Multimorbidity and healthcare utilization among home care clients with dementia in Ontario, Canada: A retrospective analysis of a population-based cohort
Identifieur interne : 000059 ( Main/Exploration ); précédent : 000058; suivant : 000060Multimorbidity and healthcare utilization among home care clients with dementia in Ontario, Canada: A retrospective analysis of a population-based cohort
Auteurs : Luke Mondor [Canada] ; Colleen J. Maxwell [Canada] ; David B. Hogan [Canada] ; Susan E. Bronskill [Canada] ; Andrea Gruneir [Canada] ; Natasha E. Lane [Canada] ; Walter P. Wodchis [Canada]Source :
- PLoS Medicine [ 1549-1277 ] ; 2017.
Abstract
For community-dwelling older persons with dementia, the presence of multimorbidity can create complex clinical challenges for both individuals and their physicians, and can contribute to poor outcomes. We quantified the associations between level of multimorbidity (chronic disease burden) and risk of hospitalization and risk of emergency department (ED) visit in a home care cohort with dementia and explored the role of continuity of physician care (COC) in modifying these relationships.
A retrospective cohort study using linked administrative and clinical data from Ontario, Canada, was conducted among 30,112 long-stay home care clients (mean age 83.0 ± 7.7 y) with dementia in 2012. Multivariable Fine–Gray regression models were used to determine associations between level of multimorbidity and 1-y risk of hospitalization and 1-y risk of ED visit, accounting for multiple competing risks (death and long-term care placement). Interaction terms were used to assess potential effect modification by COC.
Multimorbidity was highly prevalent, with 35% (
Older adults with dementia and multimorbidity pose a particular challenge for health systems. Findings from this study highlight the need to reshape models of care for this complex population, and to further investigate health system and other factors that may modify patients’ risk of health outcomes.
Url:
DOI: 10.1371/journal.pmed.1002249
PubMed: 28267802
PubMed Central: 5340355
Affiliations:
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Maxwell</name><affiliation wicri:level="1"><nlm:aff id="aff001"><addr-line>Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada</addr-line></nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>Institute for Clinical Evaluative Sciences, Toronto, Ontario</wicri:regionArea><wicri:noRegion>Ontario</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="aff002"><addr-line>Health System Performance Research Network, Toronto, Ontario, Canada</addr-line></nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>Health System Performance Research Network, Toronto, Ontario</wicri:regionArea><wicri:noRegion>Ontario</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="aff003"><addr-line>School of Pharmacy, University of Waterloo, Waterloo, Ontario, Canada</addr-line></nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>School of Pharmacy, University of Waterloo, Waterloo, Ontario</wicri:regionArea><wicri:noRegion>Ontario</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="aff004"><addr-line>School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada</addr-line></nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario</wicri:regionArea><wicri:noRegion>Ontario</wicri:noRegion></affiliation><affiliation wicri:level="4"><nlm:aff id="aff005"><addr-line>Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada</addr-line></nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>Department of Community Health Sciences, University of Calgary, Calgary, Alberta</wicri:regionArea><orgName type="university">Université de Calgary</orgName><placeName><settlement type="city">Calgary</settlement><region type="state">Alberta</region></placeName></affiliation></author><author><name sortKey="Hogan, David B" sort="Hogan, David B" uniqKey="Hogan D" first="David B." last="Hogan">David B. Hogan</name><affiliation wicri:level="4"><nlm:aff id="aff005"><addr-line>Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada</addr-line></nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>Department of Community Health Sciences, University of Calgary, Calgary, Alberta</wicri:regionArea><orgName type="university">Université de Calgary</orgName><placeName><settlement type="city">Calgary</settlement><region type="state">Alberta</region></placeName></affiliation><affiliation wicri:level="4"><nlm:aff id="aff006"><addr-line>Division