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Predicting social care costs. A feasibility study

Brief analytical summaries or syntheses #17 Predicting social care costs. A feasibility study Summary This study explores whether statistical models can be used to predict a person’s future need for intensive social care. Aside from the predictive models developed, this work points to the important potential of linked health and social-care data to support policy analysis and to guide the planning and delivery of services. Background The social care and healthcare costs of people with complex needs are set to rise steeply in the U.K. over the medium term, due to the ageing population and the growing number of people living with long-term medical conditions. It will become increasingly important to find ways of helping local councils and health services take earlier action to support people so they can remain independent and at home as long as possible. The ability to identify these people would be helpful so that they…

The role of information and communication technologies in improving health sector efficiency

Brief analytical summaries or syntheses #6 The role of information and communication technologies in improving health sector efficiency Summary This OECD health policy study provides advice on a range of policy options, conditions and practices that policymakers can adapt to their own national circumstances to accelerate adoption and effective use of information and communication technologies (ICTs) in health care. It analyses the incentives and institutional mechanisms used to encourage the adoption of these technologies in six OECD countries (Australia, Canada, The Netherlands, Spain, Sweden, and the United States). It presents an analysis of the range of incentives and institutional mechanisms that have been applied to influence introduction and successful adoption of ICTs, examines the results of these initiatives, looks at some of the new technologies in health care and helps identify the challenges in securing cooperation from the different stakeholders involved. Background Policymakers in OECD countries are faced with ever-increasing…

Canada – The Select Committee on Mental Health and Addictions of the Legislative Assembly of Ontario, recommends the creation of Mental Health and Addictions Ontario

The Select Committee recently released its final report, "Navigating the Journey to Wellness: The Comprehensive Mental Health and Addictions Action Plan for Ontarians". This follows the release of an interim report (March 2010) that provided an overview of the hearings and activities of the Committee to that date. The final report includes 23 recommendations. The main recommendation is the creation of an umbrella agency, Mental Health and Addictions Ontario, to design, manage, and coordinate the mental health and addictions system, and to ensure the consistent delivery of programs and services across Ontario.

International - Public Health Performance Strengthening at Districts. Rationale and Blueprint for Action

Published by the WHO, this paper documents the proceedings of a 2016 conference in Bellagio, Italy that convened an international group of 19 experts to discuss public health performance strengthening at district levels. Participants concluded that improving district public health practice is now a feasible priority for middle-income countries given the broad range of successful strategies tested in different international contexts.

Time for Transformative Change: A review of 2004 Health Accord

Brief analytical summaries or syntheses #40 Time for Transformative Change A review of 2004 Health Accord Summary Canada is no longer seen as a model of innovation in health care delivery and financing, says this report from the Standing Senate Committee on Social Affairs, Science and Technology. The committee’s review revealed that real systematic transformation of health care systems across the country had not yet occurred, despite more than a decade of government commitments and increasing investments. The committee made 46 recommendations it believes will truly transform the way health care professionals do business and will achieve lasting reform. Background On January 31, 2011, the Minister of Health requested that the Standing Senate Committee on Social Affairs, Science and Technology initiate the second parliamentary review of the 10-Year Plan to Strengthen Health Care (10-Year Plan), an agreement reached by First Ministers on September 16, 2004 that focuses on federal/provincial/territorial (F/P/T)…

Switzerland - Federal Council adopts addictions strategy

This strategy is based on current drugs, alcohol and tobacco programs and takes into account new forms of addiction. It aims to prevent addiction, provide early support to people at risk and provide assistance to those affected. An action plan will be developed in collaboration with key partners by the end of 2016. Efforts will be made to harmonize with the non-communicable diseases prevention strategy.

UK — Predicting social care costs: a feasibility study

This report describes a study that explored whether statistical models can be used to predict an individual person’s future need for intensive social care. Aside from the predictive models developed, this work generated important lessons about the potential of linked health and social care data to support policy analysis and to guide the planning and commissioning of services.

Ireland - Towards the Development of a Predictive Model of Long-Term Care Demand For Northern Ireland and the Republic of Ireland

This report from the Centre for Ageing Research and Development in Ireland (CARDI) analyzes long-term care utilization in Northern Ireland and the Irish Republic in order to form a predictive model of mutual demand. The two jurisdictions have distinct healthcare systems and differing demographic profiles.

Canada - Ontario Investing $28 Million in Mental Health and Addictions Services

On February 26, 2015, the Ontario Ministry of Health and Long-Term Care announced investments in local mental health and addictions organizations to provide care closer to home for people who are experiencing mental health and addictions challenges. Funding will go to improve access to supportive housing, support groups and treatment programs, a registry of inpatient mental health beds, and improved transitions between care teams.

Canada — Canadian medical schools to strengthen training on effective clinical use of information & communications technologies

Better preparing medical students to practice in modern, technology-enabled, clinical environments is the aim of a new initiative launched recently by the Association of Faculties of Medicine of Canada (AFMC) and Canada Health Infoway (Infoway). Canada’s medical schools, students, and residents are invited to join in this three-year effort to strengthen learning on effective clinical use of information and communications technologies (ICT).

Canada - A 10 Year Mental Health and Addictions Action Plan for Saskatchewan

Commissioned by Saskatchewan’s government, this panel report outlines a 10-year mental health and addictions action plan for the province’s health and social services ministries. It is the culmination of extensive public consultations. The plan lays out 62 goals for improving awareness, access, capacity, early intervention, person-centred care, recovery support, health inequities and First Nations and Métis partnerships.

Europe — Digital Agenda: European Commission seeks views on improving healthcare by applying ICT (eHealth)

The European Commission is seeking citizens' and other interested parties' views on how the EU can help to deliver widespread benefits to the quality and efficiency of healthcare by applying information and communication technologies (ICT) (so-called 'eHealth'). The online public consultation runs until 25 May. The answers will feed into the preparation of the eHealth Action Plan 2012-2020 that the Commission is due to present before the end of 2011.

Canada – Hospitals’ financing mechanisms: A comparative analysis

This analysis from CIRANO compares health reforms in six jurisdictions to determine if there are governance mechanisms, especially in terms of payments to hospitals, that lead to greater productivity. It highlights the differences between these jurisdictions and the Quebec system and proposes changes.

Canada - Rethinking Canada’s Unbalanced Mix of Public and Private Healthcare: Insights from Abroad

This commentary from the CD Howe Institute asserts that Canada’s public-private healthcare mix is unbalanced compared to European countries and blames the restrictions imposed on the private financing of hospital and physician care. The author describes how European health systems without similar restrictions devote a larger share of public resources to drugs and long-term care.

UK - Understanding NHS financial pressures: how are they affecting patient care?

This report examines what current National Health Service (NHS) financial constraints mean for patient care in four areas: genito-urinary medicine (GUM), district nursing, elective hip replacement, and neonatal services. Strong evidence was found that quality of care has suffered in GUM and district nursing services. Waiting times for hip replacements are also rising, although neonatal services appear to have maintained quality.

Germany - Do Hospitals Respond to Increasing Prices by Supplying Fewer Services?

Models of supplier-induced demand predict that medical providers will supply fewer services when faced with price increases. This paper tests this prediction by examining German hospital financing reforms that changed the overall level of reimbursement without affecting relative prices for different types of patients. The paper finds that hospitals do react to rising prices by reducing service supply.

New Zealand - Targeting Emergencies: Shorter Stays in Emergency Departments

In July 2009 the Government demonstrated its commitment to improving the quality and timeliness of the care New Zealanders receive at an ED, by introducing a Health Target of ‘Shorter Stays in Emergency Departments’. The Health Target requires District Health Boards, who run the country’s public hospitals, to ensure that: 95% of patients will be admitted, discharged or transferred from an ED within six hours. This publication looks at how District Health Boards (DHBs) are working to achieve this Health Target, and discusses the real gains which are being made thanks to the creativity, teamwork and dedication of hospital staff.

