Suchergebnisse

IntroductionA severe health shock can threaten a patient's life and alter the lives of their family. Spouses often provide care, and may change their work situation, affecting family income. This could mean less work to allow for more caregiving, or more work to make up for the patient's lower income.
Objectives and ApproachWe used the Canadian Hospital and Taxation Database to quantify the impact on workforce participation and changes in earnings among spouses of working-age Canadians who survived a heart attack, cardiac arrest, or stroke. All 40-61 year-olds who experienced a health shock between 2005 and 2010, and survived for at least 3 years, were included, along with their spouses. We use 15 variables to match case spouses with up to 5 (weighted) potential control spouses. The main outcome was Total earnings, which included the sum of wages and salaries, net self-employment income and other employment income, normalized to 2012 Cdn dollars.
ResultsOur analysis included 11,208 spouses of heart attack patients, 622 spouses of cardiac arrest patients, and 2,228 spouses of stroke patients, matched with spouses in the control group. For all three health shocks, we found no significant difference in the distribution of changes in earnings between cases and matched controls (p=0.30 for heart attack; p=0.72 for cardiac arrest and p=0.27 for stroke). We also found no difference in levels of working status (ie being employed). We found mixed impacts by spouses' sex, age, and pre-event earnings for heart attack and stroke patients. These results are consistent with previous findings, but drill deeper by analyzing the distributions of changes in earnings among spouses of patients experiencing health shocks.
Conclusion/ImplicationsDespite known decreases in work and earnings among patients experiencing heart attack, cardiac arrest, or stroke, the proportion of spouses whose work and earnings were increased, decreased, or unchanged was the same as for control spouses. This combination implies a significant reduction in family income after serious health events.

ABSTRACTObjectiveThe goal of this study was to engage members of a long-standing Integrated KT collaborative in a process to revitalize team goals and processes. "The Need to Know" Team started in 2001 in Manitoba, to engage knowledge users in the conceptualization, creation, and application of population health research. The team has garnered numerous national awards and citations for its approach.
We conducted a survey of team members (N=27), representing all Health Authorities in the province, plus provincial government reps. Questions included frequency of data use and medium (print vs online), how well the team is meeting is goals, open-ended questions about how the team could be more useful to members and their organizations, and their top 3 suggestions to ensure the ongoing success and increase the impact of the team.MethodTwenty-two of 27 members responded to the survey (81.5%) within one week. Responses to questions about how well the team is meeting its existing goals revealed high scores – especially among those goals which lay entirely within the scope of the team's control (91% extremely or moderately well). Objectives relating to larger-scale impacts on the healthcare system had lower ratings (72% extremely or moderately well), as might have been expected. ResultsOver 75% reported that the team's work had impacted their organization's work moderately or a lot. The most commonly cited examples were that the work of the team increased capacity for data analysis/interpretation and research (18%), provided results that were used in staff and/or board meetings (15%), influenced decisions and the discussions leading up to them (15%), influenced the development and use of region-relevant quality indicators (13%), and were used in the ongoing education of health professionals (13%). The open-ended questions regarding optimal next steps solicited a variety of suggestions ranging from developing even richer relationships with existing partners, to including a wider variety of partner organizations (e.g. Indigenous groups); aligning team priorities with those of the provincial government (where feasible); and moving to occasional electronic meetings for appropriate content issues and to increase impact in partner organizations.
ConclusionThis exercise in reflection and strategic planning has shown that the team has done an exceptional job in achieving its initial goals, most of which remain relevant, but some of which need revision. More importantly, several creative approaches have been suggested which may increase future impact and enhance both the breadth and depth of the team's reach.

