Characterizing high system use across the primary-tertiary care continuum: parallel analyses of select Canadian health

Nominated Principal Applicant: Dr. Tyler Williamson (University of Calgary)

Principal Applicants from Alberta: Dr. Kerry McBrien (University of Calgary)
                                                     Dr. Gabriel Fabreau (University of Calgary)
                                                     Dr. Paul Ronksley (University of Calgary)

Co-principal applicants from Alberta: Dr. Neil Drummond (University of Alberta)
                                                         Stephanie Garies (University of Calgary)
                                                         Dr. David Johnson (Alberta Children's hospital) 
                                                         Dr. Donna Manca (University of Alberta)
                                                         Dr. Lara Nixon (University of Calgary)
                                                         Dr. Maeve O'Beirne (University of Calgary)

Provinces involved: Alberta, Nova Scotia, Ontario, Manitoba, British Columbia, Newfoundland & Labrador, and Northwest Territories


In Canada, health care expenditures continue to rise unabated. This has left policy makers struggling to develop effective strategies aimed at reducing costs while at the same time improving patient care. A compelling approach to bend the cost curve has been to focus on the small number of patients who account for the majority of health care spending. It has been determined that as much as half or more of health care expenditures are accounted for by 5% of the population. Significant gaps in our understanding of these high-use patients remain, including how they engage with the health care system, and whether there are similarities and differences between the characteristics of high use patients in primary and hospital-based settings. Closing these knowledge gaps has been identified as a top research priority both provincially and nationally. A recent pan-Canadian forum on high users of health care, that included senior decision makers and researchers, specifically called for research that improves our understanding of patients with high system use.

Our work aims to address these important issues by leveraging data from electronic medical records and multiple administrative data sources from across Canada. Using these data, we will explore the similarities and differences in the characteristics of high use patients across different health care settings. This work is a necessary first step towards integrating these complementary data sources. This work will provide essential foundational information about high users across the health care continuum and will promote future inter-provincial collaborative research and health policy development. Ultimately our goal is to inform innovative clinical strategies and policies to improve quality of care and health outcomes for patients with high system use.

The Alberta SPOR PIHCIN will provide support for this project in the following areas:

  • Access to networking support in Alberta and nationally through the SPOR PIHCIN network of networks;
  • Methodology development support through the Alberta SPOR PIHCIN Coordinator and Tripartite Leads; 
  • Networking connections to the Strategic Clinical Networks (SCNs) and relevant primary health care and public health networks in Alberta;
  • Provide patient feedback on the LOI that was submitted in development of the grant proposal;
  • Facilitate any requested expertise from the seven Alberta SPOR SUPPORT Unit Platforms to ensure that integration from research into care has a significant positive impact for patients and the health care system. 

Conference presentation: (to be updated)

Publication: (to be updated)

Contact information:

Dr. Tyler Williamson
Community Health Sciences
University of Calgary
+1 (403) 210-6033