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Arthritis and Related Conditions in Ontario-ICES Research Atlas (2Nd Arthritis and related conditions in Ontario ICES Research Atlas September 2004 Arthritis and Related Conditions in Ontario ICES Research Atlas 2nd Edition September 2004 Authors EM Badley, DPhil NM Kasman, MSc E Boyle, MSc H Kreder, MD, MPH, FRCS(C) L Corrigan, BHScPT, MSc C MacKay, BScPT, MHSc D DeBoer, MMath N Mahomed, MD, ScD RH Glazier, MD, MPH MM Mamdani, PharmD, MA, MPH J Guan, MSc AV Perruccio, MHSc G Hawker, MSc, MD, FRCPC JD Power, MHSc SB Jaglal, PhD D Shipton, PhD J Williams, PhD Institute for Clinical Evaluative Sciences Toronto Arthritis and Related Conditions in Ontario Published by the Institute for Clinical Evaluative Sciences (ICES) © 2004 All rights reserved. No part of this publication may be reproduced, stored in a retrieval system or transmitted in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, without the proper written permission of the publisher. Canadian cataloguing in publication data Arthritis and Related Conditions in Ontario: ICES Research Atlas. Includes bibliographical references. ISBN 0-9730491-8-9 i. Badley, Elizabeth M. 1946 ii. Glazier, Richard H. 1956 How to cite the publication: The production of Arthritis and Related Conditions in Ontario: ICES Research Atlas was a collaborative venture. Accordingly, to give credit to individual authors, please cite individual chapters using chapter authors and title, in addition to editors and book title. For example, for Chapter 2: Perruccio AV, Badley EM, Guan J. Burden of disease. In: Badley EM, Glazier RH, editors. Arthritis and related conditions in Ontario: ICES research atlas. 2nd ed. Toronto: Institute for Clinical Evaluative Sciences; 2004. Institute for Clinical Evaluative Sciences (ICES) G1 06, 2075 Bayview Avenue Toronto, ON M4N 3M5 Telephone: 416-480-4055 www.ices.on.ca Arthritis and Related ICES Research Atlas Conditions in Ontario Authors’ affiliations…page i Acknowledgments…page ii About the organizations involved…page iii Exhibits & appendices directory…page v Map guide—Population geography and mapping boundaries …page xi Overview…page xv Key findings & policy options…page xvii Chapter 1: Emerging Issues…page 1 EM Badley Chapter 2: Burden of Disease…page 15 AV Perruccio, EM Badley and J Guan Chapter 3: Availability of Services…page 41 D Shipton and EM Badley Chapter 4: Primary and Specialist Care…page 67 JD Power, RH Glazier, E Boyle and EM Badley Chapter 5: Use of Medication…page 87 NM Kasman, JD Power, MM Mamdani and EM Badley Chapter 6: Surgical Services…page 105 J Williams, D Shipton, EM Badley, G Hawker, H Kreder, D DeBoer, J Guan and N Mahomed Chapter 7: Rehabilitation for Total Joint Replacement…page 133 SB Jaglal, C MacKay and L Corrigan Contents Arthritis and Related ICES Research Atlas Conditions in Ontario EM Badley, DPhil NM Kasman, MSc Director Research Associate Arthritis Community Research and Evaluation Unit Arthritis Community Research and Evaluation Unit Professor Departments of Public Health Sciences, Medicine and H Kreder, MD, MPH, FRCS(C) Rehabilitation Sciences, University of Toronto Adjunct Scientist Senior Adjunct Scientist Institute for Clinical Evaluative Sciences Institute for Clinical Evaluative Sciences Associate Professor Departments of Surgery, Health Policy, Management and Evaluation, and Clinical Epidemiology, E Boyle, MSc University of Toronto Doctoral Student Arthritis Community Research and Evaluation Unit Director Orthopaedic Research, Department of Orthopaedic Surgery, Sunnybrook and Women’s College Health L Corrigan, BHScPT, MSc Sciences Centre Physiotherapy Practice Leader Musculoskeletal Health and Arthritis, Toronto Western Hospital, University Health Network C MacKay, BScPT, MHSc Research Associate Arthritis Community Research and Evaluation Unit D DeBoer, MMath Director Programming and Biostatistics, N Mahomed, MD, ScD Institute for Clinical Evaluative Sciences Adjunct Scientist Institute for Clinical Evaluative Sciences RH Glazier, MD, MPH Investigator Adjunct Scientist Arthritis Community Research and Evaluation Unit Institute for Clinical Evaluative Sciences Assistant Professor Investigator Orthopaedic Surgery, University of Toronto Arthritis Community Research and Evaluation Unit Orthopaedic Surgeon and Medical Director of the Associate Professor Musculoskeletal Health and Arthritis Program Departments of Family & Community Medicine and Toronto Western Hospital, University Health Network Public Health Sciences, University of Toronto Scientist MM Mamdani, PharmD, MA, MPH Inner City Health Research Unit, St. Michael’s Hospital Scientist Institute for Clinical Evaluative Sciences J Guan, MSc Associate Professor Biostatistician Department of Health Policy, Management and Institute for Clinical Evaluative Sciences