Brandon Zagorski

BMZ Analytics / U of Toronto

Background: Home-based palliative programs rely on family caregivers, who often miss time from employment. This article identified changes in caregivers' labour force participation over the palliative trajectory. Methods: Family caregivers (n = 262) were interviewed biweekly to measure transitions across four employment categories. Results: Mo...

Background/Objectives Children using home mechanical ventilation (HMV) live at home for better quality of life, despite financial burden for their family. Previous studies of healthcare utilization and costs have not considered public and private expenditures, including family caregiver time. Our objective was to examine public and private healthca...

Background and aim Atrial fibrillation is associated with increased risk of ischemic stroke and its global prevalence is increasing. We aimed to describe the contemporary temporal trends in hospital admissions, case fatality rate, as well as sex differences in atrial fibrillation-related stroke in Canada. Methods We conducted a retrospective cohor...

Objective. Breast-conserving therapy with external beam radiotherapy (EBRT) is currently the standard of care for women with early breast cancer. Our aim was to determine if early-stage breast cancers treated with lumpectomy and primary intraoperative radiotherapy (IORT) have comparable local recurrence rates. This is the first study examining the...

Background and Purpose— The purpose of this study was to assess recent trends in the admission and mortality rates for subarachnoid hemorrhage in Canada. Methods— This retrospective cross-sectional study was based on data retrieved from the Canadian Institute for Health Information for all patients diagnosed with subarachnoid hemorrhage in Canada...

Background Gastrectomy with negative resection margins and adequate lymph node dissection is the cornerstone of curative treatment for gastric cancer (gc). However, gastrectomy is a complex and invasive operation with significant morbidity and mortality. Little is known about surgical practice patterns or short- and long-term outcomes in early-stag...

Objectives TNM stage is the preeminent cancer staging system and a fundamental determinant of disease prognosis. Our goal was to evaluate the predictive power of TNM stage for gastric adenocarcinoma (GAC), in a low-incidence country. Methods A province-wide chart review of GAC patients diagnosed from April 1, 2005 to March 31, 2008 was conducted i...

Background: Atrial fibrillation (AF) is associated with increased risk of ischemic stroke. In Canada, the contemporary burden of AF-related stroke is incompletely characterized. Our objective was to determine temporal trends in hospital admissions and in-hospital mortality for AF-related stroke in Canada from 2007 to 2015. Methods: We conducted a r...

Background Accurate TNM stage information is essential for cancer health services research, but is often impractical and expensive to collect at the population-level. We evaluated algorithms using administrative healthcare data to identify patients with metastatic gastric cancer. MethodsA population-based cohort of gastric cancer patients diagnosed...

Objectives This study estimated the health impacts of neighbourhood socioeconomic position (SEP) among public housing residents. Because applicants to public housing were assigned to housing projects primarily based on factors other than personal choice, we capitalised on a quasirandom source of variation in neighbourhood of residence to obtain mor...

167 Background: Half of gastric cancer patients in North America present with metastatic disease. The appropriate management of these patients is complex and few guidelines exist to definitively guide treatment; as a result, practice variation exists. This variation may lead to care inefficiencies with adverse outcomes. We therefore aimed to conduc...

165 Background: Gastric cancer is a highly morbid and fatal disease. While the clinical challenge with gastric cancer is widely described, little is known about the economic burden of the disease. Many guidelines outline the curative treatment for gastric cancer and in a universal healthcare system, equal access and uniform healthcare delivery is p...

Background Individuals using home mechanical ventilation (HMV) frequently choose to live at home for quality of life, despite financial burden. Previous studies of healthcare utilisation and costs do not consider public and private expenditures, including caregiver time. Objectives To determine public and private healthcare utilisation and costs f...

Background Before undergoing curative-intent resection of gastric adenocarcinoma (ga), most patients undergo abdominal computed tomography (ct) imaging to determine contraindications to resection (local invasion, distant metastases). However, the ability to detect contraindications is variable, and the literature is limited to single-institution st...

Family caregivers of patients enrolled in home-based palliative care programmes provide unpaid care and assistance with daily activities to terminally ill family members. Caregivers often experience caregiver burden, which is an important predictor of anxiety and depression that can extend into bereavement. We conducted a longitudinal, prospective...

76 Keywords: palliative care, home-based care, family caregivers, predictors of place of death, cancer, public and private expenditures, unpaid care Abstract / Many cancer patients die in institutional settings despite their preference to die at home. A longitudinal , prospective cohort study was conducted to comprehensively assess the determinants...

