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1
Simard, Jean-François, and Yvon Leclerc. "La reddition de compte : le maillon faible du développement local? Regards sur les centres locaux de développement." Économie et Solidarités 42, no. 1-2 (March 5, 2015): 105–27. http://dx.doi.org/10.7202/1029013ar.
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La création des centres locaux de développement (CLD) remonte à la seconde moitié des années 1990. Elle marque une étape singulière dans l’histoire de la décentralisation au Québec. Cette structure tout aussi inédite qu’innovante est calquée sur le territoire des municipalités régionales de comté (MRC). Elle s’est principalement vu confier la responsabilité de soutenir la création de l’emploi à l’échelle locale et supramunicipale, dans une période marquée par un taux élevé de chômage. Chaque CLD est doté d’un conseil d’administration autonome, majoritairement composé d’élus locaux. Ces organismes à but non lucratif sont financés à parts égales par l’État québécois et les municipalités. Du reste, l’idée de décentralisation est généralement associée à une plus grande transparence administrative et à un dialogue plus étroit des organisations (quasi) publiques avec la société civile. Or, une enquête menée auprès de plusieurs CLD démontre paradoxalement que ce processus de décentralisation administrative se fait en l’absence d’une reddition de compte adéquate portant sur la qualité des services offerts par les CLD à leurs collectivités respectives. En ce sens, la décentralisation administrative n’est pas forcément un gage de démocratisation du développement. Toutefois, l’introduction récente de dispositions administratives par le ministère de tutelle, de concert avec la ville ou la MRC ainsi qu’en accord avec le guide des bonnes pratiques, a permis une amélioration sensible de la reddition de compte dans les CLD.
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Craig-Dupont, Olivier, and Gérald Domon. "Protection privée de la biodiversité et fiscalisation du marché de la wilderness : une histoire de la conservation volontaire au Québec (1980-2014)." Recherche 56, no. 2-3 (December 11, 2015): 381–417. http://dx.doi.org/10.7202/1034212ar.
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Depuis la fin des années 1980, la province de Québec est le théâtre d’une véritable prolifération de statuts de protection écologique sur terres privées. Réserves naturelles en milieu privé, dons écologiques, servitudes de conservation et « fiducies foncières » se multiplient maintenant dans certaines régions du Québec méridional. Vu la nature privée des transactions foncières qui composent ce mouvement, ce dernier demeure largement méconnu. Il a pourtant eu un impact substantiel sur le façonnement de certaines politiques contemporaines concernant la conservation du patrimoine naturel au Québec. À travers une recherche détaillée de fonds d’archives ministériels et une série d’entrevues avec des acteurs clefs, cet article retrace la genèse de ce mouvement de conservation volontaire au Québec. Il souligne comment les États canadien et québécois, de même que certaines corporations à but non lucratif, ont facilité la mise en place d’un réseau d’aires protégées privées largement financées par le trésor public, par l’entremise d’avantages fiscaux. La reconstruction de cette institutionnalisation de la conservation volontaire au Québec révèle comment l’État fut un agent actif dans la décentralisation, la privatisation et la fiscalisation progressive de la conservation du patrimoine écologique au Québec.
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Landreville, Pierre. "L’absence temporaire dans les établissements de détention du Québec." Criminologie 28, no. 1 (August 16, 2005): 139–47. http://dx.doi.org/10.7202/017368ar.
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In this article the author exposes the situation of prison overcrowding in facilities in the province of Québec. He brings forth the fact that leave of absences have been used to respond to this situation and states that these programs are acceptable means of managing carcéral populations. He bases his statements on the spacial comparison of the rates of leave of absences and the rates of overcrowding between 1989 and 1992, and this by various administrative regions of Québec.
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Thibault, Normand. "Présentation des perspectives provisoires de la population du Québec, 1981-2001." Articles 11, no. 3 (October 27, 2008): 351–96. http://dx.doi.org/10.7202/600881ar.
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RÉSUMÉ Le Bureau de la statistique du Québec publiait récemment des perspectives provisoires de population pour l’ensemble du Québec. Des perspectives multirégionales construites à partir des données propres à chaque région administrative du Québec sont en préparation. Ce nouveau modèle permet de réduire d’au moins un an le délai de disponibilité des prévisions démographiques pour l’ensemble de la province. La population est projetée à l’aide de la matrice de Leslie qui permet de prendre en compte à la fois la fécondité, la mortalité, les déplacements migratoires et le vieillissement annuel. Les prévisions provisoires décrites ici seront remplacées ultérieurement par la somme des prévisions régionales produites par le modèle multirégional du Bureau de la statistique du Québec. Les hypothèses sur lesquelles elles reposent tiennent compte des tendances récentes de la fécondité, de la mortalité et des migrations au Québec.
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Lebel, Michel. "Du libre accès à l'accès restreint aux écoles anglaises du Québec." Les Cahiers de droit 24, no. 1 (April 12, 2005): 131–43. http://dx.doi.org/10.7202/042538ar.
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In this article, the author gives a historical account of the different laws enacted by the National Assembly in order to enhance the status of the French language at administrative levels as well as among the province's résidants themselves. The schools, being vehicles of social and cultural influence, were included. Laws 63 and 22 were little more than tentative, hesitant sallies into the linguistic battle confronting the province and its minority groups. Law 101 provided a more coherent line of reasoning in deciding Quebec's language policies. Nevertheless, it is contested by some groups on constitutional grounds.
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Simard, Martin, and Majella-J. Gauthier. "Les enjeux territoriaux associés à la réforme municipale au Québec. Le cas de Saguenay." Cahiers de géographie du Québec 48, no. 134 (November 14, 2005): 191–207. http://dx.doi.org/10.7202/011681ar.
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Résumé Depuis une décennie, les réorganisations politico-administratives locales et régionales sont fréquentes en Occident. Le Québec n’échappe pas à la tendance avec la réforme municipale en cours. Les regroupements de municipalités de 2001 ont ainsi affecté les six régions métropolitaines de la province et plusieurs agglomérations de plus petite taille. Cet article a pour objectif de faire ressortir les enjeux territoriaux de l’intégration socio-économique et fonctionnelle de ces nouveaux espaces politiques. À cette fin, nous regarderons la situation de Saguenay au Québec. Cette ville moyenne en région périphérique se distingue à divers égards. Elle est une agglomération possédant plusieurs centres d’affaires ayant des caractéristiques propres. Ceux-ci correspondent aux secteurs centraux des anciennes villes de Chicoutimi, Jonquière et La Baie. Par ailleurs, Saguenay est le coeur d’un espace rural agro-forestier qui possède maintenant une autonomie administrative compte tenu de la création d’une nouvelle municipalité régionale de comté (MRC). Comment seront gérées les dynamiques intra-urbaines et régionales dans le contexte de cette réorganisation administrative?
