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PubMed1996

The objectives of paying doctors: views from Saskatchewan.

Physicians in Saskatchewan still favor the fee-for-service method of payment over salaries, capitation, and sessional contract. However, there appear to be two camps. Fee-for-service adherents felt that this method best ensured clinical autonomy, practice location, control over work schedule, and adequate income. Proponents of salaries felt that such methods best ensured adequate time with patients, clinical teamwork, preventive activities, teaching and research, continuing medical education, and administrative simplicity.

Attitude of Health Personnel↗
PubMed1980

Utilization of publicly insured health services in Saskatchewan before, during and after copayment.

This study examines the effects both of introducing and of removing copayment charges under a universal public medical care and hospital insurance program. For a period between 1968 and 1971, the Province of Saskatchewan imposed user charges of approximately 33 per cent and 6 per cent on medical and hospital services, respectively. The effects of these charges are analyzed using pooled cross-section samples of families and using both multivariate methods and experimental/control groups designs. Diagnostic- and procedure-specific analysis is also performed on the hospital data using the individual as the unit of observation. The findings of the study indicate a copayment effect of 5.6 per cent for physicians' services. No evidence could be adduced that would support the conclusion of a copayment effect for hospital services.

Deductibles and Coinsurance↗
PubMed1991

Causes and clinical management of vertebral osteomyelitis in Saskatchewan.

A retrospective review of all patients with vertebral osteomyelitis admitted to all Saskatchewan referral hospitals from 1973 to 1986 was undertaken to determine the incidence and clinical characteristics of the disease. There were 73 patients, an incidence of 5.3 cases/million per year. Erroneous initial diagnoses were common (41%). There was a significantly increased risk in patients older than 60 years. Staphylococcus aureus was the most frequent organism. Mycobacterium tuberculosis was present in 29.5% and was more common in native Indian patients. Surgery was performed in 31% of all patients, and in 50% of those with tuberculous infections. The outcome was excellent in 92% of patients. Diabetes and transurethral resection of the prostate were risk factors for vertebral osteomyelitis.

Adult↗
PubMed1966

Western equine encephalitis virus in Saskatchewan garter snakes and leopard frogs.

Western equine encephalitis virus was isolated from two naturally infected snakes on first bleeding and from seven others at subsequent bleedings, both with and without preliminary chilling. One snake, with neither detectable virus nor serum neutralizing antibodies when first bled, developed viremia later. Viremia in garter snakes has a cyclic rhythm independent of the temperature of the environment. Virus was isolated from 6 frogs, and 50 out of 179 had detectable serum neutralizing antibodies. Infections with this virus are widely distributed in garter snakes and leopard frogs in the agricultural area of Saskatchewan.

Animals↗
PubMed1979

Cache Valley virus: isolations from mosquitoes in Saskatchewan, 1972-1974.

Eighteen isolations of Cache Valley virus (Bunyaviridae) were obtained from a total of 113,694 mosquitoes collected in Saskatchewan during the summers of 1972 to 1974. Most of the isolations were from mosquitoes collected during August. Culiseta inornata, the most abundant mosquito (38% of total collected), had the highest minimum vector-infection rate (0.83 isolations per 1000 mosquitoes). The virus was also isolated from Culex tarsalis and Aedes vexans. It is indicated in the isolations that the prairie grasslands of the province are enzootic for Cache Valley virus.

Aedes↗
PubMed2003

Soil microbial populations, community composition, and activity as affected by repeated applications of hog and cattle manure in eastern Saskatchewan.

A field site near Humboldt, Saskatchewan, was annually treated with hog or cattle manure and cropped to canola, spring wheat, barley, and canola from 1997 to 2000. During each growing season, soil was analyzed for microbial populations in terms of activity and community structure, and crops were assessed for root rot and foliar diseases. Microbial activity in soils treated with cattle manure was higher than in soils treated with hog manure or urea. Similarly, nitrous oxide emissions from soil increased with increasing rates of hog and cattle manure. Potential human pathogens, including Rahnella, Serratia, Proteus, Leclercia, and Salmonella species, were identified in soils that received cattle manure, whereas pseudomonads were the dominant species in the hog-manure-treated soil. Fecal coliforms were confirmed in soils that received hog or cattle manure. However, Enterobacteriaceae populations were 10-fold higher in soils receiving cattle manure than in soils receiving the other treatments. Increasing cattle manure rates increased fecal coliform population, but there was no indication that increased hog manure rates increased fecal coliform populations. Addition of urea, hog manure, or cattle manure to the soil did not increase foliar disease in wheat, barley, and canola and had variable effects on root rot incidence in cereals.

