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Healthcare Policy, Politiques de Santé

Ciara Pendrith, Amardeep Thind, Gregory S Zaric, Sisira Sarma
OBJECTIVES: The primary objective of this paper is to compare cervical cancer screening rates of family physicians in Ontario's two dominant reformed practice models, Family Health Group (FHG) and Family Health Organization (FHO), and traditional fee-for-service (FFS) model. Both reformed models formally enrol patients and offer extensive pay-for-performance incentives; however, they differ by remuneration for core services (FHG is FFS; FHO is capitated). The secondary objective is to estimate the average and marginal costs of screening in each model...
August 2016: Healthcare Policy, Politiques de Santé
Damien Contandriopoulos, Nancy Hanusaik, Katerina Maximova, Gilles Paradis, Jennifer L O'Loughlin
In the field of chronic disease prevention (CDP), collaborations between organizations provide a vital framework for intersectoral engagement and exchanges of knowledge, expertise and resources. However, little is known about how the structures of preventive health systems actually articulate with CDP capacity and outcomes. Drawing upon data from the Public Health Organizational Capacity Study - a repeat census of all public health organizations in Canada - we used social network analysis to map and examine interorganizational collaborative relationships in the Canadian preventive health system...
August 2016: Healthcare Policy, Politiques de Santé
Rachelle Ashcroft, Jose Silveira, Kwame Mckenzie
BACKGROUND: An opportunity to address the needs of patients with common mental disorders (CMDs) resides in primary care. Barriers are restricting availability of treatment for CMDs in primary care. By understanding the incentives that promote and the disincentives that deter treatment for CMDs in a collaborative primary care context, this study aims to help contribute to goals of greater access to mental healthcare. METHOD: A qualitative pilot study using semi-structured interviews with thematic analysis...
August 2016: Healthcare Policy, Politiques de Santé
Joseph Lyons
Do autonomous health units fulfil their mandate better than ones that are integrated into municipal structures? Many observers of Ontario's public health system seem to think so, but this assumption is based on very little evidence. This paper seeks to help fill this gap by grounding a comparison of the spending growth of two health units with different governing structures in the multilevel governance literature. The study finds that, after an increase in provincial funding, an autonomous health unit, the Middlesex-London Health Unit, behaved more in accordance with provincial expectations than Hamilton Public Health Services, which is integrated into the City of Hamilton...
August 2016: Healthcare Policy, Politiques de Santé
T Kue Young, Susan Chatwood, Gregory P Marchildon
OBJECTIVE: To determine if Canadians are getting value for money in providing health services to our northern residents. METHOD: Secondary analyses of data from Statistics Canada, the Canadian Institute of Health Information and territorial government agencies on health status, health expenditures and health system performance indicators. RESULTS: Per capita health expenditures in Canada's northern territories are double that of Canada as a whole and are among the highest in the world...
August 2016: Healthcare Policy, Politiques de Santé
Josée G Lavoie, Sabrina Wong, Alan Katz, Stephanie Sinclair
Access to geographically disaggregated data is essential for the pursuit of meaningful rural, remote and First Nation health services research. This paper explores the opportunities and challenges associated with undertaking administrative claims data research in the context of two different models of administrative data management: the Manitoba and British Columbia models. We argue that two conditions must be in place to support rural, remote and First Nation health services research: (1) pathways to data access that reconcile the need to protect privacy with the imperative to conduct analyses on disaggregated data; and (2) a trust-based relationship with data providers...
August 2016: Healthcare Policy, Politiques de Santé
M Ruth Lavergne
Definitions of "urban" and "rural" developed for general purposes may not reflect the organization and delivery of healthcare. This research used cluster analysis to group Local Health Areas based on the distribution of healthcare spending across service categories. Though total spending was similar, the metropolitan areas of Vancouver and Victoria were identified as distinct from non-metropolitan and remote communities, based on the distribution of healthcare spending alone. Non-metropolitan communities with large community hospitals and greater physician supply were further distinguished from those with fewer healthcare resources...
August 2016: Healthcare Policy, Politiques de Santé
Jude Kornelsen, Randy Friesen
Formalized rural health service delivery networks are emerging as an over-arching response to the attrition of rural surgical and maternity services in Canada. In effective networks, there is strong collaborative leadership, form follows function, core network elements are identified and site-specific variations are accommodated to meet the surgical needs of the population in each geographic catchment. The network catchment must reflect the natural alliances that already exist among health professionals, policy makers, health administrators, academic institutions and communities...
August 2016: Healthcare Policy, Politiques de Santé
Steven G Morgan, Marc-André Gagnon, Barbara Mintzes, Joel Lexchin
Canada needs a national strategy to fulfill its obligation to ensure universal access to necessary healthcare, including prescription drugs. A 2004 attempt at a national strategy for pharmaceutical policy failed because it lacked clear vision, logical planning and commitment from federal and provincial governments. The result of uncoordinated pharmaceutical policies in Canada has been more than a decade of poor system performance. In this essay, we present a framework for a renewed national strategy for pharmaceutical policy...
August 2016: Healthcare Policy, Politiques de Santé
Robert G Evans
Some species are more equal than others. Robert T. Paine (American ecologist, 1933-2016) discovered that if you remove starfish - what he called a "keystone species" - from a tide pool, the complex ecosystem collapses. Without the predator starfish, mussels choke out other animals and plants. This phenomenon is general. Sea otters eat the sea urchins that eat the kelp that provides food and habitat for other species. On the vast Serengeti plains, wildebeest "mow" the grass, protecting habitat for many other species...