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Laurin, Paul. "Les activités de l’équipe de gestion dans les écoles polyvalentes." Revue des sciences de l'éducation 2, no. 1 (December 10, 2009): 13–34. http://dx.doi.org/10.7202/901375ar.
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Résumé L’article a pour but de présenter la description des emplois administratifs de l’équipe de gestion dans les écoles polyvalentes du niveau secondaire de la province de Québec. On y trouve la description de l’administration considérée comme un système, les attributions de l’administration de l’éducation et l’équipe administrative d’une école secondaire. La méthodologie utilisée : un questionnaire administré dans 26 écoles secondaires de la province de Québec. Les résultats semblent se justifier sous trois aspects de la définition des emplois : 1) les tâches communes et particulières; 2) les relations entre les diverses attributions; 3) les relations entre les différents postes administratifs. Les résultats obtenus sont expliqués en détail. En conclusion il ressort que certaines équipes de gestions ont tendance à travailler collectivement sur les mêmes tâches, alors que dans d’autres équipes les membres ont tendance à accomplir d’une façon isolée les différentes tâches. Cependant avant de préconiser un type de fonctionnement plutôt qu’un autre, il serait important de rechercher quel est le type d’équipe de gestion qui obtient une plus grande efficacité au sein de l’organisation.
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Godbout, Jacques. "La formation de la communauté urbaine de Québec et le rôle de l'État dans la restructuration des pouvoirs locaux." Articles 12, no. 2 (April 12, 2005): 185–225. http://dx.doi.org/10.7202/055533ar.
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Parlant récemment des gouvernements métropolitains, B.M. Gross a qualifié cette idée de « morte mais non encore enterrée ». Dans le même sens, aux États-Unis, bien des observateurs et des promoteurs des gouvernements métropolitains semblent abandonner tout espoir de réaliser une telle structure et songent à d'autres formules pour solutionner les problèmes de gouvernement des grandes agglomérations. Cependant, à la fin de l'année 1969, l'Assemblée nationale du Québec adoptait trois projets de loi créant deux gouvernements métropolitains (communautés urbaines de Québec et Montréal) et un gouvernement régional (communauté régionale de l'Outaouais). De plus, le Ministère des affaires municipales songe à étendre ce système et à doter la province d'une structure de gouvernement régional et métropolitain. Il est étonnant de constater qu'au moment où on abandonne l'idée de gouvernement métropolitain aux États-Unis, le Québec réussisse à doter ses deux plus grandes agglomérations d'une telle structure politico-administrative et veuille étendre ce système aux différentes régions du Québec. En analysant les principales caractéristiques du processus de formation de la Communauté urbaine de Québec, ce travail vise à dégager les facteurs socio-politiques qui facilitent au Québec une telle transformation des structures politiques locales et à apporter quelques réflexions sur le fonctionnement futur du nouveau gouvernement métropolitain.
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Louder, Dean R., Michel Bisson, and Pierre La Rochelle. "Analyse centrographique de la population du Québec de 1951 à 1971." Cahiers de géographie du Québec 18, no. 45 (April 12, 2005): 421–44. http://dx.doi.org/10.7202/021221ar.
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Avant de pouvoir expliquer les processus qui sous-tendent la redistribution de la population, il est très utile de déceler les tendances générales de cette redistribution. L'un des meilleurs outils à cette fin est l'analyse centrographique. Trois mesures centro-graphiques : le centre de gravité, la distance-type et un indice de dispersion relative, sont calculées pour la répartition de la population du Québec à trois échelles différentes (division de recensement, région administrative et province) à trois points dans le temps (1951, 1961, 1971). Au premier niveau, la grande majorité des divisions de recensement sont caractérisées par la stabilité ou par une tendance à la concentration. Au niveau régional, la population tend à se concentrer dans toutes les régions administratives sauf deux : l'Abitibi et la Gaspésie. Au niveau de l'ensemble du Québec, il y a eu tendance à la concentration, le centre de gravité se situant dans le lac Saint-Pierre, au nord de la municipalité de Nicolet, mais se déplaçant progressivement vers Montréal.
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Jantchou, P., F. Conus, H. Richard, and M. C. Rousseau. "P770 Ascertainment of pediatric inflammatory bowel disease cases from administrative health data in Québec, Canada." Journal of Crohn's and Colitis 14, Supplement_1 (January 2020): S610—S611. http://dx.doi.org/10.1093/ecco-jcc/jjz203.898.
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Abstract Background Administrative databases are useful for estimating population-level disease occurrence. Our objective was to ascertain cases of pediatric inflammatory bowel disease (IBD) by applying two validated algorithms to administrative health data, evaluate agreement, and compare health services utilisation between concordant and discordant cases. Methods The Quebec Birth Cohort on Immunity Health was established through linkage of administrative databases and includes 400 611 persons born in the province of Québec (Canada) from 1970 to 1974. Physician consultations (PC) and hospitalisations (H) for IBD were documented in health databases until 2014. Two validated algorithms were used to identify pediatric IBD cases. Firstly, a single-step algorithm was applied [5PC or 2H within 4 years]. Secondly, a two-step algorithm was implemented, first considering whether the person had undergone sigmoidoscopy/colonoscopy before age 18 [yes: 4PC or 2H within 3 years; no: 7PC or 3H within 3 years]. We evaluated the agreement between both algorithms using the Kappa statistic, and compared health services utilisation among concordant and discordant cases using a t-test. Results The single-step algorithm generated 527 pediatric IBD cases (0.13%), whereas 480 (0.12%) were identified with the multi-step algorithm. Among the 534 cases identified by either algorithm, 473 (88.6%) were identified by both, 54 (10.1%) only by the single-step, and 7 (1.3%) only by the multi-step algorithm. Kappa was 0.94 (95% confidence interval: 0.92, 0.95), and the proportions of positive and negative agreement were respectively 0.94 and 1.00. The average number of PC and H before age 18 years among concordant and discordant cases was respectively 26.0 and 3.9 (p < 0.0001). Conclusion The prevalence of pediatric IBD was similar when applying two different case identification algorithms, few cases were discordant. In the near future, a survey conducted in a subset of the cohort will allow us to compare self-report with ascertainment from administrative databases.
