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https://www.readbyqxmd.com/read/28930692/palbociclib-in-hormone-receptor-positive-advanced-breast-cancer-a-cost-utility-analysis
#1
J Raphael, J Helou, K I Pritchard, D M Naimark
INTRODUCTION: The addition of palbociclib to letrozole improves progression-free survival in the first-line treatment of hormone receptor positive advanced breast cancer (ABC). This study assesses the cost-utility of palbociclib from the Canadian healthcare payer perspective. METHODS: A probabilistic discrete event simulation (DES) model was developed and parameterised with data from the PALOMA 1 and 2 trials and other sources. The incremental cost per quality-adjusted life-month (QALM) gained for palbociclib was calculated...
September 17, 2017: European Journal of Cancer
https://www.readbyqxmd.com/read/28929901/the-dementia-friendly-emergency-department-an-innovation-to-reducing-incompatibilities-at-the-local-level
#2
Belinda Parke, Kathleen F Hunter
Emergency Departments (EDs) are an integral part of the Canadian healthcare system. Older people living with dementia challenge EDs. They have complex health profiles that pose multiple challenges for staff. The current one-size-fits-all approach that aids efficiency in a technologically dependent hospital setting may not always serve older people living with dementia, their caregivers, or staff well. The premise that older people living with dementia are a problem for Canadian EDs must be reconsidered. Understanding the complexity of the situation is aided by the dementia-friendly ED framework...
January 2017: Healthcare Management Forum
https://www.readbyqxmd.com/read/28929900/a-review-of-canadian-and-international-dementia-strategies
#3
Cole Edick, Nicole Holland, Jessica Ashbourne, Jacobi Elliott, Paul Stolee
To inform future strategy development in Canada and other jurisdictions, we undertook an Internet search to identify existing national and Canadian provincial dementia strategies and their major themes. Twenty-two dementia strategies were identified through an Internet search, supplemented by hand searches of reference lists of retrieved documents. Thematic analysis identified 17 strategic themes; common themes included improved diagnoses and assessments, increased access to care, and improved education of the healthcare workforce...
January 2017: Healthcare Management Forum
https://www.readbyqxmd.com/read/28929899/nutrition-as-a-component-of-dementia-risk-reduction-strategies
#4
Carol E Greenwood, Matthew D Parrott
According to the Alzheimer Society of Canada, within the next generation, Canada will experience a more than doubling of individuals living with dementia and a potentially economically crippling 10-fold increase in costs to Canadians. Up to 50% of cases with dementia can be attributed to seven modifiable, predominantly vascular and/or lifestyle-associated, risk factors. Multi-modal dementia risk reduction strategies, targeting diet, exercise, mental stimulation, and vascular risk monitoring, are likely to be the most successful...
January 2017: Healthcare Management Forum
https://www.readbyqxmd.com/read/28929889/mental-illness-related-stigma-in-healthcare-barriers-to-access-and-care-and-evidence-based-solutions
#5
Stephanie Knaak, Ed Mantler, Andrew Szeto
Mental illness-related stigma, including that which exists in the healthcare system and among healthcare providers, creates serious barriers to access and quality care. It is also a major concern for healthcare practitioners themselves, both as a workplace culture issue and as a barrier for help seeking. This article provides an overview of the main barriers to access and quality care created by stigmatization in healthcare, a consideration of contributing factors, and a summary of Canadian-based research into promising practices and approaches to combatting stigma in healthcare environments...
March 2017: Healthcare Management Forum
https://www.readbyqxmd.com/read/28929885/first-nations-inuit-and-m%C3%A3-tis-health-considerations-for-canadian-health-leaders-in-the-wake-of-the-truth-and-reconciliation-commission-of-canada-report
#6
Mary McNally, Debbie Martin
First Nations, Inuit and Métis peoples living in Canada face profound health disparities relative to non-Indigenous Canadians on almost every measure of health and well-being. Advancing health opportunities for Indigenous peoples require responses at all levels of healthcare delivery and policy. Therefore, it is critical for health leaders and providers within Canada's healthcare institutions, systems, and settings to understand and address the determinants of health unique to Indigenous peoples, including the legacy of colonialism and both long-standing and present-day racism...
March 2017: Healthcare Management Forum
https://www.readbyqxmd.com/read/28929878/impact-of-language-barriers-on-access-to-healthcare-for-official-language-minority-francophones-in-canada
#7
Danielle de Moissac, Sarah Bowen
While there is strong international evidence that language barriers present obstacles to healthcare access, quality and safety, little research has been conducted on the experience of official language minorities in Canada. This multiple method research used on-line and paper-based surveys, combined with semi-structured individual interviews to explore the experience with access to care of Francophone minorities living in four Canadian provinces. The majority of Francophones surveyed reported limited access to French language services and described an environment where low importance is given to addressing language barriers within the health system...