of Geriatric Medicine, University of Calgary, Calgary, Alberta, Canada</addr-line></nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>Division of Geriatric Medicine, University of Calgary, Calgary, Alberta</wicri:regionArea><orgName type="university">Université de Calgary</orgName><placeName><settlement type="city">Calgary</settlement><region type="state">Alberta</region></placeName></affiliation></author><author><name sortKey="Bronskill, Susan E" sort="Bronskill, Susan E" uniqKey="Bronskill S" first="Susan E." last="Bronskill">Susan E. Bronskill</name><affiliation wicri:level="1"><nlm:aff id="aff001"><addr-line>Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada</addr-line></nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>Institute for Clinical Evaluative Sciences, Toronto, Ontario</wicri:regionArea><wicri:noRegion>Ontario</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="aff002"><addr-line>Health System Performance Research Network, Toronto, Ontario, Canada</addr-line></nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>Health System Performance Research Network, Toronto, Ontario</wicri:regionArea><wicri:noRegion>Ontario</wicri:noRegion></affiliation><affiliation wicri:level="4"><nlm:aff id="aff007"><addr-line>Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, Ontario, Canada</addr-line></nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, Ontario</wicri:regionArea><orgName type="university">Université de Toronto</orgName><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName></affiliation></author><author><name sortKey="Gruneir, Andrea" sort="Gruneir, Andrea" uniqKey="Gruneir A" first="Andrea" last="Gruneir">Andrea Gruneir</name><affiliation wicri:level="1"><nlm:aff id="aff001"><addr-line>Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada</addr-line></nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>Institute for Clinical Evaluative Sciences, Toronto, Ontario</wicri:regionArea><wicri:noRegion>Ontario</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="aff008"><addr-line>Department of Family Medicine, University of Alberta, Edmonton, Alberta, Canada</addr-line></nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>Department of Family Medicine, University of Alberta, Edmonton, Alberta</wicri:regionArea><wicri:noRegion>Alberta</wicri:noRegion></affiliation></author><author><name sortKey="Lane, Natasha E" sort="Lane, Natasha E" uniqKey="Lane N" first="Natasha E." last="Lane">Natasha E. Lane</name><affiliation wicri:level="1"><nlm:aff id="aff002"><addr-line>Health System Performance Research Network, Toronto, Ontario, Canada</addr-line></nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>Health System Performance Research Network, Toronto, Ontario</wicri:regionArea><wicri:noRegion>Ontario</wicri:noRegion></affiliation><affiliation wicri:level="4"><nlm:aff id="aff007"><addr-line>Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, Ontario, Canada</addr-line></nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, Ontario</wicri:regionArea><orgName type="university">Université de Toronto</orgName><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName></affiliation></author><author><name sortKey="Wodchis, Walter P" sort="Wodchis, Walter P" uniqKey="Wodchis W" first="Walter P." last="Wodchis">Walter P. Wodchis</name><affiliation wicri:level="1"><nlm:aff id="aff001"><addr-line>Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada</addr-line></nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>Institute for Clinical Evaluative Sciences, Toronto, Ontario</wicri:regionArea><wicri:noRegion>Ontario</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="aff002"><addr-line>Health System Performance Research Network, Toronto, Ontario, Canada</addr-line></nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>Health System Performance Research Network, Toronto, Ontario</wicri:regionArea><wicri:noRegion>Ontario</wicri:noRegion></affiliation><affiliation wicri:level="4"><nlm:aff id="aff007"><addr-line>Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, Ontario, Canada</addr-line></nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, Ontario</wicri:regionArea><orgName type="university">Université de Toronto</orgName><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName></affiliation><affiliation wicri:level="1"><nlm:aff id="aff009"><addr-line>Toronto Rehabilitation Institute, Toronto, Ontario, Canada</addr-line></nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>Toronto