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Lemasson, Morgane, Julie Haesebaert, Louis Rochette, Eric Pelletier, Alain Lesage, and Simon Patry. "Electroconvulsive Therapy Practice in the Province of Quebec: Linked Health Administrative Data Study from 1996 to 2013." Canadian Journal of Psychiatry 63, no. 7 (October 25, 2017): 465–73. http://dx.doi.org/10.1177/0706743717738492.
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Objective: As part of a quality improvement process, we propose a model of routinely monitoring electroconvulsive therapy (ECT) in Canadian provinces using linked health administrative databases to generate provincial periodic reports, influence policy, and standardise ECT practices. Methods: ECT practice in Quebec was studied from 1996 to 2013, using longitudinal data from the Quebec Integrated Chronic Disease Surveillance System of the Institut National de Santé Publique du Québec, which links 5 health administrative databases. The population included all persons, aged 18 y and over, eligible for the health insurance registry, who received an ECT treatment at least once during the year. Results: Among recorded cases, 75% were identified by physician claims and hospitalisation files, 19% exclusively by physician claims, and 6% by hospitalisation files. From 1996 to 2013, 8,149 persons in Quebec received ECT with an annual prevalence rate of 13 per 100,000. A decline was observed, which was more pronounced in women and in older persons. On average, each patient received 9.7 treatments of ECT annually. The proportion of acute ECT decreased whereas maintenance treatment proportions increased. A wide variation in the use of ECT was observed among regions and psychiatrists. Conclusion: This study demonstrates the profitable use of administrative data to monitor ECT use in Quebec, and provides a reliable method that could be replicated in other Canadian provinces. Although Quebec has one of the lowest utilisation rates reported in industrialized countries, regional disparities highlighted the need for a deeper examination of the quality and monitoring of ECT care and services.
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Leclerc, Jean-François. "La Sûreté du Québec des origines à nos jours : quelques repères historiques." Criminologie 22, no. 2 (August 16, 2005): 107–27. http://dx.doi.org/10.7202/017284ar.
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The history of the police in Canada is a field that has been little explored. This is all the more so in the case of the police corps of Quebec, the only valid monograph on the subject being one on the Montreal police. This article gives a general outline of the administrative history of the provincial police of Quebec, the “Sûreté du Québec”, since its creation in 1870 by the provincial government. The idea of creating a police force under State control was not new, going back to the first «modern» police established in 1838 in Quebec city and Montreal during a time of rebellion, by an Order in Council of governor Durham. An unsuccessful attempt was made to establish one during the 1850s. It was in 1870 that the «provincial police» were set up in Quebec City, the capital, mainly to have a force to intervene in riots and strikes. Municipalities requiring them could also obtain their services. This police corps was reduced after 1878 to become a mere guard of the Parliament which also served the Department of the Attorney General. After that, great changes were made with the integration of other police and government services : the Bureau of Provincial Detectives of Montreal in 1922, the liquor and highway police in 1934 and 1936, which in 1938 become branches of the Provincial Police. In 1938, the Duplessis government undertook to extend the provincial police by opening up stations throughout the province. After 1960, the Lesage government completed the merging of the various branches, sought to eliminate political influence in the hiring of police and opened the first training school for policemen. The Provincial Police became the Sûreté du Québec in 1968, when an administrative restructuring was started, inspired by the methods used in private enterprise, which gave its form to today's Sûreté.
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Guertin, Sophie, Karine-Sylvie Lemieux, Natalie Makhoulian, Sébastien Michaud, Rose-Marie Patry, Anne-Andrée Côté, Fabien Gagnon, Pierre Ayotte, and Stéphane Bolduc. "Variation spatiotemporelle de la cryptorchidie et de l’hypospadias au Québec : Une étude exploratoire." Canadian Urological Association Journal 5, no. 3 (April 4, 2013): 167. http://dx.doi.org/10.5489/cuaj.638.
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Objectifs : La majorité des études effectuées au cours des dernièresdécennies ont mis en évidence une augmentation du nombre decas de cryptorchidie et d’hypospadias entre 1970 et 1990. De plus,l’importante variabilité géographique de ces anomalies est biendécrite. Cette étude vise à mesurer la prévalence à la naissancede la cryptorchidie et de l’hypospadias au Québec, à vérifier sices anomalies sont en augmentation et à en évaluer la répartitioninterrégionale.Méthode : Une étude épidémiologique descriptive a été réalisée àpartir du nombre de garçons de cinq ans et moins hospitalisés pourune cryptorchidie ou un hypospadias au Québec de 1989 à 2004selon les données du fichier administratif d’hospitalisation MEDÉCHO.Les données sur les naissances provenaient de l’Institut dela statistique du Québec.Résultats : La prévalence annuelle moyenne pour 1000 naissancesvivantes de sexe masculin est de 19,1 (IC à 95 % : 18,8-19,4) pourla cryptorchidie et 11,4 (IC à 95 % 11,1-11,6) pour l’hypospadiasau Québec. Au cours de la période étudiée, la prévalence de cryptorchidiea légèrement diminué, alors que celle de l’hypospadiasest demeurée stable. Comparativement à la province du Québec,des régions présentent une prévalence significativement différentede cryptorchidie et/ou d’hypospadias. .Conclusion : Au Québec, la prévalence de cryptorchidie est enlégère diminution alors que celle de l’hypospadias est stable.Des variations régionales significatives sont observables. D’autresétudes sont nécessaires afin d’évaluer l’hypothèse d’un lien avecles contaminants environnementaux en émergence. L’implantationd’un système de surveillance des anomalies congénitales permettraitune représentation plus valide de la situation.Objectives: Previous research has shown evidence of an increasein the number of cases of cryptorchidism and hypospadias between1970 and 1990. Geographical disparities of these anomalies arewidely described. This study aims to measure the prevalence ofcryptorchidism and hypospadias at birth in the province of Quebec,to investigate if there is an increasing trend and to assess the interregionaldistribution of these anomalies. Method: A descriptive epidemiological study was undertaken toinvestigate the number of newborn males up to five years of age,hospitalized for cryptorchidism or hypospadias in Quebec between1989 and 2004 based on data collected from MED-ECHO, a databasecompiling hospitalizations and used for administrative purposes.Birth rates were provided by the Statistical Institute of Quebec. Results: Mean yearly prevalence per 1000 male live births was19.1 (95% CI 18.8-19.4) for cryptorchidism and 11.4 (95% CI11.1-11.6) for hypospadias for the province of Quebec. Within theperiod of study, the prevalence of cryptorchidism decreased slightlywhile that of hypospadias remained stable. Significant variationsin prevalence were observed in some regions compared to theprovince, for both pathologies. Conclusion: In Quebec, the prevalence of cryptorchidism isdecreasing while that of hypospadias is stable. There is significantregional variation among the province. More studies are neededto assess the potential link with environmental contaminants asan emerging explanation. The implementation of an adequate surveillancesystem for congenital anomalies would allow for a moreaccurate representation of the situation.