July 2017: Healthcare Management Forum
https://www.readbyqxmd.com/read/28929872/building-worldly-insights
#8
Michael Tremblay
This article offers health leaders in Canada an opportunity to build a more worldly understanding of healthcare challenges. The focus is on post-conflict countries and island/small countries. Small and island countries often depend on other countries for their workforce and for specialist healthcare services. Conflict usually undermines if it doesn't destroy a country's healthcare system. Small and island countries offer opportunities for the majority of Canadian provinces and territories to develop new approaches from novel comparator countries, with which they may have more in common...
July 2017: Healthcare Management Forum
https://www.readbyqxmd.com/read/28916284/stereotactic-body-radiotherapy-versus-low-dose-rate-brachytherapy-for-localised-prostate-cancer-a-cost-utility-analysis
#9
J Helou, S Torres, H B Musunuru, J Raphael, P Cheung, D Vesprini, H T Chung, L D'Alimonte, M Krahn, G Morton, A Loblaw
AIMS: To conduct a cost-utility analysis comparing stereotactic body radiotherapy (SBRT) with low dose rate brachytherapy (LDR-BT) for localised prostate cancer (PCa). MATERIALS AND METHODS: A decision-analytic Markov model was developed from the healthcare payer perspective to simulate the history of a 66-year-old man with low-risk PCa. The model followed patients yearly over their remaining lifetimes. Health states included 'recurrence-free', 'biochemical recurrence' (BR), 'metastatic' and 'death'...
September 12, 2017: Clinical Oncology: a Journal of the Royal College of Radiologists
https://www.readbyqxmd.com/read/28912198/frequency-of-low-value-care-in-alberta-canada-a-retrospective-cohort-study
#10
Finlay A McAlister, Meng Lin, Jeff Bakal, Stafford Dean
OBJECTIVE: To determine how frequently 10 low-value services highlighted by Choosing Wisely are done and what factors influence their provision. METHODS: This is a retrospective cohort study using routinely collected health data from five linked data sets from 2012 to 2015 in the Canadian province of Alberta to determine the frequency with which 10 low-value services were provided. RESULTS: Between 2012 and 2015, 162 143 people (4% of all 3 814 536 adult Albertans and 5% of the 3 423 135 who saw a physician at least once in that time frame) received at least one of the 10 low-value services, including 29...
September 14, 2017: BMJ Quality & Safety
https://www.readbyqxmd.com/read/28906237/exploring-context-and-the-factors-shaping-team-based-primary-healthcare-policies-in-three-canadian-provinces-a-comparative-analysis
#11
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
https://www.readbyqxmd.com/read/28906235/is-canadian-healthcare-affordable-a-comparative-analysis-of-the-canadian-healthcare-system-from-2004-to-2014
#12
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
https://www.readbyqxmd.com/read/28901913/professional-healthcare-regulation-and-practice-the-case-of-medicine-in-britain
#13
Mike Saks
This contribution comments selectively on the themes of the lead paper by Wilkie and Tzountzouris (2017) on aspects of Canadian healthcare regulation that impact on the crucial agenda of public protection. In a more skeptical sociopolitical climate in the modern world, these authors particularly highlight the need to ensure professional attitudes and behaviours enhance and sustain safe patient care - using the recent stance on professionalism of the College of Medical Laboratory Technologists of Ontario as an illustration of good practice...
2017: HealthcarePapers
https://www.readbyqxmd.com/read/28901911/defining-health-profession-regulators-roles-in-the-canadian-healthcare-system
#14
Joshua Tepper, Humayun Ahmed, Adalsteinn D Brown
Health professions regulation today faces a myriad of challenges, due to both the perceived performance of regulatory colleges, how health systems have evolved, and even larger political and economic shifts such as the renegotiation of NAFTA. In this issue of Healthcare Papers, Wilkie and Tzountzouris (2017) describe the work of the College of Medical Laboratory Technologists of Ontario (CMLTO) to redefine professionalism in the context of these challenges. Their paper, and the comments of the responding authors in this issue highlight that there, is an overarching perception that health regulatory structures - across a range of professions - are not working as effectively as they should...