Rehabilitation Institute, Toronto, Ontario</wicri:regionArea><wicri:noRegion>Ontario</wicri:noRegion></affiliation></author></analytic><series><title level="j">PLoS Medicine</title><idno type="ISSN">1549-1277</idno><idno type="eISSN">1549-1676</idno><imprint><date when="2017">2017</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec id="sec001"><title>Background</title><p>For community-dwelling older persons with dementia, the presence of multimorbidity can create complex clinical challenges for both individuals and their physicians, and can contribute to poor outcomes. We quantified the associations between level of multimorbidity (chronic disease burden) and risk of hospitalization and risk of emergency department (ED) visit in a home care cohort with dementia and explored the role of continuity of physician care (COC) in modifying these relationships.</p></sec><sec id="sec002"><title>Methods and findings</title><p>A retrospective cohort study using linked administrative and clinical data from Ontario, Canada, was conducted among 30,112 long-stay home care clients (mean age 83.0 ± 7.7 y) with dementia in 2012. Multivariable Fine–Gray regression models were used to determine associations between level of multimorbidity and 1-y risk of hospitalization and 1-y risk of ED visit, accounting for multiple competing risks (death and long-term care placement). Interaction terms were used to assess potential effect modification by COC.</p><p>Multimorbidity was highly prevalent, with 35% (<italic>n</italic> = 10,568) of the cohort having five or more chronic conditions. In multivariable analyses, risk of hospitalization and risk of ED visit increased monotonically with level of multimorbidity: sub-hazards were 88% greater (sub-hazard ratio [sHR] = 1.88, 95% CI: 1.72–2.05, <italic>p <</italic> 0.001) and 63% greater (sHR = 1.63; 95% CI: 1.51–1.77, <italic>p <</italic> 0.001), respectively, among those with five or more conditions, relative to those with dementia alone or with dementia and one other condition. Low (versus high) COC was associated with an increased risk of both hospitalization and ED visit in age- and sex-adjusted analyses only (sHR = 1.11, 95% CI: 1.07–1.16, <italic>p <</italic> 0.001, for hospitalization; sHR = 1.07, 95% CI: 1.03–1.11, <italic>p =</italic> 0.001, for ED visit) but did not modify associations between multimorbidity and outcomes (Wald test for interaction, <italic>p =</italic> 0.566 for hospitalization and <italic>p =</italic> 0.637 for ED visit). The main limitations of this study include use of fixed (versus time-varying) covariates and focus on all-cause rather than cause-specific hospitalizations and ED visits, which could potentially inform interventions.</p></sec><sec id="sec003"><title>Conclusions</title><p>Older adults with dementia and multimorbidity pose a particular challenge for health systems. Findings from this study highlight the need to reshape models of care for this complex population, and to further investigate health system and other factors that may modify patients’ risk of health outcomes.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Bauer, K" uniqKey="Bauer K">K Bauer</name></author><author><name sortKey="Schwarzkopf, L" uniqKey="Schwarzkopf L">L Schwarzkopf</name></author><author><name sortKey="Graessel, E" uniqKey="Graessel E">E Graessel</name></author><author><name sortKey="Holle, R" uniqKey="Holle R">R Holle</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Savva, Gm" uniqKey="Savva G">GM Savva</name></author><author><name sortKey="Stephan, Bcm" uniqKey="Stephan B">BCM Stephan</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Whitmer, Ra" uniqKey="Whitmer R">RA Whitmer</name></author><author><name sortKey="Karter, Aj" uniqKey="Karter A">AJ Karter</name></author><author><name sortKey="Yaffe, K" uniqKey="Yaffe K">K Yaffe</name></author><author><name sortKey="Quesenberry, Cp" uniqKey="Quesenberry C">CP Quesenberry</name></author><author><name sortKey="Selby, Jv" uniqKey="Selby J">JV Selby</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Bunn, F" uniqKey="Bunn F">F Bunn</name></author><author><name sortKey="Burn, A M" uniqKey="Burn A">A-M Burn</name></author><author><name sortKey="Goodman, C" uniqKey="Goodman C">C Goodman</name></author><author><name sortKey="Rait, G" uniqKey="Rait G">G Rait</name></author><author><name sortKey="Norton, S" uniqKey="Norton S">S Norton</name></author><author><name