The use of thrombolysis in acute stroke is an important indicator of the quality of stroke care, because it requires health care providers to work collaboratively, rapidly and accurately to optimize patient outcomes. We sought to assess the quality of hyperacute stroke care in Canada using the rate of thrombolysis as the key indicator. We used nati...

Purpose: To examine service use by adults with serious mental illness (SMI) rostered in new primary care models: enhanced fee-for-service (FFS), blended-capitation (CAP) and team-based capitation (TBC) models with and without mental health workers (MHW) in Ontario. Methods: This cross-sectional study used administrative health service databases to...

Background: On-site attendance to prescheduled cardiac rehabilitation visits has been shown to be associated with improved outcomes following cardiac rehabilitation. The extent to which on-site programmatic attendance represents a healthy-adherer effect remains unknown. Methods: This retrospective cohort study consisted of 17,000 consecutively r...

We studied the relationships among psychiatrist supply, practice patterns, and access to psychiatrists in Ontario Local Health Integration Networks (LHINs) with differing levels of psychiatrist supply. We analyzed practice patterns of full-time psychiatrists (n = 1379) and postdischarge care to patients who had been admitted to hospital for psychia...

Objectives To characterise trends in live birth rates, adverse neonatal outcomes and socio-demographic characteristics of pregnant women with diagnosed HIV between the ages of 18 and 49 in Ontario, Canada from 1 April 2002 to 31 March 2010.Methods We conducted a population-based study using linked administrative healthcare databases, and used gener...

Objective: This study examined factors associated with living setting of patients with acquired brain injury at discharge from inpatient rehabilitation. Design: Retrospective cohort design. Subjects/patients: Cohort of patients first identified in acute care with a diagnostic code of traumatic or non-traumatic brain injury who also subsequentl...

The objectives were to describe times to diagnosis and initiation of treatment in pediatric ALL in Ontario from 1997 to 2007, and to measure their impact on OS and EFS. In 1000 children, the median times to diagnosis and treatment were both 1day (IQR=1-2). Those who began treatment >3 days after diagnosis had inferior OS (AHR=2.49; 95% CI=1.40-4.43...

Background: Population-based estimates of HIV prevalence, rates of new HIV diagnoses, and mortality rates among persons with HIV who have entered care are needed to optimize health service delivery and to improve the health outcomes of these individuals. However, these data have been lacking for Ontario. Methods: Using a validated case-finding alg...

Acquired brain injury (ABI), which includes traumatic (TBI) and non-traumatic brain injury (nTBI), is a leading cause of death and disability worldwide. The objective of this study was to examine the trends, characteristics, cause of brain injury, and discharge destination of hospitalized older adults aged 65 years and older with an ABI diagnosis i...

The increasing attention on home-based service provision for end-of-life care has resulted in greater financial demands being placed on family caregivers. The purpose of this study was to assess publicly financed costs within a home-based setting from a societal perspective. A prospective cohort study design was employed. In all, 129 caregivers of...

To compare the operative outcomes of early and delayed cholecystectomy for acute cholecystitis. Randomized trials comparing early to delayed cholecystectomy for acute cholecystitis have limited contemporary external validity. Furthermore, no study to date has been large enough to assess the impact of timing of cholecystectomy on the frequency of se...

RÉSUMÉ Cette étude a examiné un profil basé sur la population des personnes âgées atteintes des lésions cérébrales acquises (LCA), et de leur résultats fonctionnels, en réadaptation en milieu hospitalier au Canada. Les personnes âgées de 65 ans et plus qui ont été admises en réadaptation en milieu hospitalier de soins aigus pour un traumatisme cran...

. To obtain estimates of direct health care costs for prostate cancer (PC) from diagnosis to death to inform state transition models. . A stratified random sample of PC patients residing in 3 geographically diverse regions of Ontario, Canada, and diagnosed in 1993-1994, 1997-1998, and 2001-2002, was selected from the Ontario Cancer Registry. We ret...

The Canadian STOP-PAIN Project assessed the human and economic burden of chronic pain (CP) in individuals on waitlists of Canadian multidisciplinary pain treatment facilities. This article focuses on sex differences. Objectives were to (1) determine the pain characteristics and related biopsychosocial factors that best differentiated women and men...

