MANITOBA CENTRE FOR HEALTH POLICY Annual Report 2003/2004 July 2004 Department of Community Health Sciences Faculty of Medicine, University of Manitoba Prepared by Shannon Lussier TABLE OF CONTENTS MISSION STATEMENT .......................................................................i DIRECTOR'S LETTER .........................................................................1 DELIVERABLES .................................................................................2 Deliverables Completed .............................................................2 Deliverables In Progress ............................................................2 Recent MCHP Deliverables........................................................5 RESEARCH .......................................................................................6 New Award.................................................................................6 Personnel Awards ......................................................................6 MCHP Research ........................................................................6 Research Using the Repository..................................................8 PUBLICATIONS ...............................................................................10 PRESENTATIONS ............................................................................14 EDUCATION ...................................................................................20 Courses Taught in the Department of Community Health Sciences...................................................................................20 Courses Taught in Other Departments ....................................20 Other Teaching Activities .........................................................20 Education Resources ...............................................................20 Graduate Student Supervision .................................................21 KNOWLEDGE TRANSFER .................................................................22 ADVISORY BOARD MEMBERS .........................................................31 FACULTY AND STAFF......................................................................31 ASSOCIATES ..................................................................................33 COMMITTEES .................................................................................35 FINANCIAL INFORMATION ...............................................................39 MISSION STATEMENT The Manitoba Centre for Health Policy (MCHP) undertakes population-based health services research and policy analyses. MCHP relies upon the unique Population Health Research Data Repository to describe and explain patterns of care and profiles of health and illness. MCHP’s mission 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. The Centre is a research unit in the Department of Community Health Sciences, Faculty of Medicine, University of Manitoba. i MCHP ANNUAL REPORT 2003/2004 1 DIRECTOR’S LETTER in maternal and child health. The first RBC Financial The year 2003/2004 marks my last Group Clinical Research Fellow, Anne Guèvrement, year as Director of the Manitoba began work in October 2003. Centre for Health Policy. On June 1, 2004 I will step down as Director. Congratulations to three of our MCHP Advisory Board Over the past year, I have spent members who have been appointed to the first Health much of my time working toward a Council of Canada: Michael Decter (appointed Chair), smooth transition in leadership at the Dr. Brian Postl (non-government representative), and Centre. Patricia Martens has assumed Milton Sussman (government representative). the Acting Directorship. MCHP is in great shape! My plans are not for There are numerous people whom I wish to thank for retirement, but a year’s sabbatical to their commitment and support this year; I apologize in focus on the new research with the advance for anybody that I might have overlooked: education and social assistance data, returning in the fall of • Members of our Advisory Board, especially our Chair, 2005 to continue on my Canada Research Chair work. Brian Postl; • Health Minister Dave Chomiak, Minister Jim There have been many accomplishments and recognitions Rondeau, Healthy Living, and Deputy Health for MCHP this year. Minister Milton Sussman, who maintain a strong interest in the policy implications of our work; • We are thrilled with Evelyn Shapiro’s establishing the • Minister Peter Bjornson, Education, Citizenship and Evelyn Shapiro Award for Health Services Research. Youth; Minister Diane McGifford, Advanced This will support graduate students to undertake Education and Training; Minister Christine Melnick, research using the Population Health Research Data Family Services and Housing, Minister Tim Sale, Repository. She is also to be congratulated on Energy, Science and Technology; Deputy Minister receiving the Fred Douglas Humanitarian Award for Pat Rowantree, Education, Citizenship and Youth; her many years of outstanding service to Manitoba Deputy Minister Debra Woodgate, Family Services seniors. and Housing; and Deputy Minister John Clarkson, • Anita Kozyrskyj was appointed the Director of the Energy, Science and Technology, all of whom have Western Regional Training Centre at the University encouraged and supported our research interests into of Manitoba. The Centre is designed to support the broader determinants of health; training of applied health services researchers across • Dean of Medicine Brian Hennen and Department disciplines, sectors and institutions. It is a joint Head John O’Neil who have supported new initiatives graduate training program with the University of undertaken by MCHP; British Columbia. • Louis Barre, Chief Information Officer, Manitoba • We congratulate Aynslie Hinds, a Master’s student Health, our able and reliable liaison with Manitoba and research assistant working with Lisa Lix, on being Health; awarded a Canadian Graduate Scholarship from the • Numerous individuals who have provided input and Social Sciences and Humanities Research Council. feedback for our deliverables, especially those who • Congratulations to Laurel Jebamani on receiving her have served on one of our Working Groups; and Master of Science. Her thesis was entitled "The • All the MCHP staff whose hard work and Business of Stopping AIDS: A Case Study of a Non- conscientious commitment is critical to the success of Governmental Organization in South India". MCHP’s activities. • There will be a formal announcement coming soon— Energy, Science and Technology has made the first two installments on an Endowed Chair in Child Health at MCHP in the coming year. We have much to celebrate! Noralou P. Roos, PhD Thanks to the funding received from the RBC Financial Director and Professor Group we have been able to support the recruitment of visiting scholars including Dr. Fiona Stanley, from the Telethon Institute for Child Health Research in Australia. Her research involves conducting and supervising studies 2 MCHP ANNUAL REPORT 2003/2004 DELIVERABLES Deliverables Completed Pharmaceuticals: Therapeutic Interchange and Pricing Policies This project compares the cost implications of adopting various policies to help to manage the growing spending on drugs. Policies explored are reference-based pricing versus aggressive drug use management techniques versus the status quo. The model focused on one class of drugs: a group of drugs commonly used to control high blood pressure. Our model showed Manitoba could have saved almost $7 million in 2000/01 in combined public and private spending for just this one class of drugs. Patterns of Health Care Use and Cost at the End of Life This project explores what services are used before death, how they have changed over time, how they vary by age or region of residence, and what the cost implications are. We incorporated not only use of hospitals, nursing homes and physicians before death, but also home care, pharmaceuticals, and special medical technologies such as MRI. We found that dying people do use more health services than the rest of the adult population—as one might expect—but not very much more. Also we found wide variation in the extent to which nursing home residents are hospitalized before death, a finding which has led to further research. Using Administrative Data to Develop Indicators of Quality in Family Practice The study developed indicators of quality in family practice that are suitable for a quality improvement process, and measurable with data available in the Population Health Research Data Repository. Literature, existing guidelines and focus groups of family physicians were consulted to develop the 13 indicators. We found that Manitoba’s family doctors are doing quite well, and are on a par with physicians in other provinces. Nevertheless, for some indicators, there is room for substantial improvement. Diagnostic Imaging Data in Manitoba: Assessment and Applications The purpose of this project is to develop information capabilities to understand how radiology services are being delivered across the province, including the use of general X-ray, mammography, angiography, ultrasound, bone densitometry, CT scan, and MRI. The study found that there are significant gaps in the data which limit the potential to estimate accurately Manitoba residents’ use of these services, especially outside