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Bourbonnais, Renée, Chantal Brisson, Michel Vézina, Benoît Masse, and Caty Blanchette. "Psychosocial Work Environment and Certified Sick Leave among Nurses during Organizational Changes and Downsizing." Articles 60, no. 3 (January 26, 2006): 483–509. http://dx.doi.org/10.7202/012156ar.
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The study aimed to determine whether the incidence and duration of certified sick leave (CSL) among nurses had increased during major restructuring of the health care system in the province of Québec, and to determine whether nurses exposed to adverse psychosocial factors at work showed an increased incidence of CSL. It involved nurses working in 13 health facilities. Sickness absence data were retrieved from administrative files (n = 1454). Incidence of CSL for all diagnoses and for mental health problems was examined. Telephone interviews were conducted to measure psychosocial factors at work with validated instruments. There was an increase in CSL among nurses during the restructuring, particularly for mental health problems. Modifiable adverse psychosocial work factors were identified and provide basis for interventions. Since human resources are the mainstay and primary resource of the health network, it is essential that people be able to perform their work under optimal conditions.
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Lacasse, Yves, Victor M. Montori, Claude Lanthier, and François Maltis. "The Validity of Diagnosing Chronic Obstructive Pulmonary Disease from a Large Administrative Database." Canadian Respiratory Journal 12, no. 5 (2005): 251–56. http://dx.doi.org/10.1155/2005/567975.
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BACKGROUND: Health authorities create and maintain administrative databases. Despite the potential advantages of these databases, the validity of the information they include must be considered.OBJECTIVE: To examine the validity of diagnosing chronic obstructive pulmonary disease (COPD) from a large administrative database.METHODS: Physician services and prescription claims data related to COPD and asthma were extracted from the Quebec universal medical insurance register (Régie de l'assurance-maladie du Québec; RAMQ) from the period of April 1, 1994 to March 31, 1999. Before obtaining the data, criteria for the validity of the COPD diagnosis in the database were formulated based on the epidemiology of COPD in the province. The extent to which the database satisfied these criteria are described within the present paper.RESULTS: For patients aged 65 years or older, COPD was two times more prevalent in the RAMQ database than in the 1994/1995 National Population Health Survey. One in three patients with a RAMQ-diagnosis of COPD also had a RAMQ-diagnosis of asthma, and 47% of patients aged 65 years or older with a RAMQ-diagnosis of COPD did not fill any prescription for beta-2-agonists. In addition, 42% of patients with a RAMQ-diagnosis of COPD who never had a RAMQ-diagnosis of asthma appeared only once with that diagnosis in the database. Of all patients aged 65 years or older with a RAMQ-diagnosis of COPD, 37% and 23% met the operational definitions of 'possible COPD' and 'probable COPD', respectively.CONCLUSIONS: Most RAMQ-diagnoses of COPD lack validity; therefore, the validity of database diagnoses should be routinely ascertained before using administrative databases in clinical and health services research.
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Feasby, Thomas E., Hude Quan, and William A. Ghali. "Provincial Carotid Endarterectomy Outcomes." Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques 29, no. 4 (November 2002): 333–36. http://dx.doi.org/10.1017/s0317167100002195.
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Background:Outcomes must be measured as a first step toward improving performance. We sought to measure the national and provincial outcomes from carotid endarterectomy (CE) and explain provincial differences.Methods:We analyzed a large Canada-wide administrative hospital discharge database of all patients, except those in Québec, receiving CE in 1994-1997 and used logistic regression for risk adjustment to measure adverse outcomes nationally and by province. Our main outcome measures were in-hospital stroke and/or death.Results:A total of 14,268 patients underwent CE in the years 1994-1997. The overall death rate was 1.3% and the combined stroke and/or death rate was 4.1%. There was a trend towards improvement over the four years. The provinces of Saskatchewan and Newfoundland had significantly higher adverse event rates for the risk-adjusted combined outcome measure.Conclusion:The outcome of CE in Canada is good and showed improvement over four years. However, significant differences in provincial outcomes were found. This suggests that regionalization across provincial boundaries may be needed to promote higher surgeon and hospital case volumes and thus improve outcomes.
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Duplé, Nicole. "Nouvelles récentes de l'article 96." Les Cahiers de droit 18, no. 2-3 (April 12, 2005): 315–33. http://dx.doi.org/10.7202/042168ar.
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When called upon, to ascertain the ambit of the application of section 96 of the B.N.A. Act (1867), our courts have devised a method of reasoning by historical analogy between different types of jurisdictions. In Tomko v. Labour Relations Board (N.S.) and al., the Supreme Court was given the opportunity to make a clear synthesis of the principles underlying such an approach. Although the Court's decision makes no innovations in this respect, it establishes clear guidelines to be followed by the judiciary when it shall next be called upon to pronounce itself on the constitutionnality of the conferral of jurisdiction upon inferior tribunals or provincial administrative organisms in the light of section 96. The Supreme Court is now hearing the appeal in P.g. du Québec et Tribunal des Transports v. Farrah. In that case, the Court of Appeal held that when the Transport Tribunal hears an appeal from the Transport Commission on questions of law only, it exercises a jurisdiction which is analogous to the superintending power of the Superior Court. The Court of appeal therefore considered that the judges of the Transport Tribunal fall under the application of section 96. If the Supreme Court were to confirm the appeal tribunal's decisions it most probably would also have to examin the constitutionnality of certain "privative" clauses; if it were to refuse to adopt the Court of appeal's view, it would render possible the establishment of an administrative appeal court whose judges would be nominated by the Province.
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Bélanger-Gravel, Ariane, Sophie Desroches, Isidora Janezic, Marie-Claude Paquette, and Philippe De Wals. "Pattern and correlates of public support for public health interventions to reduce the consumption of sugar-sweetened beverages." Public Health Nutrition 22, no. 17 (September 23, 2019): 3270–80. http://dx.doi.org/10.1017/s1368980019002076.
