Deliverables: Data

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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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Describing Patterns of Home Care Use in Manitoba
Chateau D, Prior H, Tan Q, Stevenson D, Jarmasz J, Burchill S

Results from a data linkage study about home care services use in Manitoba found that women aged 85 years and older are more likely to be home care clients compared to men; however, men use these services more often than women. The Manitoba Home Care Program offers at-home care for Manitobans who need health services or assistance with daily living, which includes housekeeping, nursing, physiotherapy, occupational therapy, and respite work. In recent years, Regional Health Authorities started using Procura, a new software that provides more information on home care clients. In this study, we evaluate the validity of the Procura data and use this data to look at the nature of home care use in Manitoba. We found the Procura data to be accurate and reliable, and future analyses can uncover information that is useful for health care providers.

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2021

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Gastrointestinal Endoscopy (GIE) Utilization in Manitoba
Lix LM, Singh H, Derksen S, Sirski M, McCulloch S

Gastrointestinal endoscopy (GIE) procedures are used to examine a person’s digestive tract. They are common procedures; more than 1 in 4 Manitobans will have a GIE procedure in a 10-year period. They are used to learn about the causes of symptoms, such as stomach pain or diarrhea, to diagnosis conditions of the digestive tract such as inflammatory bowel disease, and to screen people who are at risk for some cancers such as colorectal cancer. In this study, we looked at changes in procedure rates across health regions and population groups, described wait times in the Winnipeg and Southern Health-Santé Sud regions, and described outcomes after a GIE procedure, such as emergency department use and complications. We found an increase in procedure rates over time that was greatest in those 50 years and older. Wait times for GIE procedures were similar for urgent procedures in both health regions, but less similar for non-urgent procedures. Adverse outcomes are rare, but because many GIE procedures are performed each year, a large number of people can still be affected. Standardized tools and methods to collect and report on wait times and reasons for having a GIE procedure can help to reduce variations in rates and outcomes for Manitobans.

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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.

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Using Administrative Data to Predict Near-Future Critical Illness
Garland A, Chateau D, Marrie RA, Wunsch H, Yogendran M, Soodeen RA

Critically ill people are cared for in hospital intensive care units. Many die in hospital, and many who survive experience long-term problems. If we could identify people at high risk of developing critical illness before it occurs, we might be able to delay or prevent it from happening, allowing them to remain healthy in the community. This study aimed to identify adult Manitobans with a high probability of developing critical illness in the near future. The research team applied advanced statistical methods to the data in the Manitoba Population Research Data Repository at the Manitoba Centre for Health Policy. The results showed that instead of the stated goal of identifying people with at least a 1 in 3 chance of developing critical illness, the team was only able to identify people with at least a 1 in 20 chance. However, additional study may be warranted to assess the value of alerting primary care providers to such individuals on their patient rosters. Also, the finding that frail people are much more likely to develop critical illness suggests that it might be valuable to have physicians routinely measure frailty in the people they care for.

Report (PDF)

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2020

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The Diversity of Immigrants to Manitoba, Migration Dynamics and Basic Healthcare Service Use
Urquia M, Walld R, Prior H, Detillieux G, Eze N, Koseva I

Immigration is a key part of the Canadian social fabric. However, little is known about the characteristics of immigrants to Manitoba, as well as their social and health needs. The addition of the Immigration, Refugees and Citizenship Canada (IRCC) permanent resident database into the Manitoba Population Research Data Repository (Repository) at MCHP is the first step in addressing these gaps. This deliverable describes the linkage and the characteristics of international and interprovincial migrants. It also compares their basic primary care use and mortality with those of non-immigrants.

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2018

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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.

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2017

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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.

Report (PDF)

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2016

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Cancer Data Linkage in Manitoba: Expanding the Infrastructure for Research
Lix L, Smith M, Pitz M, Ahmed R, Quon H, Griffith J, Turner D, Hong S, Prior H, Banerjee A, Koseva I, Kulbaba C

The linkage of cancer registry data to other administrative health databases improves opportunities for population health and health services research for individuals who have been diagnosed with cancer. The overall purpose of this deliverable was to bring the Manitoba Cancer Registry data into the Research Data Repository housed at the Manitoba Centre for Health Policy (MCHP), in order to establish a broader base for cancer research using linked administrative health databases in Manitoba. This deliverable applied routine data quality evaluation tools developed at MCHP to the Manitoba Cancer Registry and then looked at some new measures of data quality used the linked data housed in the Repository. By conducting two demonstration projects, we examined opportunities for new cancer research projects that involve linkage of cancer registry data to administrative data: we compared the performance of comorbidity measures for predicting healthcare utilization in populations with diagnosed cancers and we investigated emergency department (ED) utilization among individuals with a cancer diagnosis to test for differences in ED use before and after diagnosis and to predict time to death.

