Therese A Stukel

..The extent to which better spending produces higher-quality care and better patient outcomes in a universal health care system with selective access to medical technology is unknown...

..A minimization algorithm will ensure balanced allocation of the intervention with respect to these factors in study hospitals...

..Restrictions on non-urgent hospital care imposed to control the 2003 Toronto severe acute respiratory syndrome outbreak led to substantial disruptions in hospital clinical practice, admission, and transfer patterns...

..The health and policy implications of the marked regional variations in intensity of invasive compared with medical management of patients with acute myocardial infarction (AMI) are unknown...

..Randomized trials have shown that medical and interventional therapies improve outcomes for acute myocardial infarction (AMI) patients. The extent to which hospital quality improvement translates into better patient outcomes is unclear...

..Comparisons of outcomes between patients treated and untreated in observational studies may be biased due to differences in patient prognosis between groups, often because of unobserved treatment selection biases...

..Taking a novel, population-based approach, we estimated the potential detrimental impact of undertriage to a non-TC (NTC) within a regional system...

..The extent to which uncomplicated obesity among an otherwise healthy middle-aged population is associated with higher longitudinal health-care expenditures remains unclear...

..We describe the impact of these restrictions on health care utilization and suggest lessons for future epidemics...

..Although approximately one third of patients with heart failure (HF) visiting the emergency department (ED) are discharged home, little is known about their care and outcomes...

....

..We test whether the balance between daily hospital admissions and discharges affects next-day ED length of stay...

..The type of outpatient physician care after an emergency department visit for heart failure may affect patients' outcomes. Methods and..

..With the increasing use of colonoscopy there is growing concern about the quality of these procedures...

..Understanding the reasons underlying this mismatch may facilitate improvements in care and outcomes for patients with heart failure...

..Temporal trends in risk factors for cardiovascular disease and the impact of socio-economic status on these risk factors remain unclear...

..However, previous studies have focused on predicting shorter-term mortality and limited data currently exist to predict expected survival among hospitalized patients with HF...

..The health implications of regional differences in Medicare spending are unknown...

..We examined recent national trends in mortality and rates of hospital admission for these 3 conditions...

..It is also not known whether subgroups of individuals are at greater risk, eg, those with radiation sensitivity or high ultraviolet radiation exposure...

..Despite a widespread interest in increasing the numbers of primary care physicians to improve care and to moderate costs, the relationship of the primary care physician workforce to patient-level outcomes remains poorly understood...

..To describe the relationship of primary care physician (PCP) supply for children and measures of health care access, use, and outcomes...

..Heart failure contributes to millions of emergency department (ED) visits, but hospitalization-versus-discharge decisions are often not accompanied by prognostic risk quantification...

..The aim of our study was to identify occupations associated with increased risk of basal cell carcinoma (BCC) and squamous cell carcinoma (SCC)...

..Higher blood pressure in acute heart failure has been associated with improved survival; however, the relationship between blood pressure and survival in stabilized patients at hospital discharge has not been established...

..We designed this study to evaluate the association of colonoscopy with colorectal cancer (CRC) death in the United States by site of CRC and endoscopist specialty...

..The health implications of regional differences in Medicare spending are unknown...

..One proposed strategy to increase hospital surge capacity is to restrict elective hospitalizations, yet the degree to which this measure would meet the anticipated is unknown...

..The objective of this study is to estimate the prevalence of people previously hospitalized with an acute myocardial infarction (AMI) using 17 years of hospital data and to create a registry of people with myocardial infarction...

..Tea constituents, including polyphenols, are hypothesized to have chemopreventive properties, and inhibit the induction of skin cancers in animal models...

..To determine whether patients who are not admitted to hospital after attending an emergency department during shifts with long waiting times are at risk for adverse events...

..Our objective was to evaluate the association between regional colonoscopy rates and death from colorectal cancer (CRC)...

..Our objectives were to evaluate the rates of bleeding, perforation, and death associated with outpatient colonoscopy and their risk factors in a population-based study...

....

..We determined if a "dose-dependent" relationship exists between heart failure events and death, accounting for temporal changes in age, comorbidities, and disease severity...

..Determining the extent to which variations in antipsychotic use are a symptom of facility-level quality problems as compared with a drug safety issue is important for selecting the correct interventions to effect change...

....

..Given the importance of ethnicity in influencing diabetes risk and its significance in a multi-ethnic population, it is prudent to determine its influence on a population-based risk prediction tool...

..There are no life-tables quantifying the average life-spans of post-hospitalized heart failure populations across various strata of risk...

..We explored variation in the use of antipsychotic therapy across nursing homes in Ontario, Canada, and determined if prescribing decisions were based on clinical indications...

