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Healthcare Policy, Politiques de Santé

Anna De Grood, Kenneth Blades, Sachin R Pendharkar
AIMS AND OBJECTIVES: Discharge prediction is designed to streamline inpatient flow and reduce hospital overcrowding without adding capacity. This study's objective was to describe the literature on discharge prediction and assess its usefulness in evaluating the implementation and outcomes of discharge prediction projects. METHODS: The authors reviewed the current peer-reviewed and grey literature on discharge prediction projects in acute care hospitals. Project descriptions were analyzed using Donabedian's structure-process-outcome model for evaluating complex healthcare innovations...
November 2016: Healthcare Policy, Politiques de Santé
Michael G Wilson, John N Lavis, Francois-Pierre Gauvin
BACKGROUND: Living with multiple chronic conditions (multimorbidity) - and facing complex, uncoordinated and fragmented care - is part of the daily life of a growing number of Canadians. METHODS: We undertook: a knowledge synthesis; a "gap analysis" of existing systematic reviews; an issue brief that synthesized the available evidence about the problem, three options for addressing it and implementation considerations; a stakeholder dialogue involving key health-system leaders; and a citizen panel...
November 2016: Healthcare Policy, Politiques de Santé
Andrea Gruneir, Susan E Bronskill, Alice Newman, Chaim M Bell, Peter Gozdyra, Geoffrey M Anderson, Paula A Rochon
BACKGROUND: Nursing home (NH) residents are frequently transferred to the emergency department (ED) but there is little data on inter-facility variation, which has implications for intervention planning and implementation. OBJECTIVES: To describe variation in ED transfer rates (TRs) across NHs and the association with NH characteristics. DESIGN/SETTING: Retrospective cohort study using linked administrative data from Ontario. PARTICIPANTS: 71,780 residents of 604 NHs in 2010 and followed for one year...
November 2016: Healthcare Policy, Politiques de Santé
Joel Lexchin
INTRODUCTION: First-in-class drugs use a unique mechanism of action. This study assessed the therapeutic innovativeness and safety of these drugs approved by Health Canada from 1997-2012. METHODS: A list of new drugs was compiled and a database from the Food and Drug Administration was used to determine first-in-class status. Post-market safety warnings and drugs withdrawn for safety reasons were identified from the MedEffect Canada website. Therapeutic innovation evaluations came from the Patented Medicine Prices Review Board (PMPRB) and Prescrire International...
November 2016: Healthcare Policy, Politiques de Santé
Raisa Deber, Robert Schwartz
A systematic review of the introduction and use of outcome-based performance management systems for public health organizations found differences between their use as a management system (which requires rigorous definition and measurement to allow comparison across organizational units) versus for improvement (which may require more flexibility). What is included in performance measurement/management systems is influenced by ease of measurement, data quality, ability of organization to control outcomes, ability to measure success in terms of doing things (rather than preventing things) and what is already happening...
November 2016: Healthcare Policy, Politiques de Santé
Julia M Langton, Sabrina T Wong, Sharon Johnston, Julia Abelson, Mehdi Ammi, Fred Burge, John Campbell, Jeannie Haggerty, William Hogg, Walter P Wodchis, Kimberlyn McGrail
OBJECTIVE: Primary care services form the foundation of modern healthcare systems, yet the breadth and complexity of services and diversity of patient populations may present challenges for creating comprehensive primary care information systems. Our objective is to develop regional-level information on the performance of primary care in Canada. METHODS: A scoping review was conducted to identify existing initiatives in primary care performance measurement and reporting across 11 countries...
November 2016: Healthcare Policy, Politiques de Santé
Amanda L Terry, Moira Stewart, Martin Fortin, Sabrina T Wong, Inese Grava-Gubins, Lisa Ashley, Patricia Sullivan-Taylor, Frank Sullivan, Lynne Zucker, Amardeep Thind
Building on a previous study, which identified gaps in primary healthcare electronic medical record (emr) research and knowledge, a one-day conference was held to facilitate a strategic discussion of these issues. This paper offers a multi-faceted research agenda and suggestions for policy actions as a way forward in bridging the gaps. one facet focuses on the need for research. The second facet focuses on harnessing the knowledge of primary healthcare emr stakeholders. finally, the third facet focuses on policy actions...
November 2016: Healthcare Policy, Politiques de Santé
Nola M Ries, Maureen Douglas, Jessica Simon, Konrad Fassbender
Health organizations in canada have invested considerable resources in strategies to improve knowledge and uptake of advance care planning (acp). Yet barriers persist and many canadians do not engage in the full range of acp behaviours, including writing an advance directive and appointing a legally authorized decision-maker. not engaging effectively in acp disadvantages patients, their loved ones and their healthcare providers. This article advocates for greater collaboration between health and legal professionals to better support clients in acp and presents a framework for action to build connections between these typically siloed professions...
November 2016: Healthcare Policy, Politiques de Santé
Jennifer Zelmer
No abstract text is available yet for this article.
November 2016: 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
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