sortKey="Robinson, L" uniqKey="Robinson L">L Robinson</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Lyketsos, Cg" uniqKey="Lyketsos C">CG Lyketsos</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Maxwell, Cj" uniqKey="Maxwell C">CJ Maxwell</name></author><author><name sortKey="Amuah, Je" uniqKey="Amuah J">JE Amuah</name></author><author><name sortKey="Hogan, Db" uniqKey="Hogan D">DB Hogan</name></author><author><name sortKey="Cepoiu Martin, M" uniqKey="Cepoiu Martin M">M Cepoiu-Martin</name></author><author><name sortKey="Gruneir, A" uniqKey="Gruneir A">A Gruneir</name></author><author><name sortKey="Patten, Sb" uniqKey="Patten S">SB Patten</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Phelan, Ea" uniqKey="Phelan E">EA Phelan</name></author><author><name sortKey="Borson, S" uniqKey="Borson S">S Borson</name></author><author><name sortKey="Grothaus, L" uniqKey="Grothaus L">L Grothaus</name></author><author><name sortKey="Balch, S" uniqKey="Balch S">S Balch</name></author><author><name sortKey="Larson, Eb" uniqKey="Larson E">EB 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Ash</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Feng, Z" uniqKey="Feng Z">Z Feng</name></author><author><name sortKey="Coots, La" uniqKey="Coots L">LA Coots</name></author><author><name sortKey="Kaganova, Y" uniqKey="Kaganova Y">Y Kaganova</name></author><author><name sortKey="Wiener, Jm" uniqKey="Wiener J">JM Wiener</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Lamantia, Ma" uniqKey="Lamantia M">MA LaMantia</name></author><author><name sortKey="Stump, Te" uniqKey="Stump T">TE Stump</name></author><author><name sortKey="Messina, Fc" uniqKey="Messina F">FC Messina</name></author><author><name sortKey="Miller, Dk" uniqKey="Miller D">DK Miller</name></author><author><name sortKey="Callahan, Cm" uniqKey="Callahan C">CM Callahan</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Lamantia, Ma" uniqKey="Lamantia M">MA LaMantia</name></author><author><name sortKey="Lane, Ka" uniqKey="Lane K">KA Lane</name></author><author><name sortKey="Tu, W" uniqKey="Tu W">W Tu</name></author><author><name sortKey="Carnahan, Jl" uniqKey="Carnahan J">JL Carnahan</name></author><author><name sortKey="Messina, F" uniqKey="Messina F">F Messina</name></author><author><name sortKey="Unroe, Kt" uniqKey="Unroe K">KT Unroe</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Phelan, Ea" uniqKey="Phelan E">EA Phelan</name></author><author><name sortKey="Debnam, Kj" uniqKey="Debnam K">KJ Debnam</name></author><author><name sortKey="Anderson, La" uniqKey="Anderson L">LA Anderson</name></author><author><name sortKey="Owens, Sb" uniqKey="Owens S">SB Owens</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Seitz, Dp" uniqKey="Seitz D">DP Seitz</name></author><author><name sortKey="Gill, Ss" uniqKey="Gill S">SS Gill</name></author><author><name sortKey="Gruneir, A" uniqKey="Gruneir A">A Gruneir</name></author><author><name sortKey="Austin, Pc" uniqKey="Austin P">PC Austin</name></author><author><name sortKey="Anderson, Gm" uniqKey="Anderson G">GM Anderson</name></author><author><name sortKey="Bell, Cm" uniqKey="Bell C">CM Bell</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Tropea, J" uniqKey="Tropea J">J Tropea</name></author><author><name sortKey="Logiudice, D" uniqKey="Logiudice D">D LoGiudice</name></author><author><name sortKey="Liew, D" uniqKey="Liew D">D Liew</name></author><author><name sortKey="Gorelik, A" uniqKey="Gorelik A">A Gorelik</name></author><author><name sortKey="Brand, C" uniqKey="Brand C">C Brand</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Callahan, Cm" uniqKey="Callahan C">CM Callahan</name></author><author><name sortKey="Arling, G" uniqKey="Arling G">G Arling</name></author><author><name sortKey="Tu, W" uniqKey="Tu W">W Tu</name></author><author><name sortKey="Rosenman, Mb" uniqKey="Rosenman M">MB Rosenman</name></author><author><name sortKey="Counsell, Sr" uniqKey="Counsell S">SR Counsell</name></author><author><name sortKey="Stump, Te" uniqKey="Stump T">TE Stump</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Sampson, El" uniqKey="Sampson E">EL Sampson</name></author><author><name sortKey="Leurent, B" uniqKey="Leurent B">B Leurent</name></author><author><name sortKey="Blanchard, Mr" uniqKey="Blanchard M">MR Blanchard</name></author><author><name sortKey="Jones, L" uniqKey="Jones L">L Jones</name></author><author><name sortKey="King, M" uniqKey="King M">M King</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Reppas