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RHA 2002 May 9 Part 2 Jul 7.Qxd The Manitoba RHA Indicators Atlas: Population-Based Comparisons of Health and Health Care Use June 2003 Manitoba Centre for Health Policy Department of Community Health Sciences Faculty of Medicine, University of Manitoba Patricia J. Martens, PhD Natalia Dik, MSc Randy Fransoo, MSc Leonard MacWilliam, MSc, MNRM The Need to Know Team Shelley Derksen, MSc (funded through CIHR) Randy Walld, BSc, BComm(Hons) Elaine Burland, MSc Carmen Steinbach Laurel Jebamani, BA(Hons) Matt Dahl, BSc Charles Burchill, MSc Bogdan Bogdanovic, BComm, BA Charlyn Black, MD, ScD ISBN: 1-896489-12-5 Ordering Information If you would like to receive a copy of this or any other of our reports, contact us at: Manitoba Centre for Health Policy University of Manitoba 4th Floor, Room 408 727 McDermot Avenue Winnipeg, Manitoba, Canada R3E 3P5 Order line: 204-789-3805 Fax: 204-789-3910 Or you can visit our WWW site at: http://www.umanitoba.ca/centres/mchp/reports.htm © Manitoba Health For reprint permission contact the Manitoba Centre for Health Policy THE MANITOBA CENTRE FOR HEALTH POLICY The Manitoba Centre for Health Policy (MCHP) is located within the Department of Community Health Sciences, Faculty of Medicine, University of Manitoba. The mission of MCHP is to provide accurate and timely information to health care decision-makers, analysts and providers, so they can offer services which are effective and efficient in maintaining and improving the health of Manitobans. Our researchers rely upon the unique Population Health Research Data Repository to describe and explain pat- terns of care and profiles of illness, and to explore other factors that influ- ence health, including income, education, employment and social status. This Repository is unique in terms of its comprehensiveness, degree of inte- gration, and orientation around an anonymized population registry. Members of MCHP consult extensively with government officials, health care administrators, and clinicians to develop a research agenda that is topi- cal and relevant. This strength along with its rigorous academic standards enable MCHP to contribute to the health policy process. MCHP under- takes several major research projects, such as this one, every year under con- tract to Manitoba Health. In addition, our researchers secure external fund- ing by competing for other research grants. We are widely published and internationally recognized. Further, our researchers collaborate with a num- ber of highly respected scientists from Canada, the United States and Europe. We thank the University of Manitoba, Faculty of Medicine, Health Research Ethics Board for their review of this project. The Manitoba Centre for Health Policy complies with all legislative acts and regulations governing the protection and use of sensitive information. We implement strict policies and procedures to protect the privacy and security of anonymized data used to produce this report and we keep the provincial Health Information Privacy Committee informed of all work undertaken for Manitoba Health. i ACKNOWLEDGEMENTS This RHA indicators report was possible because it built upon the previous work of those at MCHP who have developed and tested many of the concepts during previous research projects. A special thanks to Dr. Charlyn Black who originally developed the idea of RHA indicators reports throughout the 1990s. This was a comprehensive project requiring a team effort. The authors of this report would like to acknowledge the contributions of the many individuals and organizations whose efforts and expertise made it possible to produce this report: ● The Canadian Institutes of Health Research (Community Alliances for Health Research program) for funding this five-year collaboration. ● The individual members of The Need To Know Team since its inception in the spring of 2001 up to March 2003: ● The RHA representatives on The Need To Know Team, including Jody Allen, Shelley Buchan, Connie Chapen, Eilish Cleary, Sue Crockett, Bev Cumming, Susan Derk, Albert De Villiers, Tannis Erickson, Margaret Fern, Bonnie Frith, Betty MacKenzie, Debbie Nelson, Pam Seitz, Faye White. ● Others who have participated on behalf of their RHAs include: Maggie Campbell, Cynthia Carr, Marion Ellis, Doreen Fey, Catherine Hynes, Nancy McPherson, Carmel Olson, Jan Roberts. ● The Manitoba Health representatives on The Need to Know Team, including Valdine Berry, Lorraine Dacombe Dewar, Deborah Malazdrewicz. ● Others who have participated on behalf of Manitoba Health include: Shirley Dzogan, Shahin Shoostari, Heather Sparling. ● The MCHP staff members on The Need to Know Team, who contribute to the ongoing support and planning, including Darlene Harder, Linda Kostiuk, Eileen Pyke. ● The evaluator of The Need To Know project, Sarah Bowen, whose extremely valuable input throughout the process continues to enrich and maximize the productivity of the team and its