Agriculture↗
PubMedDate not supplied

Validity of stroke diagnosis on hospital discharge records in Saskatchewan, Canada: implications for stroke surveillance.

This study examines the validity of the diagnosis of stroke on hospital discharge records in Saskatchewan, Canada. In total, 1,494 records with a discharge diagnosis of 'stroke' or a 'stroke-related condition' were reviewed. The clinical algorithm of the 1980 USA National Survey of Stroke was considered the 'gold standard'. The positive predictive value of a primary diagnosis of stroke in the tertiary-care hospitals was about 90%. In community hospitals the majority of stroke cases were coded as ICD9 436 in which the positive predictive value was 78%. The variation between regions would limit the use of hospital discharge data for stroke surveillance.

Cerebrovascular Disorders↗
PubMed2003

An association of maternal age and birth weight with end-stage renal disease in Saskatchewan. Sub-analysis of registered Indians and those with diabetes.

AIMS: To determine links between birth related factors and end-stage renal disease (ESRD). METHODS: This 1:3 age, sex, and source population (registered Indians [SkRI] and other Saskatchewan people [OSkP]) matched case-control study, compared maternal age and parity, gestational age, low birth weight (LBW), and high birth weight (HBW), between subjects with and without ESRD. RESULTS: Of 1,162 subjects, 277 cases (48 SkRI and 229 OSkP) and 601 controls (112 SkRI and 489 OSkP) had birth weight information. A trend for increased LBW rates occurred among SkRI and OSkP cases compared to controls (10.4 vs. 5.3% and 6.6 vs. 4.3%), and was significant for OSkP female cases (OR 3.66; 95% confidence interval [CI] 1.05, 12.73). Higher HBW rates occurred in SkRI cases (14.6% compared to 11.6% controls; N/S), and 3/5 female SkRI diabetic ESRD (DESRD) cases were over 3,750 g compared to 1/14 controls (p < 0.05). Only maternal age >/=30 years was an independent predictor for ESRD, particularly for OSkP non-DESRD cases (OR 2.45; 95% CI 1.03, 5.8). Cases with older mothers had lower mean birth weights than controls (3,236 vs. 3,434 g; p = 0.005). CONCLUSIONS: Older maternal age may predispose offspring to ESRD through mechanisms that differ for DESRD versus non-DESRD, and that may relate to ethnicity.

Adolescent↗
PubMed1982

Increased mortality in the siblings and offspring of Pi type MS and MZ men from Saskatchewan. Mortality and Pi type.

alpha 1-Antitrypsin phenotypes were determined in 1,395 male Saskatchewan grain buyers. These included 1,254 type M, 80 MS, 35 MZ and 26 which were untyped or other rare phenotypes. Sibling and offspring of the MS men had a significantly greater number of deaths (p less than 0.01). Offspring of MZ men also had an increased number of deaths. These appeared to occur in all age except in those 2-17 years of age. This finding raises questions about the role of both the S and Z alleles.

Adolescent↗
PubMedDate not supplied

Absence of the atypical mitochondrial aldehyde dehydrogenase (ALDH2) isozyme in Saskatchewan Cree Indians.

Three methods were employed to assess whether human volunteers (Caucasian, Asian or Cree Indian) possessed the typical or atypical mitochondrial aldehyde dehydrogenase (ALDH2) isozyme. These methods were: (1) questioning individuals about facial flushing responses following alcohol consumption; (2) application of the ethanol skin patch test, and (3) direct analysis using isoelectric focusing and activity staining of ALDH activity in hair root samples. The results from the three methods were in good agreement and revealed that only the typical ALDH2 isozyme was expressed in Saskatchewan Cree Indians. In agreement with previous reports, the typical ALDH2 was expressed in the Caucasian group of subjects, while both the typical and atypical forms were expressed in the Asian subjects.

