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Healthcare Policy, Politiques de Santé

Clare Liddy, Isabella Moroz, Amir Afkham, Erin Keely
OBJECTIVE: To replicate an existing electronic consultation (eConsult) service in a new jurisdiction to test its generalizability. METHODS: We conducted a cross-sectional study of all eConsults submitted by providers in the region of Mississauga Halton, Ontario, between January 5, 2015, and May 31, 2016. We compared our results to those from the original pilot in Eastern Ontario. The RE-AIM model served as our study framework. RESULTS: Providers submitted 594 patient cases to 46 different specialty groups during the study period...
November 2017: Healthcare Policy, Politiques de Santé
Lulu Gao, Mina Tadrous, Sandra Knowles, Muhammad Mamdani, J Michael Paterson, David Juurlink, Tara Gomes
PURPOSE: Provincial public drug formularies in Canada have different mechanisms for reimbursement of direct-acting oral anticoagulants (DOACs). We investigate how these differences influence DOAC utilization and expenditure across the country. METHODS: We conducted a population-based, cross-sectional study of all out-patient prescriptions for OACs dispensed to public beneficiaries between January 1, 2010, and June 30, 2015. We calculated quarterly rates of OAC use and expenditures stratified by OAC type and province...
November 2017: Healthcare Policy, Politiques de Santé
Anne J Kearney, Julie Polisena, Andra Morrison
Organized breast screening programs in Canada recommend that women, usually 50-74 years of age, are screened regularly with mammography to reduce their risk of breast cancer death. There is increasing evidence that estimates of mortality reduction are overestimated and harms under-reported. This article will report on a review of the websites of 12 breast screening programs in Canada. The primary goal is to determine what information is provided to enable women to make an informed decision about mammography and whether choice is emphasized...
November 2017: Healthcare Policy, Politiques de Santé
Carolyn J Barg, Fiona A Miller, Robin Z Hayeems, Yvonne Bombard, Céline Cressman, Michael Painter-Main
OBJECTIVES: We explored public preferences for involvement in health policy decisions, across the contexts of medical research and healthcare. APPROACH: We e-surveyed a sample of Canadians, categorizing respondents by preferences for decision control: (1) more authority; (2) more input; (3) status quo. Two generalized ordered logistic regressions assessed influences on preferences. RESULTS: The participation rate was 94%; 1,102 completed responses met quality criteria...
November 2017: Healthcare Policy, Politiques de Santé
Katherine Zagrodney, Mike Saks
There has been much recent discussion internationally about the emergence in modern society of a new class of workers - the precariat - with a common consciousness based on features such as low wages, insecurity, short-term jobs, minority status and restricted rights. This paper critically explores the extent to which the growing, large-scale group of personal support workers (PSWs) can be viewed as part of a new precariat in terms of their position in the healthcare labour market. Drawing on currently available empirical data, this issue is examined particularly with reference to PSWs in Canada - drawing out some of the implications for government health policy in this sphere...
November 2017: Healthcare Policy, Politiques de Santé
Kimberlyn McGrail, Megan Ahuja
Health expenditures in most OECD countries have increased at a slower rate since 2008/2009. Potential drivers of this bending of the cost curve include: (1) changes in pharmaceuticals and technology innovations; (2) healthcare reforms, and specifically those focusing on care for complex and high-user patients and (3) government expenditure controls resulting from general economic conditions. We use publicly available National Health Expenditure data from the Canadian Institute for Health Information to assess the merits of each of these drivers, with a focus on British Columbia...
November 2017: Healthcare Policy, Politiques de Santé
Avra Selick, Alexandra Lamoureux, Karen O'Connor, Janet Durbin
Equity has been identified as a core component of quality healthcare in Ontario. However, translating policy into practice can be challenging. This paper reports results from a province-wide survey of early psychosis intervention programs to assess the extent to which equity has been incorporated into program delivery. All 56 programs (100%) completed the survey. Results found that while most programs perceive that they are meeting equity aims, they reported limited use of practices to support this aim, and few systematically collect information on performance...
November 2017: Healthcare Policy, Politiques de Santé
Jennifer Zelmer
No abstract text is available yet for this article.
November 2017: Healthcare Policy, Politiques de Santé
Renée Misfeldt, Esther Suter, Sara Mallinson, Omenaa Boakye, Sabrina Wong, Louise Nasmith
This paper discusses findings from a high-level scan of the contextual factors and actors that influenced policies on team-based primary healthcare in three Canadian provinces: British Columbia, Alberta and Saskatchewan. The team searched diverse sources (e.g., news reports, press releases, discussion papers) for contextual information relevant to primary healthcare teams. We also conducted qualitative interviews with key health system informants from the three provinces. Data from documents and interviews were analyzed qualitatively using thematic analysis...
August 2017: Healthcare Policy, Politiques de Santé
Said Ahmad Maisam Najafizada, Thushara Sivanandan, Kelly Hogan, Deborah Cohen, Jean Harvey
INTRODUCTION: Since the release of the World Health Report in 2000, health system performance ranking studies have garnered significant health policy attention. However, this literature has produced variable results. The objective of this study was to synthesize the research and analyze the ranked performance of Canada's health system on the international stage. METHOD: We conducted a scoping review exploring Canada's place in ranked health system performance among its peer Organisation for Economic Co-operation and Development countries...
