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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)…

Canada - Measuring the Level and Determinants of Health System Efficiency in Canada

What factors affect the efficiency of Canada’s health system? Why are some of Canada’s health regions more efficient than others? The Canadian Institute for Health Information (CIHI) examines these and other questions in a new report from the Canadian Population Health Initiative: Measuring the Level and Determinants of Health System Efficiency in Canada. Building on findings from the CIHI report Developing a Model for Measuring the Efficiency of the Health System in Canada, this study uses a made-in-Canada model to measure health system efficiency and shed light on the factors that help explain variations in efficiency across Canada’s health regions. Complementary products are available in addition to the full report, including a public summary and an Analysis in Brief that highlights the key findings.

National health expenditure trends in Canada, 1975 to 2010

Brief analytical summaries or syntheses #12 National health expenditure trends in Canada, 1975 to 2010 Summary Healthcare spending in Canada is expected to reach $191.6 billion this year, an estimated increase of $9.5 billion, or 5.2%, over 2009 spending, according to figures recently published by the Canadian Institute for Health Information (CIHI). This represents an increase of $216 per Canadian, bringing total health expenditure per capita to an estimated $5,614 this year. After adjusting for inflation and population growth, spending on health care is expected to grow by 1.4% in 2010, the lowest annual growth in 13 years. Background Both the public and private sectors finance Canada’s health system. Public sector funding includes payments by governments at the federal, provincial/territorial and municipal levels and by workers’ compensation boards and other social security schemes. Private sector funding consists primarily of health expenditures by households and private insurance firms. The CIHI tracks…

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 - Canada ranks 10th in population health among 17 countries in The Conference Board of Canada’s 2012 Health report card

The Conference Board’s Health Report Card assesses the overall health status of Canadians against that of citizens in 16 other industrialized countries on 11 indicators. Canada receives a “B” grade overall. Canada earns “A” grades on self-reported health status, mortality due to circulatory diseases and premature mortality. Canada receives “B” grades on mortality due to mental disorders and respiratory diseases, and a “C” grade on mortality due to musculoskeletal diseases, cancer and diabetes. Japan, Switzerland, and Italy earned overall “A” grades in this year’s Health Report Card.

Canada - Innovative practices from coast to coast to coast now fully integrated in the Leading Practices Database at Accreditation Canada

On February 17, 2014, Accreditation Canada completed the integration of the contents of the Health Innovation Portal (developed and launched by the Health Council of Canada 2012) with its own Leading Practices Database. The Database features more than 900 innovative practices submitted from health care organizations across Canada.

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 - Canada invests $500 million in electronic health record (EHR) systems with a focus on physicians and nurse practitioners across Canada

Canadian physicians and nurse practitioners will benefit from a $500 million investment made by the Government of Canada in Budget 2010, announced Richard Alvarez, President and CEO of Canada Health Infoway (Infoway). Of the total amount allocated to Infoway, $380 million of the new money will be directed to speed up the implementation of electronic medical record systems.

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.

Canada - Canada's International Health System Performance Over 50 years: Examining Potential Years of Life Lost

This report and accompanying web tool compare Canada's international performance in premature mortality — measured by potential years of life lost (PYLL) — with the performance of 17 other high-income countries in the Organisation for Economic Co-operation and Development (OECD) from 1960 to 2010. The report examines how Canada performed overall on PYLL, how Canadian men and women performed in relation to men and women internationally and how Canada performed on 4 specific causes of premature mortality (cancer, heart disease, stroke, and deaths due to external causes).

Canada - International Comparisons at CIHI

This report from the Canadian Institute for Health Information (CIHI) presents various measures of how health care in Canada compares to that in other countries, and discusses CIHI's contribution to international data and knowledge production. The report highlights some key comparisons in clear graphic form: Canada spends 10% of its GDP on health, compared to the OECD average of 9%; Canada is above average in reducing premature mortality, especially among men; Canada is in the middle of the pack on combined measures of health status, determinants of health, quality of care, patient safety and access to care.

Canada - Doctor Shortage Much More Severe in Canada’s North

Canada’s doctor shortage is far worse in the North than in the South. Where the population-to-physician ratio in the South is usually 400 or 500 to one, the ratio across the North can be 2,000 or even 3,000 to one, depending on the Northern region in question. The Conference Board of Canada’s Somebody Call a Doctor map is part of an ongoing Centre for the North series, which illustrates similarities and differences between Canada’s North and South and among Northern regions.

Canada - Critical Condition: A Historian’s Prognosis on Canada’s Aging Healthcare System

Reforms to reduce the fiscal burden of Canada’s public healthcare costs should preserve the core value of equal access, while evolving away from universality, according to the author of the C.D. Howe Institute’s 2010 Benefactors Lecture, released recently. In Critical Condition: A Historian’s Prognosis on Canada’s Aging Healthcare System, Michael Bliss, Professor Emeritus of the University of Toronto, reviews the history of Canada’s healthcare system and draws lessons for future reforms.

Canada - Home Care in Canada: Advancing Quality Improvement and Integrated Care

This report from Accreditation Canada and the Canadian Home Care Association tracks the evolution of home care in Canada and highlights results achieved in the context of Accreditation Canada's QMENTUM program. It features tools to assess governance and safety culture, presents best practices and looks at future directions.

