Objectives To assess whether recently-proposed alternatives to the quality-adjusted life year (QALY), intended to address concerns about discrimination, are suitable for informing resource allocation decisions. Methods We consider two alternatives to the QALY: the Health Years in Total (HYT), recently proposed by Basu et al., and the Equal Value of Life Years Gained (evLYG),…
| Aaron J Trachtenberg, Amity Quinn, Braden Manns, Brenda Hemmelgarn, Flora Au, Kerry McBrien, Marcello Tonelli, Sepideh Souri, Elissa Rennert-May, Liam Manns, Nikita Arora, Paul Ronksley, Yewande Ogundeji
Physician payment models are perceived to be an important strategy for improving health, access, quality, and the value of health care. Evidence is predominantly from primary care, and little is known regarding whether specialists respond similarly. We conducted a systematic review to synthesize evidence on the impact of specialist physician payment models across the domains of…
| Amity Quinn, Braden Manns, Brenda Hemmelgarn, Flora Au, Marcello Tonelli, Peter Faris, Aaron J Trachtenberg, Jianguo Zhang, Scott Klarenbach, Robert G. Weaver
Health care payers are interested in policy-level interventions to increase peritoneal dialysis use in end-stage renal disease. We examined whether increases in physician remuneration for peritoneal dialysis were associated with greater peritoneal dialysis use.
| Alun Edwards, Amity Quinn, Braden Manns, Brenda Hemmelgarn, Flora Au, Kerry McBrien, Marcello Tonelli, Peter Faris, Peter Senior, Robert G. Weaver, Zhihai Ma
Question Is a specialist physician payment model associated with visit frequency, quality of care, and costs for people with chronic disease? Findings In this population-based cohort study that included a propensity-score matched cohort of 31?898 adults with diabetes or chronic kidney disease seen by 489 physicians, there was no statistical evidence of a difference…
Health Technology Assessment (HTA) has always sought to incorporate the evidence of all patients affected in the decision-making process. While health system budgets could increase to cover costs of new technologies, the relevant patients are those benefitting from access to the technology being appraised. More recently, with health system budgets effectively fixed, costs of new…
| Amity Quinn, Braden Manns, Brenda Hemmelgarn, Flora Au, Marcello Tonelli, Robert G. Weaver, Scott Klarenbach, Helen So
As the adverse clinical outcomes common in patients with chronic kidney disease (CKD) can be prevented or delayed, information on the cost of care across the spectrum of CKD can inform investments in CKD care.
| Amity Quinn, Alun Edwards, Peter Senior, Kerry McBrien, Brenda Hemmelgarn, Marcello Tonelli, Flora Au, Zhihai Ma, Robert G. Weaver, Braden Manns
Background: As the number of people with chronic diseases increases, understanding the impact of payment model on the types of patients seen by specialists has implications for improving the quality and value of care. We sought to determine if there is an association between the specialist physician payment model and the types of patients seen.
The purpose of this study was to examine the acceptance of Global Positioning System (GPS) used to help people with dementia, who are at risk for wandering in their communities. We used a mixed methods research approach that included use logs, pre and post paper-based questionnaires, and focus groups. Forty-five client-caregiver pairs (dyads) were included to use one of the GPS…