health economics, health financing, performance measurement / program evaluation, health services delivery, chronic and long-term care, elderly
1) Health Links: The Health System Performance Research Network (HSPRN) is helping policy and clinical decision-makers to think differently about health system performance – moving from how well providers individually care for patients to how well different providers together care for patients across the care continuum. As lead for the HSPRN, I have developed research to understand high users of the health care system and engaged with Ontario Health Links and the MOHLTC Transformation Secretariat to help understand the characteristics and utilization patterns of individuals with complex needs who are in “the top 5%” of health care cost. This work is advanced with ten active engagement of IHPME students and collaborators across many Ontario institutions. The results of this research has become an important motivator for the transformation agenda of the MOHLTC and is impacting the evolving design of Ontario health care system.
2) Functionality Quality Based Payment in the Community: As the payment model for health care in Ontario is changing from an institutional (global budget) model to a person-centered (patient/quality-based payment, QBP_ approach, a group of researchers at the HSPRN, lead by myself and including students and post-doctoral fellows have been working with an MOHLTC export panel and subsequently with the Evidence Standards Division of Health Quality Ontario (formally the Medical Advisory Secretariat) to help design QBP in the community sector. Our research was used to understand care bundles for post-acute care, providing the basis for pricing and quality measurement. Related research for the Ontario Association of Community Care Access Centres (OACCAC) described the cost drivers for care coordinator activities which will also be important for the implementation of care coordinators in Health Links and QBP in the community care setting.
3) Understanding Successful Models of Integrated Care: In collaboration with The Commonwealth Fund (US) and The Kings Fund (UK), and the Monieson Centre, at Queen’s University in Ontario, and supported by a five year international team grant from the Canadian Institutes for Health Research and the Health Research Council of New Zealand, faculty at IHPME are advancing the understanding of integrated care, including understanding what it is , who needs it, and most importantly, how it can be implemented. We produced or collaborated in three white papers on integrated care for persons with multimobidity, on integrating care for persons with chronic health and social need, and a summary of seven inter national case studies of successful models of integrated care. All of these are informing my ongoing research program and the case studies and cross case synthesis will be published in the International Journal of Integrated Care.
As lead for these teams, I coordinate and facilitate the excellent research being undertaken across many institutes by students, post-doctoral fellows and researchers creating critical mass that is resulting in excellent research and training opportunities and successes. I also ensure that the research produced by our team is readily available to decision makers by engaging in consultations and presentations with providers, policy makers and other stakeholders where I bring this body of research to their consideration.
- Research Chair of Implementation and Evaluation Science and Senior Scientist, Trillium Health Partners' Institute for Better Health
- Adjunct Scientist, Institute for Clinical Evaluative Sciences (ICES)
Thesis Supervision (2011+)
- Gustavo Mery. Public, Private and Informal Homecare in Canada: What are the Determinants of Utilization and the Interrelationships among Different Types of Services? (2013)
- Maude Pascale Laberge. How does Ontario Primary Care Perform? Effectiveness, Costs and Efficiency (2015)
- Natasha Erin Lane. Determinants of Disability and Disablement in Ontario Long-term Care Residents (2016)
- Yelena Petrosyan. The Quality of Care Among Older Adults with Diabetes Comorbid with Other Chronic Conditions (2017)
- Chelsea Robin Hellings. Stroke Services in Ontario-based Long Term Care Homes (2011)
- Kevin Ross Walker. Assessing the Determinants of Quality in Ontario’s Long-term Care Homes: Relationships between Staff and Resident Satisfaction (2011)
- Shannon Reynolds. A Comparative Analysis of Long-term Care Policies and Placements (2013)
- Jocelyn Pang. Association of Primary Care Structures with Patient Utilization of Acute Health Services (2015)
- Tommy Lok Hin Tam. Validation of a Health-related Quality of Life Measure based on the Minimum Data Set by Mapping and Regression (2015)
- Allanah Li. Accumulating Multimorbidity: the Role of Depression, Socioeconomic Status, and Other Factors (2019)
- Phat Edward Chau. Effect of Continuity of Care on the Risk of Developing Multimorbidity in Ontario, Canada between 2001 – 2015: A Retrospective Cohort Study (2020)
- Daniel Pincus. Understanding and Improving Wait Times for Hip Fracture Surgery (2019)