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Bulletin

The OISSS electronic monitoring bulletin is disseminated free of charge to subscribers every two weeks in French and English. The Bulletin monitors current news, upcoming events, and publications related to reforms of healthcare systems around the world, in particular in OECD countries and countries of the Americas.

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Headlines

Australia - Similar treatment – but costs vary greatly across hospitals

In Australia, the cost of treating patients varies significantly between hospitals, according to a report from the Australian Institute of Health and Welfare (AIHW). The report shows that some hospitals spend up to $6,400 to deliver ‘average’ services for acute patients that cost as little as $3,300 in other hospitals. Looking at metropolitan hospitals, the authors find that while some hospitals have reduced their average costs of delivering care by between 4% and 9% since 2012, others saw increases of the same order.

Canada - Canada’s drug spending growth outpaces that for hospitals and doctors

According to the Canadian Institute for Health Information (CIHI), drug spending in Canada is now outpacing other major areas of health spending. Canada is expected to spend $33.7 billion on prescribed drugs in 2018, an estimated annual increase of 4.2% compared with increases of 4.0% and 3.1% for hospitals and doctors, respectively.

Canada - 2018 Cancer System Performance Report

The Canadian Partnership Against Cancer's annual report examines Canada's cancer system to show what’s working and where improvements are needed. The report finds that while many Canadians are still being diagnosed with preventable cancers and waiting too long for diagnostic tests, more people are surviving cancer than ever before.

Europe – Mental health problems costing Europe heavily

This OECD Europe report says greater efforts in the treatment of mental illness would improve the lives of millions of Europeans and contribute to strengthening the economy. The report estimates the total costs of mental ill health in Europe at over 600 billion euros ($900 billion Cdn), more than 4% of GDP.

France -Agnès Buzyn launches 'My Health 2022'

On November 19, 2018, the French government released its plan for changes to France's health system. The 'My Health 2022' strategy redesigns the system's financing model, structuring of local networks and training for health professionals, while increasing funding for digital technologies and eHealth. Legislation concerning the changes will be introduced in parliament in early 2019.

Upcoming Events

Canada - Mental Health in the Capital 2019

Developed with an advisory committee of workplace health professionals, this conference aims to inspire positive change in the workplace. Speakers will explore best practices in workplace mental health. The conference takes place April 8 and 9, 2019, in Ottawa.

New Zealand - 23rd IUHPE World Conference on Health Promotion

The Health Promotion Forum of New Zealand is hosting the 2019 conference from April 7 to 11. The meeting defines the state of the art in health promotion practice, research, and theory. It also represents a unique platform to showcase New Zealand’s innovation and excellence in health promotion to a global audience.

Reports and Issue Portfolios

Canada - How Equity-Oriented Health Care Affects Health: Key Mechanisms and Implications for Primary Health Care Practice and Policy

Equity oriented health care (EOHC) is care that addresses the cumulative effects of trauma, violence, poverty and racism on people's lives and health and offers culturally safe and contextually-tailored care. This study of 395 patients in British Columbia and Ontario empirically demonstrates that providing EOHC predicts improved health outcomes for people living in marginalized conditions. This is achieved by enhancing patients’ comfort and confidence in their care and their own confidence in preventing and managing health problems, which, in turn, improved health outcomes (depressive symptoms, PTSD symptoms, chronic pain, and quality of life).

Europe - Health system performance assessment – Integrated Care Assessment

Commissioned by the European Union (EU), this study reviews integrated care performance in the 28 EU countries and tests a performance assessment framework. Analyzing 71 integrated care policies and 550 initiatives, the review finds that the characteristics, depth and breadth of IC penetration vary considerably across Europe. The study's Integrated Care Performance Assessment Framework contains 58 indicators to track integrated care outcomes and patient experiences.

Canada - The Generation of Integration: The Early Experience of Implementing Bundled Care in Ontario, Canada

Integrated healthcare models bundle services and encourage interprofessional and organizational collaboration to counter fragmented healthcare delivery and rising system costs. In this study, authors interviewed program stakeholders to provide examples of integration strategies in six Ontario pilot programs, suggest contexts that lend themselves to integration initiatives, and explore the generation of integration through the dynamic interplay of contexts, mechanisms, structures and subjects.

Europe - Inequalities in access to healthcare - A study of national policies

Exploring inequalities in access to health care in European countries, this European Union (EU) report shows that important inequities persist both between and within countries. Sizeable vulnerable populations, especially women, minorities and the poor, continue to face multiple hurdles to accessing care and obtaining quality care. The report makes 20 recommendations concerning service availability, health coverage and insurance, system financing and initiatives for vulnerable populations.

UK - Shifting the centre of gravity: making place-based, person-centred health and care a reality

This report reviews recent efforts by the National Health Service (NHS) to institute localized, integrated person-centred care. It includes six case studies of local integrated care initiatives and a national evidence review of good practice as examples of key actions NHS organizations should take. The report finds that the biggest challenge continues to be the severe financial pressure currently facing all parts of the NHS.

UK - Barriers and enablers for clinicians moving into senior leadership roles

The Faculty of Medical Leadership and Management (FMLM), the parent body of Great Britain's medical royal colleges and faculties, undertook a review of factors that facilitate or impede the movement of National Health Service (NHS) clinicians into senior management roles. The report calls for a concerted strategy that emphasizes structured talent management, and makes recommendations concerning organizational culture, career planning, incentives and regulation.

The Netherlands - Competition in the Dutch Health care system

Providing an overview of The Netherlands' health system, this article describes its basis in competition between private health insurers and providers. Mandatory private insurance provides broad coverage determined by government, and consumers have a choice of insurers, who compete on price, service and choice of providers. The authors note that market failures have led to progressively tighter government regulation of both the insurance market and healthcare provision.

International - Values of Integrated Care: A Systematic Review

A better understanding of the factors driving decision-making, collaboration, and governance processes in integrated care networks is urgently needed. To gain more insight into these topics, this study by Dutch researchers developed and defined a set of underlying values of integrated care. The practical application of these values is discussed and an agenda for future research proposed.

International - How can we evaluate the cost-effectiveness of health system strengthening? A typology and illustrations

This paper analyzes how strengthening health systems can improve economic efficiency in health services. The authors model three types of strengthening (investing in the efficiency of a shared service delivery platform; relaxing the capacity constraints of a shared platform; and providing an entirely new shared platform). The models extend conventional cost-effectiveness analysis to identify a balance between investing in health system strengthening and expenditures on specific interventions.