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AbstractObjective:To examine the pattern and correlates of public support for twelve public health interventions aimed at reducing sugar-sweetened beverage (SSB) consumption.Design:Cross-sectional population-based survey. Respondents were recruited using a random digit dialling procedure (landline telephone) and a random selection of telephone numbers (mobile telephone). Sampling quotas were applied for age, and the sample was stratified according to administrative regions.Setting:The province of Québec, Canada.Subjects:One thousand adults aged between 18 and 64 years and able to answer the survey questionnaire in French or English.Results:Support was observed for a number of public health interventions, but the more intrusive approaches were less supported. Support for taxation as well as for sale and access restriction was positively associated with the perceived relevance of the government intervention, perceived effectiveness, and perceived associations between SSB consumption and chronic diseases. Believing that SSB consumption is a personal choice and daily consumption were generally negatively associated with strong support and positively associated with strong opposition. Sparse associations between sociodemographic and socio-economic characteristics were observed, with the exception of sex and age: women were generally more likely to support the examined public health strategies, while younger respondents were less likely to express support.Conclusions:Increasing perceived effectiveness and government responsibility for addressing the issue of SSB consumption could lead to increased support for SSB interventions. Increasing the belief that SSB consumption could be associated with chronic diseases would increase support, but SSB consumers and younger individuals are expected to be resistant.
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Arulanandam, Brandon, Marc Dorais, Patricia Li, and Dan Poenaru. "The burden of waiting: wait times for pediatric surgical procedures in Quebec and compliance with national benchmarks." Canadian Journal of Surgery 64, no. 1 (February 2021): E14—E22. http://dx.doi.org/10.1503/cjs.020619.
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Background: Wait time information and compliance with national guidelines are limited to a few adult conditions in the province of Quebec. We aimed to assess compliance with Paediatric Canadian Access Targets for Surgery (P-CATS) guidelines and determine the burden incurred due to waiting for 3 common elective surgical conditions (inguinal hernia, cryptorchidism and hypospadias) in a pediatric population. Methods: We carried out a population-based retrospective cohort study of randomly selected children residing in Quebec without complex chronic medical conditions, using administrative databases belonging to the Régie de l’assurance maladie du Québec for the period 2010–2013. Disability-adjusted life years (DALYs) were calculated to measure the burden due to waiting. Multivariate forward regression identified risk factors for compliance with national guidelines. Results: Surgical wait time information was assessed for 1515 patients, and specialist referral wait time was assessed for 1389 patients. Compliance with P-CATS benchmarks was 76.6% for seeing a specialist and 60.7% for receiving surgery. Regression analysis identified older age (p < 0.0001) and referring physician specialty (p = 0.001) as risk factors affecting specialist referral wait time target compliance, whereas older age (p = 0.040), referring physician specialty (p = 0.043) and surgeon specialty (p = 0.002) were significant determinants in surgical wait time compliance. The total burden accrued due to waiting beyond benchmarks was 35 DALYs. Conclusion: Our results show that provincial compliance rates with wait time benchmarks are still inadequate and need improvement. Patient age and physician specialty were both found to have significant effects on wait time target compliance.
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Giasson, Thierry, Colette Brin, and Marie-Michele Sauvageau. "Le Bon, la Brute et le Raciste. Analyse de la couverture médiatique de l'opinion publique pendant la «crise» des accommodements raisonnables au Québec." Canadian Journal of Political Science 43, no. 2 (May 28, 2010): 379–406. http://dx.doi.org/10.1017/s0008423910000090.
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Résumé.De mars 2006 à décembre 2007, le Québec a été secoué par un débat sociétal sur la question de la gestion de la diversité culturelle. Cette «crise» aurait été alimentée par untsunami médiatiquetraitant de divers cas d'accommodements juridiques ou d'ajustements administratifs accordés dans les services publics à des citoyens québécois issus de l'immigration dans la grande région de Montréal (Giasson et coll., 2008). Par le biais d'une couverture étendue, les médias ont attiré l'attention de la population sur ces pratiques d'accommodement. L'article présente les données exploratoires d'une analyse de contenu de la couverture faite par onze journaux québécois du climat de l'opinion des Québécois en matière de diversité et d'immigration pendant la phase intensive de développement du débat. L'étude montre que dans leur analyse des sondages d'opinion et dans la présentation générale des tendances de l'opinion publique sur les accommodements raisonnables, les journaux ont mis l'accent sur l'évaluation du malaise des répondants envers l'immigration et la diversité religieuse plutôt que sur l'ouverture de la population québécoise envers la diversité et sur l'apport social de l'immigration, renforçant ainsi davantage l'impression populaire qu'une crise sociale majeure se déroulait et qu'il existait un fossé entre les Québécois «de souche», les Québécois issus de l'immigration et les autres Canadiens.Abstract.From March 2006 to December 2007, the province of Quebec experienced a contentious public debate on diversity. The “crisis” was fueled by a “media tsunami” during which news outlets actively reported on numerous cases of reasonable accommodation practices or administrative agreements in public services granted in the Greater Montreal region to citizens of immigrant background (Giasson et al., 2008). Through this extensive coverage, the media brought these instances of accommodation to the public's attention. The research studies the press coverage that 11 daily newspapers dedicated to the state of public opinion in Quebec during the active and intense development phase of the “crisis”. The study shows that in their analysis of polls and their general framing of the mood of public opinion towards reasonable accommodation, newspapers focused mostly on the malaise in the population toward immigration and religious diversity rather than on its openness to diversity and to the positive social outcomes of immigration. In doing so, the media further anchored the popular impression that a serious social crisis was ongoing and that a wide gap in tolerance existed between Francophone Quebeckers, Quebeckers of recent immigrant background and other Canadians.
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Houle, France. "Consultation During Rule-Making: A Case Study of the Immigration and Refugee Protection Regulation." Windsor Yearbook of Access to Justice 28, no. 2 (October 1, 2010): 395. http://dx.doi.org/10.22329/wyaj.v28i2.4506.
