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Healthcare Policy, Politiques de Santé

Astrid Brousselle, Damien Contandriopoulos, Jeannie Haggerty, Mylaine Breton, Michèle Rivard, Marie-Dominique Beaulieu, Geneviève Champagne, Mélanie Perroux
Context: Significant reforms are needed to improve healthcare system performance in Quebec. Even though the characteristics of high-performing healthcare systems are well-known, Quebec's reforms have not succeeded in implementing many critical elements. Converging evidence from political science models suggests stakeholders' preferences are central in determining policy content, adoption, and implementation. Objective: To analyze whether doctors', nurses', pharmacists' and health administrators' preferences could explain the observed inability to implement known characteristics of high-performing healthcare systems...
August 2018: Healthcare Policy, Politiques de Santé
Alix J E Carter, Jan L Jensen, David A Petrie, Jennifer Greene, Andrew Travers, Judah P Goldstein, Jolene Cook, Dana Fidgen, Janel Swain, Luke Richardson, Ed Cain
Background: Emergency medical services (EMS) leaders and clinicians need to incorporate evidence into safe and effective clinical practice. Access to high-quality evidence, and the time to synthesize it, can be barriers to evidence-based practice. The Prehospital Evidence-Based Practice (PEP) program is an online, freely accessible, repository of critically appraised evidence specific to EMS. This paper describes the evolution and current methodology of the PEP program. Methods|design: The purpose of PEP is to identify, catalog and critically appraise relevant studies...
August 2018: Healthcare Policy, Politiques de Santé
Susan E Slaughter, C Allyson Jones, Misha Eliasziw, Carla Ickert, Carole A Estabrooks, Adrian S Wagg
With provincial policy changing institutional care provision for older adults who are unable to safely remain at home, supportive living represents a new middle-ground to provide care for older adults. We compared characteristics of supportive living staff and residents to those in long-term care (LTC), using facility and staff surveys, as well as administrative Resident Assessment Instrument (RAI) data, to describe differences and similarities between facility types. Data analysis included t-tests, chi-square tests, ridit analyses and odds ratios...
August 2018: Healthcare Policy, Politiques de Santé
Allie Peckham, David Rudoler, Joyce M Li, Sandra D'Souza
This paper considers one of Ontario's largest reform efforts: the Aging at Home Strategy (AHS). The AHS was initiated in 2007 to enable people to live independent lives in their own homes. A document review was conducted on relevant government materials to assess the goals and objectives of the AHS as it was rolled out over the course of three years. The findings identify that by the third year of the AHS, there was a reduction in the discretionary powers of the regional health authorities to allocate funds based on local priorities...
August 2018: Healthcare Policy, Politiques de Santé
Clare Liddy, Isabella Moroz, Justin Joschko, Tanya Horsley, Craig Kuziemsky, Katharina Kovacs Burns, Sandi Kossey, Gunita Mitera, Erin Keely
This paper explores our efforts to support the expansion of a regional electronic consultation (eConsult) service on a national level by addressing potential policy barriers. We used an integrated knowledge translation (IKT) strategy based on five key activities leading to a National eConsult Policy Think Tank meeting: (1) identifying potential policy enablers and barriers; (2) engaging national and provincial/territorial partners; (3) including patient voices; (4) undertaking co-design and planning; and (5) adopting a solution-based approach...
August 2018: Healthcare Policy, Politiques de Santé
Ella Vermeir, Lois A Jackson, Emily Gard Marshall
Research indicates that trans people face a number of barriers to healthcare, including challenges in finding healthcare providers (HCPs) who are knowledgeable about, and sensitive to, trans identity and health issues. These and other barriers contribute to this population's under-usage of healthcare services and, in turn, their poor overall health outcomes compared to the general population. This article provides research-informed recommendations to improve HCPs' cultural competence, which may increase trans individuals' utilization of healthcare and thus contribute to better health outcomes for this population...
August 2018: Healthcare Policy, Politiques de Santé
Jennifer Zelmer
No abstract text is available yet for this article.
August 2018: Healthcare Policy, Politiques de Santé
Mylaine Breton, Sabrina T Wong, Mélanie Ann Smithman, Sara Kreindler, Jalila Jbilou, Jason Sutherland, Astrid Brousselle, Jay Shaw, Valorie A Crooks, Damien Contandriopoulos, Martin Sasseville, Michael Green
Introduction: Centralized waiting lists (CWLs) are one solution to reduce the problematic number of patients without a regular primary care provider. This article describes different models of CWLs for unattached patients implemented in seven Canadian provinces and identifies common issues in the implementation of these CWLs. Methods: Logic models of each province's intervention were built after a grey literature review, 42 semi-structured interviews and a validation process with key stakeholders were performed...
May 2018: Healthcare Policy, Politiques de Santé
Bradley Hiebert, Sandra Regan, Beverly Leipert
Rural male farmers (RMFs) are an understudied population with high mortality, morbidity and co-morbidities due to preventable injury, most of which occur on-farm. This study examines how RMFs and their health needs are discussed in Ontario rural health policy documents. A retrospective analysis of policy was conducted to analyze the content of Ontario rural healthcare policy documents published since 2006. Discussions of RMFs were categorized by two themes: tokenism and mending fences. Tokenism refers to RMFs' invisibility, except when farming stereotypes were used to describe rural areas...
