By 2031, one-quarter of the Canadian population is expected to consist of adults aged 65 years and older. While many seniors lead healthy and active lives, a significant number live with multiple chronic health issues that require a broad spectrum of social and health services. In order to understand the health needs of seniors and the ability of the health system to meet them, high quality evidence about health and health care delivery is required to answer the many questions that still remain regarding seniors’ access to health services. Dr. Adrian Levy’s research encompasses four inter-related projects focused on generating knowledge about health services required for older adults in BC, including the impacts of changing health services and future health services requirements. These projects include: describing process flows for seniors from independent living to long-term care in the Vancouver Coastal Health Authority; examining the impact of closing residential care beds in BC; comparing wait times to long-term care in BC with those in Ontario; and determining the number of seniors who are institutionalized within in the community in which they live. Dr. Levy’s research findings regarding the health care needs and challenges facing older adults in BC will inform policy and program decision-making related to long-term care in the Vancouver Coastal Health Authority.
Research Pillar: Health Services
An interventional HIV research program to reduce transmission and enhance antiretroviral treatment outcomes among highly marginalized populations
The prevalence of HIV infection among injection drug users and other highly marginalized groups is a significant health issue in Canada. Vancouver’s Downtown Eastside (DTES) is particularly hard hit, with HIV prevalence rates estimated at 25 per cent. These high rates of HIV infection persist in spite of efforts to reduce HIV transmission through various prevention programs, harm reduction strategies, treatment facilities and community law enforcement. HIV prevention strategies and treatment therapies that are effective among other populations have not had the same success in the most vulnerable and marginalized members of society. As an HIV clinician and researcher in the DTES, Dr. Mark Tyndall’s research takes three streams: Observational Cohort Studies: Identifying trends in risk behaviors, drug use patterns, HlV/Hepatitis C rates, social changes, law enforcement initiatives, and the impact of harm reduction interventions on key health indicators; Antiretroviral Therapy: Developing and evaluating strategies and programs that enhance the uptake, delivery and sustainability of antiretroviral therapy to marginalized groups; and Clinical trials research: Advancing Vancouver as a centre for clinical trials research for the evaluation of candidate HIV vaccines and other novel therapies among marginalized groups. Together, Dr. Tyndall’s studies will allow for evidence-based decision-making and improved health outcomes for marginalized groups living with HIV in the DTES and other urban areas in BC.
Health Care Operations Analysis to Reduce Attending Times for seniors presenting to the Emergency Department with a Fall
To examine the flow patterns in emergency departments when seniors present with falls, with the goal of improving care for these patients, reducing the time they spend in the ED, and to better understand the economic costs and the proportion of patients who receive health services to prevent future falls.
Informed Decision Making: The Interaction Between Sustainable Maternity Care Services and Community Sustainability
To examine the role of maternity care in the sustainability of rural and remote communities, with the goal of assisting decision-makers in understanding the implications for the community and to provide them with a framework for making challenging decisions involving changes to the provision of these and other health services.
Changing Prescription Practices to Limit Selection for Resistant Organisms: A Population and System Approach
To evaluate the effectiveness of a three-year BC pilot of “Do Bugs Need Drugs?”, a public and professional education program developed to reduce antibiotic use and the spread of resistant organisms.
Substance-Using Women and Experiences of Primary Health Care
To analyze the social, political, and economic determinants that influence health status and access to health services among women who use injection drugs and live in Vancouver’s Downtown Eastside.
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Measuring the Quality of End of Life Care Provided in Inpatient Health Care Settings
To explore differences in satisfaction with the quality of care received at end of life in different types of hospital wards/settings and to better understand the organizational barriers and facilitators that influence how well that care is provided.
Priority Setting Methods in Cancer: Evidence-Based Marginal Analysis
The challenge of priority setting in cancer has never been so great. Over the past 20 years, over 2.3 million Canadians developed cancer, of which 1.1 million died prematurely. Over the next 20 years, these levels will rise by approximately 56% and 48% respectively. Cancer control and care in BC faces many other challenges: the rising costs of innovation and technology, allocating resources across the spectrum of interventions, a lack of incremental funding growth despite growth in incidence and prevalence, growth in all cancer control programs, need for new programs required with no defined funding, and rising community expectations and demand. A systematic organization of the limited resources in cancer control and care is urgently needed to respond to the potential impacts of cancer.
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Assessment of Pain, Psychosocial Variables, Cognitive Variables, and Work Outcomes in Healthcare Workers Registered in PEARS Programs – A Longitudinal Study
To explore the relationship between depression, pain, and specific cognitive factors in healthcare workers who have had a work-related injury, and how these factors influence their ability and the time it will take for them to recover from injury and return safely to work.
Priority Setting, Health Care Utilisation and Outcomes Evaluation in Seniors’ Care in Interior Health
With about 20% of the region’s population being 65 years and older, the proportion of seniors in the Central Interior region is high compared with provincial and national averages (13%). Projections over the next ten years suggest that the seniors’ population in this region will continue to exceed that of other regions and provinces. As a result, health care for seniors has been identified by Interior Health as one of its key areas of strategic interest.