Rindlisbacher, Ce" uniqKey="Reppas Rindlisbacher C">CE Reppas-Rindlisbacher</name></author><author><name sortKey="Fischer, Hd" uniqKey="Fischer H">HD Fischer</name></author><author><name sortKey="Fung, K" uniqKey="Fung K">K Fung</name></author><author><name sortKey="Gill, Ss" uniqKey="Gill S">SS Gill</name></author><author><name sortKey="Seitz, D" uniqKey="Seitz D">D Seitz</name></author><author><name sortKey="Tannenbaum, C" uniqKey="Tannenbaum C">C Tannenbaum</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Amjad, H" uniqKey="Amjad H">H Amjad</name></author><author><name sortKey="Carmichael, D" uniqKey="Carmichael D">D Carmichael</name></author><author><name sortKey="Austin, Am" uniqKey="Austin A">AM Austin</name></author><author><name sortKey="Chang, C H" uniqKey="Chang C">C-H Chang</name></author><author><name sortKey="Bynum, Jpw" uniqKey="Bynum J">JPW Bynum</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Vu, M" uniqKey="Vu M">M Vu</name></author><author><name sortKey="Hogan, Db" uniqKey="Hogan D">DB Hogan</name></author><author><name sortKey="Patten, Sb" uniqKey="Patten S">SB Patten</name></author><author><name sortKey="Jette, N" uniqKey="Jette N">N Jette</name></author><author><name sortKey="Bronskill, Se" uniqKey="Bronskill S">SE Bronskill</name></author><author><name sortKey="Heckman, Ga" uniqKey="Heckman G">GA Heckman</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Mondor, L" uniqKey="Mondor L">L Mondor</name></author><author><name sortKey="Maxwell, Cj" uniqKey="Maxwell C">CJ Maxwell</name></author><author><name sortKey="Bronskill, Se" uniqKey="Bronskill S">SE Bronskill</name></author><author><name sortKey="Gruneir, A" uniqKey="Gruneir A">A Gruneir</name></author><author><name sortKey="Wodchis, Wp" uniqKey="Wodchis W">WP Wodchis</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Gruneir, A" uniqKey="Gruneir A">A Gruneir</name></author><author><name sortKey="Bronskill, Se" uniqKey="Bronskill S">SE Bronskill</name></author><author><name sortKey="Maxwell, Cj" uniqKey="Maxwell C">CJ Maxwell</name></author><author><name sortKey="Bai, Yq" uniqKey="Bai Y">YQ Bai</name></author><author><name sortKey="Kone, Aj" uniqKey="Kone A">AJ Kone</name></author><author><name sortKey="Thavorn, K" uniqKey="Thavorn K">K Thavorn</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Jaakkimainen, Rl" uniqKey="Jaakkimainen R">RL Jaakkimainen</name></author><author><name sortKey="Bronskill, Se" uniqKey="Bronskill S">SE Bronskill</name></author><author><name sortKey="Tierney, Mc" uniqKey="Tierney M">MC Tierney</name></author><author><name sortKey="Herrmann, N" uniqKey="Herrmann N">N Herrmann</name></author><author><name sortKey="Green, D" uniqKey="Green D">D Green</name></author><author><name sortKey="Young, J" uniqKey="Young J">J Young</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Kone Pefoyo, Aj" uniqKey="Kone Pefoyo A">AJ Koné Pefoyo</name></author><author><name sortKey="Bronskill, Se" uniqKey="Bronskill S">SE Bronskill</name></author><author><name sortKey="Gruneir, A" uniqKey="Gruneir A">A Gruneir</name></author><author><name sortKey="Calzavara, A" uniqKey="Calzavara A">A Calzavara</name></author><author><name sortKey="Thavorn, K" uniqKey="Thavorn K">K Thavorn</name></author><author><name sortKey="Petrosyan, Y" uniqKey="Petrosyan Y">Y Petrosyan</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Lane, Ne" uniqKey="Lane N">NE Lane</name></author><author><name sortKey="Maxwell, Cj" uniqKey="Maxwell C">CJ Maxwell</name></author><author><name sortKey="Gruneir, A" uniqKey="Gruneir A">A Gruneir</name></author><author><name sortKey="Bronskill, Se" uniqKey="Bronskill S">SE Bronskill</name></author><author><name sortKey="Wodchis, Wp" uniqKey="Wodchis W">WP Wodchis</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Wodchis, Wp" uniqKey="Wodchis W">WP Wodchis</name></author><author><name sortKey="Hirdes, Jp" uniqKey="Hirdes J">JP Hirdes</name></author><author><name sortKey="Feeny, Dh" uniqKey="Feeny D">DH Feeny</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Hirdes, Jp" uniqKey="Hirdes J">JP Hirdes</name></author><author><name sortKey="Frijters, Dh" uniqKey="Frijters D">DH Frijters</name></author><author><name sortKey="Teare, Gf" uniqKey="Teare G">GF Teare</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Campitelli, Ma" uniqKey="Campitelli M">MA Campitelli</name></author><author><name sortKey="Bronskill, Se" uniqKey="Bronskill S">SE Bronskill</name></author><author><name