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Research
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Quality of Life Instruments Developed
For the past 5 years, a group of researchers (Gary Naglie, Jane
Irvine, Paul Ritvo, Murray Krahn) have been developing instruments to
evaluate health outcomes in prostate cancer. They initially developed a
disease-specific instrument to measure patients’ utilities, but
completing the task of utility assessment was a lengthy (1 hr.) and
fairly demanding process. As part of the utility instrument, a
multi-attribute health state classification system was developed. This
looks like a 10 item questionnaire. Recently, another grant was
successfully obtained and it will allow the team to further develop the
instrument as a disease-specific health index by developing a system of
utility weights similar to that used in the Health Utilities Index. The
result will be what one colleague felicitously described as the “Swiss
Army Knife” of quality of life Instruments. By completing a 10 item
questionnaire, patients can generate valid psychometric and utility
measures of health related quality of life. It is hoping that these
instruments, which are all versions of the PORPUS (Patient Oriented Prostate
Utility Scale) will be widely used in prostate cancer outcomes research.
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From Hospital to
Home and Community: A Developing Research Agenda
Major health system
restructuring initiatives, technological advances and changing social
values have resulted in rapid reductions in numbers of hospital beds,
hospital admissions, and average lengths of hospital stay across
Canada. However, public
Medicare only covers “medically necessary” services provided by doctors
and in hospitals; services provided in home and community by providers
other than physicians may be publicly covered, but there is no
requirement to do so. As
well as changing the site of care, the ongoing shift out of
hospitals thus results in an increasing proportion of care moving beyond
universal public coverage.
Over the past 18 months, Professors Raisa Deber and A.
Paul Williams have been working to establish the infrastructure for
multidisciplinary teams of researchers, graduate students and community
partners which will investigate different aspects and consequences of the
ongoing shift out of hospitals for providers, consumers and
governments. For example,
two major funded research
projects assess the implications for home care expenditures of different
regionalization models now in place in the Atlantic provinces; and the
capacity of not-for-profit community-based agencies to respond to the
growing numbers of Canadians with higher levels of health care needs who
now require continuing care in home and community.
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