August 2016: Healthcare Policy, Politiques de Santé
Jennifer Zelmer
No abstract text is available yet for this article.
August 2016: Healthcare Policy, Politiques de Santé
Sharon Johnston, Matthew Hogel
In 2004, Canada's First Ministers committed to reforms that would shape the future of the Canadian healthcare landscape. These agreements included commitments to improved performance reporting within the primary healthcare system. The aim of this paper was to review the state of primary healthcare performance reporting after the public reporting mandate agreed to a decade ago in the Action Plan for Health System Renewal of 2003 expired. A grey literature search was performed to identify reports released by the governmental and independent reporting bodies across Canada...
May 2016: Healthcare Policy, Politiques de Santé
Allyson Ion
In the process of receiving perinatal care, women living with HIV (WLWH) in Canada have experienced disclosure of their HIV status without their express consent. This disclosure often occurs by well-intentioned healthcare providers; however, from the perspective of WLWH, it is a breach of confidentiality and leaves WLWH to manage the consequences. This paper is a critical review of the regulatory and legislative infrastructure that exists to protect the personal health information of WLWH in Ontario and Canada; the recourse that WLWH have in the event that their confidentiality is breached; and potential approaches that could be applied to organize the system differently to decrease the chance of a privacy breach and to facilitate appropriate collection, use and disclosure of personal health information...
May 2016: Healthcare Policy, Politiques de Santé
Matthew Herder, Timothy Mark Krahn
We examined whether access to US-approved orphan drugs in Canada has changed between 1997 (when Canada chose not to adopt an orphan drug policy) and 2012 (when Canada reversed its policy decision). Specifically, we looked at two dimensions of access to US-approved orphan drugs in Canada: (1) regulatory access; and (2) temporal access. Whereas only 63% of US-approved orphan drugs were granted regulatory approval in 1997, we found that regulatory access to US-approved orphan drugs in Canada increased to 74% between 1997 and 2012...
May 2016: Healthcare Policy, Politiques de Santé
Philippe Fache, Claude Sicotte, Étienne Minvielle
OBJECTIVE: This research looks back at a 10-year period (2004-2014) to understand the development and outlook for healthcare organization performance measurement in the Quebec healthcare system, in an attempt to objectivize relationships within the configuration of its principal institutional actors. METHODS: This is a qualitative study combining the use of official publications and fieldwork based on 13 semi-directed interviews, conducted in 2014, with informers in key performance measurement positions within the Quebec healthcare system...
May 2016: Healthcare Policy, Politiques de Santé
Annie Tessier, Marie-Dominique Beaulieu, Carrie Anna Mcginn, Renée Latulippe
The ageing of the population and the increasing need for long-term care services are global issues. Some countries have adapted homecare programs by introducing an intervention called reablement, which is aimed at optimizing independence. The effectiveness of reablement, as well as its different service models, was examined. A systematic literature review was conducted using MEDLINE, CINAHL, PsycINFO and EBM Reviews to search from 2001 to 2014. Core characteristics and facilitators of reablement implementation were identified from international experiences...
May 2016: Healthcare Policy, Politiques de Santé
Jean-Christophe Bélisle Pipon, Marie-Ève Lemoine, Maude Laliberté
When decision-makers are engaged in a polarized discourse and leaving aside evidence-based recommendations, is there a role for researchers in the dissemination of this scientific evidence to the general public as a means to counterbalance the debate? In response to the controversial Bill 10 in Quebec, we developed and posted a knowledge transfer video on YouTube to help stimulate critical public debate. This article explains our approach and methodology, and the impact of the video, which, in the space of two weeks, had more than 9,500 views, demonstrating the pertinence of such initiatives...
May 2016: Healthcare Policy, Politiques de Santé
Julia E Moore, Michelle Grouchy, Ian D Graham, Maureen Shandling, Winnie Doyle, Sharon E Straus
Despite evidence on what works in healthcare, there is a significant gap in the time it takes to bring research into practice. The Council of Academic Hospitals of Ontario's Adopting Research to Improve Care program addresses this research-to-practice gap by incorporating the following components into its funding program: strategic selection of evidence for implementation, education and training for implementation, implementation supports, executive champions and governance, and evaluation. Funded projects have been sustained (76% reported full sustainability) and spread to over 200 new sites...
May 2016: Healthcare Policy, Politiques de Santé
J Ross Graham
North American hospitals have historically struggled to engage in prevention and health promotion activities because they have not been incentivized or held accountable for doing so. However, in order to be exempt from federal taxes, 3,000 non-profit hospitals in the US must now regularly assess the health status of the communities they serve, and take action to address identified health needs. This is called "accountability for community benefit," and it is required under the Patient Protection and Affordable Care Act (commonly known as Obamacare)...
May 2016: Healthcare Policy, Politiques de Santé
Robert G Evans
The correlation between health and wealth is arguably a very solidly established relationship. Yet that relationship may be reversing. Falling oil prices have raised (average) per capita incomes, worldwide. But from a long-run perspective they are a public health disaster. The latter is easy to see: low oil reduces the incentive to develop alternative energy sources and "bend the curve" of global warming. Their principal impact on incomes has been redistributional - Alberta and Russia lose, Ontario and Germany gain, etc...
May 2016: Healthcare Policy, Politiques de Santé
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