..To investigate access to effective primary health care services in children of new immigrants to Canada by assessing immunization coverage at age 2...

..Our objective was to evaluate the extent to which demand-side factors such as clinical urgency/need, and supply-side factors, as reflected by differences in physician and procedural supply account for these inequalities...

..Vaccination of patients with MG against influenza was not found to be associated with exacerbations of the disease. Our findings do not support the practice of withholding influenza vaccination in patients with MG...

..We believe that hospital-specific measures can be helpful in identifying providers with acceptable quality indices who are also relatively efficient in managing chronic illness...

..CONCLUSION: Influenza vaccination is associated with a small but significantly increased risk for hospitalization because of GBS...

..Our objective was to estimate the annual incidence of CRC within 7 yr following FS and to identify factors associated with incident CRC in those with a negative FS...

....

..We evaluated the effect of Ontario's UIIP on influenza-associated mortality, hospitalizations, emergency department (ED) use, and visits to doctors' offices...

....

....

..National estimates of the upcoming diabetes epidemic are needed to understand the distribution of diabetes risk in the population and to inform health policy...

..The objective of the present study was to examine the relationship among cardiovascular evaluation and management intensity, physician supply and cardiovascular disease burden in the Canadian population...

..To evaluate the effect of emergency department (ED) clinical decision units (CDUs) on overall ED patient flow in a pilot project funded in 2008 by the Ontario Ministry of Health and Long-Term Care (MOHLTC)...

..Since observational studies are prone to bias, future efforts to estimate vaccine effectiveness in the elderly should strive to minimize bias through improved data quality, novel data sources, and/or new analytical techniques...

..Findings suggest that cumulative, but not intermittent, measures of sun exposure derived from a personal interview appear to reflect a person's exposure history based on histologic evidence...

..Previous analyses of undertriage focused only on survivors to trauma center care and were potentially subject to survivor bias. Using a novel population-based design, we evaluated the true mortality cost of undertriage...

..Nonetheless, unmeasured confounding may unduly influence this comparison. This unmeasured risk may have less influence on comparisons of patients undergoing surgery at hospitals with differing transfusion rates...

..Estimates of influenza vaccine effectiveness in elderly individuals are largely from observational studies, which are susceptible to bias. Instrumental variable (IV) methods control for overt and hidden biases in observational studies...

..We aimed to compare rates of admission for congestive heart failure in elderly patients who were newly dispensed COX-2 inhibitors or non-selective NSAIDs...

..To evaluate the use of healthcare resources during the last six months of life among patients of US hospitals with strong reputations for high quality care in managing chronic illness...

..This study measures regional variation in LBW rates and identifies regions of neonatal health services with significantly high or low adjusted rates...

..This has not been well documented. We compared the risk of development of incident parkinsonism among older adults dispensed atypical relative to typical antipsychotics...

..Furthermore, measures of treatment effectiveness were attenuated when obtained using clinical data compared to when administrative data were used...

..We conducted a population-based study to determine the colonoscopy completion rate and to identify factors associated with incomplete procedures...

..This article examines the association between introduction of Ontario's Universal Influenza Immunization Program and changes in vaccination rates over time in Ontario, compared with the other provinces combined...

..There were some indications of a modest, nonsignificant reduction on the number of BCCs and SCCs with NSAID use. Our data suggest a weak and inconsistent chemopreventive effect of NSAIDs on BCC and SCC...

..g., <5 live births) (pOR 0.33, 95% CI 0.14-0.75). The results are compatible with an effect of reproductive history-related factors on melanoma risk, but also could reflect differences in other factors, such as sun exposure history...

..The objective of this study was to examine the temporal trends in the utilization and costs of cardiovascular technologies for the evaluation and/or management of patients with ischemic heart disease in Canada...

..By promoting competition between hospitals and providers, market-based models may exacerbate existing variations in the quality of hospital care...

..We conducted a study to determine whether a greater supply of neonatologists or neonatal intensive care beds is associated with lower neonatal mortality...

..We studied the association between immunization coverage for a cohort of 2-year-old children covered by a universal health insurance plan and pediatric provider and other health services characteristics...

..Efforts to control an outbreak of severe acute respiratory syndrome (SARS) in Toronto, Canada, led to the imposition of major restrictions on nonurgent use of hospital-based services...

..Pain, a common reason for visits to primary care physicians, is often not well managed. The objective of this study was to determine the effectiveness of pain management interventions suitable for primary care physicians...

..These influence measures are applied to an analysis of 5-year Medicare reimbursements to colon cancer patients to identify the most influential observations and their effects on the fixed-effects coefficients...

..Future directions include extending these results to multivariate analyses and pulmonary function data...

..The methods we propose will circumvent many of the above technical difficulties and would not require either special software or high performance computer workstations. ..