sortKey="Hogan, Db" uniqKey="Hogan D">DB Hogan</name></author><author><name sortKey="Diong, C" uniqKey="Diong C">C Diong</name></author><author><name sortKey="Amuah, Je" uniqKey="Amuah J">JE Amuah</name></author><author><name sortKey="Gill, S" uniqKey="Gill S">S Gill</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Bice, Tw" uniqKey="Bice T">TW Bice</name></author><author><name sortKey="Boxerman, Sb" uniqKey="Boxerman S">SB Boxerman</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Kralj, B" uniqKey="Kralj B">B Kralj</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Fine, Jp" uniqKey="Fine J">JP Fine</name></author><author><name sortKey="Gray, Rj" uniqKey="Gray R">RJ Gray</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Prince, M" uniqKey="Prince M">M Prince</name></author><author><name sortKey="Bryce, R" uniqKey="Bryce R">R Bryce</name></author><author><name sortKey="Albanese, E" uniqKey="Albanese E">E Albanese</name></author><author><name sortKey="Wimo, A" uniqKey="Wimo A">A Wimo</name></author><author><name sortKey="Ribeiro, W" uniqKey="Ribeiro W">W Ribeiro</name></author><author><name sortKey="Ferri, Cp" uniqKey="Ferri C">CP Ferri</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Schubert, Cc" 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Sicras-Mainar</name></author><author><name sortKey="Soljak, M" uniqKey="Soljak M">M Soljak</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Fox, C" uniqKey="Fox C">C Fox</name></author><author><name sortKey="Smith, T" uniqKey="Smith T">T Smith</name></author><author><name sortKey="Maidment, I" uniqKey="Maidment I">I Maidment</name></author><author><name sortKey="Hebding, J" uniqKey="Hebding J">J Hebding</name></author><author><name sortKey="Madzima, T" uniqKey="Madzima T">T Madzima</name></author><author><name sortKey="Cheater, F" uniqKey="Cheater F">F Cheater</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Callahan, Cm" uniqKey="Callahan C">CM Callahan</name></author><author><name sortKey="Schubert, Cc" uniqKey="Schubert C">CC Schubert</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Haggerty, Jl" uniqKey="Haggerty J">JL Haggerty</name></author><author><name sortKey="Reid, Rj" 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Koh</name></author></analytic></biblStruct></listBibl></div1></back></TEI><affiliations><list><country><li>Canada</li></country><region><li>Alberta</li><li>Ontario</li></region><settlement><li>Calgary</li><li>Toronto</li></settlement><orgName><li>Université de Calgary</li><li>Université de Toronto</li></orgName></list><tree><country name="Canada"><noRegion><name sortKey="Mondor, Luke" sort="Mondor, Luke" uniqKey="Mondor L" first="Luke" last="Mondor">Luke Mondor</name></noRegion><name sortKey="Bronskill, Susan E" sort="Bronskill, Susan E" uniqKey="Bronskill S" first="Susan E." last="Bronskill">Susan E. 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Lane</name><name sortKey="Lane, Natasha E" sort="Lane, Natasha E" uniqKey="Lane N" first="Natasha E." last="Lane">Natasha E. Lane</name><name sortKey="Maxwell, Colleen J" sort="Maxwell, Colleen J" uniqKey="Maxwell C" first="Colleen J." last="Maxwell">Colleen J. Maxwell</name><name sortKey="Maxwell, Colleen J" sort="Maxwell, Colleen J" uniqKey="Maxwell C" first="Colleen J." last="Maxwell">Colleen J. Maxwell</name><name sortKey="Maxwell, Colleen J" sort="Maxwell, Colleen J" uniqKey="Maxwell C" first="Colleen J." last="Maxwell">Colleen J. Maxwell</name><name sortKey="Maxwell, Colleen J" sort="Maxwell, Colleen J" uniqKey="Maxwell C" first="Colleen J." last="Maxwell">Colleen J. Maxwell</name><name sortKey="Maxwell, Colleen J" sort="Maxwell, Colleen J" uniqKey="Maxwell C" first="Colleen J." last="Maxwell">Colleen J. Maxwell</name><name sortKey="Mondor, Luke" sort="Mondor, Luke" uniqKey="Mondor L" first="Luke" last="Mondor">Luke Mondor</name><name sortKey="Wodchis, Walter P" sort="Wodchis, Walter P" uniqKey="Wodchis W" first="Walter P." last="Wodchis">Walter P. Wodchis</name><name sortKey="Wodchis, Walter P" sort="Wodchis, Walter P" uniqKey="Wodchis W" first="Walter P." last="Wodchis">Walter P. Wodchis</name><name sortKey="Wodchis, Walter P" sort="Wodchis, Walter P" uniqKey="Wodchis W" first="Walter P." last="Wodchis">Walter P. Wodchis</name><name sortKey="Wodchis, Walter P" sort="Wodchis, Walter P" uniqKey="Wodchis W" first="Walter P." last="Wodchis">Walter P. Wodchis</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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