Deliverables: Chronic Disease
Type 2 Diabetes in Manitoba
Ruth C, Sellers E, Chartrand C, McLeod L, Prior H, Sirski M, Dragan R, Chen H, McDougall C, Schultz J
This deliverable, undertaken in partnership with The First Nation Health and Social Secretariat of Manitoba provides an analysis of trends in incidence and prevalence of for all types of non-gestational diabetes from the 1985 to 2017 allowing comparison to national and international statistics. Then, using the wealth of data within the Repository, especially the Diabetes Education Resource for Children and Adolescents (DER-CA) clinical database, Manitobans diagnosed with type 2 diabetes mellitus (T2DM) were identified and their outcomes over the last 6 years were described. This includes diabetes control, complications, mortality and health service use including hospitalizations, continuity of primary care and specialist care. Multiple analyses were undertaken to examine whether the care received by Manitobans living with T2DM met current guidelines. There are also a number of special analyses in cohorts of people matched to those without diabetes for childhood onset T2DM, T2DM in pregnancy, and for mental health outcomes in adults. Information is presented for different age groups, by sex, by health region and by Tribal Council Area and results were compared between registered First Nation Manitobans and all other Manitobans.
Exploring Tuberculosis Treatment, Management, and Prevention in Manitoba's Administrative Health Data
Lix LM, Plourde PJ, Larcombe L, Kinew KA, Basham CA, Derksen S, Srisakuldee W, Schultz J, McCulloch S
This report, produced in collaboration with First Nations partners, linked the Manitoba Tuberculosis (TB) Registry to other administrative health databases to investigate the health, healthcare use, and outcomes of people with active TB disease. In addition, we examined the health and outcomes of people receiving treatment for a latent (i.e., sleeping) TB infection; these people were identified from Manitoba’s prescription drug data. We looked at all active TB cases and treated latent TB cases in Manitoba spanning 15 years (1999-2014). People with active TB had high rates of health service use around the time of diagnosis. Persons with latent TB demonstrated treatment completion rates that may not be high enough to prevent TB from spreading, suggesting a need for better treatments that make it easier for patients to complete their treatment. The data tell us that there is still room for improvement in many areas to help identify persons with active and latent TB across Manitoba as early as possible. As well, funding for new technology and research is essential to help with monitoring new TB cases, so that healthcare providers can act quickly to curb the spread of TB. Manitoba has the highest rate of TB of all Canadian provinces. With adequate funding and the support of partners in TB monitoring and care, the goal of TB elimination in Manitoba is realistic.Outpatient Oral Anticancer Agents in Manitoba
Raymond C, Leong C, Fransoo R, Geirnaert M, Dragan R, Yogendran M, Thomson T, Rajotte L, Koseva I, Schultz J, Burchill S
Most Manitobans who receive treatment for cancer do so with intravenous therapy at Cancer Care Manitoba. However, in recent years, the use of oral anticancer agents has increased. Traditionally, prescriptions for these medications are filled at community pharmacies through the usual system of prescription drug coverage, including a deductible for eligible Pharmacare prescriptions. In 2012, the Home Cancer Drug (HCD) Program was launched. This is a program for Manitobans diagnosed with cancer that allows access to eligible outpatient oral cancer and specific supportive care drugs at no cost to the patient (with no deductible). This research project sought to determine usage of oral medications in Manitoba, changes in patterns of use and prescription filling over time, and the impact of the HCD program on prescription filling patterns. Using prescription drug data for outpatients we examined prescription utilization trends, costs associated with such therapies and patterns of health services use.Health and Social Outcomes Associated with High-Risk Alcohol Use
Nickel NC, Bolton J, MacWilliam L, Ekuma O, Prior H, Valdivia J, Leong C, Konrad G, Finlayson G, Nepon J, Singal D, Burchill S, Walld R, Rajotte L, Paille M
Alcohol is enjoyed by many Canadians and has special social and cultural significance in Canadian society. However, over-consumption of alcohol is linked with many, far-reaching harms. Recent data suggest that one in five Canadian drinkers exceed Canada’s low-risk drinking guidelines. This study examined high-risk drinking behaviours and associated outcomes among Manitobans. We used linked data housed in the Manitoba Population Research Data Repository to answer the following questions: (1) How many Manitobans are drinking more alcohol than is recommended by Canada’s low-risk drinking guidelines and has this number changed over time? (2) How many Manitobans have been diagnosed with an Alcohol Use Disorder over the past 20 years? (3) What are the patterns in healthcare utilization, social service use, and interactions with the justice system among individuals with a diagnosed Alcohol Use Disorder? Our analyses suggest several opportunities where supports can be put in place sooner to help Manitobans who are dealing with harmful consequences of high-risk drinking.