2017: HealthcarePapers
https://www.readbyqxmd.com/read/28886671/canadian-schizophrenia-guidelines-schizophrenia-and-other-psychotic-disorders-with-coexisting-substance-use-disorders
#15
David Crockford, Donald Addington
OBJECTIVE: Persons with schizophrenia and other psychotic disorders frequently have coexisting substance use disorders that require modifications to treatment approaches for best outcomes. The objectives of this review were to identify evidence-based practices best practices that improve outcomes for individuals with schizophrenia and substance used disorders. METHOD: We reviewed guidelines that were published in the last 5 years and that included systematic reviews or meta-analyses...
September 2017: Canadian Journal of Psychiatry. Revue Canadienne de Psychiatrie
https://www.readbyqxmd.com/read/28873469/the-direct-healthcare-costs-associated-with-psychological-distress-and-major-depression-a-population-based-cohort-study-in-ontario-canada
#16
Maria Chiu, Michael Lebenbaum, Joyce Cheng, Claire de Oliveira, Paul Kurdyak
The objective of our study was to estimate direct healthcare costs incurred by a population-based sample of people with psychological distress or depression. We used the 2002 Canadian Community Health Survey on Mental Health and Well Being and categorized individuals as having psychological distress using the Kessler-6, major depressive disorder (MDD) using DSM-IV criteria and a comparison group of participants without MDD or psychological distress. Costs in 2013 USD were estimated by linking individuals to health administrative databases and following them until March 31, 2013...
2017: PloS One
https://www.readbyqxmd.com/read/28865034/-the-elephant-on-the-table-religious-and-ethnic-diversity-in-home-health-services
#17
Sheryl Reimer-Kirkham, Sonya Sharma, Sonya Grypma, Barbara Pesut, Richard Sawatzky, Dorolen Wolfs
Healthcare services are increasingly being provided in the home. At the same time, these home contexts are changing as global migration has brought unprecedented diversity both in the recipients of care, and home health workers. In this paper, we present findings of a Canadian study that examined the negotiation of religious and ethnic plurality in home health. Qualitative analysis of the data from interviews and observations with 46 participants-clients, administrators, home healthcare workers-revealed how religion is expressed and 'managed' in home health services...
September 1, 2017: Journal of Religion and Health
https://www.readbyqxmd.com/read/28864487/self-administered-versus-provider-directed-sampling-in-the-anishinaabek-cervical-cancer-screening-study-accss-a-qualitative-investigation-with-canadian-first-nations-women
#18
Ingeborg Zehbe, Pamela Wakewich, Amy-Dee King, Kyla Morrisseau, Candace Tuck
BACKGROUND: While (Pap)anicolaou screening has helped to decrease cervical cancer incidence in Canada, First Nations women continue to have a higher burden and mortality relative to mainstream populations. Many First Nations women may feel uncomfortable with the invasiveness of this test, contributing to this statistic. Implemented from 2009 to 2015 in 10 Northwest Ontario First Nations communities, the Anishinaabek Cervical Cancer Screening Study (ACCSS) uniquely addressed this Indigenous health inequity through a mixed methods approach...
September 1, 2017: BMJ Open
https://www.readbyqxmd.com/read/28862475/a-survey-of-canadian-interprofessional-student-run-free-clinics
#19
Enoch Ng, Tina Hu
Student-run free clinics (SRFCs) have existed in Canada since 1971, providing interprofessional healthcare to underserved populations. SRFCs are seen as vehicles for socially accountable health professional education. Literature on how Canadian SRFC function is lacking. Web-based surveys were sent to student leaders from Canadian SRFCs regarding their 2014 activities. All six fully-functioning SRFCs responded reporting on the following: services provided, professions involved, governing structure, funding sources, clients seen, types of care sought, students and preceptors involved, as well as perceived strengths, weaknesses, opportunities and threats...
September 1, 2017: Journal of Interprofessional Care
https://www.readbyqxmd.com/read/28841054/reorienting-public-health-nurses-practice-with-a-professional-practice-model
#20
Cheryl Cusack, Benita Cohen, Javier Mignone, Mariette J Chartier, Zana Lutfiyya
Purpose Documents articulating public health nurses' (PHNs') roles, including Canadian standards and competencies, depict a broad focus working at multiple levels to improve population outcomes through the promotion of health equity. Conversely, Canadian experts depict a looming crisis, based on the rising disconnect between daily activities and ideal practice. While perfectly positioned, PHNs' skills and abilities are under-utilized and largely invisible. The intention of this study was to develop a model to support the full scope of equity-focused PHN practice...
March 2017: Canadian Journal of Nursing Research, Revue Canadienne de Recherche en Sciences Infirmières
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