Health in the Americas. 2012 edition

Brief analytical summaries or syntheses #53 Health in the Americas. 2012 edition Summary In Health in the Americas 2012, the Pan American Sanitary Bureau presents and analyzes health data and information from every country in the Region of the Americas. In drafting the publication, it has used data from many domestic and international, as well as unofficial, sources, trying as much as possible to identify and eliminate any discrepancies. Background Chapter 1 A Century of Public Health in the Americas In the last 110 years, Latin America and the Caribbean have experienced great transformations, from the independence of the Caribbean countries to the construction of modern states, from authoritarian regimes and dictatorships to democracy and the rule of law, and from cycles of economic growth and high productivity to financial crises, economic slow-downs, and massive foreign debt. The Region also has achieved a notable increase in life expectancy and a…

International – Development of predictive models in international health systems

Predictive models of health usage events, such as unplanned hospitalizations or entry into a care home, have been under development for a decade. A risk score is calculated for each individual, according to the probability that the event will occur. This article describes the different uses of this information for resource allocation, improvement of care pathways, remuneration and evaluations.

Canada - Mental Health and Addictions System Performance in Ontario: A Baseline Scorecard

This scorecard assesses mental health and addictions care in outpatient physician and acute care settings in Ontario from 2006 to 2014. The scorecard comprises 10 performance indicators that describe how well the health system responded to patient needs, along with eight contextual indicators reflecting the services provided and patient outcomes. Performance on each indicator is evaluated by age, sex, geography, neighbourhood income, and immigration status.

International - ICTs and the Health Sector: Towards Smarter Health and Wellness Models

A whole new world of possibilities in using mobiles and the Internet to address healthcare challenges has opened up. A key hurdle is, however, the big data challenge, dealing with the exponentially accelerating accumulation of patient data – all of which must be mined, stored securely and accurately, and converted to meaningful information at the point of care.

UK - Horizon 2035: International responses to big picture challenges

Published by the Centre for Workforce Intelligence, this report provides short, digestible analysis of international examples that might help to meet big picture challenges facing the health and care workforce challenges in England. Among the areas of interest are the retention of home care workers, the role of informal caregivers, the adoption of technology and the impact of 24/7 services. Changes or planned changes in Australia, Germany, Japan, the Netherlands, Sweden and the US are described.

OCDE - Achieving Efficiency Improvements in the Health Sector through ICTs - Final report

This report presents an analysis of OECD countries’ efforts to implement information and communication technologies (ICTs) in health care systems. It provides advice on the range of policy options, conditions and practices that policy makers can adapt to their own national circumstances to accelerate adoption and effective use of these technologies.

Canada – An Experimental Investigation of Mixed Systems of Public and Private Health Care Finance

This study from the Department of Economics at McMaster University tests theoretical predictions of a mixed model of public and private healthcare finance by investigating behavioural responses to changing the public-sector allocation. The authors found that the amount of insurance purchased was consistently larger than predicted in the theoretical model, and that a mixed system resulted in higher healthcare prices and sicker, poorer people being left untreated.

OCDE - Achieving Efficiency Improvements in the Health Sector through ICTs - Final report

This report presents an analysis of OECD countries’ efforts to implement information and communication technologies (ICTs) in health care systems. It provides advice on the range of policy options, conditions and practices that policy makers can adapt to their own national circumstances to accelerate adoption and effective use of these technologies.

Canada - Alberta acts on mental health recommendations

Alberta is moving to prioritize recommendations made in a report from its Mental Health Review Committee. The province will add medical detoxification beds, expand access to addiction treatment for youth, develop an opiates addiction action plan, launch a child and youth mental health website, and develop performance monitoring and implementation teams.

New Zealand – Launch of the Mental Health and Addiction Action Plan 2010

The Action Plan describes a work programme of Ministry-led activities in four key areas through to November 2011 to advance the Government's priorities for mental health and addictions.

Canada - Toward Quality Mental Health Services in Canada: A Comparison of Performance Indicators across 5 Provinces

In 2015, the Centre for Applied Research in Mental Health & Addiction (CARMHA) at Simon Fraser University led an initiative to develop mental health and addictions performance indicators that could be used comparatively across five provinces: British Columbia, Alberta, Manitoba, Ontario and Québec. These two reports present the project: one provides an overall summary and the other details technical information on indicators and results.

New Zealand - Exploring the Links between Quality Improvement Strategies and Organisational Outcomes in Four New Zealand District Health Boards: Final Report

This publication reports on the results of a project initiated by three New Zealand government agencies in 2015 that examined links between quality improvement strategies implemented by New Zealand district health boards (DHBs) and their organizational outcomes. A number of DHBs use quality frameworks and concepts as core elements of their strategies to improve patient outcomes and manage costs.

Australia - One in every eight Australians sees a GP at least 12 times a year

This government report provides a picture of use of general practitioner (GP) services in Australia. It shows that one in eight Australians (12.5%) saw a GP at least 12 times in 2012–13. Among very high GP users (over 20 visits), 67% were aged 60 or older. Australians visit a GP five times per year on average.

USA - Policy Recommendations to Guide the Use of Telemedicine in Primary Care Settings: An American College of Physicians Position Paper

The American College of Physicians (ACP) has issued 23 policy recommendations on primary care telemedicine that buttress calls for its expansion, especially in established physician-patient relationships. The ACP supports government funding of the broadband infrastructure needed for telehealth and advocates lifting restrictions limiting the reimbursement of telemedicine services by US Medicare.

Canada - Action underway to improve rural health care in Alberta

Alberta’s Rural Health Services Review Committee has delivered a report of its recommendations to improve rural health care. Two actions are already underway: the development of an emergency medical service (EMS) delivery model, and the establishment of 10 Alberta Health Services (AHS) operational districts to give rural communities a voice in decision-making.

Canada - Modelling helps Saskatchewan health care managers, policy makers make better, more informed decisions

The Health Quality Council's Measurement and Analysis Services team is now able to offer predictive modelling services to healthcare managers based on evidence around factors that affect the use of a service. Modeling holds the potential to help regions anticipate changes in demand.

Australia - The use of financial incentives in Australian general practice

Relying on extensive surveys, this study examines the uptake of financial incentive payments by Australian general practitioners (GPs) and identifies those most likely to participate. The study concludes that administrative support appears to be an important predictor of use, indicating that GPs do not always consider it worth their while to claim incentives. Rural GPs claim incentive payments most often.

New Zealand - Measuring health system performance: A new approach to accountability and quality improvement in New Zealand

A new whole-of-system approach to measuring health system performance, based on Triple Aim objectives, is being introduced in New Zealand. This article in Health Policy presents the features of the program, called the Integrated Performance and Incentive Framework (IPIF). Measures will be set at both national and district levels and will be applied first to primary health care before being expanded to other services.

France - National health strategy : Marisol Touraine receives the Devictor report on territorial public health services

This report, prepared for the Ministère des Affaires sociales et de la Santé in France, draws the contours of territorial health services and public hospitals, two key concepts for an upcoming health law. These are part of a wider national health strategy, which aims to reorganize the health system around the patient and his or her healthcare trajectory.

Norway - Physicians' engagement in dual practices and the effects on labor supply in public hospitals: results from a register-based study

Dual practice, where physicians work in both public and private practice, has attracted negative attention due to fears of reduced physician availability in public systems and physician conflicts of interest. This Norwegian study analyzes dual practice among hospital physicians and its effects on physician availability in public hospitals. Its findings indicate that dual practice may increase total labour supply.

Australia - NSW Government Commits $120 Million to Integrated Health Care

In Australia, the state government of New South Wales (NSW) is allocating $120 million to provide integrated health care at the community level. The NSW government is committing $30 million annually over the next four years to implement integrated care models in local health districts.

Europe - EU Action Plan on Childhood Obesity 2014-2020

Childhood obesity has tripled across Europe since the 1980s. This plan developed by the European Union (EU) sets out priority areas for action and includes measures to keep track of progress across EU member states. Priority actions include restricting advertising to children and promoting physical fitness and healthier environments.

Canada - Alberta Health Services (AHS) recently released new performance measures that will help Albertans easily understand how the province’s health system is performing

Alberta Health Services (AHS) has developed 16 new performance measures to help Albertans understand how the province’s health system is performing. The 16 measures better reflect the spectrum of health care in Alberta and will depict health system performance more accurately.

