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Canadian healthcare

Ashleigh A McGirr, Kevin L Schwartz, Upton Allen, Melinda Solomon, Beate Sander
Background Children with cystic fibrosis (CF) are at higher risk of severe respiratory syncytial virus (RSV) infection, which can lead to a decline in lung function. A monoclonal antibody, palivizumab (PMB), effectively prevents RSV hospitalizations; however, the high cost of PMB, approximately C$10,000 per patient per RSV season, limits its widespread use. We assess the cost-effectiveness of PMB prophylaxis in CF children less than 2 years of age from the Canadian healthcare payer's perspective. Methods In 2014, a Markov cohort model of CF disease and infant RSV infections in the Canadian setting was developed based on literature data...
October 21, 2016: Human Vaccines & Immunotherapeutics
Fawziah Marra, Mei Chong, Mehdi Najafzadeh
BACKGROUND: Recent studies have shown an increasing incidence of herpes zoster (HZ) infection, which may be related to the introduction of varicella vaccination programs in children. We examined the epidemiology and treatment costs of HZ and post-herpetic neuralgia (PHN) over time in British Columbia, Canada. METHODS: The cohort consisted of all cases with HZ infection from January 1, 1997 and December 31, 2012. Incident zoster was defined as a case (ICD-9 053 or ICD-10 B02) without a previous episode of HZ or PHN in the previous 12 months...
October 20, 2016: BMC Infectious Diseases
Kim Tran, Chaim Bell, Nathan Stall, George Tomlinson, Allison McGeer, Andrew Morris, Michael Gardam, Howard B Abrams
BACKGROUND: Isolation precautions have negative effects on patient safety, psychological well-being, and healthcare worker contact. However, it is not known whether isolation precautions affect certain hospital-related outcomes. OBJECTIVE: To examine the effect of isolation precautions on hospital-related outcomes and cost of care. DESIGN: Retrospective, propensity-score matched cohort study of inpatients admitted to general internal medicine (GIM) services at three academic hospitals in Toronto, Ontario, Canada between January 2010 and December 2012...
October 17, 2016: Journal of General Internal Medicine
Anaïs Lacasse, Judy-Ann Connelly, Manon Choinière
Background. In order to better design awareness programs on chronic pain (CP), measurement of knowledge, beliefs, and attitudes of people in the community towards this condition is most useful. Objectives. To develop and validate a French-Canadian scale that could be used for this purpose. Methods. Items of the Chronic Pain Myth Scale (CPMS) were developed based on different information sources, reviewed by pain experts, and pretested. The CPMS was administered to 1555 participants among the general Quebec population...
2016: Pain Research & Management: the Journal of the Canadian Pain Society
Donald M Ford
Today, 25% of Canadians live in rural and remote parts of Canada. The evidence is that these Canadians do not enjoy the same health status as citizens living in more urban settings. This article explores four persistent healthcare challenges: population demographics, place, professionals, and public participation. By exploring solutions that some rural communities have used to address these challenges, this article aims to provide insights into lessons that have been learned that they may be considered and potentially applied to both rural and urban environments in the interest of better healthcare for all...
October 15, 2016: Healthcare Management Forum
Steven G Morgan, Katherine Boothe
Canada's universal public healthcare system is unique among developed countries insofar as it does not include universal coverage of prescription drugs. Universal, public coverage of prescription drugs has been recommended by major national commissions in Canada dating back to the 1960s. It has not, however, been implemented. In this article, we extend research on the failure of early proposals for universal drug coverage in Canada to explain failures of calls for reform over the past 20 years. We describe the confluence of barriers to reform stemming from Canadian policy institutions, ideas held by federal policy-makers, and electoral incentives for necessary reforms...
October 15, 2016: Healthcare Management Forum
D Wayne Taylor
Canadians need to talk about their healthcare, about who pays for what, when. Lack of money is not the issue; how that money is spent is the issue-what public healthcare is covering and not covering. The same dollar amount can be spent quite differently and more effectively. The 1950s first-dollar, single-payor decision shifted the burden from the individual to government, but a lot has changed since the 1950s. Today Medicare is not universal, comprehensive, reasonably accessible, or portable. With residual constitutional power residing in Ottawa, there is no reason for the fragmentation and inequalities facing Canadians...
October 15, 2016: Healthcare Management Forum
Yves Bergevin, Bettina Habib, Keesa Elicksen-Jensen, Stephen Samis, Jean Rochon, Jean-Louis Denis, Denis Roy
A study on the impact of regionalization on the Triple Aim of Better Health, Better Care and Better Value across Canada in 2015 identified major findings including: (a) with regard to the Triple Aim, the Canadian situation is better than before but variable and partial, and Canada continues to underperform compared with other industrialized countries, especially in primary healthcare where it matters most; (b) provinces are converging toward a two-level health system (provincial/regional); (c) optimal size of regions is probably around 350,000-500,000 population; d) citizen and physician engagement remains weak...
