Bridging the urban-rural divide in pediatric surgical care using multi-regional health data
A new study aims to bridge the urban-rural divide in pediatric surgical care to ensure that a child’s postal code does not determine the quality of care they receive. Evaluating Sociodemographic Factors Influencing Pediatric Surgical Care in Canada, led by Dr. Hussein Wissanji, surveys the current landscape of pediatric surgery in Canada with the goal of improving quality and accessibility.
The study uses data from the Canadian Institute for Health Information and the Institut de la statistique du Québec (ISQ) to identify sociodemographic, economic and geographical factors associated with disparities in outcomes and costs of the most common surgical procedures in Canada. “We need to address disparities to ensure that people have equitable care across the country, especially in a country as vast as Canada where there is a significant urban-rural divide,” said Dr. Wissanji, a pediatric surgeon with Montreal Children’s Hospital and an Assistant Professor at McGill University.
We need to address disparities to ensure that people have equitable care across the country, especially in a country as vast as Canada where there is a significant urban-rural divide. ~ Dr. Hussein Wissanji
According to Dr. Wissanji, the need for children to travel to a university centre to receive surgical care can have a significant impact on a family. Yet, there is a lack of comparative information on the quality and performance of surgical care in different communities to help inform decisions about when travel might actually be necessary. Using HDRN Canada’s Data Access Support Hub (DASH), Dr. Wissanji’s research team was able to access data on pediatric surgical care from every province across Canada with the aim of analyzing regional outcomes to inform such decision making. They also hope to identify areas of best practices and areas of underperformance across the country with the goal of sharing successes and offering recommendations for improvement.
“This is the first time this type of work is going to happen in pediatric surgery,” said Dr. Wissanji. He explained that a reason there are few truly pan-Canadian health care studies is the challenge of accessing data from Quebec, which involves a unique process different from the rest of Canada. Working with DASH made it possible for his team to access data from coast to coast, including Quebec data held by ISQ, an HDRN Canada member. “It’s amazing that DASH can help bridge the gap to make sure we have representation of the country as a whole. If we exclude any provinces, we’re missing part of the picture.”
HDRN Canada’s DASH is a one-stop data access service portal for researchers seeking administrative health data from more than one province or territory. “It really facilitated my work as a researcher,” Dr. Wissanji commented. “Once everyone understood the purpose of the research, it created a great collaboration that wasn’t just focused on the data request, but on how we can make the data relevant and maximize its impact.”
Using multi-regional data for his study was vital to ensure broad impact, said Dr. Wissanji, while also providing opportunities for comparison within provinces — both made possible through DASH. “You can’t have too much granularity in the data due to privacy reasons, but if you show a national average, people are not necessarily going to feel that it represents their practice,” he explained. “The beauty of this project lies in achieving a well-balanced approach that provides sufficiently granular data for each province, making the information both meaningful and relevant for understanding pediatric surgical care delivery..”
Evaluating Sociodemographic Factors Influencing Pediatric Surgical Care in Canada is the first DASH project to complete the data access process with ISQ. ISQ provides statistical information on all aspects of Québec society; it produces, analyzes and disseminates statistical information for government departments and agencies, and conducts statistical surveys of general interest. “ISQ was a phenomenal collaborator,” said Dr. Wissanji.
As the research team works towards creating the architecture necessary to make use of the huge amount of data received, Dr. Wissanji looks forward to the first results in the coming months as well as the potential for collaboration. “We are open to collaborate, whether it is with clinicians, researchers or policy makers – anyone who is interested in improving pediatric surgical care across the country should reach out. This dataset is meant to be used to help kids.”