Characterizing the Public Health and Health Care System
Understanding health care usage is critical to planning and improving our health care system. Likewise, measuring the inputs and outcome of the public health system is key to understanding how the system is functioning and where improvements are needed. Our team investigates: who are these users, presently, and based on their habits, who will the users be in the future? Our goal is to use this present-moment inquiry into health care spending to generate comprehensive expenditure categories, which will afford health care forecasting, and reveal the effects of broader determinants, like socioeconomic status (SES), in leading to high health care utilization.
Since 2014, Dr. Rosella and her team have published on the role of various factors including health behaviours demographics and SES gradients in relation to health care and public health systems. Her team is focused on honing the beacon of inquiry in this area, so that the rising cost of health care may be understood from an upstream perspective.
To learn more about our work in this area, please see the following resources:
- Smith RW, Jarvis T, Sandhu HS, Pinto AD, O’Neill M, Di Ruggiero E, Pawa J, Rosella LC, Allin S. Centralization and integration of public health systems: Perspectives of public health leaders on factors facilitating and impeding COVID-19 responses in three Canadian provinces. Health Policy (2022). https://doi.org/10.1016/j.healthpol.2022.11.011
- O’Neill M, De Prophetis E, Allin S, Pinto A, Smith R, Di Ruggiero E, Schwartz R, Pawa J, Ammi M, Rosella LC. “We cobble together a storyline of system performance using a diversity of things”: a qualitative study of perspectives on public health performance measurement in Canada. Arch Public Health. 2022; 80, 177. https://doi.org/10.1186/s13690-022-00931-1
- Mondor L, Watson T, Kornas K, Bornbaum C, Wodchis W, Rosella LC. Direct and indirect pathways between low-income status and becoming a high-cost health care user in Ontario, Canada: a mediation analysis of health risk behaviors. Annals of Epidemiology. 2020; 51:28-34.e4. Available at: https://www.sciencedirect.com/science/article/abs/pii/S104727972030266
- Wallar LE, De Prophetis E, Rosella LC. Socioeconomic inequalities in hospitalizations for chronic ambulatory care sensitive conditions: a systematic review of peer-reviewed literature, 1990–2018. Int J Equity Health. 2020;19,60. Available at: https://equityhealthj.biomedcentral.com/articles/10.1186/s12939-020-01160-0#citeas
- O’Neill M, Kornas K, Buajitti E, Bornbaum C, Wodchis W, Rosella LC. Predicting high resource users in Ontario, 2013/14-2018/19: Characterizing high resource users in Public Health Units. Toronto, ON: Population Health Analytics Lab; 2018. Available at: https://pophealthanalytics.com/wp-content/uploads/2019/02/HRUPoRT_PHUReport_FinalVersion.pdf
- Rosella LC, Pinto A, Petch J. Opinion: What’s really driving high-cost use of health care. 2015 May 8. Available at: http://healthydebate.ca/opinions/high-cost-users
- Stone C, Rosella LC, Goel V. High users of health care: are we asking the right questions? Healthy Debate. 2013 September 25. Available at: http://healthydebate.ca/opinions/a-population-health-perspective-on-high-users-of-health-care.
- Rosella LC, Wodchis W, Fitzpatrick T, Manson H, Goel V. High-cost health care users in Ontario, Canada: demographic, socio-economic, and health status characteristics. BMC Health Services Research. 2014; 14:532. Available at: https://www.ncbi.nlm.nih.gov/pubmed/25359294
- Fitzpatrick T, Rosella LC, Calzavara A, Pinto A, Petch J, Manson H, Goel V, Wodchis W. Looking beyond income and education: SES gradients among future high-cost users of healthcare. American Journal of Preventive Medicine. 2015; 49(2): 161-171. Available at: http://www.sciencedirect.com/science/article/pii/S0749379715000823.
- Stone CJ, Rosella LC, Goel V. Population health perspective on high users of health care: Role of Family Physicians. Canadian Family Physician. 2014; 60: 781-783. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4162685/.