2016: HealthcarePapers
Raymond Zakhari, Susan E Sterrett
BACKGROUND AND PURPOSE: A large degree of variation in clinical practice exists among clinicians evaluating and treating individuals with minor head injuries. Noncontrast head computerized tomography (CT) scans are commonly used to assess for intracranial damage in patients presenting with head injury. This practice is not supported by the evidence and poses harm to patients by increasing exposure to ionizing radiation. This form of radiation exposure increases the risk of developing cancers over the course of the individual's life, and further strains the limited resources of the healthcare system...
September 22, 2016: Journal of the American Association of Nurse Practitioners
Gin S Malhi, Yulisha Byrow, Frederick Cassidy, Andrea Cipriani, Koen Demyttenaere, Mark A Frye, Michael Gitlin, Sidney H Kennedy, Terence A Ketter, Raymond W Lam, Rupert McShane, Alex J Mitchell, Michael J Ostacher, Sakina J Rizvi, Michael E Thase, Mauricio Tohen
SUMMARY: The appeal of ketamine - in promptly ameliorating depressive symptoms even in those with non-response - has led to a dramatic increase in its off-label use. Initial promising results await robust corroboration and key questions remain, particularly concerning its long-term administration. It is, therefore, timely to review the opinions of mood disorder experts worldwide pertaining to ketamine's potential as an option for treating depression and provide a synthesis of perspectives - derived from evidence and clinical experience - and to consider strategies for future investigations...
May 2016: BJPsych Open
Marie-Pierre Gagnon, Julie Payne-Gagnon, Erik Breton, Jean-Paul Fortin, Lara Khoury, Lisa Dolovich, David Price, David Wiljer, Gillian Bartlett, Norman Archer
BACKGROUND: Healthcare stakeholders have a great interest in the adoption and use of electronic personal health records (ePHRs) because of the potential benefits associated with them. Little is known, however, about the level of adoption of ePHRs in Canada and there is limited evidence concerning their benefits and implications for the healthcare system. This study aimed to describe the current situation of ePHRs in Canada and explore stakeholder perceptions regarding barriers and facilitators to their adoption...
April 6, 2016: International Journal of Health Policy and Management
Jacqueline Margaret Cumming
With demand for health services continuing to grow as populations age and new technologies emerge to meet health needs, healthcare policy-makers are under constant pressure to set priorities, ie, to make choices about the health services that can and cannot be funded within available resources. In a recent paper, Smith et al apply an influential policy studies framework - Kingdon's multiple streams approach (MSA) - to explore the factors that explain why one health service delivery organization adopted a formal priority setting framework (in the form of programme budgeting and marginal analysis [PBMA]) to assist it in making priority setting decisions...
May 16, 2016: International Journal of Health Policy and Management
Mayilee Canizares, Monique Gignac, Sheilah Hogg-Johnson, Richard H Glazier, Elizabeth M Badley
OBJECTIVE: In light of concerns for meeting the provision of healthcare services given the large numbers of ageing baby boomers, we compared the trajectories of primary care and specialist services use across the lifecourse of 5 birth cohorts and examined factors associated with birth cohort differences. DESIGN: Longitudinal panel. SETTING: Canadian National Population Health Survey (1994-2011). POPULATION: Sample of 10 186 individuals aged 20-69 years in 1994-1995 and who were from 5 birth cohorts: Generation X (Gen X; born: 1965-1974), Younger Baby Boomers (born: 1955-1964), Older Baby Boomers (born: 1945-1954), World War II (born: 1935-1944) and pre-World War II (born: 1925-1934)...
2016: BMJ Open
Madhur Nayan, Erin M Macdonald, David N Juurlink, Peter C Austin, Antonio Finelli, Girish S Kulkarni, Robert J Hamilton
Survival rates in kidney cancer have improved little over time, and diabetes may be an independent risk factor for poor survival in kidney cancer. We sought to determine whether medications with putative anti-neoplastic properties (statins, metformin and non-steroidal anti-inflammatory drugs (NSAIDs)) are associated with survival in diabetics with kidney cancer. We conducted a population-based cohort study utilizing linked healthcare databases in Ontario, Canada. Patients were aged 66 or older with newly diagnosed diabetes and a subsequent diagnosis of incident kidney cancer...