France - Trends in the activity of healthcare insitutions: description, determinants and predictions

The General Inspectorate of Social Affairs in France has studied the evolution of hospital activity in recent years in order to identify determinants of the volume of activity. An increase in the number of visits accounts for about a third of the growth, and two thirds are due to longer stays. More serious cases associated with an aging population explain part of the increase.

France - The value of a strategic approach for the development of a primary care health centre

Predicting an explosion in the need for nursing homes in coming decades, this paper by French researchers develops a wide-ranging strategy for expanding the nursing home of tomorrow. The authors clarify their multidisciplinary and patient-centred approach with illustrations from existing models and practices.

Canada - Huge reorg of Nova Scotia's health system

Nova Scotia’s new Health Authorities Act is cutting the number of district health authorities in the province from 10 to two, a measure that will save $5 million annually in senior management salaries. Forthcoming changes to physician bylaws are also expected to simplify credentialing under the consolidated system.

Australia - OECD Reviews of Health Care Quality: Australia 2015. Raising Standards

Published by the OECD, this review provides an overview of Australia’s mixed public and private health sector and the quality of its health services and institutions. It calls for a national approach to raise quality and performance, but says Australia’s health system functions well despite many overlapping jurisdictions that disrupt care funding and continuity.

Canada - Quebec Ranks In The Middle Of The Pack On Population Health

Quebecers give themselves top grades for their health. Yet, when Quebecers' health is compared to that of other Canadian provinces and advanced countries, Quebec ranks in the middle of the pack, according to The Conference Board of Canada's How Canada Performs: Health report card. Quebec gets an overall "B" grade and finishes 11th among 29 jurisdictions in the first-ever report card that includes the provinces, territories and 16 peer countries. Quebec places third among the provinces behind British Columbia and Ontario, and just below Canada as a whole.

Canada - First Nations Mental Wellness Continuum Framework Launched

The First Nations Mental Wellness Continuum Framework identifies ways to enhance service coordination among various systems and support culturally safe delivery of services. The Framework is the result of extensive collaboration that began in 2012 among the Assembly of First Nations, Health Canada, and community mental health leaders. The process included a comprehensive mapping of existing mental health and addictions programming that identified gaps and ways to address and avoid them.

Lunch hour conferences 2015

By Michel Perreault, psychologist-researcher, Douglas Mental Health University Institute, associate professor, Psychiatry Department, Université McGill Hélène Provencher, professor, Nursing Faculty, Université Laval, researcher, Groupe de recherche sur l'Inclusion sociale, l'Organisation des services et l'Évaluation en santé mentale (GRIOSE-SM), CSSS de la Vieille-Capitale This conference will address the added value question of the intervention focusing on the contribution of peer helpers in care and services network, particularly in the area of mental health. The major findings from two research projects supported by the MSSS will be presented, one about the peer helpers intervention to facilitate access to clinical treatment for people with anxiety disorders with the support group Phobies-Zéro and the other one addressing the peer helpers integration in teams of support in the community for people with severe mental disorders proposed by the “Peer Helpers Network Program” associated with the Association québécoise pour la réadaptation psychosociale. Peer helpers accompany researchers…

Canada - Aspiring to a new standard of healthcare for Canada

This paper maintains that Canadian healthcare can be transformed using health information technology and highlights international examples of relevant programs. The paper explores the impact of existing incentive programs in Canada’s provinces and presents a three-stage model for better care.

USA - Beacon Communities Share Strategies for Using Health Information Technology in New eGEMs Special Issue

The online journal, eGEMS, has published a special issue on lessons learned from eight ‘Beacon Communities’ that are using information technology (IT) to achieve better health care at lower costs. Beacon Communities are part of a program by the Office of the US National Coordinator for Health IT to strengthen health IT infrastructure, reduce costs and improve care quality.

New Zealand - Measuring progress with clinical governance development in New Zealand: perceptions of senior doctors in 2010 and 2012

Clinical governance is the subject of this New Zealand study, in which researchers interviewed senior hospital doctors in 2010 and 2012, and created a clinical governance development index (CGDI) to measure policy implementation over that period. The CGDI showed improvements in the overall development of clinical governance, but found marked differences between New Zealand’s 20 District Health Boards.

Canada - Mental Health Commission of Canada Releases Summary of Report on Support to Emerging Adults

On February 23, 2015, the Mental Health Commission of Canada released the executive summary of its forthcoming report on how to promote a more seamless continuum of services for emerging adults. Developed in partnership with a research team from the Children’s Hospital of Eastern Ontario (CHEO), the report will detail the current state of policies and practices in the area of youth transitioning from child and youth to adult mental health and addiction services. It will also present best practices and policies from the Canadian and international experience.

Canada - Registered Nurses’ Association of Ontario issues recommendations to ensure patients come first

The Registered Nurses' Association of Ontario (RNAO) has released a report saying upcoming reforms to health services delivery in Ontario won’t succeed unless they include a health human resources (HHR) strategy. The report identifies provincial nursing employment trends that contradict the government’s stated priorities.

Europe - Public Consultation on Health and Care in the Digital Single Market

This consultation investigates the need for policy measures that will promote digital innovation for better health and care in Europe. It is seeking views on cross-border access to and management of personal health data, joint European exploitation of digital infrastructure, and measures to support interaction between patients and providers. Citizens, patient organisations, health and care professionals, public authorities, researchers, industries, investors and users of digital health tools are invited to respond to the consultation by October 12 2017.

Europe - Austerity and health: the impact in the UK and Europe

Government austerity measures have enormous social impact, including on health. This review evaluates the evidence of austerity’s health impacts using two mechanisms: a ‘social risk effect’ of catalogued socio-economic risk factors, and a ‘healthcare effect’ viewed through analysis of service cuts, reductions in coverage, and restrictions on access to care.

Ireland - Minister Catherine Byrne launches third annual Healthy Ireland Survey

Ireland’s Minister of State for Health Promotion has released the third annual Healthy Ireland Survey. The 2017 Survey of 7,500 people aged 15 and over gives an up-to-date picture of the health of the nation and reports on many lifestyle behaviours, such as smoking, alcohol consumption, diet and sexual health.

Spain - Austerity, health care provision, and health outcomes in Spain

The 2008 economic crisis led to strict government austerity measures in Spanish health care, many of which remain in place today. This study finds that hospital staff and bed reductions played a role in increased mortality rates due to difficult births and cardiovascular disease. Overall analysis suggests that the impact of decreased healthcare provision on mortality is statistically significant but variable across Spain’s 17 regions.

Canada - Primary Care Access and Emergency Department Utilization: Theory and Evidence from Canada

Studying how after-hours physician incentives affect emergency department (ED) use, this paper developed a model suggesting reduced ED use is related to expanded primary care access. However, incentivizing primary care physicians to provide after-hours services can also reduce service during regular hours and increase ED utilization: an ambiguous result. Testing with Ontario healthcare administrative data from 2004-2013 produced findings consistent with these predictions.

Canada - The Value of Expanded Pharmacy Services in Canada

The scope of pharmacy services has expanded in many Canadian jurisdictions in recent years. This report estimates the health and economic impact of three pharmacy services with the potential for further expansion: smoking cessation, management of cardiovascular disease, and pneumococcal vaccination. Over the 20-year forecast period, the estimated economic value of expanding these services ranges from $2.5 billion to $25.7 billion.

Canada - Ontario Passes Legislation on Medical Assistance in Dying

The province of Ontario passed legislation on May 9, 2017 that will support the implementation of medical assistance in dying in the province. The law provides more protection and clarity for patients, families, healthcare providers and institutions. The new act aligns with federal legislation and will address areas that fall under provincial jurisdiction.

UK - Falling short: Why the NHS is still struggling to make the most of new innovations

In recent years, significant resources have gone into understanding why Britain’s National Health Service (NHS) is often slow to adopt innovations despite strong evidence of benefit. This briefing by the Nuffield Trust consultancy pins the problem on an approach to innovation that is overly supply-driven and top-down, a lack of timely generation of evidence, and the silo-based structure within NHS organizations that restricts the broader adaptation of research and development.

