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.
Describing Patient Populations for the My Health Team Initiative
Chateau D, Katz A, Metge C, Taylor C, McDougall C, McCulloch S
The province of Manitoba is in the process of restructuring primary care through the development of My Health Teams, which are networks consisting of primary care providers (physicians and nurse practitioners) and other professionals from health or related disciplines (e.g., dieticians, mental health counsellors, social workers). This study describes the patient populations that current or future My Health Teams could expect to provide care to. We examined where patients access primary care in relation to where they live in order to provide a more accurate description of patient populations. We also examined if patients were high users of services, medically complex, or socially complex. The last category addresses the social determinants of health and this is the first study to apply these social complexity indicators across the province. In addition, we examined the overlap between these three types of patients to determine how distinct patients with social complexities and medical complexities were, and whether these patients were also high user of services.Variations in Resource Use and Costs of Hospital Care in Manitoba
Nickel N, Finlayson G, Fransoo R, Dragan R, Burchill C, Ekuma O, Thomson T, Rajotte L, Ginter J, Soodeen R-A, Burchill S
Hospital expenditures comprise over 40% of provincial healthcare spending. As well, hospital expenditures have increased over the past several years. This study aimed to identify drivers of hospital expenditures, over time. The study team used hospital expenditure data along with administrative health records to examine several factors, which may be related costs; for example, whether costs are being driven by sociodemographic changes in the patient population. As well, this project took an in-depth exploration of the financial data recorded across the province.
Supportive Housing for Seniors: Reform Implications for Manitoba's Older Adult Continuum of Care
Doupe M, Finlayson G, Khan S, Yogendran M, Schultz J, McDougall C, Kulbaba C
The older adult care continuum is generally comprised of home care services, community-based supportive housing, and personal care homes (PCHs). This research examines supportive housing and PCH use in the Winnipeg Health Region, first by identifying the proportion of newly admitted PCH residents who are clinically similar to most supportive housing tenants. We also compare some additional features of these groups, such as differences in user fees paid, differences in people’s informal support networks, and differences in their healthcare use patterns. Collectively, this research helps to define the potential for expanding supportive housing as an alternate to PCH use in Winnipeg, and identifies some of the more salient reform strategies required to help make this work.
The Cost of Smoking: A Manitoba Study
Martens P, Nickel N, Forget E, Lix L, Turner D, Prior H, Walld R, Soodeen RA, Rajotte L, Ekuma O
This study focused on estimating the excess burden that smoking places on the healthcare system. We used survey data (i.e., Manitoba Heart Health Survey, National Population Health Survey, and the Canadian Community Health Survey) from over 45,000 Manitobans to measure individuals' smoking behaviours. We then linked individuals' survey data with their administrative health data held in the Population Health Research Data Repository. We followed survey respondents for ten years after survey to measure the excess healthcare use and expenditures associated with smoking. Smoking rates have decreased from 1989 to 2011. The study found that smoking is associated with increased physician visits, hospitalizations, and prescription drugs. This increased healthcare use translates into excess annual costs: $39M in physician costs, $40M in prescription drugs, $147M in hospital-related expenses, and $18M in cancer-related costs for a total costs of $244 million a year.
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.
The Direct Cost of Hospitalizations in Manitoba, 2005/06
Finlayson G, Reimer J, Dahl M, Stargardter M, McGowan K
Have you ever wondered which type of hospitalization the Manitoba government spends the most on? If you were to guess, would you say hip or knee replacements? Heart attacks? Or perhaps treating people for pneumonia?
Allocating Funds for Healthcare in Manitoba Regional Health Authorities: A First Step--Population-Based Funding
Finlayson GS, Forget E, Ekuma O, Derksen S, Bond R, Martens P, De Coster C
Imagine you are put in charge of Manitoba's annual healthcare budget. How would you allocate those funds across Manitoba's Regional Health Authorities? This report takes a look at a population-based approach to allocating healthcare funds.
High-cost Users of Pharmaceuticals: Who are They?
Kozyrskyj A, Lix L, Dahl M, Soodeen R
In Manitoba, over 40% of prescription dollars get consumed by only 5% of the Manitobans taking prescription drugs. This study looks at these "high-cost" users and compares them to other Manitobans taking prescriptions. What drug categories account for higher prescription costs? What explains the higher drug costs? Are there signs or predictors that someone will become a high-cost user?
Using the Manitoba Hospital Management Information System: Comparing Average Cost Per Weighted Case and Financial Ratios of Manitoba Hospitals. The Next Step
Finlayson G, Roos NP, Jacobs P, Watson D
Cleaned data from the Management Information System were used to develop financial and statistical indicators, as well as an average cost per weighted case for each Manitoba hospital. Comparisons were made between hospitals, between Regional Health Authorities, and between hospital categories.A Comparison of Preliminary and Adjusted Cost per Weighted Case Determinations for Manitoba Hospitals: Impact for Evaluation and Report Cards
Finlayson G, Jacobs P, Watson D, Bogdanovic B
In previous reports we made adjustments to routinely-prepared hospital financial records and discharge reports to make sure that per-patient costs could be fairly compared. This report investigates whether these time-consuming adjustments are necessary.
Cost List for Manitoba Health Services
Jacobs P, Shanahan M, Roos NP, Farnworth M
The Cost List is an important tool for researchers and others who are interested in the costs of health care. The Winnipeg and Regional Health Authorities, and groups that want to compare the costs of health care will find it a valuable resource.
Issues in Developing Indicators for Needs-Based Funding
Frohlich N, Carriere KC
Here we focus on the theoretical question of how to distribute resources for a single sector - physician services - in which the data are good but services are not currently distributed according to need.A Needs-Based Funding Methodology for Regional Health Authorities: A Proposed Framework
Mustard CA, Derksen S
This report describes a method that central governments could use to allocate funding to Regional Health Authorities based on the need for health care. The report also discusses critical issues that would need to be resolved before the method could be implemented.Interprovincial Comparisons of Health Care Expenditures
Shanahan M, Gousseau C
Is the level of provincial health care spending across the country related to the health needs of Canadians? Do provinces with sicker residents, lower socioeconomic circumstances or a higher proportion of elderly people spend more per person on health care?A Project to Investigate Provincial Expenditures on Health Care to Manitobans: A POPULIS Project
Shanahan M, Steinbach C, Burchill C, Friesen D, Black C
How much does Manitoba Health spend per capita for health care? We developed a method to allocate 1993/94 health care expenditures for hospitals, nursing homes, physicians, mental health hospitals and home care for each Regional Health Authority and nine socioeconomic areas of Winnipeg.
Update Hospital Case Mix Costing: 1993/94
Shanahan M, Lloyd M
This report compares the cost of providing inpatient care at each Manitoba hospital for 1993/94, using our previously developed case mix costing methodology.
Hospital Case Mix Costing Project 1991/92: Methodological Appendix
Lloyd M, Shanahan M, Brownell M, Roos NP
Hospital Case Mix Costing Project 1991/92
Shanahan M, Lloyd M, Roos NP, Brownell M
To compare how hospitals use resources, a measure of case mix adjustment has been developed by MCHP called Hospital Case Mix Costing. Using this approach, MCHP compares the costliness of Manitoba hospitals in 1992.Estimating Per Diem Costs for Manitoba Hospitals: A First Step
Wall R, De Coster C, Roos NP
Hospital Funding within the Health Care System: Moving Towards Effectiveness (Report #91-05-02)
Black C, Frohlich N
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