Canada - Should Canada's Hospitals Open Their Doors to Medical Tourists? Health Care in Canada: An Economic Growth Engine

This Conference Board briefing describes the current state of medical tourism in Canada and internationally and looks at potential advantages and risks for Canada's hospitals and healthcare system. It also presents thoughts on ways to ensure that it would make a positive contribution were it developed further.

Canada - Implementing Choosing Wisely Canada Recommendations in Ontario to Improve Quality of Care

Choosing Wisely Canada is clinician-led campaign to help patients and healthcare providers engage in conversations about unnecessary care. This report from Ontario highlights provincial and local initiatives across three sectors (hospital, long-term and primary care) to improve quality of care by implementing Choosing Wisely Canada recommendations. The report provides an overview of resources and support tools available in Ontario.

Canada - Costs of Treating Pneumonia Will More Than Double By 2025

A report by the Conference Board of Canada says the cost of treating pneumonia and the number of hospitalized cases will rise dramatically in Canada by 2025 due to the aging of the population. The report, co-sponsored by the Canadian Alliance for Sustainable Health Care and Pfizer Canada estimates the number of pneumonia cases requiring hospitalization will double to 49,400, while treating the disease will cost over $530 million annually by 2025. Increasing vaccination is recommended to control the cost burden.

Canada - Public Health Observatories: Learning From our World neighbours

In November 2008, seven representatives from Canada’s Public Health Observatory (PHO) community attended the “Health Observatories: Learning from Our World Neighbours, 2008” meetings hosted by the London Public Health Observatory, in London and Newcastle, England. The purpose of the tour was twofold: to understand in greater depth Public Health Observatories; and, through sharing Canada’s PHO progress to date, explore the possibility of establishing an Observatory network between Canada’s nascent Association of Population Health Observatories (CaNPHO), the United Kingdom’s established Association of Public Health Observatories (APHO), and APHO’s European partners. The document provides an overview of England’s Public Health and Theme-based Observatories, as well as the UK’s Association of Public Health Observatories (APHO). The document also briefly profiles the Canadian Public Health Observatories and technologies showcased during the tour.

Canada - Increasing the Use of Physician Assistants Could Lead to Significant Cost Savings for the Canadian Health Care System

Hiring more physician assistants (PAs) and effectively integrating them into health care teams could save the Canadian health care system millions in efficiency gains, according to a new report released by The Conference Board of Canada. Canada’s health care system cost Canadians $219 billion in 2015, and hospital, drugs and physician services accounted for 60 per cent of this spending. Physician assistants (PAs) could help lower Canada’s health care spending, by completing more routine tasks and freeing up physicians’ time.

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 — Innovation Procurement in Health Care: A Compelling Opportunity for Canada

Governments are the largest purchasers of health care products and services in Canada. Procurement —what governments and public institutions buy and how they buy it—therefore offers huge potential to improve health system performance and value. But a Conference Board of Canada report finds that Canadians are still hesitating, while others, notably the United Kingdom, use new approaches to procurement to drive fundamental improvements in public health care. The report calls for action on four fronts to seize these opportunities: federal leadership; targeted funding; regional implementation; and culture and attitudes.

Canada - Euro-Canada Health Consumer Index 2010

This is the third annual Euro-Canada Health Consumer Index (ECHCI). The ECHCI is an international comparison of healthcare system performance in 34 countries. All 27 European Union member states are examined, along with Norway, Switzerland, Croatia, FYR Macedonia, Iceland, Albania and Canada. For the third straight year, the Netherlands finishes in first place in the ECHCI, earning 857 out of 1,000 possible points.

Canada — Curing the Chronic Healthcare Spending Disease: Four Tough Choices for Canadians

The amount Canadians spend on healthcare is set to rise rapidly over the next two decades and Canadians need to face up to tough choices to deal with this “spending disease,” according to a new C.D. Howe Institute study by David A. Dodge, former Governor of the Bank of Canada, and Richard Dion, a former economist at the Bank of Canada. The study examines the trajectory of total healthcare spending – public and private – in Canada and the policy choices Canadians must make in response.

Canada - Wait Times for Priority Procedures in Canada, 2016

Variations still exist in the percentage of patients receiving treatment within wait time benchmarks, depending on the province and the priority procedure. Priority procedures reported on include hip replacement, knee replacement, hip fracture repair, cataract surgery and radiation therapy. The overall number of priority procedures done continued to increase between 2011 and 2015, and about 8 out of 10 Canadians continued to receive their procedure within benchmarks. Wait Times for Priority Procedures in Canada, 2016, released by the Canadian Institute for Health Information (CIHI), provides a snapshot of wait times in Canada. Data on trends from 2008 to 2015 is available in CIHI’s online Wait Times tool, organized by province, health region and procedure.

Canada - Health Council of Canada report on decade of health reform finds governments’ status quo approach is failing Canadians

On September 19, 2013, the Health Council of Canada released its report "Better health, better care, better value for all," showing that a decade of health care reform in Canada has produced disappointing results for taxpayers and patients alike.

Canada - New report shows overuse of diagnostic imaging and inappropriate prescribing

A report released recently by the Health Council of Canada, Decisions, Decisions: Family Doctors as Gatekeepers to Prescription Drugs and Diagnostic Imaging in Canada , calls for better management of prescription drugs and diagnostic imaging services in this country. The report examines the increasingly complex role of family physicians and the effects of their decisions on usage of Canada’s health care services.

Canada - Changing Directions, