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This research was supported by a research grant from the Ontario Ministry of Health and Long-Term Care (MOHLTC) to the Bruyère Center of Learning Research and Innovation in Long-Term Care (CLRI). This study was also supported by the Institute for Clinical Evaluative Sciences (ICES), which is funded by an annual grant from the Ontario MOHLTC. The opinions, results and conclusions reported in this paper are those of the authors and are independent from the funding sources. No endorsement by MOHLTC is intended or should be inferred. The funders had no influence in study design; in the collection, analysis, and interpretation of data; in the writing of the report; and in the decision to submit the article for publication.
This study has been approved by the research ethics board at the Institute for Clinical Evaluative Sciences (ICES), at Sunnybrook Health Sciences Centre in Toronto, Ontario, and by the research ethics board at the Ottawa Hospital Research Institute at Ottawa, Ontario (Protocol #20130579-01H).
Using encrypted health card numbers as unique identifiers, records of healthcare use and costs were linked across various administrative databases. No written consent was obtained; all data were encrypted using health card numbers as unique identifiers. Thus, all records used were deidentified and anonymized. All data were housed and analyzed at ICES, a prescribed entity for the purposes of section 45 Ontario's Personal Health Information Privacy Act.
The authors declare no conflicts of interest.