Our Research

Our research spans a number of key areas, primarily related to healthcare funding. Our core research is around the following key areas:

Activity-based funding (ABF)

This study examines the impact of activity-based funding (ABF) on acute care hospitals and related services in BC. This is the first formal evaluation of the effects of ABF in Canada, and will provide an evidence base for policy makers. Early results are published each month:

Aligning Structures and Incentives in Loosely Organized Systems

Episodes of Care: This study targets the development of methods for funding health care services across settings and providers related to a specific episode of care, commonly referred to as “bundled payment” methods. Bundled payments have two primary aims: 1) to improve the coordination and quality of care by prospectively identifying all settings and providers involved in the delivery of a specific episode of care and 2) to reduce the cost and improve the efficiency of care by linking settings and providers with a single funding amount.

Patient reported outcome measures (PROMs)

The goal of this project is to better understand the effect of wait times on health outcomes and changes in patient health while on the surgical waitlist. This project also seeks to provide insight into the appropriateness of wait times for elective surgery. More details on this project are available on our associated website patient-reported outcomes.

Review and Analysis of Methods for Funding Health Care in Quebec

This Canadian Foundation for Healthcare Improvement-commissioned project looks at the current state of literature on financing models and forms of financial incentives used to enhance the performance of health facilities and social services to inform recommendations for changes to funding of the Quebec health care system.

Marginal Costs of Hospitalizations in BC

This project developed a methodology to estimate the marginal cost of hospitalizations for different patient and hospital types, by disentangling fixed and variable overhead and non-overhead costs. This methodology will allow the BC Ministry of Health to better direct funds to hospitals via newly introduced ABF policies.

Derivation of an Socioeconomic Status Index for BC

This technical report (1) reviews a prototype index of socioeconomic status for small areas of BC developed by the BC Ministry of Health using principle components analysis methodology and (2) offers recommendations to improve this methodology.

Pay-for-Performance

This project looks at understanding the potential for P4P programs to impact quality of care as they begin to be implemented in Canada. We have evaluated the effectiveness of BC’s emergency department P4P program and provide policy options and advice based on international evidence and local findings.

ABF for long-term care

This project evaluated long-term care funding in Alberta. Creating an environment that provides cost-efficient, accessible and high quality LTC is a key objective for Alberta Health Services (AHS). Analyses of weighted cost per day in 2009 revealed previous LTC funding mechanisms in Alberta were disconnected from resident’s needs and reforms were deemed necessary. The Patient/Care-Based Funding (PCBF) model is a stand-alone outputbased allocation method which ‘splits the pie’ of total LTC funding among providers based on aligning the funding per resident with the intensity of caring for each resident, including the scope of expected services. This report was commissioned by AHS and identifies strengths and weaknesses of the LTC funding model and provides specific feedback to AHS regarding possible actions to mitigate actual or perceived weaknesses of the LTC funding model.

Hospital Quality Ranking

This project developed a summary indicator that can be used to measure and rank Canadian acute care hospitals based on overall quality. We used publicly reported risk-adjusted quality indicators from The Canadian Institute for Health Information (CIHI) for our analysis, and attempted to address some of the criticisms the Canadian Broadcast Corporation (CBC) received when they published their hospital ranking system in 2013.