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Introduction: British Columbia (BC) declared a public health emergency in April 2016 in response to a rapid rise in overdose deaths. Further understanding of health care utilization is needed to inform prevention strategies for individuals who overdose from illegal drugs. Methods: The Provincial Overdose Cohort includes linked administrative data on health care utilization by individuals who experienced an illegal drug overdose event in BC between 1 January 2015 and 30 November 2016. Overdose cases were identified using data from ambulance services, coroners' investigations, poison control centre calls and hospital, emergency department and physician administrative records. In total, 10 455 overdose cases were identified and compared with 52 275 controls matched on age, sex and area of residence for a descriptive analysis of health care utilization. Results: Two-thirds (66%) of overdose cases were male and about half (49%) were 20-39 years old. Over half of the cases (54%) visited the emergency department and about one-quarter (26%) were admitted to hospital in the year before the overdose event, compared with 17% and 9% of controls, respectively. Nevertheless, nearly onefifth (19%) of cases were recorded leaving the emergency department without being seen or against medical advice. High proportions of both cases (75%) and controls (72%) visited community-based physicians. Substance use and mental health-related concerns were the most common diagnoses among people who went on to overdose. Conclusion: People who overdosed frequently accessed the health care system in the year before the overdose event. In light of the high rates of health care use, there may be opportunities to identify at-risk individuals before they overdose and connect them with targeted programs and evidence-based interventions. Further work using the BC Provincial Overdose Cohort will focus on identifying risk factors for overdose events and death by overdose. [ABSTRACT FROM AUTHOR]

Background The Canadian Nosocomial Infection Surveillance Program (CNISP) has conducted surveillance for vancomycin-resistant enterococci (VRE) in sentinel hospitals since 1999. In 2010, a reliability audit of the 2008 data was conducted. Methods Stratified random sampling was used to obtain a proportional sample of VRE case forms submitted in 2008 from 36 CNISP hospitals. The original VRE data were compared to re-abstracted data for congruence on 16 pre-selected variables. Any discrepancy between the original and re-abstracted data was identified as a discordant response. Results Re-abstracted data were received from 35 out of 36 hospitals, providing 98% (n=428) of the 437 case forms requested. Of these, 37% (n=157) had zero discordant responses, 29% (n=126) had one discordant response, 16% (n=70) had two discordant responses and two forms (0.5%) had eleven discordant responses. Among the 35 hospitals, one hospital (3%) submitted forms with no discordant responses. Overall, the percentage of discordant and missing responses was 5%, ranging from 1% (n=29) for type of infection to 22% (n=93) for previous hospitalization. Conclusions Overall case forms were complete. However, discordant responses were more likely for variables that require interpretation and judgment or using historical data. Clearly defining variables and providing applicable response options may improve data quality. As well, the implementation of electronic health records may also improve the reporting of historical data. [ABSTRACT FROM AUTHOR]

Background: Health care workers have long observed increased rates of hospital admissions for respiratory illness in infants from the northern regions of Canada. Particularly high rates have been reported in the Inuit population. The purpose of the present study was to compare rates of hospital admission in Inuit versus non-Inuit infants from the perspective of a single northern health region., Methods: A retrospective review of all hospital admissions for lower respiratory tract infections (LRTIs) in infants from the Northwest Territories and the Kitikmeot region of Nunavut between 2000 and 2004 was completed and admission rates were compared by health region., Results: Hospital admission rates for LRTIs in infants were above the Canadian rate for all regions. The rate of hospital admission for LRTIs in infants from the Kitikmeot region of Nunavut was dramatically high at 590 hospital admissions/1000 live births in the first 12 months of life. The majority of hospitalized infants were previously healthy, non-breastfed term infants with no underlying disease., Interpretation: The rate of hospital admission in the Kitikmeot region of Nunavut is the highest reported in the current literature. The reason for such significant morbidity is difficult to explain and raises the question of an underlying predisposition to severe disease in this infant population. The question warrants further study to gain a better understanding of risk factors as well as the role of prevention.