May 2018: Healthcare Policy, Politiques de Santé
Karen L Tang, Fartoon Siad, Dima Arafah, Jocelyn Lockyer
Background: The most commonly recommended strategy in Canada for patients wishing to find a regular family physician (FP) is through the use of websites with FP listings. We aimed to explore the content and usability of these websites. Methods: We identified publicly available websites with FP listings in Western Canada, analyzing them thematically through open coding for website content and conducting framework analysis for website usability. Results: Twelve unique websites were identified and grouped into three categories: (1) Physician regulatory authorities ("Colleges"); (2) Governmental; and (3) Miscellaneous...
May 2018: Healthcare Policy, Politiques de Santé
Leah T Kelley, Tim Tenbensel, Ana Johnson
Ontario is a strong candidate for a comprehensive pharmacare program, given that it has a pre-existing public drug benefit program (the Ontario Drug Benefit Program [ODBP]). This paper outlines strategies from New Zealand's national pharmacare program (the Pharmaceutical Management Agency [PHARMAC]) and compares these strategies to other international examples. It is recommended that the ODBP engage in three strategies currently utilized by the PHARMAC to achieve significant cost savings and create potential to increase their insurance coverage: (i) strict budgeting; (ii) tendering and negotiating; and (iii) reference pricing...
May 2018: Healthcare Policy, Politiques de Santé
Carolyn Hughes Tuohy
Is medicare a reflection of Canadian values? Or did those values develop as we experienced the common ground of a universal system? Nothing in public opinion in Canada and the US in the 1960s, or in their respective healthcare systems, would have suggested that they would evolve in such divergent ways. Instead, decisions taken by political elites set the two systems on very different courses. In Canada, that course profoundly shaped the way we understand ourselves as citizens, and also established a powerful place for clinicians at the political core...
May 2018: Healthcare Policy, Politiques de Santé
Jennifer Zelmer
No abstract text is available yet for this article.
May 2018: Healthcare Policy, Politiques de Santé
Clare Liddy, Nikhat Nawar, Isabella Moroz, Shelagh Mcrae, Christopher Russell, Ariana Mihan, Fanny Mckellips, Derek McLellan, Lois Crowe, Amir Afkham, Erin Keely
CONTEXT: When examining wait times for specialist care, the duration between a patient's referral and specialist visit (wait time one) is poorly understood. OBJECTIVES: To calculate wait time one in primary care clinics across Ontario using chart audit. METHODS: We conducted a retrospective chart audit at five Ontario-based primary care clinics in 2014-2015. RESULTS: We analyzed 461 referrals. Median wait time one for non-urgent and urgent referrals was 79 and 49 days, respectively...
February 2018: Healthcare Policy, Politiques de Santé
Roland K Maier, Devidas Menon, Tania Stafinski
New health technologies enter Canadian healthcare organizations in various ways, and understanding them is essential to the development of a pan-Canadian Health Technology Management (HTM) Strategy, now a priority of governments across Canada. One way is through Health Canada's Medical Devices Special Access Program (MDSAP), which permits unlicensed devices to be obtained by healthcare professionals. However, the circumstances around and implications of the current use of this program are not clear. A scoping literature review was conducted to clarify these and identify important roles and issues related to the MDSAP...
February 2018: Healthcare Policy, Politiques de Santé
Ruolz Ariste
As per the Canada Health Act, hospital and physician services (Medicare) are covered by the public sector. With the 2004 First Minister's Health Accord showcasing a 10-Year Plan to strengthen healthcare in Canada, significant investments have been made to improve access to these services. The average annual growth rate (AAGR) of spending between 2004 and 2014 was 5.1% for hospitals and 6.6% for physicians. The key policy question is whether or not these increases were just used to boost unit cost? An accounting approach was used to address this issue...
February 2018: Healthcare Policy, Politiques de Santé
Martha J Paynter, Kathryn Hayward
The use of peer-to-peer online networks to access both pasteurized and unpasteurized human donor milk is increasing in Canada. In the absence of a mother's own milk, donor milk is the next best nutrition available for all infants in need of supplementation. Limited supply and the cost of pasteurized milk puts it out of reach for many. Although milk banks in Canada all operate on a non-profit basis, there is a lack of regulatory safeguards regarding for-profit operations and private milk exchange. This paper describes regulation of human donor milk and identifies gaps putting families at risk...
February 2018: Healthcare Policy, Politiques de Santé
Ubaka Ogbogu, Amy Zarzeczny, Jay Baltz, Patrick Bedford, Jenny Du, Insoo Hyun, Yasmeen Jaafar, Andrea Jurisicova, Erika Kleiderman, Yonida Koukio, Bartha Maria Knoppers, Arthur Leader, Zubin Master, Minh Thu Nguyen, Forough Noohi, Vardit Ravitsky, Maeghan Toews
Research involving human embryos and reproductive materials, including certain forms of stem cell and genetic research, is a fast-moving area of science with demonstrated clinical relevance. Canada's current governance framework for this field of research urgently requires review and reconsideration in view of emerging applications. Based on a workshop involving ethics, legal, policy, scientific and clinical experts, we present a series of recommendations with the goal of informing and supporting health policy and decision-making regarding the governance of the field...
February 2018: Healthcare Policy, Politiques de Santé
Jennifer Zelmer
No abstract text is available yet for this article.
February 2018: 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
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