Canada - Qualitative analysis of the dynamics of policy design and implementation in hospital funding reform

Like healthcare jurisdictions elsewhere, Canada’s provinces have begun shifting away from global hospital budgets. This evaluation focuses on Ontario’s implementation of quality-based procedures (QBPs), a funding approach involving a pre-set price per episode of care coupled with best practice clinical pathways. The evaluation concludes that implementation of QBPs has suffered from policy drift, and says the funding mechanism remains misunderstood in Ontario’s healthcare system.

Canada - Health Canada launches consultations on palliative care framework

Health Canada has launched public consultations on a framework for palliative care in Canada that will help improve access and provide a useful reference point across jurisdictions to identify opportunities, address gaps, and share promising practices. People are invited to submit their views online before July 13, 2018.

Canada - Modernizing Canada’s Healthcare System through the Virtualization of Services

In Canada, investments in digital health currently amount to several billion dollars. This article suggests using the Quadruple Aim (QA) framework devised by the Institute for Healthcare Improvement (IHI) to further modernize care delivery using virtual services. The QA framework focuses on improved population health, patient and provider satisfaction, and reduced costs. The article proposes 10 strategies to improve virtual services in Canadian health care.

Germany - Waiting times in primary care depending on insurance scheme in Germany

The aim of this study was to uncover possible differences in waiting times dependent on health insurance scheme (public or private), and to identify predictors for excessive waiting times in primary care. After analyzing data from 5,618 respondents, the study found that barriers to access most often depend on insurance status, age, and region of residence. Privately insured respondents reported shorter waiting times for appointments.

Canada - Ontario Making Historic Investment in Mental Health Care

Ontario has announced the biggest provincial investment in Canadian history in mental health and addiction services: a four-year investment of $2.1 billion that will reframe the system to deliver better and more accessible integrated care. The investment will make it easier to access services through a local school, family doctor's office, or community-based organization.

Europe - Synopsis Report Consultation: Transformation Health and Care in the Digital Single Market

In 2017, the European Union (EU) announced a digital health and care strategy based on three pillars: citizen access to their health records, a supportive data infrastructure, and patient-centred interoperability of healthcare data. This report provides an analysis of consultation activities connected to the strategy that involved online surveys and questionnaires answered by respondents across Europe. Results showed strong support for the EU actions.

Canada - How Canadian Health Care Differs from Other Systems

Canada’s approach to health policy is much more restrictive than in other developed countries with more successful universal health-care systems, notably on the use of the private sector and patient cost-sharing, finds a new study released by the Fraser Institute.

International - Future and potential spending on health 2015–40: development assistance for health, and government, prepaid private, and out-of-pocket health spending in 184 countries

Published in the Lancet, this study analyses all-sector government spending and health spending data in 184 countries from 1980–2015 to estimate government and health spending (government, out-of-pocket, and private) through the year 2040. The study expects global spending on health to increase from $9 trillion in 2014 to $24 trillion in 2040, and predicts that health spending will increase fastest in upper-income countries.

Belgium - The patient's bill for services made clear

On December 19, 2013, the Council of Ministers in Belgium agreed on a draft bill regarding transparency in healthcare billing. The project deals with four major areas: the obligation for providers to mention the fees collected in the patient record; the obligation, if no record of care is delivered, to provide a document justifying all costs for health care; strict supervision of any advance payment requested by the care provider, and better information on the rates charged by doctors in laboratories.

Canada - Ambulatory EMR Use Delivers Health System and Patient Benefits

According to a study by Canada Health Infoway, electronic medical record (EMR) use in ambulatory care is yielding benefits in improved patient safety and clinic efficiency. The study found that 57% of clinics using EMRs report quality improvements and that 1.2 million additional patient visits in 2015 resulted from enhanced efficiency.

Canada - Primary Care in Ontario, Canada: New Proposals after 15 Years of Reform

Ontario has led the way in Canada in implementing innovative primary care practice models, but funding constraints have led to increased conflict with physicians. In response, Ontario’s government is now considering more changes to primary care governance. This article discusses preliminary policy proposals suggested by a provincial primary care advisory committee.

France - The relationship between costs and quality of care : a profitable alliance for hospitals?

Investigating the relationship between cost reduction and quality of care, this review considers whether the two objectives are contradictory or can be resolved to the benefit of hospitals and health systems overall. Its findings show that no international consensus has yet developed because the impact of quality of care on costs is still difficult to quantify.

International - Interprofessional teamwork innovations for primary health care practices and practitioners: evidence from a comparison of reform in three countries

Investigating primary care interprofessional teamwork innovations in Australia, Canada and the US, this Australian review examined 12 studies to assess the impact and local context of reforms. Variations were associated with contextual factors such as the size, power dynamics, leadership, and physical environment of the practice. Unintended consequences included conflict between medical and nonmedical professional groups.

Europe - Taking a participatory approach to development and better health. Examples from the Regions for Health Network

Released by the WHO, this report documents participatory approaches to development and health improvement taken by health systems with regional jurisdictions in four European countries. Case studies provide details of participatory health approaches in the regions of Skåne (Sweden), Trento (Italy), Andalusia (Spain), and Wales (UK).

France: Health system review. Health Systems in Transition, 2015

Assessing the current performance of France’s healthcare system, this review notes that, while the French population has a good level of health, the overall picture is mixed. Rising healthcare costs along with large-scale health inequalities across socioeconomic and geographical groups are increasingly problematic. Public financing of healthcare expenditure is nearly the highest in Europe.

UK - Demand management for planned care: a realist synthesis

The task of matching demand with capacity is a pressing concern in healthcare systems as increasing demand (aging populations, the availability of new treatments) meets stagnating supply (capacity and funding restrictions on staff and services). This report reviews the effectiveness of British strategies to alleviate demand pressures in planned care and finds little alignment between purported problems and proposed solutions.

Europe - WHO Europe launches new action plan for noncommunicable diseases

In September 2016, the WHO launched a new action plan for noncommunicable diseases (NCDs) in Europe that outlines actions to reduce the burden of NCDs, improve quality of life, and make healthy life expectancy more equitable. Along with early detection of NCDs, the plan advocates the use of marketing restrictions to promote healthy eating.

Denmark - Physician Response to Target-Based Performance Payment

In many healthcare systems, payers reward physicians for reaching predetermined performance targets. This paper analyzes physician response to target-based performance payment and shows that responses depend both on payment size and uncertainty about performance. The paper concludes that the design of target-based payment schemes must include baseline measurements to predict physicians’ ability to assess their own performance.

USA - Cardiovascular disease costs will exceed $1 trillion by 2035

In this report, released on Valentine's Day, the American Heart Association predicts that 45% of the total US population will have cardiovascular disease (CVD) by 2035. The Association calls for action on prevention and maintaining health coverage by protecting the ban on pre-existing conditions. In 2015, 100 million Americans were suffering from CVD, imposing high direct and indirect costs in terms of treatment and lost productivity.

UK - Saving STPs: achieving meaningful health and social care reform

This report, from the think tank Reform, looks at the progress of sustainability and transformation plans (STPs) in England. They have been developed in 44 jurisdictions to break down barriers between different levels of health and social service on a local basis. Interviews with experts across the system reveal some progress, especially in places that already had integration efforts in place, and raise issues that contribute to difficulties.

Canada - Measuring Patient Harm in Canadian Hospitals

A national picture of patient harm in acute care hospitals (outside Quebec) is now available, thanks to a new measure developed by the Canadian Institute for Health Information (CIHI) and the Canadian Patient Safety Institute (CPSI). The joint report Measuring Patient Harm in Canadian Hospitals, reveals that in 2014–2015 harm was experienced by patients in 1 of every 18 hospital stays, or 138,000 hospitalizations. Of those, 30,000 (or 1 in 5) involved more than 1 form of harm. The rate (5.6%) has remained stable over the past few years.

UK - New plans to expand the use of digital technology across the NHS

The UK government has announced plans to fast track digital excellence and improve the digital skills of the National Health Service (NHS) workforce. An academy to train NHS staff in digital skills will be established and 12 NHS organizations will be selected to receive £10 million ($17 million Cdn) to deliver innovative digital service.

International - eHealth Advances in Support of People with Complex Care Needs: Case Examples from Canada, Scotland and the US

Advances in eHealth offer better care and support for people with complex care needs. This article presents case studies from Ontario, Scotland, and the state of Colorado to identify how these jurisdictions are using eHealth to address multi-morbidity. A SWOT (strengths, weaknesses, opportunities, threats) analysis is presented for each case, and thoughts on eHealth's future in complex care are presented.

