Harkness Project Title: Comparing Intensity of Care Received at the End of Life in the United States and Canada
Biography at time of Harkness Fellowship: Robert Fowler, M.D., a 2011-12 Canadian Harkness Fellow in Health Care Policy and Practice, is a critical care physician and associate professor, Department of Medicine, University of Toronto, since 2010. He also has positions as research chair, Department of Medicine/Critical Care, Sunnybrook Hospital, clinician scientist (Phase II), Heart and Stroke Foundation (Ontario), and adjunct scientist, Institute for Clinical Evaluative Sciences. From 2006-09, he was acting chief, Department of Critical Care Medicine, Sunnybrook Hospital, 2006-09 and had a 5-year Career Scientist Award from the Ontario Ministry of Health and Long-term Care, 2005-10. He had a key role in Canada on the SARS response and led the international critical care work on H1N1, including shaping the Canadian and WHO guidelines and establishing the online database that became the standard of reporting. He has over 70 peer-reviewed publications, including in top journals such as Journal of the American Medical Association, Lancet, and the New England Journal of Medicine. He received his M.D. from McGill University in 1995 and his M.Sc. from Stanford University in 2002.
Project: Fowler’s project looked to quantify differences in intensity and costs of end-of-life care for Americans and Canadians over age 65. His measures included hospital admissions, number of physicians seen, admission to the intensive care unit, provision of mechanical ventilation, and receipt of diagnostic and therapeutic procedures. He conducted a population-based cohort study of all decedents in the U.S. and Canada, using a retrospective, 2-year look-back design between 2003 and 2011.
Current Positions:
- Senior Scientist, Evaluative Clinical Sciences, Trauma, Emergency and Clinical Care Research Program, Sunnybrook Research Institute
- Physician, Sunnybrook Health Sciences Centre
- Associate Professor, Department of Medicine and Interdepartmental Division of Critical Care Medicine
- Associate Director, Clinical Epidemiology and Health Care Research, Institute of Health Policy, Management and Evaluation, Dalla Lana School of Pubic Health, University of Toronto
Email: [email protected]
Harkness Related Publications
V. Costa, C.C. Earle, M.J. Esplen, R. Fowler, R. Goldman, D. Grossman, L. Levin, D.G. Manuel, S. Sharkey, P. Tanuseputro , J.J. You. “The determinants of home and nursing home death: a systematic review and meta-analysis,” BMC Palliat Care. 2016.