research activities. ● The RHA CEOs for their support, as well as their input into the topic for the first “Team” collaborative research project. ● The MCHP personnel and others who helped us immensely in the reviewing, edit- ing and production of this report, as well as in the provision of advice on some of the indicators: Fred Toll, Renee Robinson, Greg Finlayson, Carolyn De Coster, Janine Harasymchuk, Evelyn Shapiro, Les Roos, Noralou Roos and Marni Brownell. ● CancerCare Manitoba for providing us with cancer data. We want to thank Wendy Fonseca-Holt for preparing the cancer data and Donna Turner for facilitating the provision of the data and providing feedback on section of the report pertaining to cancer incidence rates. ii The authors are indebted to Health Information Services, Manitoba Health and the Office of Vital Statistics in the Agency of Consumer and Corporate Affairs for the provision of data. We acknowledge the financial support of the Department of Health of the Province of Manitoba. The results and conclusions are those of the authors and no official endorsement by Manitoba Health was intended or should be inferred. This report was prepared at the request of Manitoba Health as part of the contract between the University of Manitoba and Manitoba Health. iii iv TABLE OF CONTENTS EXECUTIVE SUMMARY . .xv CHAPTER 1: INTRODUCTION AND METHODS . .1 1.1 Background of the Collaborative Network . .1 1.2 The Geographical Boundaries in This Report . .2 1.3 What’s in This Report? . .2 1.4 Choosing the Districts and the Indicators . .5 1.5 The Methods Used . .8 1.6 Related Sources of Information . .10 1.7 How to Use This Report . .11 References . .15 CHAPTER 2: INTERPRETING THE DATA FOR LOCAL USE . .17 2.1 What’s in This Chapter? . .17 2.2 How the Chapters Are Set Up . .17 2.3 How the Regions and Subregions are Defined and Displayed . .18 2.4 Understanding the Population Structure of the RHAs . .19 2.5 Rates (adjusted and crude) and Actual Client Numbers . .20 2.6 The Meaning of the Statistical Notations . .23 2.7 Summary . .25 References . .26 CHAPTER 3: DEMOGRAPHIC AND SOCIOECONOMIC MEASURES . .27 3.1 What’s in This Chapter? . .27 3.2 Socioeconomic Factor Index (SEFI) . .30 3.3 Population Pyramids . .32 References . .42 CHAPTER 4: HEALTH STATUS AND MORTALITY . .43 4.1 What’s in This Chapter? . .43 4.2 Premature Mortality Rates (PMR) . .46 4.3 Life Expectancy . .48 4.4 Potential Years of Life Lost (PYLL) . .52 4.5 Total Mortality Rates . .58 4.6 Injury Mortality Rates . .60 4.7 Top Causes of Deaths and Injury Deaths . .62 References . .67 v CHAPTER 5: ILLNESS BURDEN . .69 5.1 What’s in This Chapter? . .69 5.2 Diabetes Treatment Prevalence . .72 5.3 Hypertension Treatment Prevalence . .74 5.4 Acute Myocardial Infarction (AMI) Treatment Prevalence 76 5.5 Stroke Treatment Prevalence . .78 5.6 Cancer Incidence . .80 5.7 Total Respiratory Morbidity Treatment Prevalence . .82 References . .84 CHAPTER 6: PREVENTIVE CARE . .85 6.1 What’s in This Chapter? . .85 6.2 Childhood Immunizations - One Year . .88 6.3 Childhood Immunizations - Two Years . .90 6.4 Childhood Immunizations - Seven Years . .92 6.5 Influenza Immunization Rates for Older Adults . .94 6.6 Breast Cancer Screening Rates . .96 6.7 Cervical Cancer Screening Rates . .98 References . .100 CHAPTER 7: CHILD HEALTH . .101 7.1 What’s in This Chapter? . .101 7.2 Preterm Births . .104 7.3 Low Birth Weight . .106 7.4 High Birth Weight . .108 7.5 Breastfeeding Initiation Rates . .110 7.6 Infant Mortality Rate . .112 7.7 Teen Pregnancy Rate . .114 References . .116 CHAPTER 8: PHYSICIAN SERVICES . .117 8.1 What’s in This Chapter? . .117 8.2 Use of Physicians . .122 8.3 Ambulatory Visits . .124 8.4 Ambulatory Consultations . .126 8.5 Visits to General and Family Practitioners (GP/FPs) . .128 8.6 Visit Rates by Age and Gender . .130 8.7 Location of Visits to GP/FPs . .134 8.8 Location of Visits to Specialists . .136 8.9 ‘Causes’ of Physician Visits . .138 CHAPTER 9: HOSPITAL SERVICES . .143 9.1 What’s in This Chapter? . .143 9.2 Supply of Hospital Beds . .146 9.3 Separation Rates . .148 vi 9.4 Days Used for Short Stays . .150 9.5 Days Used for Long Stays . .152 9.6 Hospitalization Rates for Injuries . .154 9.7 Locations: Where did RHA Residents Go for Hospitalization? . .156 9.7.1 Where RHA Residents Went for Hospital Separation . .156 9.7.2 Where RHA Residents Went for Hospital Days . .158 9.8 Catchments: Whose Residents Did this RHA’s Hospitals Serve? . .160 9.8.1 Where RHA Hospital Patients Came From, Based on Separations . .160 9.8.2 Where RHA Hospital Patients Came From, Based on Days . .162 9.9 Causes of Hospitalization . .164 CHAPTER 10: HIGH PROFILE AND DISCRETIONARY SURGICAL PROCEDURES . .167 10.1 What’s in This Chapter? . .167 High Profile Procedures: . .170 10.2 Cardiac Catherizations . .170 10.3 Angioplasty . .172 10.4 Coronary Artery Bypass Graft Surgery . .174 10.5 Hip Replacement . .176 10.6 Knee Replacement .
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