Canada - The Public Health Care Monopoly on Trial: The Legal Challenges Aiming to Change Canada’s Health Care Policies

Yanick Labrie from the Montreal Economic Institute looks, in this article, at past and upcoming challenges in provincial courts to restrictions on private health care. He compares Canadian policies with those of other countries and discusses their impact on timeliness of care, principally for elective surgeries.

International - How to recruit and retain health workers in rural and remote areas in developing countries

In response to the ongoing challenge to recruit and retain health workers in rural and poorer areas, this paper proposes the application of Discrete Choice Experiments (DCEs) to allow for measurement of health workers' preferences and quantitatively predict uptake given a set of job characteristics.

Decentralization in health care

Brief analytical summaries or syntheses #18 Decentralization in health care Summary The Spring issue of Euro Observer looks at decentralization as a governance tool in health care. Case studies on Norway, Spain and the United Kingdom (U.K.) highlight how decentralized arrangements work in practice in these countries. Background A common challenge across most countries in Europe is finding the appropriate level for the making and implementation of policy and administration, particularly in health care. Many countries have decentralized, recentralized and then decentralized again in an ongoing cycle, searching the right balance of efficiency and responsiveness in their health care system. Looking at the arguments for and against, in many cases the same reasons are used to justify movement in opposite directions. This issue of Euro Observer looks at whether decentralization is purely a politically driven phenomenon or the wrong instrument used for the right objective. The debate about decentralization is…

A new look at OECD health care systems: Typology, efficiency and policies

Brief analytical summaries or syntheses #19 A new look at OECD health care systems Typology, efficiency and policies Summary This 2011 edition of the OECD’s Economic Policy Reforms features a chapter on health care (Chapter 6), a key contributor to individual wellbeing and an important driver of long-term economic growth. The OECD has assembled a new cross-country comparative data on health policies and health care system efficiency, which shows that there is room in all countries surveyed to improve the effectiveness of their public health care spending. Background Rising health care spending is putting pressure on government budgets. Governments will have to make their health systems more efficient if they are to maintain quality without putting further stress on public finances. The OECD has assembled new comparative data on health policies and health care system efficiency for its member countries. These show that all countries surveyed can improve the effectiveness…

Canada — Health Care in a Renewed Federalism

In this paper, Tom Kent argues that confusion and conflict in the Canadian fiscal federalism are inhibiting nation-wide economic, social and environmental policies of which Canada has urgent need. The impending negotiation of new financing arrangements for Medicare can be the occasion for a wide reshaping of federal-provincial relations.

Canada — Eight out of 10 Canadians receive priority area procedures within recommended wait times

At least 8 out of 10 Canadian patients are receiving priority area procedures, such as hip replacements, cataract surgery and cancer radiation treatment, within medically recommended wait times, according to a new study from the Canadian Institute for Health Information (CIHI). The study provides the first comprehensive national picture of how long Canadians wait for care in priority areas as compared with evidence-based benchmarks of acceptable waits. In 2010, more than 80% of Canadian patients received hip replacements (84%) and cataract surgery (83%) within wait time benchmarks, while the proportion of patients receiving knee replacements and hip fracture repairs within recommended waits was slightly lower, at 79% and 78%, respectively. Almost all (98%) Canadians who needed radiation treatment received it within the clinically recommended time frame.

Canada — Government policies restricting medical training mean Canada's physician shortage will worsen; recruiting foreign doctors a necessary short-term solution

Canada’s physician shortage will grow worse in coming years because of ill-conceived policies on physician supply, says a new article published by the Fraser Institute. In the article, Nadeem Esmail examines the evolution of Canada’s physician supply over time and projects what could happen in the coming years, taking into account factors such as population growth and Canada’s aging workforce.

USA — Review of recent studies shows predominantly positive results for health information technology

A study completed by the Office of the National Coordinator for Health Information Technology (ONC) and published in the journal Health Affairs finds growing evidence of the benefits of health information technology (HIT). Using methods that were employed by two previous independent reviews, the new study finds that 92 percent of articles on HIT reached conclusions that showed overall positive effects of HIT on key aspects of care including quality and efficiency of health care.

Australia - Release of draft eHealth Legislation

On September 30, 2011, Australia’s Minister for Health and Aging Nicola Roxon released proposed legislation on eHealth records for public consultation. The draft legislation outlines how consumers, healthcare organizations and data repositories will be incorporated into the eHealth system. It also establishes an independent advisory council and institutes a strict security regime to protect patient privacy.

Europe - Social Security and Health Services in EU Law: Towards Convergence or Divergence in Competition State Aids and Free Movement?

This working paper, published in March 2011 by the Robert Schuman Centre for Advanced Studies (RSCAS) in Florence, looks at the regulation of social security and health care in European Union (EU) law and the quest for balance between conflicting interests. It discusses state and market issues, European social and mobility rights, the distribution of competencies, and EU states’ autonomy over redistribution within their borders.

Canada - Prescription renewals by pharmacists, enhanced home care services for seniors and expanded addiction and mental health services are just some of the benefits for Albertans in the 2012-13 Health and Wellness budget

On February 9, 2012, the Government of Alberta released details of the Ministry of Health and Wellness’s 2012-13 budget. Total spending is $16 billion, an increase of $1.2 billion or 7.9% from 2011-12. Home care, rehabilitation and chiropractic services, mental health programs, and support for rural pharmacies all receive additional funding.

Canada - Canadian Primary Healthcare Policy: The Evolving Status of Reform

This report from the Canadian Health Services Research Foundation (CHSRF) provides an update on the current status of primary health care policy and reform across Canada. Much work has been undertaken since the late 1990s in the context of service integration and health system reform, but there is some impatience with the slow pace of change. This study was undertaken to allow decision-makers to better understand the current picture, consider the legitimacy of significant recent primary health care investments and showcase and promote positive change and progress. It also enables scrutiny of what might not be working in Canadian primary health care today.

International - Paying for “End-of-Life” Drugs in Australia, Germany, and the United Kingdom: Balancing Policy, Pragmatism, and Societal Values

This edition of Issues in International Health Policy analyses British, German, Australian and American policies on the coverage of costly life-extending medicines. For Europe and Australia, the challenge is to pay for medicines through publicly-funded systems without undermining core principles. In the U.S., the goal is to ensure the sustainability of Medicare and the private insurance market without restricting choice.

Assessing initiatives to transform healthcare systems:Lessons for the Canadian healthcare system

Brief analytical summaries or syntheses #25 Assessing initiatives to transform healthcare systems Lessons for the Canadian healthcare system Summary Canada has invested significant financial resources and energy (including numerous federal and provincial commissions) in efforts to make the healthcare system more responsive to evolving needs. Nonetheless, there is general consensus that Canada’s healthcare systems have been too slow to adapt. This paper suggests avenues that governments can take to support the transformation of the healthcare system to provide better care and services. Background This paper suggests that money alone cannot improve healthcare. A clear vision and a coherent set of strategies are required to transform the system and achieve better alignment between the care offered and the care the population needs today (primary healthcare, more effective management of chronic diseases, mental health, etc.). Canada has invested significant financial resources and energy (including numerous federal and provincial commissions) in efforts to…

Canada - Number of physician assistants set for "dramatic growth," report predicts

A new report says that Canadian health care is poised for a period of dramatic growth in the number of physician assistants it employs. The report, published by the Journal of the American Academy of Physician Assistants (JAAPA), indicates that the new profession is expanding rapidly within provincial health systems.

Austria - Entry and exit of physicians in a two-tiered public/private health care system

The authors of this paper analyze the entry and exit decisions of physicians working in the private outpatient sector of the Austrian health care system. The outpatient sector of the health care system in Austria is characterized by a strict separation of private and public physicians.

