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Healthcare Policy, Politiques de Santé

Janine Brown, Lilian Thorpe, Donna Goodridge
Policies and practices have been developed to operationalize assisted dying processes in Canada. This project utilized an environmental scan to determine the spectrum of assisted death reporting practices and medical certificate of death (MCD) completion procedures both nationally and internationally. Findings suggest medically assisted dying (MAiD) is represented on the MCD inconsistently nationally and internationally. Related factors include the specifics of local assisted death legislation and variations in death-reporting legislation, variation in terminology surrounding assisted death and designated oversight agency for assisted dying reporting...
November 2018: Healthcare Policy, Politiques de Santé
Andrew M Briggs, Carolyn J Page, Bridget R Shaw, Andrea Bendrups, Kathleen Philip, Belinda Cary, Peter F Choong
Osteoarthritis (OA) imposes a significant burden to the person, the health system and the community. Models of Care (MoCs) drive translation of evidence into policy and practice and provide a platform for health system reform. The Victorian MoC for OA of the hip and knee was developed following a best-practice framework, informed by best-evidence and iterative cross-sector consultation, including direct consumer consultation. Governance and external expert advisory committees consisting of local OA care champions facilitated the development and consultation processes...
November 2018: Healthcare Policy, Politiques de Santé
Anna Durbin, Yona Lunsky, Ri Wang, Rosane Nisenbaum, Stephen W Hwang, Patricia O'Campo, Vicky Stergiopoulos
This paper reports on the association between intellectual functioning and lifetime homelessness duration among 172 homeless adults with mental illness in Toronto, Canada. Using a standardized test of intellectual functioning, we created two groups: individuals with borderline or lower intellectual functioning (16%) and individuals with above borderline intellectual functioning (84%). Lifetime homelessness duration was approximately three years longer, or almost twice as long, for individuals with borderline or lower intellectual functioning...
November 2018: Healthcare Policy, Politiques de Santé
Lindsay Hedden, M Ruth Lavergne, Kimberlyn M McGrail, Michael R Law, Lucy Cheng, Megan A Ahuja, Morris L Barer
Policy makers and health workforce planners rely on counts of practice licences as a measure of the size of the active physician workforce. We use a population-based approach to correlate estimates of retirement from clinical care based on these data with those produced using physician payment data. We find that licensure data generates per-capita estimates of physician supply in British Columbia that are substantially higher than activity-based estimates. Licensure data are unlikely to produce reliable estimates of the timing and extent of physician retirement and therefore should not be used as the primary basis for estimating current or future physician supply...
November 2018: Healthcare Policy, Politiques de Santé
Kellie Thiessen, Nathan Nickel, Heather J Prior, Margaret Morris, Kristine Robinson
Introduction: The concept, "most responsible provider" has a specific definition in the Canadian National Discharge Abstract Database (DAD). Variation exists in how care providers are defined in administrative data. Methods: We compared chart data with administrative data to understand how "most responsible provider" was identified in these two data sources. Results: We found a 3% discrepancy between data sources. Differences between data sources were attributable to transfers in care that occurred at birth...
November 2018: Healthcare Policy, Politiques de Santé
Shiva Nourpanah, Ivy Bourgeault, Lois Jackson, Sheri Price, Pauline Gardiner Barber, Michael P Leiter
Mobility and movement is an increasingly important part of work for many, however, Employment-Related Geographical Mobility (ERGM), defined as the extended movement of workers between places of permanent residence and employment, is relatively understudied among healthcare workers. It is critical to understand the policies that affect ERGM, and how they impact mobile healthcare workers. We outline four key intersecting policy contexts related to the ERGM of healthcare workers, focusing on the mobility of Registered Nurses (RNs), Licensed Practical Nurses (LPNs) and Continuing Care Assistants (CCAs) in Nova Scotia: international labour mobility and migration; interprovincial labour mobility; provincial credential recognition; and, workplace and occupational health and safety...
November 2018: Healthcare Policy, Politiques de Santé
J Ross Graham
I applaud Breton et al. (2018) for their recent logic analysis on primary care centralized waiting lists (CWLs) in seven Canadian provinces, recently published in your journal. This is an important step towards better understanding the effectiveness of these approaches. Given the dire situation of primary care in many jurisdictions across Canada, CWLs deserve greater research attention. In particular, I agree with the authors' comments that future research should explore CWLs effectiveness from the patient perspective...
November 2018: Healthcare Policy, Politiques de Santé
Jennifer Zelmer
The ripple effects of major policy changes are difficult to predict in advance. That is why the ability to track consequences of decisions - intended and unintended - is an important role of health services and policy research. In this issue of the journal, Janine Brown, Lilian Thorpe and Donna Goodridge discuss our ability to track medically assisted death (MAiD), one of the most significant health policy changes in Canada in recent history. Whatever one's views on MAiD, there is consensus on the need to understand how often, and in what circumstances, such deaths take place...
November 2018: 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
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