Alcohol Drinking↗
PubMed1977

Patterns in the delivery of psychiatric care in Saskatchewan 1971-1972 (II). Types of contacts and some patient career characteristics.

A previous paper dealt with an overview of service sectors and patient volumes (2), whereas this one concentrates on types of contacts and some patient career characteristics. Analysis of a comprehensive psychiatric care utilization data file for Saskatchewan for the 1971-1972 period shows that 'public' sector patients were hospitalized for a greater average length of time than were 'private' sector patients. This may reflect differences in the styles of practice, exigencies of the demand for hospital beds in the 'private' as opposed to the 'public' sector and/or intrinsic differences in the nature of the problem treated in each sector. Some interesting facts regarding patterns of contact were uncovered. The bimodal nature of the 'psychiatric population' was further evident from the data which show that the majority of patients used relatively few services whereas a few used a large number of services. This suggests that the majority of the people seen for psychiatric reasons by medical practitioners were suffering from relatively minor psychiatric disorders. Heavy users of services were much more likely to have had some'public' or University Hospital-based contact. Conversely, light users were predominantly private sector patients. In the 'public' sector, those who had had some in patient treatment were consistently higher users of all services. It is evident that psychiatrists held a dominant position in this community-oriented public sector, having seen a large number of patients, but having had a low average rate of services per patient. In contrast, community nurses saw relatively few patients but saw them very often. This no doubt reflects their role in providing 'maintenance' services to chronic patients in approved homes in the community. In the 'private' sector, 69 percent of the services were delivered by GPs and 23 percent by psychiatrists were more likely to have had 'public' sector activity than were those seen only by GPs; also once in the 'public' sector, they were likelier to have had in patient as well as outpatient treatment. This suggests a 'sifting' of the more "difficult" patients through the private specialist sector into the public sector.

Community Mental Health Services↗
PubMed1978

Indian people and community psychiatry in Saskatchewan.

A discrepancy is identified between the increase in inpatient admissions and of outpatient contacts of Treaty Indians in Saskatchewan from 1967 to 1976. This is the reverse of the trend in the non-Treaty Indian population, and represents a contradictory effect to the intention of the Community Psychiatry Program of the province's government. No major diagnostic differences were at statistically significant levels, which might have accounted for the higher inpatient admission rates and the relatively lower outpatient contact rates of Treaty Indians. This is an interesting example of the use of governmental statistics and a promising one for the identification and solution of problems in health care delivery.

Ambulatory Care↗
PubMed1979

Sex differences in the utilization of health services for psychiatric problems in Saskatchewan.

Comprehensive data on all pscyhiatric patients in Saskatchewan show that women are substantially higher users of health services for psychiatric problems than are men. Women: 1) use up to twice as many services as men in the private sector, but use almost the same number of public sector services; 2) tend to be treated for psychosomatic and neurotic disorders on an outpatient basis; 3) have only a slightly greater chance than men of being hospitalized; and 4) are less likely than men to have organic or addictive diagnoses. These differentials in utilization cannot be explained by age, diagnoses and/or marital status. Sex is the best predictor of utilization. These results are largely consistent with utilization and epidemiological literature. It seems more likely that these sex differences in utilization result from the interaction of biology, sex roles, and the functioning and labelling processes of the health system rather than from any single factor. Combining Andersen's components of health behaviour with Freidson's lay-professional construction of illness continuum yields a possible framework for understanding sex differences in the utilization of psychiatric health services.

Adult↗
PubMed1979

10 year survey of pretrial examinations in Saskatchewan.

The results of a survey of pretrial examination cases admitted to the provincial psychiatric hospital in Saskatchewan from 1966 to 1975 are reported. The demographic and psychiatric data and data from the psychiatric reports to the Court are analyzed. Some deficiencies noted in the reports to the Court are discussed and some remedial measures are suggested.

Adolescent↗
PubMed1983

Utilization of psychotropic drugs in Saskatchewan: 1977-1980.

