HPME Research Highlights
Proceedings from Strategic Levers Symposium
In the Fall of 2006, Ontario Ministry of Health and Long-Term Care policy-makers, Department of HPME researchers, and senior health system decision-makers put together a two-day symposium, Strategic Levers for a High-Performing Health System. The symposium showcased national and international experiences in decentralized decision-making in two key areas, equity and strategic purchasing. In Ontario, health decision-making has been transformed with the devolution of decisions to Local Health Integration Networks (LHINs), resulting in a variety of challenges in ensuring both equity and efficiency in healthcare delivery. The symposium provided an opportunity for knowledge exchange between academic researchers and policy-makers
Proceedings from this event are now available in Healthcare Papers: Vol. 8 Special Issue: Strategic Partnerships. Full-text articles can also be downloaded from the Reports and Publications section of the HPME website. This collection provides a valuable resource to inform ongoing debates both locally and in other regions and countries undergoing similar transformations.
New Research Group Focuses on Health Technology Assessment
HPME is a leading player in a new research collaborative focused on health technology assessment (HTA). The Toronto Health Economics and Technology Assessment (THETA) Collaborative will foster innovative research and effective health policy by building linkages between health technology assessment researchers, policy makers and health service providers.
The multi-disciplinary collaborative is funded by a grant from the Ministry of Health and Long-Term Care, and brings together close to 20 researchers from the Faculties of Arts and Science, Medicine (including HPME) and Pharmacy. Louise Lemieux-Charles, Chair of HPME, and Murray Krahn, HPME Associate Professor and the F. Norman Hughes Chair in Pharmacoeconomics at the Leslie Dan Faculty of Pharmacy are co-principal investigators. The University Health Network (UHN) and Cancer Care Ontario are also partners in the Collaborative.
As a leading source of HTA expertise, THETA will design, implement and analyze health technology assessment studies for the government's Medical Advisory Secretariat (MAS). HTA is an important source of support to decision-makers who must make drug and device purchasing decisions that both contain costs and maintain access. The collaborative will also focus on building HTA capacity in Ontario by providing learning opportunities for students, and engaging in various knowledge translation activities.
Are Quality and Efficiency at Odds?
Hospitals are expected to improve access to high quality care while remaining financially accountable. This has resulted in increasing attention to measuring and improving efficiency. Yet assessing the relationship between the numerous inputs and outputs that make up hospital performance is a complex undertaking.
This study, led by HPME's Walter Wodchis and Audrey Laporte, will use a unique technique called Data Envelopment Analysis (DEA) to examine the relationship between inputs and outputs in Ontario hospitals from 1999 to 2006. DEA has proven effective in other industries for assessing relative efficiency of organizations. The findings from this study will extend existing research on hospital performance and contribute to on-going hospital funding and accountability initiatives at organizational and policy levels.
Primary Care Reform in Ontario: More Access, Better Quality?
Primary care has been shown to contribute to healthier populations and lower healthcare costs. Declining numbers of family physicians and their uneven distribution between urban and rural regions has made access to primary care a key policy concern in Ontario. Primary care reform is one of several strategies the Ontario government is pursing to improve access and quality. Newer models of primary care replace straight fee-for-service physician compensation with blended capitation models which provide incentives for continuity of care, after hours care and prevention. This study will compare the effects of different models of primary care reform on patterns of use and quality of care in Ontario from 1998 to 2010.
Principal investigator Rick Glazier and colleagues will use several provincial databases to examine the extent to which newer models of care have been taken up across geographic regions and physician and patient characteristics. They will compare patient claims for primary care and specialist visits, diagnostic tests, procedures, prescriptions, emergency care visits and hospital admissions across models. Do patterns of use and quality of care vary across models? Have they changed over time? This study will provide valuable evidence to health policymakers in evaluating the effects of primary care reform.
Team Grant to Optimize Work Rehabilitation and QOL
A new CIHR-funded team grant, awarded to HPME's Dorcas Beaton (co-principal investigator with McMaster University's Joy MacDermid), seeks to transform rehabilitation practice, increase work participation and enhance quality of life for people with musculoskeletal diseases (MSKD). The new team grant will bring leaders in work rehabilitation research and practitioners from specialized injured worker clinics in Ontario together to establish a research agenda and develop strategies for translating research into clinical practice.
The research platform will have two foci: identifying patients at risk of severe disablement and determining the most effective rehabilitation strategies depending on patient level of risk. Co-investigators based out of HPME include Jill Hayden and Sheila Hogg Johnson.
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