Subnational health spending and soft budget constraints in OECD countries

Brief analytical summaries or syntheses #3 Subnational health spending and soft budget constraints in OECD countries Summary Government spending on health has grown as a percent of GDP over the last 40 years in industrialized countries. Widespread decentralization of healthcare systems has often accompanied this increase in spending. This paper explores the effect of soft budget constraints on subnational health spending in a sample of OECD countries. It finds that countries where subnational governments rely primarily on central government financing and enjoy large borrowing autonomy have higher healthcare spending than those with more restrictions on subnational government borrowing. Background There has been a tendency toward decentralization in the health systems of OECD member countries over the last 40 years. The tendency reflects government desire to bring fiscal decisions closer to voter preferences and to improve the efficiency of transfer payments. Subnational spending makes up a large portion of total healthcare…

Canada - McGuinty Government Helps Recruit More Doctors

Ontario is improving access to health care with two new programs that will help communities that have traditionally had the hardest time recruiting doctors. The province is introducing: 1. The Northern and Rural Recruitment and Retention Initiative, which will provide grants to doctors and new doctor graduates who agree to practise in a northern or highly rural community. 2. The Postgraduate Return of Service Program, in which international medical graduates agree to practise for five years in any Ontario community, except the Toronto area and Ottawa, in exchange for postgraduate training opportunities. Previously, these doctors were restricted to practising in rural and northern communities for five years, following graduation.

Canada - Simple tool identifies patients who may need closer monitoring after leaving hospital

Canadian researchers have developed a simple tool to predict the probability that a patient discharged from hospital to the community will die or be unexpectedly readmitted within 30 days. The study, published in the Canadian Medical Association Journal, could help identify patients who may benefit from closer monitoring and care, so that serious health problems can be prevented.

USA - Health Care Reform. A Collection of Articles on U.S. Health Care Reform

Victor R. Fuchs is the Stanford economics professor who is the dean of American health economists and is best known for his thoughtful book Who Shall Live? In just the past two years he has written 12 short articles that have appeared in such prestigious publications as the Journal of the American Medical Association (JAMA), New England Journal of Medicine and Health Affairs: Eliminating “Waste” in Health Care, Four Health Care Reforms for 2009, Cost Shifting Does Not Reduce the Cost of Health Care, The Proposed Government Health, Insurance Company — No Substitute for Real Reform, Reforming US Health Care – Key Considerations for the New Administration, Health Reform: Getting The Essentials Right, Health Care Reform — Why So Much Talk and So Little Action?, Three “Inconvenient Truths” about Health Care, The Perfect Storm of Overutilization, Who Really Pays for Health Care? The Myth of Shared Responsibility, What Are The…

International - Health Systems Institutional Characteristics: A Survey of 29 OECD Countries

In 2008, the OECD launched a survey to collect information on the characteristics of member countries' health systems. This paper presents the information provided by 29 of these countries in 2009. It describes country-specific arrangements to organise the population coverage against health risks and the financing of health spending. It depicts the organisation of health care delivery, focusing on the public/private mix of health care provision, provider payment schemes, user choice and competition among providers, as well as the regulation of health care supply and prices. Finally, this document provides information on governance and resource allocation in health systems (decentralisation in decision making, nature of budget constraints and priority setting).

Canada - Health Indicators 2010

Health Indicators 2010, the 11th in a series of annual reports, presents the most recent health indicator data from the Canadian Institute for Health Information (CIHI) and Statistics Canada on a broad range of measures. As in the past, the report seeks to answer two important questions: “How healthy are Canadians?” and “How healthy is the Canadian health system?” Health regions and other stakeholders may use this information to identify areas where improvements are needed and to learn from jurisdictions with the best outcomes.

Recentralization tendencies within healthcare services: Implementation of a new idea ?

Brief analytical summaries or syntheses #9 Recentralization tendencies within healthcare services Implementation of a new idea? Summary Decentralization has been a widespread trend in European health sectors for many years. More recently, however, a new set of reforms is observable, implying ambitions to regain lost control. This paper by Renate Minas, Associate professor of Social Work at Stockholm University in Sweden, looks at what this general trend toward recentralization is about and what happens when reforms promoting recentralization are implemented in different national contexts. The establishment of regional health authorities in Norway and regional hospital agencies in France are used as examples to analyze the spread of recentralization reforms. Background General context of health care Health care is a highly political area, subject to intense negotiations on the distribution of power and resources between the institutions responsible for financing, planning and delivering health services. Pressures to control spending and increase…

Financing long-term care in Scandinavian countries

Brief analytical summaries or syntheses #7 Financing long-term care in Scandinavian countries Summary This paper by two researchers from the Department of Health Management and Health Economics at Oslo University compares and analyzes the systems for financing long-term care for older people in Scandinavian countries (Denmark, Norway and Sweden). The institutional setup is almost identical in the three countries local government carries the main responsibility for the funding and provision of long-term care, and national government defines general goals and principles for the locally provided services. The study shows that individuals are highly dependent on their savings to pay for long-term care services, which does not correspond to aspirations of accessibility. As well, there is significant regional variation in the level of services provided, which is in direct contrast with the political goals of universality in these countries. Background Policy objectives The three Scandinavian countries share common political traditions of…

Opportunities and challenges in measuring the quality of care in England

Brief analytical summaries or syntheses #5 Opportunities and challenges in measuring the quality of care in England Summary Greater use of quality measurement in the National Health Service (NHS) has real potential for improving quality of care, efficiency and productivity. Changes in the economic climate in England since the publication of the NHS Next Stage Review in 2008 are challenging healthcare authorities to achieve demonstrable improvements in outcomes for patients but also greater productivity and efficiency. This paper sets out the issues that need to be considered in developing and using indicators to measure quality. It attempts to define what is meant by ‘quality’ in health care, examine initiatives likely to improve quality and identify not only the potential benefits of quality indicators, but also the complexities and challenges involved in their implementation. Background The transition from an NHS focused on targets, activity volumes and waiting times to one focused…

World Health Report 2010
Health systems financing: The path to universal coverage

Brief analytical summaries or syntheses #10 World Health Report 2010 Health systems financing The path to universal coverage Summary The 2010 World Health Report presents practical guidance on ways to finance health care. It describes different options for changing healthcare financing systems in order to move towards universal coverage and maintain gains that have been achieved to date. The report draws on evidence and lessons from a number of different countries. Background Promoting and protecting health is essential to human welfare and sustained economic and social development. This was recognized more than 30 years ago by the Alma-Ata Declaration signatories, who noted that Health for All would contribute both to a better quality of life and also to global peace and security. In this context, timely access to health services is critical. This cannot be achieved, except for a small minority of the population, without a well-functioning health financing system.…

Canada - Bridging the Gap. Building Collaborative Foundations for an Effective and Efficient Health Care System

In its brief to the Standing Committee on Finance, Bridging the Gap, Building Collaborative Foundations for an Effective and Efficient Health Care System, the Royal College of Physicians and Surgeons of Canada identifies priorities for investments in health care that will contribute to a healthier society, better patient care, enhanced systems and improved productivity. The Royal College makes four recommendations to be included in the next federal government budget: 1. Leverage investment in human resources for health by laying the groundwork to create a pan-Canadian observatory to help jurisdictions optimize their expenditures in human capital; 2. Invest in health and health care research funding and enhance our ability to recruit and retain leading health, scientific and biomedical researchers; 3. Promote and support innovation in the delivery of high-quality health care to promote Canada as a leader in medical practices, innovation and best practices; and 4. Invest in the health and…

International - Sub national Health Spending and Soft Budget Constraints in OECD Countries

Government spending on health has grown as a percent of GDP over the last 40 years in industrialized countries. Widespread decentralization of healthcare systems has often accompanied this increase in spending. The authors of this paper explore the effect of soft budget constraints on sub national health spending in a sample of OECD countries. The authors of the study find countries where sub national governments rely primarily on central government financing and enjoy large borrowing autonomy have higher healthcare spending than those with more restrictions on sub national government borrowing.

USA — Implementing Health Reform: Federal Rules & State Roles

Implementing the new health reform law falls in large measure to the federal government. But all 50 states and the District of Columbia have responsibilities under the new law. This issue brief describes how some key tasks to be performed by each and how state government implementation efforts will mesh.

