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Small area rate variation of hospitalization in New Brunswick

Category(s): Health
Status: Closed
Principal: Daniel Dutton
Project Number: P0057
Year Approved: 2021

Project Description

It is clear that the healthcare system in New Brunswick (NB) has significant challenges that are intertwined with radical demographic shifts, higher than average observed rates of disease and adverse health conditions and increasing demands for health services. While fewer diseases are fatal, an increasingly number of people are living with one or more complex chronic diseases and require years or even decades of support from care systems. The impact is most profoundly felt at the local level where care is provided and where communities are tasked with responding to changing health needs. An understanding of who is getting sick, what illnesses are making them sick and why some populations seem to do particularly poorly or well over time, is necessary to inform and guide health policy, planning and research  
Rate differences, population projections and social determinants of health are inherently geographic in nature. Our communities are not homogeneous. Nor is demographic change occurring uniformly across our communities. However, these important considerations were not incorporated into the existing regional-level population projections. Moreover, important processes may be otherwise obscured by the geographic scale used in the construction of these projections.  
This project will address these important limitations and expand on demographic projections of population change by concurrently measuring and modelling how rates of chronic disease will vary with population shifts at the local level. These small-area rate variations and projection scenarios are essential to inform NB health policy and research.  
Previous work in this area formed part of a multi-provincial project to examine small-area rate variation (SARV) in the Maritimes. This work will now also be a component of a SARV work at a national level, whose results will be used as a comparator against the national-level data. This national level project titled "Estimating and Mapping Urban Community Differences in Health Outcomes for Adults with Chronic Disease in Canada" is funded by a CIHR Operating Grant and will use a dynamic cohort dataset created by CIHI to replicate the high-cost hospital SARV work on a national level. This dynamic cohort has some limitations, and to understand the extent of the limitations we plan to use high-cost hospital SARV results from NB and NS as comparators to the findings for those provinces using the cohort. To accomplish this, the code to pull the data required for the analyses has been updated to ensure comparability with how the Nova Scotia data pull was created.