Helicobacter pylori (H. pylori) infection can be significantly reduced by immunization in mice. Th17 cells play an essential role in the protective immune response. Th1 immunity has also been demonstrated to play a role in the protective immune response and can compensate in the absence of IL-17. To further address the potential of Th1 immunity, we...

Objective: To examine the impact of anxiety disorders comorbid to bipolar disorder (BD) in a large, nationally representative sample, to describe the sociodemographic and clinical profiles of Canadians living with BD and with or without comorbid anxiety disorders, to identify the characteristics uniquely associated with comorbid anxiety, and to ex...

With increasing emphasis on the provision of home-based palliative care in Canada, economic evaluation is warranted, given its tremendous demands on family caregivers. Despite this, very little is known about the economic outcomes associated with home-based unpaid care-giving at the end of life. The aims of this study were to (i) assess the magnitu...

Cardiac rehabilitation (CR) is associated with mortality and morbidity benefits. Treatment adherence rates of 20% to 60% for patients with diabetes and obesity undermines CR effectiveness. Identification of factors that account for poorer adherence to CR in these populations is needed. Data from 12 003 CR patients from 1995 to 2010 were analyzed. D...

Large multispecialty physician group practices, with a central role for primary care practitioners, have been shown to achieve high-quality, low-cost care for patients with chronic disease. We assessed the extent to which informal multispecialty physician networks in Ontario could be identified by using health administrative data to exploit natural...

Background: Despite evidence in favour of early cholecystectomy for most patients with acute cholecystitis, variation in practice has been reported across hospitals worldwide. We sought to characterize the extent and potential sources of variation in the performance of early cholecystectomy for acute cholecystitis within a large regional health ca...

Cardiovascular disease (CVD) is a leading cause of hospitalizations, death, and health care costs. Although studies have shown that modifying CVD risk factors at the patient level improves patient prognosis, the effect of community-wide interventions at the population level has been uncertain. To evaluate the resource use and cost consequences of a...

Background: Health system restructuring coupled with the preference of patients to be cared for at home has altered the setting for the provision of palliative care. Accordingly, there has been emphasis on the provision of home-based palliative care by multidisciplinary teams of health care providers. Evidence suggests that these teams are better...

Background: A limited understanding of satisfaction with home-based palliative care currently exists. Aim: This study measured family caregivers' satisfaction with home-based physician and nursing palliative care services, and explored predictors of satisfaction, across the palliative care trajectory. Design: A longitudinal, cohort design was...

: To explore whether a discrepancy between the availability of trauma services (potential access) and trauma center utilization rates (realized access) exists, with the aim of informing strategies to improve access. : Lack of access to trauma center care has frequently been attributed to the geographic distribution of trauma centers. Alternatively,...

Randomized trials and expert opinion support early laparoscopic cholecystectomy for most patients with acute cholecystitis (AC); however, practice patterns remain variable worldwide, and delayed cholecystectomy remains a common practice. We therefore present a population-based analysis of the clinical course of patients with AC discharged without c...

Current data on the clinical course of patients with acute cholecystitis managed with percutaneous cholecystostomy (PC) are limited by small sample size and imperfect follow-up. We present the characteristics and clinical course of a population-based cohort with acute cholecystitis managed with PC. We designed a retrospective cohort study using adm...

Among people living with HIV infection in the era of combination antiretroviral therapy (cART), admission to hospital may indicate inadequate community-based care. As such, population-based assessments of the utilization of inpatient services represent a necessary component of evaluating the quality of HIV-related care. We used a validated algorith...

Evidence-based priority setting is increasingly important for rationally distributing scarce health resources and for guiding future health research. We sought to quantify the contribution of a wide range of infectious diseases to the overall infectious disease burden in a high-income setting. We used health-adjusted life years (HALYs), a composite...

Syndromes and episode lengths. (DOCX)

Parameters for estimating the disease burden due to Salmonella . (DOCX)

Parameters for estimating the disease burden of various health states of human papillomavirus (HPV). (DOCX)

Parameters for estimating the disease burden due to human immunodeficiency virus (HIV). (DOCX)

Parameters for estimating the disease burden due to human papillomavirus (HPV)-related cancers. (DOCX)

Parameters for estimating the disease burden due to Streptococcus pneumoniae. (DOCX)

HALY formulae. (DOCX)

Background: More than a third of patients with severe injury who receive initial care at nontrauma centers (NTCs) are not transferred to trauma center care. In those who are transferred, significant delays have been described. The availability of specialists, imaging modalities, or critical care resources might significantly affect transfer practi...

