MCHP IS AN OUTSTANDING WORKPLACE
THE STORY OF THE MANITOBA CENTRE FOR HEALTH POLICY
MCHP is rich with stories that punctuate its history. A qualitative study exploring the details of MCHP was written by Dr. Gail Marchessault to celebrate the founding of the Centre and the 20 years of research it has produced. This study explores the challenges and success of MCHP and includes insights from key people at Manitoba Health and the University of Manitoba, including the Faculty of Medicine and the Department of Community Health Sciences.
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What is MCHP?
MCHP is a research unit in the University of Manitoba's Faculty of Medicine, Bannatyne Campus. About 60 people work here, including University researchers and graduate students, systems analysts and support staff. Our researchers benefit from collaboration with peers across Canada, the United States, Europe and Australia. We also have an Advisory Board bolstered by high-profile representatives from research, healthcare, business and government.
MCHP does research on the health of Manitobans. Our primary focus is the question, What makes people healthy? Many factors affect health, such as health care, health programs and policies, income, education, employment and social circumstances. At MCHP, we are sorting out the contribution of these factors.
For instance, we have shown again and again that there is an income-health gradient. It isn't just that poor people are sicker than rich people. Poor people are sicker than middle income people, who in turn are sicker than the upper middle, and so on. We see the same gradient between education and health. Simply put: the poorer you are, the sicker you are likely to be; the less educated you are, the sicker you are likely to be.
Most of our information comes from the Repository - a comprehensive anonymized database that tells us about Manitobans' use of such services as physicians, hospitals, home care, nursing homes and prescriptions. It also offers anonymized information about education and family services.
Prior to transferring data to the Repository, Manitoba Health removes the names and addresses of all individuals, and identification numbers are changed to fake ones. So, we may know that, say, 100 patients saw the same physician, but we don't know the patients' names nor the doctor's.
We also get non-personalized socioeconomic data from other sources, such as information from Statistics Canada on income, education, employment and social circumstance. By non-personalized, we mean the information is about groups not individuals - like what the average income is of a neighbourhood.
Our top priority is to respect the privacy of patients and providers. As we said, the records are anonymous so we never know the names or addresses of patients or physicians. We also have many security safeguards such as firewalls, passwords, file encryption and restricted access to protect pri-vacy. Our Pledge of Privacy is on our website.
Our research helps decision-makers and providers address some of today's difficult health questions: How can we make the best use of our healthcare resources? What services will Manitobans need in the future? What can we do to level the playing field between children from low- and high-income neighbourhoods? Do people living in rural or northern areas have different access to care than people living in Brandon or Winnipeg?
We are a research unit at the University, not a government agency. We have five-year contracts with the Province of Manitoba (since 1991) to provide six major research projects annually. These studies deal with health and social issues that can best be answered using the Repository. Topics are jointly decided upon by MCHP's Director and the Deputy Minister of Health. This agreement provides roughly half of our funding.
The other half of our funding comes from organizations - provincial, national or international - created to fund research. Our researchers must compete for these funds. The merit of each application - which must adhere to strict scientific principles - is reviewed by committees of other scientists.
Our track record is excellent, based on two measures of academic achievement. One is our level of funding. Another is our number of publications in peer-reviewed journals - meaning they are accepted only after scrutiny by experts in the same field. We've had nearly 350 publications in the last ten years. We've also had a half-dozen supplements - special journal issues devoted to an area of MCHP research - Aboriginal health, children's health or seniors' health for example.
Yes, there are always surprising findings! One recent surprise is how wide-spread chronic illness is. High blood pressure, diabetes and asthma affect 6 out of 10 Manitobans. And what about mental illness? Over a five-year study period we found that more than 1 in 4 Manitobans had at least one mental illness diagnosis and they used nearly half the days that people spent in Manitoba hospitals. We could go on.
We involve policy-makers, planners and clinicians at every step in our research - from conception, to analysis and interpretation, to application. They are often members of our working groups, who advise on the research, or they may be co-authors. We believe - and practice this belief - that research is stronger when users have a say in what is studied and how. One of our most successful examples of this belief is The Need to Know Team.
The Team is a collaboration of MCHP researchers and high-level planners from Manitoba's Regional Health Authorities and Manitoba Health. The Need To Know Team was originally funded through the Canadian Institutes of Health Research (CIHR). Its underpinnings are simple: by having researchers work closely with decision-makers, perhaps research can be brought closer to policy. In other words, the hope is to smooth the transition between analysis and application, between paper and practice.
In 2005, The Need to Know Team received a national Knowledge Translation award from the Canadian Institutes of Health Research for regional impact of health research.
Our healthcare system is a very good one. We need to preserve its best characteristics into tomorrow - effective care, universal access, public funding - while focussing less on illness and more on what makes people healthy. MCHP's work can play a part in that future.
And that future looks exciting. In Canada, there has been an increased interest in population-health approaches; MCHP is ideally situated to capitalize on that interest. Our ability to combine data from multiple sources makes our research leading edge, and gives a more clearer picture of what is going on. We are continually adding new datasets to our Repository, constantly improving our ability to answer the question, What makes people healthy?
Healthcare Policy Special Issue
Going for the Gold: Celebrating 20 Years of Experience in Population-Based Research in Manitoba and Beyond
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