J Intellect Disabil Res 57:226-239. Dual Diagnosis Program, Centre for Addiction and Mental Health, Toronto, ON, Canada BACKGROUND: Hospitalisations for ambulatory care-sensitive (ACS) conditions are […]

Cardiovascular safety of inhaled long-acting bronchodilators in individuals with chronic obstructive pulmonary disease

JAMA Intern Med 173:1175-1185. Institute for Clinical Evaluative Sciences, Toronto, ON, Canada; Department of Medicine, Sunnybrook Health Sciences Centre, Toronto, ON, Canada; Child Health Evaluative […]

The disconnect between better quality of glucocorticoid-induced osteoporosis preventive care and better outcomes: a population-based cohort study

J Rheumatol 40:1736-1741. University of Alberta, Edmonton, AB, Canada; University of Manitoba, Winnipeg, MB; McGill University, Montreal, QC, Canada OBJECTIVE: The quality of glucocorticoid-induced osteoporosis […]

Glucagonlike peptide 1-based therapies and risk of hospitalization for acute pancreatitis in type 2 diabetes mellitus: a population-based matched case-control study

JAMA Intern Med 173:534-539. Department of Medicine, Johns Hopkins University Schools of Medicine and Public Health, Baltimore, MD, USA IMPORTANCE: Acute pancreatitis has significant morbidity […]

The association between obesity and outpatient visits for acute respiratory infections in Ontario, Canada

Int J Obes 38:113-119. Institute for Clinical Evaluative Sciences, Toronto, ON, Canada; Public Health Ontario, Toronto, ON, Canada; University of Toronto, Toronto, ON, Canada OBJECTIVE: […]

Effects of impairment in activities of daily living on predicting mortality following hip fracture surgery in studies using administrative healthcare databases

BMC Geriatr 14:9. Queen’s University, Kingston, ON, Canada BACKGROUND: Impairment in activities of daily living (ADL) is an important predictor of outcomes although many administrative […]

Variation in inpatient hospital prices and outpatient service quantities drive geographic differences in private spending in Texas

Health Serv Res. University of Texas School of Public Health, Houston, TX, USA OBJECTIVE: To measure the contribution of market-level prices, utilization, and health risk […]

Predictive validity of tools used to assess the risk of unplanned admissions: a rapid review of the evidence

York, UK: University of York. University of York, York, UK CRD has developed an evidence briefing and support service tailored to the needs of commissioners […]

Physician integrated network: a second look

Winnipeg, MB, Canada: Manitoba Centre for Health Policy. Manitoba Centre for Health Policy, Winnipeg, MB, Canada This is the second report from Manitoba Centre for […]