Background Acquired Brain Injury (ABI) from traumatic and non traumatic causes is a leading cause of disability worldwide yet there is limited research summarizing the health system economic burden associated with ABI. The objective of this study was to determine the direct cost of publicly funded health care services from the initial hospitalizati...

Helicobacter pylori (H. pylori) is a bacterial pathogen that resides at the gastric mucosa and has a world-wide prevalence of over 50%. Infection usually lasts for the life of the host, and although all infected individuals will develop histologic gastritis only a subset will develop symptomatic gastritis, peptic ulcer disease, gastric MALT lymphom...

Disparities in access to services across genders have been reported in many healthcare settings. The extent to which this occurs in the case of emergency surgical care is unknown. We set out to evaluate whether gender is a determinant of access to trauma center care, particularly in the setting where trauma triage guidelines are strong facilitators...

By ensuring timely access to trauma center (TC) care, well-organized trauma systems have the potential to significantly reduce injury-related mortality. However, undertriage continues to be a significant problem in many regional trauma systems. Taking a novel, population-based approach, we estimated the potential detrimental impact of undertriage t...

Alternate-level-of-care (ALC) days represent hospital beds that are taken up by patients who would more appropriately be cared for in other settings. ALC days have been found to be costly and may result in worse functional outcomes, reduced motor skills and longer lengths of stay in rehabilitation. This study examines the factors that are associate...

The aim of this paper is to examine factors associated with discharge destination after acquired brain injury in a publicly insured population using the Anderson Behavioral Model as a framework. We utilized a retrospective cohort design. Inpatient data from provincial acute care records from fiscal years 2003/4 to 2006/7 with a diagnostic code of t...

The risk of relapsing bacteremia was assessed retrospectively among a cohort of 348 patients who underwent peripherally inserted central catheter (PICC) insertion within 6 weeks of a documented bacteremia. The overall risk of relapsing bacteremia was low (three of 348; 0.9%) when PICC insertion was performed in the context of a recent bloodstream i...

To assess whether antidepressant treatment is associated with a temporary increase in the risk of a motor vehicle crash among older adults. Population-based case-only time-to-event analysis. Data from transportation and healthcare databases for adults age 65 and older in Ontario, Canada, between January 1, 2000, and October 31, 2007. Consecutive ad...

Purpose: To obtain population-based estimates of direct healthcare costs for prostate cancer (PC) from diagnosis to death for health states in a state-transition model. Method: PC patients, diagnosed in 1993, 1994, 1997, 1998, 2001, and 2002, and residing in three regions of Ontario, Canada, were selected from the Ontario Cancer Registry. We retr...

Past varicella infection (chicken pox) may reactivate into herpes zoster (shingles). Varicella vaccination leads to a reduction in cases of varicella that may in turn increase herpes zoster rates due to reduction in the immune boosting effect of exposure to varicella zoster virus against varicella reactivation. We assessed the impact of childhood v...

Emergency departments are medical treatment facilities, designed to provide episodic care to patients suffering from acute injuries and illnesses as well as patients who are experiencing sporadic flare-ups of underlying chronic medical conditions which require immediate attention. Supply and demand for emergency department services varies across ge...

List of algorithms (DOC)

We sought to validate a case-finding algorithm for human immunodeficiency virus (HIV) infection using administrative health databases in Ontario, Canada. We constructed 48 case-finding algorithms using combinations of physician billing claims, hospital and emergency room separations and prescription drug claims. We determined the test characteristi...

To evaluate the effectiveness of the community based Cardiovascular Health Awareness Program (CHAP) on morbidity from cardiovascular disease. Community cluster randomised trial. 39 mid-sized communities in Ontario, Canada, stratified by location and population size. Community dwelling residents aged 65 years or over, family physicians, pharmacists,...

Disease-specific estimates of medical costs are important for health policy decision making. To identify predictors of health care costs associated with hepatitis C virus (HCV) seropositivity across disease phases. HCV laboratory tests from the BC Centre for Disease Control were linked to administrative data pertaining to health services and drugs...

The aim of this study was to determine the number of annual hospitalizations and overall episodes of care that involve a traumatic brain injury (TBI) by age and gender in the province of Ontario. To provide a more accurate assessment of the prevalence of TBI, episodes of care included visits to the emergency department (ED), as well as admissions t...