Deliverables: Process Improvement

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2022

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Orthopedic and Ophthalmology Surgical Projection Models
Katz A, Taylor C, Ekuma O, Bowes JM, Soodeen RA, Owczar H

The Manitoba health care system has faced long wait times for orthopedic and ophthalmological surgical procedures. Wait times for surgeries are considered a significant barrier to accessing health care and can have negative health impacts for patients. Recently, the Government of Manitoba identified reducing surgical wait times as a key health care priority. In this study, we explored the delivery of orthopedic and ophthalmology surgical procedures between April 2004 and March 2020 in relation to population demographics. Using this data, we developed models to project surgical procedure demands up to 2027. We found that orthopedic procedures are expected to increase by 18.8% from 2020 to 2027, with growth resulting from a projected 40% increase in clinic-based procedures. Additionally, the number of ophthalmology procedures is also expected to increase as models projected a 67.6% rise from 2020 to 2027.

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Report (PDF)
Additional Materials

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2021

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Outpatient Antibiotic Prescribing by Manitoba Clinicians
Ruth C, Fanella S, Raymond C, Dragan R, Prior H, Dik N, Stevenson D, Koseva I, Valdivia J

Antibiotics are essential to the health of Manitobans. However, the more they are used the more bacteria can develop resistance, making the antibiotics less effective. This study looked at antibiotics dispensed in the community from 2011 to 2016, and how they linked to physician visits and diagnoses. The study found that antibiotic use increased from 2011 to 2016, with highest use in adults aged 65+ and in children under age 5; rates of inappropriate antibiotic use was high and increasing. For conditions that may need antibiotics, the antibiotics being given were often not the ones recommended by guidelines. Physicians and other providers varied widely in how often they prescribed antibiotics for a given condition. The study findings clearly indicate the need for antibiotic stewardship programs to improve antibiotic use in the community. Several other recommendations are also included in the report.

Report (PDF)
Summary (PDF)
Updates and Errata (PDF)
Additional Materials

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2020

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Innovating MCHP Deliverables
Randall S, Mahar A, Green C, Soodeen RA

This project looked at the processes for deliverables and considered ways to improve them. This included options to develop a more collaborative approach for determining the deliverable descriptions and solutions to more fully engage end-users throughout the life of the deliverable and through to use of the new knowledge. It also explored the options for new deliverable products and ways of presenting information. This report makes recommendations for Manitoba Health, Seniors and Active Living and the Manitoba Centre for Health Policy to develop further for a redefined process.

Report (PDF)

Revisiting Primary Care Provider Projection Models
Katz A, Chateau D, Taylor C, Koseva I

The 2009 MCHP Deliverable, Physician Resource Projection Models, developed a novel methodology for predicting resource needs for family doctors for Manitoba. The projections were based on previous patterns of services provided by family physicians over 30 years and population projections for Manitoba as a whole for 2015 and 2020. This deliverable validated the methodology by comparing the projections to the current reality. Updated analyses add nurse practitioners to the models as well as analyses at the local level with projections to 2025.

Report (PDF)
Summary (PDF)
Additional Materials

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2015

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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?

Report (PDF)
Summary (PDF)
Updates and Errata (PDF)
Additional Materials

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2012

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Projecting Personal Care Home Bed Equivalent Needs in Manitoba Through 2036
Chateau D, Doupe M, Walld R, Soodeen R, Ouelette C, Rajotte L

Manitoba Health's Aging in Place initiative has created relatively new alternatives to care for aging adults, such as supportive housing and home care which has helped to keep the demand for personal care homes down. Expanding these services will be crucial for the future care of seniors in the province because, as more Manitobans age into their golden years, the need for long-term care also increases. By 2031, all Baby Boomers will be 65 or older and almost half will be older than 75, presenting a growing challenge for the healthcare system. The latest report from MCHP estimates how much the need for personal care home beds or equivalent alternatives such as supportive housing and extended home care is expected to rise. Researchers also looked into family structure - they found being married and having children lowers personal care home use. The study found the proportion of Manitobans using personal care homes has shrunk since 1985 however, by 3036 space for 5,100 more seniors will be needed in long-term care facilities. The extra capacity for care won't be needed all at once and won't be the same across the province, thus healthcare planners from across the province can use this report to prepare for future needs.

Report (PDF)
Summary (PDF)
Updates and Errata (PDF)

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2011

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Population Aging and the Continuum of Older Adult Care in Manitoba
Doupe M, Fransoo R, Chateau D, Dik N, Burchill C, Soodeen R-A, Bozat-Emre S, Guenette W

Health regions in Manitoba are at various stages of population aging, and projected growth in the number of 75+ year-olds, the predominant personal care home (PCH) users, will vary tremendously across the province. The analyses in this report indicate PCH use will increase modestly in Manitoba until about 2020/21. Shortly after this time Baby Boomers will reach age 75 and by 2030/31, Manitoba may need 29.1% more PCH beds to cope with increasing older adult numbers. Manitoba has expanded its continuum of older adult care with supportive housing provided as an alternate to PCH use. This report provides a tool (LTCPEXP) for allocating people to these different areas. Using RAI-HC© data from Winnipeg, this tool correctly identifies, on average, 76.0% of home care, supportive housing, and PCH users. Use of this tool is important for ensuring that supportive housing fulfills its role as an alternate to PCH use, so people receive the best type of care to match their needs. Using a process called cluster analysis, this research creates a tool (LofCEXP) for describing PCH residents' needs, at least in the WRHA. By combining this strategy with provincial PCH projections, some evidence is also provided to help planners prepare for the future.

Report (PDF)
Summary (PDF)

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2009

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Physician Resource Projection Models
Katz A, Bogdanovic B, Ekuma O, Soodeen RA, Chateau D, Burnett C

This project will provide scenarios that incorporate different assumptions that have an impact on the demand for physicians in four key areas identified by Manitoba Health: Family Medicine, Pediatrics, General Surgery and Orthopedic Surgery. Two sets of models will be developed: (1) models that will project the service needs of the population given various characteristics, e.g., age, sex, socioeconomic status, comorbidities; (2) models that will project the number of services that can be provided by the physician workforce given their characteristics, e.g., age, sex, number of years since graduation, average workloads, etc. MCHP will use historical data housed in the Population Health Research Data Repository to develop and test these models. The output of the project will not be a definitive answer to the question: "How many physicians are needed in Manitoba?" but will provide tools that can be used by Manitoba Health and potentially other organizations, such as the University of Manitoba's Faculty of Medicine to project supply and demand under different conditions.

Report (PDF)
Summary (PDF)

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2002

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Estimating Personal Care Home Bed Requirements
Frohlich N, De Coster C, Dik N

As Manitoba's population ages, there is concern about how many nursing home beds we should have in the future. This project uses historical data to answer that question for the year 2020.

Report (PDF)
Summary (PDF)

Projecting Hospital Bed Needs for 2020
Stewart D, Finlayson G, MacWilliam L, Roos NP

Will the aging of the population put intolerable strains on our health care system? This study develops two models of hospital use and combines them with population projections to predict hospital bed days to the year 2020.

Report (PDF)
Summary (PDF)

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1997

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Issues in the Management of Specialist Physician Resources for Manitoba
Roos NP, Fransoo R, Bogdanovic B, Friesen D, MacWilliam L

In this report, we examine the current supply of specialist physicians in Manitoba, incorporate Statistics Canada data to help project future requirements, and analyze access to specialists by area of residence and socioeconomic status. .

Report (PDF)
Summary