September 24, 2016: Pharmacological Research: the Official Journal of the Italian Pharmacological Society
Nancy Carter, Esther Sangster-Gormley, Jenny Ploeg, Ruth Martin-Misener, Faith Donald, Abigail Wickson-Griffiths, Sharon Kaasalainen, Carrie McAiney, Kevin Brazil, Alan Taniguchi, Lori Schindel Martin
The aim of this paper is to explore the role and activities of nurse practitioners (NPs) working in long-term care (LTC) to understand concepts of access to primary care for residents. Utilizing the "FIT" framework developed by Penchanksy and Thomas, we used a directed content analysis method to analyze data from a pan-Canadian study of NPs in LTC. Individual and focus group interviews were conducted at four sites in western, central and eastern regions of Canada with 143 participants, including NPs, RNs, regulated and unregulated nursing staff, allied health professionals, physicians, administrators and directors and residents and family members...
2016: Nursing Leadership
Debbie L Becker, Ayman Chit, Carlos A DiazGranados, Michael Maschio, Eddy Yau, Michael Drummond
Seasonal influenza infects approximately 10-20% of Canadians each year, causing an estimated 12,200 hospitalizations and 3,500 deaths annually, mostly occurring in adults ≥65 years old (seniors). A 32,000-participant, randomized controlled clinical trial (FIM12; NCT01427309) showed that high-dose inactivated influenza vaccine (IIV-HD) is superior to standard-dose vaccine (SD) in preventing laboratory-confirmed influenza illness in seniors. In this study, we performed a cost-utility analysis (CUA) of IIV-HD versus SD in FIM12 participants from a Canadian perspective...
September 26, 2016: Human Vaccines & Immunotherapeutics
Samuel D Appavoo, Alexander Khemlin, Donna M Appavoo, Candi J Flynn
INTRODUCTION: On 21 August 2011 an F3 tornado hit the Canadian town of Goderich, Ontario, leaving 40 people injured and one dead. Specific medium-term changes in utilization of health care following a disaster have not been analyzed in medical literature. Documenting the emergency department utilization through this subacute period would be helpful to enable institutions and healthcare practitioners to be better prepared for future events. METHODS: A medical chart review was conducted at the<b> </b>Alexandra Marine and General Hospital in Goderich...
July 2016: Rural and Remote Health
R Douglas Wilson, Isabelle De Bie, Christine M Armour, Richard N Brown, Carla Campagnolo, June C Carroll, Nan Okun, Tanya Nelson, Rhonda Zwingerman, Francois Audibert, Jo-Ann Brock, Richard N Brown, Carla Campagnolo, June C Carroll, Isabelle De Bie, Jo-Ann Johnson, Nan Okun, Melanie Pastruck, Karine Vallée-Pouliot, R Douglas Wilson, Rhonda Zwingerman, Christine Armour, David Chitayat, Isabelle De Bie, Sara Fernandez, Raymond Kim, Josee Lavoie, Norma Leonard, Tanya Nelson, Sherry Taylor, Margot Van Allen, Clara Van Karnebeek
OBJECTIVE: This guideline was written to update Canadian maternity care and reproductive healthcare providers on pre- and postconceptional reproductive carrier screening for women or couples who may be at risk of being carriers for autosomal recessive (AR), autosomal dominant (AD), or X-linked (XL) conditions, with risk of transmission to the fetus. Four previous SOGC- Canadian College of Medical Geneticists (CCMG) guidelines are updated and merged into the current document. INTENDED USERS: All maternity care (most responsible health provider [MRHP]) and paediatric providers; maternity nursing; nurse practitioner; provincial maternity care administrator; medical student; and postgraduate resident year 1-7...
August 2016: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
Edward R Melnick
In an electronic health record (EHR) chart review of adult ED trauma patients receiving a head CT from 2008-2013 within 14 community EDs, Sharp et al. estimate that approximately 1/3 of computed tomography (CT) scans in head injury are likely avoidable based on the Canadian CT Head Rule (CCHR).(1) The analysis includes 27,240 adult trauma patients receiving head CTs and uses in-depth chart review of 100 random encounters with 2 independent abstractors (with high inter-rater reliability) to adjust the estimated number of avoidable CTs-the top Choosing Wisely initiative for emergency medicine...
September 12, 2016: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Timothy K Nguyen, Glenn S Bauman, Christopher J Watling, Karin Hahn
PURPOSE: Increasingly, patient- and family-centered care (PFCC) is recognized as a valuable component of healthcare reform with rich opportunities for improvement within oncology. Shifting toward PFCC requires physician buy-in; however, research examining their perspectives on PFCC is lacking. We sought to explore oncologists' perspectives on PFCC to identify factors that influence their ability to practice PFCC. METHODS: We conducted semi-structured interviews with 18 oncologists (8 radiation, 4 medical, 4 surgical, 2 hematologist-oncologists) at a single Canadian academic cancer institution...
September 11, 2016: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
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