Health Services

Addressing disparities in access to living donor kidney transplantation in South and East Asian Canadians

Kidney Transplantation is the treatment of choice for patients with end stage kidney disease. Living donor kidney transplantation ensures the timeliest transplant and offers the best post-transplant survival, making it the gold standard therapy for patients with kidney failure. Unfortunately, access to living donor kidney transplantation varies by age, socioeconomic status, and race. However, our understanding of these disparities are severely limited, particularly in Canada - therefore strategies to address these issues remain poorly characterized.

Primary Investigator: 
Award Type: 
Year: 
2014

Integrating knowledge generation and translation: a unique research program to study the population-level clinical outcomes, health utilization and health services delivery for patients with glomerulonephritis in BC

Glomerulonephritis (GN) is a group of immune diseases that target the kidney and affect younger and otherwise healthy people. Although each type of GN is rare, the group overall is likely a substantial burden to the healthcare system because 25% of dialysis patients have kidney failure due to GN. While GN can be treated with immune medications, these have side effects and many patients progress to dialysis despite treatment.

Primary Investigator: 
Award Type: 
Year: 
2014

Emergency department overcrowding: Determinants, measures and pediatric outcomes

Children needing emergency care are brought for help to either a general emergency department (ED) that treats patients of all ages or a pediatric unit (PED) dedicated to children. In both settings, timely access to quality care is often threatened by overcrowding. There is substantial evidence about the factors causing overcrowding in general EDs and about the association of overcrowding and poor patient outcomes in adults. In contrast, we know little about the relationships among root causes, measures of overcrowding in PEDs, and pediatric patient outcomes.

Primary Investigator: 
Award Type: 
Year: 
2014

Pharmacoepidemiologic and pharmaceutical outcomes research to improve medication use, adherence, and outcomes in patients with arthritis

Arthritis consists of more than 100 types of conditions and is the most common cause of severe chronic pain and disability in Canada, affecting 4.4 million Canadians. People living with arthritis rely on medications to relieve symptoms, prevent their disease from worsening, and allow them to participate in daily activities. However, there are still many unanswered questions regarding these medications.

Primary Investigator: 
Award Type: 
Year: 
2014

A retrospective cohort study of maternal and newborn outcomes and maternity care provider mix in rural British Columbia

Over 40,000 babies are born each year in BC; approximately 15,000 to mothers who live outside the core urban areas of the province. A wave of obstetric service closures over the past ten years has resulted in increasing numbers of pregnant women having to travel long distances to access maternity services or having to relocate to a referral centre in their third trimester.

Primary Investigator: 
Award Type: 
Year: 
2013

Exploring how the process of genetic counselling influences outcomes for individuals with serious mental illnesses

Serious mental illness (SMIs), like schizophrenia, schizoaffective, and bipolar disorder, impact almost one million Canadians. The cause of SMIs are extremely complex. While research clearly demonstrates a genetic component, multiple genes are thought to interact with environmental factors to cause the illnesses. Until recently, knowledge on the genetic and environmental causes of SMIs have not been addressed in standard medical care.

Primary Investigator: 
Year: 
2013

Evaluating the impact of moral arguments on societal values for orphan drug coverage

As a member of the CIHR New Emerging Team for Rare Diseases, Nick is exploring citizens’ attitudes and behaviour as they relate to the challenge of providing accessible treatments for patients suffering from rare diseases. The development of accessible orphan drugs poses a dual problem. On the one hand, the small potential market for orphan drugs for rare diseases makes it difficult for many innovators to access sufficient private capital to develop new orphan drugs, resulting in a lack of treatment options for many rare disease patients.

Primary Investigator: 
Award Type: 
Year: 
2013

Practice experiences of rural GP surgeons in British Columbia

The recruitment and retention of health care professionals is one of the most pressing challenges currently facing the Canadian health care system. In rural communities, the number of obstetricians and general surgeons is diminishing for a number of reasons, including difficulties in recruitment, an aging workforce, resistance to a demanding call schedule, and an increase in sub-specialization resulting in fewer ‘general’ surgeons. In some rural communities, maternity care is provided by general surgeons with enhanced obstetrical skills.

Primary Investigator: 
Award Type: 
Year: 
2007

Effects of antiretroviral therapy (ART) program design on the HIV epidemic in sub-Saharan Africa

Access to antiretroviral therapy (ART) for HIV infection has dramatically increased in recent years. More than eight million people worldwide are now being treated, the majority of whom reside in sub-Saharan Africa. The success of ART roll-out has been possible through large increases in funding, but has been facilitated by the promotion of the “public health approach” to implementing ART in resource-limited settings.

Primary Investigator: 
Award Type: 
Year: 
2012
Health Category: 

An international comparative case study of the health equity impacts of medical tourism in destination countries

Canadians take part in medical tourism when they travel to other countries with the intent of accessing private medical care. It has been speculated that medical tourism by patients from countries such as Canada is exacerbating health inequities in destination countries, and particularly in developing countries. However, there is a lack of evidence demonstrating that this is the case.

Primary Investigator: 
Award Type: 
Year: 
2012

Family planning health services research

Unplanned pregnancy is a problem in BC, especially among vulnerable populations who face stark economic, education-related, and work consequences. Women in BC spend almost 30 years trying to avoid pregnancy, compared with an average of less than three years spent pregnant or trying to conceive. Current surveys indicate that few women use highly effective contraception methods. Half of all pregnancies are unplanned and almost a third of BC women have an abortion. BC has Canada’s second highest abortion rate, and without the recent rate declines seen nationally.

Primary Investigator: 
Award Type: 
Year: 
2012
Health Category: 

Health economic evaluation to inform strategies for HIV treatment and prevention

HIV treatment has advanced remarkably since 1996, with the advent of highly active antiretroviral therapy (HAART). HAART stops HIV replication and, as a result, the virus is reduced to undetectable levels. This allows immune reconstitution to take place, leading to long-term disease remission and prolonged survival.

Primary Investigator: 
Award Type: 
Year: 
2012

Socioeconomic status as a predictor of prenatal mental health, use of selective serotonin reuptake inhibitors during pregnancy, and infant outcomes

During pregnancy, approximately 15 per cent of women experience depression requiring medical intervention. Although these conditions are often treated with Serotonin Reuptake Inhibitor (SRI) antidepressants, these drugs are reported to increase the risks of adverse infant outcomes, including preterm birth, small for gestational age (SGA) birth, respiratory distress, and some congenital heart malformations.

Primary Investigator: 
Award Type: 
Year: 
2011
Health Category: 

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