Canada - McGuinty Government Proposes New Rules, Higher Standards for Broader Public Sector

Ontario is proposing strict new rules that would prevent organizations funded with taxpayer dollars from using public funds to hire external lobbyists to ask for more funding. The proposed Broader Public Sector Accountability Act would, if passed, bring in new rules and higher accountability standards for hospitals, Local Health Integration Networks (LHINs) and the broader public sector around the use of external lobbyists, consultants and expenses. Hospital and LHIN executives could see reductions in pay, should they fail to comply with the requirements under the proposed Act. In addition to ending the use of taxpayer dollars to hire lobbyists, the new rules would: 1. Expand Freedom of Information legislation to cover hospitals, 2. Require hospitals and LHINs to post expenses of senior executives online, 3. Require hospitals and LHINs to report annually on their use of consultants.

Australia - Industry champions national telehealth strategy for Australia

The Health Informatics Society of Australia released a first national telehealth strategy. The paper is the work of the Australian National Consultative Committee on e-Health, which represents major ICT industry players and stakeholders.

Canada - New journal to offer best available evidence on Canadian health care reforms

Health Reform Observer – Observatoire des Réformes de Santé is a new open access, peer-reviewed, online journal publishing concise, plain-language analyses of individual health reforms related to the governance, financing and delivery of health care in the Canadian provinces and territories, as well as in-depth, cross-issue and cross-jurisdictional “roll-ups” of these reforms. Launched in May 2013, the journal is actively seeking submissions and building its list of reviewers.

Canada - Report Card on Wait Times in Canada : Progress Has Stalled

Canadians are waiting as long, if not longer, than previous years for medical care, the eighth report card issued by the Wait Time Alliance has concluded. The 2013 WTA report card, entitled "Time for transformation: Canadians still waiting too long for health care," gives Canadians a picture of how long they have to wait to access a broad range of medical procedures and services.

Canada - Health apps, virtual visits and remote monitoring - Canadians looking to manage their health one click at a time: PwC report

In this report, PwC surveys Canadians about their attitudes toward and use of virtual health technologies in their own care or for someone they care for. Two-thirds of Canadians would consider using the technologies and the top motivators include convenient access to a physician, ability to obtain information, and greater control over one's health. One third believe that mobile apps will make health care more convenient in the next three years.

USA - The Evolving Role of Emergency Departments in the United States

This RAND Corporation project was performed to develop a more complete picture of how emergency departments (EDs) contribute to the US health care system. It explores the evolving role that hospital EDs play in evaluating and managing complex and high-acuity patients, serving as the major portal of entry to inpatient care, and providing “the safety net of the safety net” for patients who are unable to get care elsewhere.

Canada – Health Indicators 2013

Before Health Indicators moves to interactive, digital reporting in the spring of 2014, this final report in the 14-year series presents the initial objectives of the CIHI–Statistics Canada Health Indicators project and some accomplishments in reporting on the performance of the health system and on the health of Canadians. It also introduces a new program of work that CIHI initiated to support Canadian jurisdictions’ efforts to stimulate health system performance.

Europe - New Action Plan agreed for innovative cross-border healthcare

European Union (EU) health ministers attending the May 2013 EU Ministerial eHealth Conference in Dublin agreed on a new ehealth action plan and Declaration on eHealth. These aim to prioritize the use of cross-border health information and communications technology (ICT) within the EU.

Canada - Health care reforms not keeping pace with needs of Canadians, says report

The Health Council of Canada progress report highlights five key areas: wait times, primary health care and electronic health records, pharmaceuticals management, disease prevention/health promotion and Aboriginal health. It finds significant variability across Canada and shortcomings in many areas. To achieve better health care for all Canadians, the report calls for governments to set clear policy goals with clear lines of responsibility, to continue the spread of innovative practices, and to support collaborative efforts across all jurisdictions, including the federal government.

International - World Bank Group President Urges Countries to Deliver Universal Health Coverage to Help End Poverty

According to worldwide estimates, out-of-pocket health spending forces 100 million people into extreme poverty every year and inflicts severe financial hardship on another 150 million people. At the World Health Assembly held on May 21, 2013, Jim Yong Kim, President of the World Bank Group, called on countries to ensure universal access to quality, affordable health services.

New Zealand - New health data will help drive improvements in patient safety

This report from the Health Quality and Safety Commission of New Zealand provides data on the quality and safety of care in each District Health Board (DHB). Measures include falls, healthcare-associated infections, hand hygiene and perioperative harm and enable comparison between different DHBs and a view of progress made in each against baseline measures.

New Zealand - Targeting Waiting Times

This report published by New Zealand’s Health Ministry examines how that country’s district health boards are achieving three patient access targets — briefer emergency department stays, improved access to elective surgery, and shorter wait times for cancer treatment. Nine case studies describe initiatives, innovations and organizations that contribute to improvements.

Canada - Supporting Research and Innovation in Health Technology Sector. Ontario Creates New Council to Study Sector Innovation

This council, established by the Ministry of Research and Innovation, will help to enhance the province's world renowned health technology sector by developing recommendations to identify opportunities for Ontario's small- and medium-sized businesses, adapt best practices of other jurisdictions, and expand the adoption of new technologies across health care settings.

Brazil - Interregional Performance of the Public Health System of a High-Inequality Country

In the decentralized Brazilian health system, the country’s 27 federal units (FUs) are responsible for health care in their jurisdictions. This study examines the efficiency of individual FUs and explores the overall performance of the health system in a country with high rates of social and health inequality.

Australia - Health in Australia: A Quick Guide

Australia’s health system arrangements are a mix of public and private funding involving blurred lines of jurisdictional responsibility, multiple providers, and different regulatory regimes. This guide provides an overview of the country’s complex health system, identifying the role of government and private health insurance, and giving information on funding and outcomes.

Lunch hour conferences 2012

Why a good idea as the integration of services is taking so long to implement ? May 25, 2012 By Yves Couturier, holder of Canada Research Chair in Professional Integration Practices of Gerontology Services, Université de Sherbrooke Louis Demers, professor, École nationale de santé publique Francis Etheridge, doctoral student and organizational change specialist This conference will address the results of a study on the implementation status of Quebec’s project to integrate services in three health and social services centres and will allow to reflect on the conditions that affect the ability of institutions to fully achieve the outcomes of the reform. It will also present the opportunity to discuss a new research project aimed at better understanding the role of health and social services agencies in Quebec and health agencies in France in the context of services integration. [b][i]Strategies for implementing quality indicators for primary care health service professionals and…

UK - Helping the NHS to provide better care and to improve health services

The National Health Service (NHS) in England will be collecting basic information from electronic medical records to improve the way health care is delivered. Strict rules govern how information is stored and used and patients can request that their information not be shared outside their GPs practice.

Canada - Simple tool identifies patients who may need closer monitoring after leaving hospital

Canadian researchers have developed a simple tool to predict the probability that a patient discharged from hospital to the community will die or be unexpectedly readmitted within 30 days. The study, published in the Canadian Medical Association Journal, could help identify patients who may benefit from closer monitoring and care, so that serious health problems can be prevented.

New Zealand - The quest for integrated health and social care. A case study in Canterbury, New Zealand

This paper published by the King's Fund describes the journey made by the District Health Board for Canterbury, New Zealand, towards its goal of providing integrated care for all. It looks at the drivers for change and the leadership values shown by key players. Important success factors were the goal of one system-one budget, and the spread of leadership from a few to the collective.

USA - HHS announces 2013 agenda to bring down costs and improve quality of care through implementation of health information technology

The US Department of Health and Human Services (HHS) has announced a new agenda to accelerate health information exchange (HIE) and build a secure flow of information across the system. The HHS will emphasize interoperability, implement new rules on data exchange, ensure program security, and work to enhance the effective use of electronic health records.

Canada – Québec-China third call for proposals

The governments of Quebec and China announced the launch of a third call for Québec-China proposals for collaboration in research and innovation. Two research projects will be supported financially: one in the field of information and communications technology (ICT) and one in the field of life sciences.

Canada - One in 12 patients readmitted to Canadian hospitals within 30 days - Study examines who is returning and why

This study, undertaken by the Canadian Institute for Health Information (CIHI) and called All-Cause Readmission to Acute Care and Return to the Emergency Department, included more than 2.1 million hospitalizations across the country. It looked at surgical, medical, pediatric and obstetric patients to better understand who returned to acute care after discharge and for what clinical reason. It found that soon after their discharge from hospital, more than 180,000 Canadians were readmitted to acute care in 2010. And in some jurisdictions, nearly 1 in 10 acute care patients returned to the ED within seven days of hospital discharge.