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2013

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Social Housing in Manitoba. Part I: Manitoba Social Housing Data
Finlayson G, Smith M, Burchill C, Towns D, Peeler W, Soodeen RA, Prior H, Huq S, Guenette W

Part I of this report describes bringing in the Tenant Management System (TMS) data for the period 1995/96-2009/10) and integrating it into the Repository at MCHP. Tests were conducted to determine the amount of data which were missing, inconsistent, or out of range.

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Summary (PDF)

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2012

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A Systematic Investigation of Manitoba's Provincial Laboratory Data
Lix L, Smith M, Azimaee M, Dahl M, Nicol P, Burchill C, Burland E, Goh C, Schultz J, Bailly A

As the Provincial LIMS (Laboratory Information Management System) Project progresses, Cadham Lab's historical datasets will no longer be used for recording current lab test results; these datasets will be archived. MCHP received these historical datasets and conducted a systematic study to validate, document, and evaluate their quality for research purposes. The outcome of this project is a summary assessment of the feasibility of using these data for population-based investigations. For the study, records for the entire population of Manitoba were looked at from 1992 to 2010. Information was compared by age, sex, income, and where people lived. By using Cadham Provincial Laboratory data linked to other administrative data, new opportunities could emerge in future studies to better understand the spread of diseases, identify facilities that are successful in avoiding outbreaks, and examine the cost effectiveness of immunization programs.

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2010

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Physician Integrated Network Baseline Evaluation: Linking Electronic Medical Records and Administrative Data
Katz A, Bogdanovic B, Soodeen R

Electronic medical records (EMRs) help family doctors provide better care to their patients. Without these records it's difficult to measure what kind of care patients receive. Manitoba Health asked researchers at MCHP to look for patterns among groups of patients in the Physician Integrated Network (PIN). The PIN initiative aims to improve patients' access to doctors and interdisciplinary teams while creating a system to manage information more effectively so doctors can make better decisions. The study found improvements in the use of electronic medical records by helping to define criteria for the use of standard fields. This allows doctors to make better use of their own EMRs and helps manage chronic conditions and the overall health of their patients. Family doctors can use information from EMRs to graph patients' health by measuring weight, blood pressure, and so on with each visit. The same techniques can be used to monitor chronic conditions such as diabetes and more importantly, measurements can be taken on how patients respond to treatment.

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2006

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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.

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2005

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Primary Prevention: An Examination of Data Capabilities in Manitoba (January 2005)
Lix L, Finlayson G, Yogendran M, Bond R, Bodnarchuk J, Soodeen R

Different initiatives are offered across Manitoba designed to promote good health�??called primary prevention�??rather than to treat poor health. In this study we look at primary prevention data. Is it sufficient for research purposes? Can we relate it to data we do have on health and the use of health care services?

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2004

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Diagnostic Imaging Data in Manitoba: Assessment and Applications
Finlayson G, Leslie WD, MacWilliam L

Diagnostic imaging plays a prominent role in the health of Manitobans, from both a health and cost perspective. Technology-driven as it is, diagnostic imaging data is evolving. How much of the current data is useful for research? How much can it tell us about what these services are contributing to the health of Manitobans?

Report (PDF)
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Using Administrative Data to Develop Indicators of Quality in Family Practice
Katz A, De Coster C, Bogdanovic B, Soodeen R, Chateau D

Is there a way to know how family physicians in Manitoba measure up to each other? Or to physcians outside of the province? MCHP developed a set of thirteen indicators that were used to assess the quality of care Manitoba doctors deliver.

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2001

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Perspectives on Home Care Data Requirements
Roos NP, Mitchell L, Peterson S, Shapiro E

The strengths and weaknesses of the data currently collected in Manitoba's home care program were evaluated, with recommendations for improvement.

Report (PDF)

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1999

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Measuring Morbidity in Populations: Performance of the Johns Hopkins Adjusted Clinical Group (ACG) Case-Mix Adjustment System in Manitoba
Reid RJ, MacWilliam L, Roos NP, Bogdanovic B, Black C

The Johns Hopkins Adjusted Clinical Group system is a new case-mix tool, which uses ambulatory and hospital diagnostic information, in addition to demographics, to measure the burden of illness in a population. This report explores its capabilities using Manitoba administrative data.

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Summary (PDF)

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1993

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Assessing Quality of Care in Manitoba Personal Care Homes by Using Administrative Data to Monitor Outcomes (Report #93-02)
Shapiro E, Tate RB

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1991

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Units of Observation and Measures of Socio-Economic Status (Manitoba Population Health Project)
Mustard CA

Report (PDF)