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Since it prescribed its first regulatory policy in 1986, the Federal government implemented a consultation process with stakeholders and the general public during the rule-making process. This process is not legally mandatory (unlike in the province of Quebec). However, failure to conduct a consultation process results in an administrative sanction: the refusal to approve the new regulation by Cabinet. This article reports on the results of an empirical research project we conducted in 2004 within the Immigration Division of the Citizenship and Immigration Canada Department [CIC]. Our general research question was exploratory in nature. We wanted to know how CIC civil servants understood their obligation to consult with citizens. Our case-study indicates that it is difficult to implement a consultative culture within a department that has a strong long-term commitment to protect the integrity of the Canadian territory.Depuis la mise en oeuvre de sa toute première politique réglementaire en 1986, l’administration publique fédérale consulte les parties prenantes et le public en général lors de l’élaboration d’un projet de règlement. Ces politiques n’ont pas pour effet de rendre la consultation légalement obligatoire (comme au Québec), mais administrativement obligatoire. La sanction du non-respect de cette obligation résulte en le refus par le Cabinet d’approuver le nouveau règlement. Dans cet article, nous faisons rapport sur les résultats d’une recherche empirique que nous avons menée en 2004 avec la section de l’immigration du ministère de la Citoyenneté et de l’Immigration du Canada [CIC]. Notre question générale de recherche était de nature exploratoire : nous voulions savoir comment les fonctionnaires de CIC comprenaient l’obligation qui leur était faite de consulter les citoyens. Notre étude de cas indique qu’il est difficile d’implanter une culture de consultation dans un ministère dont la mission est, depuis longtemps, de protéger l’intégrité du territoire canadien.
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Bertulies-Esposito, Bastian, Marie Nolin, Srividya N. Iyer, Ashok Malla, Phil Tibbo, Nicola Otter, Manuela Ferrari, and Amal Abdel-Baki. "Où en sommes-nous? An Overview of Successes and Challenges after 30 Years of Early Intervention Services for Psychosis in Quebec: Où en sommes-nous? Un aperçu des réussites et des problèmes après 30 ans de services d’intervention précoce pour la psychose au Québec." Canadian Journal of Psychiatry 65, no. 8 (January 8, 2020): 536–47. http://dx.doi.org/10.1177/0706743719895193.
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Introduction: Over the last 30 years, early intervention services (EIS) for first-episode psychosis (FEP) were gradually implemented in the province of Quebec. Such implementation occurred without provincial standards/guidelines and policy commitment to EIS until 2017. Although the literature highlights essential elements for EIS, studies conducted elsewhere reveal that important EIS components are often missing. No thorough review of Quebec EIS practices has ever been conducted, a gap we sought to address. Methods: Adopting a cross-sectional descriptive study design, an online survey was distributed to 18 EIS that existed in Quebec in 2016 to collect data on clinical, administrative, training, and research variables. Survey responses were compared with existing EIS service delivery recommendations. Results: Half of Quebec’s population had access to EIS, with some regions having no programs. Most programs adhered to essential components of EIS. However, divergence from expert recommendations occurred with respect to variables such as open referral processes and patient–clinician ratio. Nonurban EIS encountered additional challenges related to their geography and lower population densities, which impacted their team size/composition and intensity of follow-up. Conclusions: Most Quebec EIS offer adequate services but lack resources and organizational support to adhere to some core components. Recently, the provincial government has created EIS guidelines, invested in the development of new programs and offered implementation support from the National Centre of Excellence in Mental Health. These changes, along with continued mentoring and networking of clinicians and researchers, can help all Quebec EIS to attain and maintain recommended quality standards.
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Verdon, C., J. Reinglas, C. Filliter, J. Coulombe, L. Gonczi, W. Afif, G. Wild, et al. "DOP45 Increased prevalence but not incidence of myocardial infarction and stroke in patients with inflammatory bowel diseases in Quebec in 1996–2015." Journal of Crohn's and Colitis 14, Supplement_1 (January 2020): S082—S085. http://dx.doi.org/10.1093/ecco-jcc/jjz203.084.
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Abstract Background Chronic inflammatory diseases have been linked to increased risk of atherothrombotic events, but the risk associated with inflammatory bowel disease (IBD) is conflictive. We, therefore, examined the risk of and risk factors for myocardial infarction (MI) and stroke in patients with IBD in Quebec. Methods We used the public health administrative database from the Province of Québec to identify newly diagnosed IBD patients between 1996 and 2015 with established case ascertainment algorithm. Incidence and prevalence of stroke and myocardial infarction were defined using ICD codes found in primary, secondary care visits or admission. Comorbidity analysis was performed by both using a logistic regression or a Poisson model with outcome rates for 1000 person-years adjusted for age and sex along with one comorbidity of interest, or with medical therapy as a time-varying variable. Significant variables (p < 0.05) were added to a multivariable models along with age and sex. Analyses were run overall and stratified by disease type. Incidence rate ratios, 95% CIs and p-values were computed. Results In total, 34 644 newly diagnosed IBD patients (CD: 59.5%) were identified. The prevalence but not incidence rates of MI was higher in IBD (prevalence at the end on 2013: 3.98%, OR:2.03 95% CI: 1.92–2.15, incidence: 0.234 per 1000 patient-years) compared with the background Canadian rates (prevalence in 2012–2013: 2.0%, incidence: 0.220 per 1000 patient-years), while the prevalence and incidence rates of stroke were not significantly higher in IBD (prevalence in 2012–2013: 2.98%, OR: 1.15 95% CI:1.08–1.23, incidence: 0.122 per 1000 patient-years vs Canadian rates: (prevalence in 2012–2013: 2.60%, incidence: 0.297 per 1000 patient-years). We identified age, sex, hyperlipidaemia and hypertension (p < 0.001 for each) as risk factors for developing MI and stroke in both CD and UC. Diabetes was identified as an additional risk factor for MI in CD and stroke in UC. Exposure to biologicals was associated with a higher incidence of MI compared with the non-treatment group (IRR: 1.51, 95% CI: 0.82–2.76, p = 0.07) in the insured IBD population. Conclusion Increased prevalence but not incidence of MI and no increased risk of stroke was identified in this population-based IBD cohort from Quebec. Risk factors for both MI and stroke included age, sex, hyperlipidaemia, hypertension and diabetes in IBD. Exposure to biologicals, reflecting disease severity in administrative databases, was associated with a higher incidence rate ratio for MI in IBD.
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Tagalakis, Vicky, Valerie Patenaude, Susan R. Kahn, and Samy Suissa. "Oral Anticoagulation Treatment and Persistence After Venous Thromboembolism In a Real World Population: The Q-VTE Study Cohort." Blood 122, no. 21 (November 15, 2013): 2386. http://dx.doi.org/10.1182/blood.v122.21.2386.2386.