Switzerland - Fiscal federalism and income redistribution through healthcare financing: an empirical analysis for the Swiss cantons

Studies have viewed Swiss healthcare financing as regressive because of jurisdictional imbalances. This paper from the Swiss Centre for Economic and Political Research on Aging (CEPRA) explores differences in healthcare financing across regional canton governments. It concludes that variations in equity across Swiss cantons remain significant.

Financial sustainability and affordability of health care systems. Lessons from OECD countries

Brief analytical summaries or syntheses #46 Financial sustainability and affordability of health care systems. Lessons from OECD countries Summary This presentation by Mark Pearson, head of the Health Division at the OECD, reviews how health spending has been affected during the economic crisis in various countries. the author makes some recommendations on how policy should react. The presentation was delivered at the International Conference of Social Security Actuaries and Statisticians that took place in Berlin from May 30 to June 1, 2012. Background The problem facing many European health systems is one of fiscal unsustainability. Claims that health spending is good value for money compared to many other things that people purchase are beside the point. Fiscal sustainability needs to be restored in the short term and once this is done, there will still remain the longer-term challenge of ensuring economic sustainability, which requires a different agenda of policies –…

Canada - Report Card on Wait Times in Canada

The absence of a concerted national effort to reduce wait times is undermining progress on addressing the time lags endured by Canadians needing medical care, warns the Wait Time Alliance (WTA). The 2012 WTA report card gives Canadians a picture of how long they have to wait to access a broad range of medical procedures and services. In a reversal from past years, the 2012 Report Card shows a decline in performance for patients receiving care in the five areas identified as priorities by federal, provincial and territorial governments under the 2004 Health Accord.

Telehealth : what can the NHS learn from experience at the U.S. Veterans Health Administration?

Brief analytical summaries or syntheses #35 Telehealth what can the NHS learn from experience at the U.S. Veterans Health Administration? Summary Published on the website, this comparative study examines the largest implementation of telehealth anywhere, the Veterans Health Administration in the U.S. With the British government's announcement of the positive results of the Whole System Demonstrators and the launch of the 3 Million Lives Programme, this report is timely as U.K. stakeholders plan how to implement telehealth widely and deliver significant benefits. Background As a large publicly funded system delivering comprehensive services to a veteran population of 23m and with an annual budget of over £30bn, the VHA has many parallels with the NHS. Extensive studies show that the VHA consistently provides a better quality of care than other health systems in the U.S., and at a lower cost. Central to its strategy of ‘keeping patients healthy’, the VHA…

International - Consumers Are Ready to Adopt Mobile Health Faster than the Health Industry is Prepared to Adapt, Finds PwC Study on Global mHealth Adoption

This report, conducted by the Economist Intelligence Unit (EIU) for PwC, examines the current state and potential of mHealth (the provision of healthcare or health-related information through the use of mobile devices) and the barriers to adoption and opportunities for companies seeking growth in the mHealth market. The report includes findings of two surveys conducted by the EIU: one of consumers and one of physicians and government and private payers in 10 markets, including Brazil, China, Denmark, Germany, India, South Africa, Spain, Turkey, the UK and the US.

Health policy responses to the financial crisis in Europe

Brief analytical summaries or syntheses #47 Health policy responses to the financial crisis in Europe Summary This August 2012 report by the Health Evidence Network (HEN) identifies key challenges for European health policy makers in the wake of the ongoing financial crisis. The report focuses on responses to essential service cuts and interruptions in revenue streams, as well as on inefficiencies and exacerbations of adverse effects evident in national health systems. Background The global financial crisis that began in 2007 can be classified as a health system shock – that is, an unexpected occurrence originating outside the health system that has a large negative effect on the availability of health system resources or a large positive effect on the demand for health services. Economic shocks present policy-makers with three main challenges Health systems require predictable sources of revenue with which to plan investment, determine budgets and purchase goods and services.…

Shared-savings payment arrangements in health care. Six case studies

Brief analytical summaries or syntheses #48 Shared-savings payment arrangements in health care. Six case studies Summary American shared-savings programs are an alternative approach to paying health care providers. Providers receive a share of savings achieved by reducing costs for care. This Commonwealth Fund paper presents six case studies of pilot shared-savings programs. Background One of the most talked-about new ideas in health care is rewarding providers for reducing medical spending by giving them a share of the net cost savings. Driven by an interest in seeing medical homes and other providers shift to some form of performance-based payment, as well as by the Affordable Care Act’s push for "accountable care," shared-savings approaches are currently being tested by numerous payer and provider organizations across the United States. A previous Commonwealth Fund policy brief summarized 27 examples of shared-savings initiatives and found wide variation in how participants implemented such initiatives. These variations…

Canada - How do Quebec primary care physicians rate the health system?

The Commissaire à la santé et au bien-être du Québec collaborated with the Commonwealth Fund and the Canadian Health Council to present survey data on the Quebec health care system. The 2012 survey collected information from primary care physicians in Quebec and compared it to other Canadian and international jurisdictions. Quebec physicians have a rather negative perception of the health system and more than half indicate deterioration in the quality of care over the last three years.

UK - Big picture challenges for health and social care: implications for workforce planning, education, training and development

Produced by the Centre for Workforce Intelligence, this project report describes overall challenges facing England’s health and social care system, and their implications for education and training in the health system. The project offers the opportunity to move away from professional silo thinking about workforce planning by looking at overarching challenges in a sectoral context.

Finland - eHealth and eWelfare of Finland - Checkpoint 2011

This report was produced by the National Institute for Health and Welfare, Finland, and FinnTelemedicum, from the results of the national eHealth implementation survey. It describes the status and trends in health care information and communication technology and eHealth usage in Finland in 2011, comparing the results with earlier surveys carried out in 2003, 2005 and 2007.

Canada - Doctors’ pay still growing, but slower than before

The Canadian Institute for Health Information (CIHI) reports that payments for physician services grew by 6% in 2010–2011, less than the growth seen in 2008–2009 (9.7%) and 2009–2010 (7.9%). Spending on physicians remains the third-largest source of health care spending, behind hospitals and drugs. For the first time, this year’s annual report on physician compensation, National Physician Database, 2010–2011, presents the average gross clinical payment per physician, including fee-for-service payments and alternative payments, providing a more comprehensive picture of how much doctors are paid. Previously, CIHI’s average payment indicators were based on fee-for-service payments only.

Re-orienting health systems : Towards modern, responsive and sustainable health promoting systems

Brief analytical summaries or syntheses #55 Re-orienting health systems Towards modern, responsive and sustainable health promoting systems Summary This position paper from EuroHealthNet is the culmination of a policy dialogue process with stakeholders, experts and European Union (EU) institutions to identify key contributions to sustainable health systems across Europe. The paper frames its findings in the context of the EU 2020 Europe strategy for continental growth. Background The sustainability of national health systems is a core concern of the European Member States, the European Commission, and the World Health Organisation. As early as 2001, the European Commission identified ‘financial viability’ as one of three long-term objectives for national health systems, along with accessibility and quality. Since then, the development of high-quality, accessible and sustainable services has been in the spotlight of different EU policy agendas social protection, public health, and economic and financial affairs. Initially, the issue was incorporated in…

USA - HHS Health IT Safety Plan open for public comment

In December 2012, the US Department of Health and Human Services (HHS) released the Health IT Patient Safety Action and Surveillance Plan, a report on the ways health information technology can eliminate medical errors, improve quality of care, and make health care more efficient. The plan builds on a 2011 report from the Institute of Medicine (IOM).

UK - NHS services, seven days a week - costing seven day services. The financial implications of seven day services for acute emergency and urgent services and supporting diagnostics

This report assesses the financial consequences of introducing seven-day service for acute and emergency care and supporting diagnostics into Britain’s National Health Service (NHS). The costs of implementing seven-day services are predicted to be 2% of a local health authority’s total income. Introducing seven-day services would reduce mortality and provide easier access to health care.