Care of Manitobans Living with Chronic Kidney Disease
Chartier M, Dart A, Tangri N, Komenda P, Walld R, Bogdanovic B, Burchill C, Koseva I, McGowan K-L, Rajotte L
Rates of kidney failure or end stage kidney disease (ESKD) have been steadily increasing with the prevalence of diabetes and the aging population in Manitoba. The purpose of this report was to gain a greater understanding of chronic kidney disease (CKD) and ESKD in adults and children in the province. The findings will provide background knowledge to prevent new cases of CKD, to intervene early to slow the progression to ESKD and to plan resources for kidney health services in the future. Manitoba Health, Healthy Living and Seniors asked Manitoba Centre for Health Policy to answer the following research questions: a) What are the future needs for kidney health services (peritoneal dialysis, home hemodialysis, in-centre dialysis and kidney transplant) in Manitoba? b) What is the geographic distribution of this population? c) What are the characteristics of the future population of Manitoba residents who will require renal replacement treatment? d) What preventive, screening, and education measures and affiliations with existing programs, might reduce the number of Manitobans who will require dialysis?
Adult Obesity in Manitoba: Prevalence, Associations, and Outcomes
Fransoo R, Martens P, Prior H, Chateau D, McDougall C, Schultz J, McGowan K, Soodeen R, Bailly A
Obesity doesn't kill people directly but is related to the development of a number of poor health outcomes, including high blood pressure and diabetes. These are important because they cause serious problems themselves, and they're related to heart disease and stroke, which are leading causes of death. The scope of the deliverable is to include the analysis of provincial trends of obesity and related chronic diseases over a 10-year period. The findings indicate the impact on the healthcare system from obese and overweight people may not be as significant as expected. Using nationally-administered health surveys from 1989 to 2008 the study found obesity rates increased in Manitoba. Overall, more than a quarter of people in the province are now considered obese. This report also confirms what's been proven in the past - geography, marital status, employment, age, sex, education, smoking, and physical activity level can influence weight.
The Additional Cost of Chronic Disease in Manitoba
Finlayson G, Ekuma O, Yogendran M, Burland E, Forget E
Researchers at the University of Manitoba compared the costs of healthcare for people with arthritis, asthma and chronic obstructive pulmonary disease (COPD), coronary heart disease, diabetes, and stroke over a two-year period. The report compares what it costs the province to provide healthcare to individuals with one of these conditions with individuals who do not have the condition. Spending on average for all Manitobans without one of the chronic condition studied is about $4,000 per person over two years. Spending on Manitobans with a chronic condition is from twice as much for asthma and COPD to six times as much for people who have had a stroke. The report also breaks-down costs by looking at physician services, inpatient and day surgery, hospital care, prescription drugs, home care and nursing homes for each of these conditions. One of the most interesting findings of this research is that the cost of treating chronic disease is different throughout the province. After considering age, sex, and other influencing factors, people who were treated for similar conditions had different costs for healthcare depending upon where they lived. These differences are not caused by the actual cost of providing services because these values have been equalized - they're caused by using services differently. The report includes important information that will be useful for health and social policy makers in the province to determine the potential impact of healthcare costs for programs designed to reduce the incidence of chronic disease.
Defining and Validating Chronic Diseases: An Administrative Data Approach
Lix L, Yogendran M, Burchill C, Metge C, McKeen N, Moore D, Bond R
Six out of ten Canadians have a chronic disease, such as high blood pressure, diabetes or asthma.To prevent chronic diseases in Manitoba, we need to know how widespread they are, who is at risk of getting a them, and how disease patterns are changing over time. The tools developed in this report provide some answers.
Manitoba Centre for Health Policy
Community Health Sciences, Max Rady College of Medicine,
Rady Faculty of Health Sciences,
Room 408-727 McDermot Ave.
University of Manitoba
Winnipeg, MB R3E 3P5 Canada