ABSTRACT
ObjectivesRoots of Empathy is a school-based mental health program with demonstrated effectiveness in reducing bullying and aggression, and raising children's social/emotional competence and empathy. This study examines the program's impact on several longer-term health and social outcomes that are related to the program's goals, but not specifically targeted by the program's design or objectives.
ApproachThis study used linked, de-identified administrative records of health, education, social service use and justice system involvement for children and youth in Manitoba who participated in the ROE program, along with a carefully matched comparison group. Propensity scores were used along with hard matching on key variables to ensure comparability of groups. Outcome measures encompass a broad array of health, educational, and social indicators including hospitalization for injury, teen pregnancy, high school graduation, involvement with the criminal justice system, and suicide attempts. Analyses were performed at the Manitoba Centre for Health Policy (MCHP), using SAS 9.4.
ResultsFindings from analyses of data from the pilot study (N=688) reveal several 'collateral benefits' that may be related to the program, though most differences did not reach statistical significance in this initial sample. (Results from the full sample will be available May 2016; N ~ 8000.) Compared to matched counterparts who did not receive the program, ROE participants had lower rates of teen pregnancy (6.6% vs 9.6%; p=0.19), and school grade repetition (2.4% vs 3.8%, p=0.09), and higher rates of high school graduation (77.7% vs 73.5%, p=.36). However, they also had higher rates of injury-related hospitalization (6.4% vs 5.0%, p=0.14). Even in this small pilot, sub-group analyses for some outcomes showed significant differences for some strata but not others. Analyses of the full study group (underway) will provide more robust results.
ConclusionThese findings provide intriguing evidence suggesting beneficial impacts in several longer-term health and social outcomes that could feasibly be related to participation in the Roots of Empathy program. The multi-variable propensity scores and hard-matching algorithms used on this large group provide considerable confidence in attributing group differences to program participation. Results from the full sample will provide more conclusive results, and allow sub-group analyses. The linkage of databases from health, education, social service and justice systems provides a unique opportunity to examine the truly multi-dimensional long-term impacts of a program already proven to provide dramatic improvements in short and medium-term outcomes.

ABSTRACT
ObjectivesThis project links data on acute inpatient hospitalizations from the Canadian Discharge Abstract Database (DAD) with data on income and employment from various taxation- and employment-based administrative files. The goal was to create a linked database that will support research on the labour market and financial outcomes experienced by individuals and families following acute illness requiring hospitalization.
ApproachData from the 1999/00 to 2014/15 Discharge Abstract Database (DAD) were linked to the 1981-2013/14 T1 Tax filer data and the Canadian Child Tax Benefit data. We sought to create a unique association between Health Insurance Numbers (HIN) available in the DAD and Social Insurance Numbers (SIN) available in the tax data by using variables common to both data sets – date of birth, postal code and sex. Both transactional data sets were "individualized" such that unique combinations of the linkage variables were identified and eligible for linkage. The linkage was conducted using deterministic methods.
ResultsApproximately 97% of combinations involving date of birth, postal code and sex in the hospitalization data were uniquely related to a single valid HIN (n=18.8 million). Similarly, approximately 96% of the keys on the Tax data file were associated with a unique person. Approximately 86% of HINs were associated with a unique identifier in the tax file and these HINs account for approximately 83% of the hospital records. The linkage was consistent over time, with linkage rates between 85% and 88% of HINs for all years. Some variation in linkage rates were observed by jurisdiction and by age. (Error estimates to be reported)
ConclusionThis project has created a unique linked database that will support research on the economic consequences of 'health shocks' for individuals and their families, and the implications for income, labour and health policies. This database represents a new and unique resource that will fill an important national data gap, and enable a wide range of relevant research.

IntroductionThe leveraging of multi-sector, whole-population, linked administrative data is advantageous for conducting research on complex real-world problems. However, such large and complex data repositories can sometimes appear impersonal and overwhelming. Establishing organizational empathy (OE) in thecontext of a multi-sector partnership between academic, government and community representatives can help us understand the data better for social policy research. Evidence stemming from this research can then inform policy decisions, ultimately increasing the potency of linked data analysis and creating more meaningful student experiences. Our objective is to examine the role of OE in the student research experience.
Objectives and ApproachSPECTRUM (Social Policy Evaluation Collaborative Team Research at Universities in Manitoba) is a multi-disciplinary partnership working to provide evidence-based solutions to 'wicked' social issues by using linked data from multiple sectors. SPECTRUM provides fellowships to students to become partners in the collaboration. Students have participated in quarterly workshops, building relationships with community leaders, government decision-makers and academic researchers. Students are from various faculties, bringing their unique frameworks and research interests to the collective. Through OE, students observeand participate in SPECTRUM, relating its goals and outcomes to society and their own research.
ResultsStudent inclusion in SPECTRUM enhances the partnership by providing a greater range of perspectives and facilitates the development of OE among SPECTRUM members. Students are using linked administrative data, while actively engaging in dialogue with stakeholders, thereby enriching their knowledge and understanding of research.
Conclusion / ImplicationsData linkage involves more than just use of the repository; it requires establishing common ground since the data have different meaning to each partner. OE developed through SPECTRUM provides invaluable insight into and context for the data. Knowledge transfer among members of the partnership will enrich SPECTRUM's research outcomes while building capacity among Students.