CIHR and the Canadian Institute for Health Information (CIHI) have partnered to create a dynamic cohort of complex, high system users. The Dynamic Cohort was developed using CIHI’s in-house datasets to facilitate cross-jurisdictional research. Cross-jurisdictional research can shed light on how variations in health care delivery affect health outcomes.
High systems users with complex care needs are a relatively small subgroup of the population yet it is responsible for a significant amount of health services use and costs. For example, in Ontario in 2007, 5% of the population was responsible for 66% of health care expenditures. High system users are identified in the literature as a medically and socially vulnerable population including, but not limited to, older adults with multiple chronic conditions, the frail elderly, those with mental illness, individuals with complex multi-morbidity, low socio-economic status, low self-reported health status, minorities, children and youth with complex care needs, those lacking family or social support, and others. This subgroup of the population often use the emergency department (ED) for care that could be prevented or treated in a community setting, are more likely to cycle in and out of hospitals and ED’s and experience gaps in transitions of care.
The purpose of this funding opportunity is to provide funding to support cross-jurisdictional research on high system users using the Dynamic Cohort to improve the evidence for policy making in Canada. A detailed overview of the cohort and descriptive statistics from 2011-2015 is available here.
Relevant program and policy decision-makers must be included on the research team, and the research questions must be driven by the needs of policy makers to have evidence-informed decision making.