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Abstract Background For patients who are diagnosed with venous thromboembolism (VTE) provoked by transient risk factors, clinical guidelines typically recommend 3 months of oral anticoagulation, with longer treatment considered for unprovoked VTE. Describing treatment patterns of VTE in a real world population may identify remedial gaps in patient care. Aim We aimed to characterize oral anticoagulant treatment with vitamin K antagonists (VKA) following incident VTE and assess persistence of VKA therapy in patients with provoked vs. unprovoked VTE in a real world setting. Methods We used the linked administrative healthcare databases of the province of Québec, Canada, including the hospitalization, universal healthcare services, and out-patient prescription databases. We identified all beneficiaries with an incident DVT or PE between 2000 and 2009, which we classified as definite or probable VTE using a priori determined diagnostic algorithms based on ICD-9-CM or ICD-10-CA diagnosis codes. We formed two patient cohorts, one with definite and the other including definite or probable first-time VTE, that were followed until death or end of study (December 31, 2009). Anticoagulant out-patient prescription patterns were analyzed for both patient cohorts. Results From 245,452 Québec residents between 2000 and 2009 with at least 1 VTE diagnosis in RAMQ or MED-ÉCHO, we formed the definite VTE cohort including 40,776 definite cases and the any VTE cohort consisting of 54,803 definite or probable cases. From the 40,776 patients with a first definite VTE, there were 24,860 patients with DVT alone (61%) and 15,916 with PE with or without DVT (39%). Furthermore, there were 78% of patients over the age of 60 and 58.3% of patients were women. In all, 8,998 (22.1%) patients had an unprovoked VTE event while 19,010 (46.6%) patients had a provoked non-cancer event. Similar findings were found in the any VTE cohort. Among definite VTE cohort patients with a provoked non-cancer VTE, 68.6% of patients received anticoagulation after the VTE event. Most were dispensed VKA (64.9%) and 23.9% received a prescription for low molecular weight heparin (LMWH). Among patients with an unprovoked VTE, 86.3% of patients were prescribed anticoagulation (84.5% used VKA and 39.9% used LMWH). Overall, a greater number of patients received anticoagulation following PE (85.2%) than DVT alone (66.2%). Results were similar in the any VTE cohort. Persistence with VKA therapy among patients with provoked VTE was 86.9% at 90 days, 59.5% at 180 days and 19.9% at 365 days. Treatment persistence for patients with unprovoked non-cancer VTE was 88.8%, 66.8% and 22.9% for 90, 180 and 365 days, respectively. Similar findings were found in the any VTE cohort. Conclusions Our study provides useful information on VTE management in a real world population. Treatment persistence was similar for patients with provoked and unprovoked VTE. VKA therapy duration after provoked VTE was longer than the recommended 3 months, whereas treatment was shorter than suggested in patients with unprovoked VTE. Further investigation is needed to determine reasons for non-adherence to clinical guidelines. Disclosures: No relevant conflicts of interest to declare.
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Létourneau, Gilles. "Problématique de la violence dans les loisirs et moyens d’action corrective et préventive : l’expérience québécoise et canadienne." Informations et documents 19, no. 3 (April 8, 2019): 653–69. http://dx.doi.org/10.7202/1058601ar.
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La violence qui jadis évoquait l’horreur s’est au fil des ans développée une facette récréative et s’est infiltrée progressivement dans le domaine du sport qui compte pour une partie importante des activités de loisir. La société canadienne n’a malheureusement pas échappé à ce phénomène. Le hockey, ce sport adulé des Canadiens, offre un exemple regrettable d’infiltration de la violence récréative, violence à la fois néfaste, pernicieuse et prompte à l’escalade. À cause de l’ampleur du phénomène et des coûts sociaux qui en découlent, une prise de conscience individuelle et collective apparaît comme un véritable prérequis à l’adoption de mesures correctives efficaces. Les moyens traditionnels de contrôle et de prévention tels le droit sportif, le droit civil et le droit pénal n’ont pas produit les résultats escomptés et, de toute façon, ne sont destinés à servir que des fins précises et limitées. La province de Québec a innové en créant une Régie de la sécurité dans les sports. Cet organisme public indépendant s’est vu conféré des fonctions conseil, d’assistance, d’éducation, de contrôle, d’information ainsi que d’analyse et recherche. À ces fins la Régie a été dotée de pouvoirs d’inspection des centres sportifs et de l’équipement utilisé, d’émission de permis aux promoteurs d’activités sportives, d’adoption et d’approbation de règlements de sécurité tant pour les spectateurs que les participants et de pouvoirs d’enquête sur toute situation qui risque de mettre en danger la sécurité des personnes lors de la pratique d’un sport. Après un début lent dû à la phase laborieuse d’implantation administrative et de pénétration du milieu, la Régie s’est impliquée auprès de la population et du réseau scolaire par des campagnes publicitaires et d’information visant à promouvoir la sécurité et l’esprit sportif dans la pratique des sports. Elle s’est associée aux diverses fédérations sportives dans l’analyse et la révision de la réglementation applicable aux sports et aux loisirs afin de prévenir les accidents. L’action concertée de la Régie et des intervenants des milieux sportifs et récréatifs ont contribué grandement à la « responsabilisation » individuelle et collective en cours et devrait, à moyen et à long terme, permettre au sport de revenir à son but principal, c’est-à-dire favoriser le développement harmonieux du corps et de l’esprit ainsi que la recherche d’un équilibre entre ces deux composantes humaines ou mieux encore, selon l’idéal rêvé de de Coubertin, apporter le calme, la philosophie, la santé et la beauté.
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Huỳnh, Christophe, Steve Kisely, Louis Rochette, Éric Pelletier, Kenneth B. Morrison, Shelley Li, Gareth Hopkin, et al. "Measuring Substance-Related Disorders Using Canadian Administrative Health Databanks: Interprovincial Comparisons of Recorded Diagnostic Rates, Incidence Proportions and Mortality Rate Ratios." Canadian Journal of Psychiatry, September 27, 2021, 070674372110434. http://dx.doi.org/10.1177/07067437211043446.