Psychotropic drug use in Saskatchewan during 1977, 1978, 1979 and 1980 was determined. Approximately one in five prescriptions dispensed was for a psychotropic. About 20% of the population received psychotropic drugs in each year but use has declined slightly, especially that of tranquilizers. Psychotropic use increased with the patient's age and nearly two-thirds were women. Considerable caution should be exercised in making comparisons with other drug utilization studies. There may be substantial differences in the drugs selected for study, the categorization of these drugs, and the methodology used to analyze drug use. Also, most studies are based on data that is from a decade old or older. Moreover, most if not all other studies on drug use are based on sample surveys (from different sampling universes), whereas the present study is based on the entire population. Nevertheless, some generalizations may be valid. Since non-formulary drugs are excluded, the findings should be regarded as conservative. Examples of non-formulary drugs considered to be psychotropic include antispasmodic/tranquilizer/sedative combinations (example: Librax, Donnatal), combination hypnotics (example: Tuinal, Mandrax), and some combination analgesics (example: propoxyphene compounds, pentazocine compound, oxycodone compound).

Adolescent↗
PubMed2002

The use of alternative therapies in the Saskatchewan stroke rehabilitation population.

BACKGROUND: Many patients use alternative therapies. The purpose of this study was to determine the percentage of stroke rehabilitation patients in Saskatchewan using alternative therapies, whether patients found these therapies effective in alleviating stroke-related symptoms, how often those patients who used alternative therapies discuss this fact with their primary care doctor and the main reason why patients might not do so. METHODS: Telephone questionnaire surveys were conducted with 117 patients who had suffered a stroke and undergone inpatient or outpatient rehabilitation at Saskatoon City Hospital. RESULTS: The study revealed that 26.5% of 117 stroke rehabilitation patients visited alternative practitioners at least once or used some form of unconventional therapy. Only 16.1% of patients found that alternative therapy made them feel much better. Of those who used alternative therapy, 61.3% did not discuss this fact with their primary physician. Many of the respondents (47.3%) who did not inform their physician stated that they did not see the necessity of talking about these treatments and 21.1% did not discuss the issue with their physician because they felt that he or she might disapprove of alternative therapies. CONCLUSION: A relatively small percentage of stroke patients found alternative therapies beneficial. Doctors should be aware that a significant number of patients will try alternative treatment without discussion with their primary care physician or specialist. The current study suggests that after completing routine questioning, doctors should also ask their patients about their use of alternative therapies and, when appropriate, review issues of safety and efficacy.

Adult↗
PubMed2006

Knowledge loss of medical students on first year basic science courses at the University of Saskatchewan.

BACKGROUND: Many senior undergraduate students from the University of Saskatchewan indicated informally that they did not remember much from their first year courses and wondered why we were teaching content that did not seem relevant to later clinical work or studies. To determine the extent of the problem a course evaluation study that measured the knowledge loss of medical students on selected first year courses was conducted. This study replicates previous memory decrement studies with three first year medicine basic science courses, something that was not found in the literature. It was expected that some courses would show more and some courses would show less knowledge loss. METHODS: In the spring of 2004 over 20 students were recruited to retake questions from three first year courses: Immunology, physiology, and neuroanatomy. Student scores on the selected questions at the time of the final examination in May 2003 (the 'test') were compared with their scores on the questions 10 or 11 months later (the 're-test') using paired samples t -tests. A repeated-measures MANOVA was used to compare the test and re-test scores among the three courses. The re-test scores were matched with the overall student ratings of the courses and the student scores on the May 2003 examinations. RESULTS: A statistically significant main effect of knowledge loss (F = 297.385; p < .001) and an interaction effect by course (F = 46.081; p < .001) were found. The students' scores in the Immunology course dropped 13.1%, 46.5% in Neuroanatomy, and 16.1% in physiology. Bonferroni post hoc comparisons showed a significant difference between Neuroanatomy and Physiology (mean difference of 10.7, p = .004). CONCLUSION: There was considerable knowledge loss among medical students in the three basic science courses tested and this loss was not uniform across courses. Knowledge loss does not seem to be related to the marks on the final examination or the assessment of course quality by the students.

Adult↗