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Brain Disorders in Ontario:
Prevalence, Incidence and Costs from Health Administrative Data

OFCP is pleased to share the final report of Brain Disorders in Ontario: Prevalence, Incidence, and Costs from Health Administrative Data.

This Report is the culmination of a two-year collaboration between the Ontario Brain Institute and the Institute for Clinical Evaluative Sciences which involved the contributions from clinicians, patients, and advocates. OFCP was very proud to be involved and to have an opportunity to contribute in this major undertaking. Below is an info-graphic, followed by the briefing note, followed by the link to the report.



 

It is all about the brain.
All the various conditions in the scope of mental health and neurologic disease manifest in a change of brain function. This report examines these otherwise disparate conditions collectively as ‘brain disorders’- an integrated approach to view them as diseases of a single organ. This is a necessary first step to bring greater awareness and attention to the health consequences and care needs of those affected by all disorders of the brain. As a group, the brain disorders included in this report demonstrate the breadth and diversity of conditions affecting Ontarians. Although those included in this report are only a subset of the hundreds of brain disorders, they represent many of the most common and impactful disorders affecting the healthcare system and society. There are many conditions missing, including highly prevalent disorders such as autism, depression, and addiction, but over time methods will be developed to measure these as well.

Brain disorders are a big issue that will continue to get bigger.
Individuals with brain disorders represent a large and growing population, which will increase as our population continues to age. Brain disorders are a growing public health concern: they exist as chronic conditions with no known cures and individuals with brain disorders often require lifelong treatment and care. This can also be very hard on caregivers who support individuals living with brain disorders – the economic and societal impact is multiplied, reaching far beyond those directly affected. The growing prevalence and tremendous economic and societal impact of brain disorders is why it is critical that the Government of Ontario continue to place a strong focus on brain research and innovation by supporting the Ontario Brain Institute and other groups working towards improving brain health.

A baseline measurement of brain disorders is needed to improve care and support.
To date, there have been no region-specific estimates of the prevalence and economic impact of brain disorders. Defining brain disorders, and measuring them from the perspective of the healthcare system, helps estimate the needs of affected individuals and their caregivers. This report lays the groundwork necessary for the healthcare system to respond to these needs by planning or building services and support, and by creating greater capacity for care in areas of need. By documenting the sheer number of individuals affected by brain disorders, this report confirms the need for more research and better care for individuals living with brain disorders which is why the OBI was established.

Health administrative data can be used for disease surveillance.
The methods used in this report to measure prevalence, incidence, and cost provide several advantages over survey or other self-report data sets: the large number of individuals contained in the data holdings improves precision and generalizability of estimates, and the longitudinal aspect of the data allows the examination of time trends in data. This approach is a starting point to better understand the present issues but it is not without limitations. This report only captures those who have interacted with the healthcare system in the year of measure (2010), and requires that individuals also receive a diagnosis or drug therapy related to their brain disorder. Therefore the results may underestimate the true number of individuals with each disorder for various reasons including stigma, lack of access to care, or temporary lack of need of care.

As a new resource, this report was created with the following objectives:

• To estimate the prevalence and incidence of brain disorders from population-based health administrative data


• To provide an overview of costs associated with all publically provided health care services used by individuals with brain disorders


• To present evidence to inform program and resource planning, policy and decision-making regarding brain disorders in the Ontario health system

The report contains data on thirteen brain disorders:

• Brain tumor (benign and primary malignant), cerebral palsy, dementia including Alzheimer’s disease, epilepsy, motor neuron disease, multiple sclerosis, parkinsonism including Parkinson’s disease, schizophrenia, spina bifida, spinal cord injury, stroke and transient ischemic attack, and traumatic brain injury


• Number and proportion of persons with the selected brain disorder by sex, age group, rural or urban residence, and neighbourhood income quintile (as of 2010/11)


• Age- and sex-adjusted prevalence and incidence of the selected brain disorder (from 2004/05 to 2010/11 in Ontario and by Local Health Integration Network)


• Crude prevalence of the selected brain disorder, by sex and age group (from 2004/05 to 2010/11)


• Distribution of the costs associated with one year of health system use for persons with the selected brain disorder, by age group


• Proportion of costs associated with one year of health system use for persons with the selected brain disorder, by type of health care service and age group

Here is the link to the report:

https://www.ices.on.ca/Publications/Atlases-and-Reports/2015/Brain-Disorders-in-Ontario