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Context Assessing temporal changes in the recorded diagnostic rates, incidence proportions, and health outcomes of substance-related disorders (SRD) can inform public health policymakers in reducing harms associated with alcohol and other drugs. Objective To report the annual and cumulative recorded diagnostic rates and incidence proportions of SRD, as well as mortality rate ratios (MRRs) by cause of death among this group in Canada, according to their province of residence. Methods Analyses were performed on linked administrative health databases (AHD; physician claims, hospitalizations, and vital statistics) in five Canadian provinces (Alberta, Manitoba, Ontario, Québec, and Nova Scotia). Canadians 12 years and older and registered for their provincial healthcare coverage were included. The International Classification of Diseases (ICD-9 or ICD-10 codes) was used for case identification of SRD from April 2001 to March 2018. Results During the study period, the annual recorded SRD diagnostic rates increased in Alberta (2001–2002: 8.0‰; 2017–2018: 12.8‰), Ontario (2001–2002: 11.5‰; 2017–2018: 14.4‰), and Nova Scotia (2001–2002: 6.4‰; 2017–2018: 12.7‰), but remained stable in Manitoba (2001–2002: 5.5‰; 2017–2018: 5.4‰) and Québec (2001–2002 and 2017–2018: 7.5‰). Cumulative recorded SRD diagnostic rates increased steadily for all provinces. Recorded incidence proportions increased significantly in Alberta (2001–2002: 4.5‰; 2017–2018: 5.0‰) and Nova Scotia (2001–2002: 3.3‰; 2017–2018: 3.8‰), but significantly decreased in Ontario (2001–2002: 6.2‰; 2017–2018: 4.7‰), Québec (2001–2002: 4.1‰; 2017–2018: 3.2‰) and Manitoba (2001–2002: 2.7‰; 2017–2018: 2.0‰). For almost all causes of death, a higher MRR was found among individuals with recorded SRD than in the general population. The causes of death in 2015–2016 with the highest MRR for SRD individuals were SRD, suicide, and non-suicide trauma in Alberta, Ontario, Manitoba, and Québec. Discussion Linked AHD covering almost the entire population can be useful to monitor the medical service trends of SRD and, therefore, guide health services planning in Canadian provinces.
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Kuenzig, M. Ellen, Alain Bitton, Matthew W. Carroll, Gilaad G. Kaplan, Anthony R. Otley, Harminder Singh, Geoffrey C. Nguyen, et al. "Inflammatory Bowel Disease Increases the Risk of Venous Thromboembolism in Children: A Population-Based Matched Cohort Study." Journal of Crohn's and Colitis, June 27, 2021. http://dx.doi.org/10.1093/ecco-jcc/jjab113.
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Abstract Background and Aims Although venous thromboembolism [VTE] is a well-known complication of inflammatory bowel disease [IBD] in adults, limited data exist on the risk in children. We report the incidence of VTE among children with and without IBD. Methods We conducted a matched cohort study within a distributed network of population-based Canadian provincial health administrative databases. Children <16 years diagnosed with IBD were identified using validated algorithms from administrative data in Alberta, Manitoba, Nova Scotia, Ontario and Québec and compared to age- and sex-matched children without IBD. Hospitalizations for VTE within 5 years of IBD diagnosis were identified. Generalized linear mixed-effects models were used to pool province-specific incidence rates and incidence rate ratios [IRR] with 95% confidence intervals [CI]. Hazard ratios [HR] from Cox proportional hazards models were pooled with fixed-effects meta-analysis. Results The 5-year incidence of VTE among 3593 children with IBD was 31.2 [95% CI 23.7–41.0] per 10 000 person-years [PY] compared to 0.8 [95% CI 0.4–1.7] per 10 000 PY among 16 289 children without IBD [unadjusted IRR 38.84, 95% CI 16.59–90.83; adjusted HR 22.91, 95% CI 11.50–45.63]. VTE was less common in Crohn’s disease than ulcerative colitis [unadjusted IRR 0.47, 95% CI 0.27–0.83; adjusted HR 0.52, 95% CI 0.29–0.94]. The findings were similar for deep vein thrombosis and pulmonary embolism when comparing children with and without IBD. Conclusions The risk of VTE is much higher in children with IBD than controls without IBD. While the absolute risk is low, we found a higher incidence rate than previously described in the pediatric literature. Conference Presentation: An abstract based on the data included in this paper was presented at Canadian Digestive Diseases Week [Montréal, Canada] in March 2020.
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Verdon, Christine, Jason Reinglas, Janie Coulombe, Lorant Gonczi, Talat Bessissow, Waqqas Afif, Maria Vutcovici, et al. "No Change in Surgical and Hospitalization Trends Despite Higher Exposure to Anti-Tumor Necrosis Factor in Inflammatory Bowel Disease in the Québec Provincial Database From 1996 to 2015." Inflammatory Bowel Diseases, July 17, 2020. http://dx.doi.org/10.1093/ibd/izaa166.
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Abstract Background Crohn disease (CD) and ulcerative colitis (UC) have high health care expenditures because of medications, hospitalizations, and surgeries. We evaluated disease outcomes and treatment algorithms of patients with inflammatory bowel disease (IBD) in Québec, comparing periods before and after 2010. Methods The province of Québec’s public health administrative database was used to identify newly diagnosed patients with IBD between 1996 and 2015. The primary and secondary outcomes included time to and probability of first and second IBD-related hospitalizations, first and second major surgery, and medication exposures. Medication prescriptions were collected from the public prescription database. Results We identified 34,644 newly diagnosed patients with IBD (CD = 59.5%). The probability of the first major surgery increased after 2010 in patients with CD (5 years postdiagnosis before and after 2010: 8% [SD = 0.2%] vs 15% [SD = 0.6%]; P < 0.0001) and patients with UC (6% [SD = 0.2%] vs 10% [SD = 0.6%] ;P < 0.0001). The probability of the second major surgery was unchanged in patients with CD. Hospitalization rates remained unchanged. Patients on anti-tumor necrosis factor (anti-TNF) medications had the lowest probability of hospitalizations (overall 5-year probability in patients with IBD stratified by maximal therapeutic step: 5-aminosalicylic acids 37% [SD = 0.6%]; anti-TNFs 31% [SD = 1.8%]; P < 0.0001). Anti-TNFs were more commonly prescribed for patients with CD after 2010 (4% [SD = 0.2%] vs 16% [SD = 0.6%]; P < 0.0001) in the public health insurance plan, especially younger patients. Corticosteroid exposure was unchanged before and after 2010. Immunosuppressant use was low but increased after 2010. The use of 5-ASAs was stable in patients with UC but decreased in patients with CD. Conclusions The probability of first and second hospitalizations remained unchanged in Québec and the probability of major surgery was low overall but did increase despite the higher and earlier use of anti-TNFs.