Santé et Services sociaux Québec.
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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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Canada - Emergency room waits continue to increase

New data from the Canadian Institute for Health Information (CIHI) shows that time spent in emergency departments (EDs) waiting to be admitted to the hospital is increasing. The data shows that 90% of admissions following ED visits were completed within 32.6 hours in 2016, a 3.3-hour increase from 29.3 hours in 2015.

Canada - Demand for Long-Term Care Beds in Canada Could Nearly Double in Little More Than 15 Years

According to a Conference Board of Canada report, Canada could need to create 42,000 new long-term care beds in the next five years to meet the needs of the country’s aging population. The report says Canada may need an additional 199,000 beds by 2035, nearly double the number of long-term care beds currently available.

Canada - Improving Youth Mental Health a Priority for Society and the Economy

Close to two million working Canadians have unmet mental health care needs that prevent them from performing at their highest potential. Among them, young Canadians living with depression and/or anxiety represent the highest cost to the Canadian economy in lost productivity. New research by The Conference Board of Canada suggests that reducing the barriers for young adults seeking treatment and support for mental illness could lead to significant long-term benefits.

Europe - Commission diagnoses the state of health in the EU

The European Commission has published 28 country health profiles of member-states of the European Union (EU). The EU country profiles consider population health and risk factors while assessing the effectiveness, accessibility and resilience of national health systems. Many EU member states are increasingly focusing on primary care, health promotion, and disease prevention.

Ireland - 120 new ANPs will drive improvements in the delivery of health services

Ireland is launching a recruitment and training program for advanced nursing practice (ANP) that will result in the creation of 700 ANP positions by 2021. The program will initially train 120 ANP professionals to work with the elderly and manage chronic diseases and unscheduled care. A consortium of colleges is overseeing the program.

Upcoming Events

Canada - Choosing Wisely Canada National Meeting 2018

Choosing Wisely is a national effort to reduce unnecessary care. At the 2018 national meeting, providers, patients and system leaders will describe practical projects implemented in various contexts and look at emerging evidence on the impact of the campaign. The meeting takes place April 23, 2018, in Toronto.

Netherlands - 18th International Conference on Integrated Care

The conference will bring together researchers, clinicians and managers from around the world who are engaged in the design and delivery of integrated health and social care. The latest evidence will be presented on areas such as integrating health and social care, new roles for hospitals, integrated mental and physical care, mobile and digital health solutions, clinical leadership and coproduction with individuals, carers, communities and populations. It takes place in The Netherlands from May 23 to 25, 2018.

Reports and Issue Portfolios

Canada - Blurred Lines. Private Membership Clinics and Public Health Care

Published by the University of Alberta’s Parkland Institute, this report looks at private membership clinics (PMCs) in Alberta that charge annual fees for combined physician and complementary practitioner care. Finding little public data available, the report analyzes Alberta Health audits of PMCs. It concludes that membership clinics skirt the boundaries of provincial and federal health legislation in order to maximize profits and maintain exclusivity.

Europe - Public health in Europe during the austerity years

Released by the UK International Longevity Centre (ILC-UK), this report explores the relationship between European governments’ economic austerity policies and public health across Europe. Using cross-national data and evidence from individual countries, the report charts the evolution of austerity across the continent since the financial crisis of 2008, describes subsequent changes to health systems and health outcomes, and identifies channels through which austerity impacts on health.

France - The future of health insurance. Assure the efficacy of spending and encourage responsible use of resources

This thematic public report by the French Auditor General seeks to shed light on the collective choices that must be made in order to preserve solidarity in health care. The Auditor gathered findings and survey results from many areas of care, and held a brainstorming seminar to explore anticipated progress in medicine and the organization of care. These investigations indicate that large-scale efforts are needed to increase the efficiency and coherence of health insurance in the country.

Spain - Effect of having private health insurance on the use of health care services: the case of Spain

This paper analyzes the effect of private health insurance on public healthcare utilization in Spain. The authors use techniques based on propensity score methods and the latest micro-data from the Spanish National Health Survey (SNHS). Results show that Spaniards with additional private health insurance use the country’s public health system less than peers without private coverage.

UK - Review of Targets and Indicators for Health and Social Care in Scotland

Scotland’s government commissioned this independent expert review of targets and indicators in Scottish health and social care. The review considers how targets and performance indicators can lead to best outcomes, and looks at how they align with government strategy for the future of health and social care services. The review identifies key principles and recommendations for future development of targets and indicators.

UK - Some assembly required: implementing new models of care. Lessons from the new care models programme

In 2015, the National Health Service (NHS) selected 50 local vanguard sites to implement innovative models of care. This report draws on the experiences of those leading the vanguard sites over the past three years to set out lessons for systematic improvement across local health and care services. It emphasises the value of local co-creation and extensive testing of new care models.

UK - Does hospital competition improve efficiency? The effect of the patient choice reform in England

This paper focuses on the UK’s 2006 relaxation of constraints on patient choice of hospital to investigate the effect of hospital competition on dimensions of efficiency, including indicators of resource management and costs. Findings suggest that competition has had mixed effects on hospital efficiency, increasing the proportion of day cases and reducing the number of untouched meals but also leading to a greater number of cancelled elective operations.

International - Nurses in advanced roles in primary care. Policy levers for implementation

Many countries have introduced advanced roles for primary care nurses to improve access and care while reducing costs. This paper from the OECD provides an analysis of nursing reforms in 37 OECD countries. The paper notes three trends: the development of advanced practice nursing roles; the introduction of supplementary nursing roles; and increases in nursing education programs.

International - Indicators and Measurement Tools for Health Systems Integration: A Knowledge Synthesis

Conducted by Brazilian and western Canadian researchers, this knowledge synthesis identifies indicator domains and tools to measure progress towards integrated care. Establishing measurement domains, the researchers reviewed 7,133 studies and identified 114 tools to measure the integration of care across 16 domains. Few tools were found in the domains of performance measurement, information systems, organizational goal alignment and resource allocation.