Evaluation, Faculty of Medicine and Faculty of Pharmacy, University of Toronto G Hawker, MD, MSc, MD, FRCPC Senior Adjunct Scientist AV Perruccio, MHSc Institute for Clinical Evaluative Sciences Research Associate Arthritis Community Research and Evaluation Unit Investigator Arthritis Community Research and Evaluation Unit JD Power, MHSc Associate Professor Research Associate Departments of Medicine, and Health Policy, Arthritis Community Research and Evaluation Unit Management and Evaluation, University of Toronto Staff Rheumatologist and Director, FM Hill Chair in Academic Women’s Medicine D Shipton, PhD Osteoporosis Research Program, Sunnybrook and Postdoctoral Fellow Women’s College Health Sciences Centre, WC Campus Arthritis Community Research and Evaluation Unit J Williams, PhD SB Jaglal, PhD Adjunct Scientist Scientist Emeritus Institute for Clinical Evaluative Sciences Institute for Clinical Evaluative Sciences Associate Professor Department of Physical Therapy, University of Toronto Authors’ affiliations i Arthritis and Related Conditions in Ontario The authors and editors sought to produce work that is Linda Li relevant to a wide range of stakeholders, from research Physiotherapist, Research Fellow to policy, public health to clinical nursing, rehabilitation Toronto General Research Institute and medicine. Accordingly, a number of leaders in Donald E. McGregor these fields reviewed the atlas from the perspective of Consumer (Vice-Chair Board of Directors, The Arthritis their professional expertise. We thank them for their Society—Ontario Division) contribution to the success of this project. We Dianne Mosher apologize in advance for any unintentional omissions. Rheumatologist Queen Elizabeth II Health Science Centre, Halifax, Nova Scotia Critical Review Peter Norton Professor and Head Patricia Beckett Department of Family Medicine, University of Calgary Physiotherapist The Arthritis Society Janet Pope Rheumatologist Claire Bombardier St. Joseph’s Health Centre Professor of Medicine, Rheumatology Division Director Mark Sack University of Toronto Consumer (Vice-President, Institutional Investments) Robert Bourne Jo-Anne Sobie Orthopaedic Surgeon Executive Director London Health Sciences Centre The Arthritis Society—Ontario Division Ruth Carlisle Margaret Vas Policy Analyst Physiotherapist Ministry of Health and Long-Term Care The Arthritis Society Pierre Côté James Waddell Scientist Orthopaedic Surgeon Institute for Work and Health St. Michael’s Hospital Sharon Cummings Kathryn Whaley Occupational Therapist Consumer The Arthritis Society James Wright Pat D’Hondt Orthopaedic Surgeon Physiotherapist The Hospital for Sick Children The Arthritis Society Susan Jaglal Institute for Clinical Evaluative Sciences Adjunct Scientist Paula McColgan Institute for Clinical Evaluative Sciences Director Policy and External Relations Meera Jain Senior Policy Analyst Carolynne Varney Ministry of Health and Long-Term Care Editor Laura Benben Marjorie Keast Design Manager Population Health Strategies Unit Continental Press Ministry of Health and Long-Term Care Printing Deborah Kennedy Physiotherapist, Research Associate (Arthroplasty Program) ACREU Scientific Coordinator Orthopaedic and Arthritis Institute Crystal MacKay Mary Kim ACREU Internal Review Consumer (Patient Partners in Arthritis and Canadian Arthritis Patient Alliance) Nada Abdel-Malek Rachel Devitt Anne Lyddiatt Olga Manuk Consumer (National Trainer for Patient Partners in Arthritis) Cristina Mattison Michel Landry Leslie Soever Physiotherapist, Research Fellow Jeanette Tyas Medicare to Home and Community Research Unit Annette Wilkins University of Toronto Rose Wong Jody Lewtas ACREU Administrative Support Rheumatologist Acknowledgments Markham Stouffville Health Centre Olga Manuk ii ICES Research Atlas About the organizations involved in the study Institute for Clinical Evaluative educational backgrounds ensures a The Arthritis Society Sciences (ICES) multi-disciplinary approach to issues The mission of The Arthritis Society is Ontario’s resource for informed management and creates a real-world to search for the underlying causes and health care decision-making mosaic of perspectives that is vital to subsequent cures for arthritis, and to shaping Ontario’s future health care. promote the best possible care and ICES is an independent, non-profit treatment for people with arthritis. The organization that conducts research on a ICES collaborates with experts from a Arthritis Society is Canada’s not-for-profit broad range of topical issues to enhance diverse network of institutions, organization devoted solely to funding the effectiveness of health care for government agencies, professional and promoting arthritis research, Ontarians. Internationally recognized for organizations and patient
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