August 2017: Healthcare Policy, Politiques de Santé
Lesley J J Soril, Ted Adams, Madeleine Phipps-Taylor, Ulrika Winblad, Fiona Clement
OBJECTIVE: To compare cost-related non-adherence (CRNA), serious problems paying medical bills and average annual out-of-pocket cost over time in five countries. METHODS: Repeated cross-sectional analysis of the Commonwealth Fund International Health Policy survey from 2004 to 2014. Responses were compared between Canada, the UK, Australia, New Zealand and the US. RESULTS: Compared to the UK, respondents in Canada, Australia and New Zealand were two to three times and respondents in the US were eight times more likely to experience CRNA; these odds remained stable over time...
August 2017: Healthcare Policy, Politiques de Santé
Gail Tomblin Murphy, Stephen Birch, Adrian Mackenzie, Janet Rigby, Joanne Langley
Healthcare systems must be responsive to the healthcare needs of the populations they serve. However, typically neither health services nor health workforce planning account for populations' needs for care, resulting in substantial and unnecessary unmet needs. These are further exacerbated during unexpected surges in need, such as pandemics or natural disasters. To illustrate the potential of improved methods to help planning for these types of events, we applied an integrated, needs-based approach to health service and workforce planning in the context of a potential influenza pandemic at the provincial level in Canada...
August 2017: Healthcare Policy, Politiques de Santé
Eldon Spackman, Rebecca Haines-Saah, Vishva M Danthurebandara, Laura E Dowsett, Tom Noseworthy, Fiona M Clement
OBJECTIVES: To describe marijuana use by Canadians and their perceptions of risk and harm. DESIGN: A cross-sectional, structured, online and telephone survey. PARTICIPANTS: A nationally representative sample of Canadians. METHODS: This survey used random probability sampling and targeted respondents based on age, sex, region and their expected response rate. RESULTS: Of the 20% of respondents reporting marijuana use in the past 12 months, they were more likely to be younger and male...
August 2017: Healthcare Policy, Politiques de Santé
Joel Lexchin
The interest of the pharmaceutical industry is in achieving a profit for its shareholders while the interest of the Canadian government should be in protecting public health. However, over the course of the past few decades the actions of the Canadian government have been tilted in favour of industry in two areas. The first is in the relationship between industry and Health Canada and is manifested in the regulation of clinical trials, the drug approval system, drug safety and promotion. The second is in economic policy as it applies to policies about patent protection, the price of medications and measures taken to incentivize research and development...
August 2017: Healthcare Policy, Politiques de Santé
Jennifer Zelmer
No abstract text is available yet for this article.
August 2017: Healthcare Policy, Politiques de Santé
Gregory P Marchildon, Caroline A Beck, Tarun R Katapally, Sylvia Abonyi, James A Dosman, Jo-Ann Episkenew
BACKGROUND: A complex, poorly understood bifurcated health policy regime exists for Canada's First Nations people for extended health benefits coverage. This research adds to a small body of literature on the regime's impact on access and quality of care and its role in perpetuating health inequities in First Nations populations. METHODS: Using a case study of sleep apnea care in Saskatchewan, we identified issues of health service access and coverage through a literature review of extended benefits programs, legislation and policies and through 10 key informant interviews with federal and provincial extended benefit program administrators and sleep medicine physicians...
May 2017: Healthcare Policy, Politiques de Santé
Robert Schwartz, Farzana Haji, Alexey Babayan, Christopher Longo, Roberta Ferrence
Insurance coverage for evidence-based smoking cessation treatments (SCTs) promotes uptake and reduces smoking rates. Published studies in this area are based in the US where employers are the primary source of health insurance. In Ontario, Canada, publicly funded healthcare does not cover SCTs, but it can be supplemented with employer-sponsored benefit plans. This study explores factors affecting the inclusion/exclusion of smoking cessation (SC) benefits. In total, 17 interviews were conducted with eight employers (auto, retail, banking, municipal and university industries), four health insurers, two government representatives and three advisors/consultants...
May 2017: Healthcare Policy, Politiques de Santé
Ethan Holtzer, Alicia Moore-Dean, Amirrtha Srikanthan, Kerry Kuluski
Refugee healthcare in Canada has been a controversial and heavily debated topic over the past several years. In this paper, we present a policy analysis of the 2012 Canadian federal government decision to change the criteria and funding of the Interim Federal Health Program (IFHP). The IFHP provides federally funded healthcare coverage for refugees until they gain access to provincially funded health insurance. The paper offers a policy perspective on the changes to refugee health coverage over time. We draw on the policy concepts of agenda setting, framing, venues and causal stories to explore this topic...
May 2017: Healthcare Policy, Politiques de Santé
Maria Mathews, Rima Kandar, Steve Slade, Yanqing Yi, Sue Beardall, Ivy Bourgeault
OBJECTIVES: Are Canadians who study abroad (CSAs) more likely to stay in Canada than other international medical graduates (IMGs)? We looked at retention patterns of CSAs and immigrant IMGs who completed post-graduate medical education (PGME) training in Canada to describe the proportion and predictors of those working in Canada and in rural communities in Canada in 2015. METHODS: We linked the National IMG Database to Scott's Medical Database to track the work locations of CSAs and immigrant IMGs in 2015...
May 2017: Healthcare Policy, Politiques de Santé
Elena Neiterman, Ivy Lynn Bourgeault, Christine L Covell
BACKGROUND: The literature on international medical graduates (IMGs) in Canada is growing, but there is a lack of systematic analysis of the literature. OBJECTIVES: To examine (1) the major themes in academic and grey literature pertaining to professional integration of IMGs in Canada; and (2) the gaps in our knowledge on integration of IMGs. METHODS: This paper is based on the scoping review of academic and grey literature published during 2001-2013 about IMGs in Canada...
May 2017: Healthcare Policy, Politiques de Santé
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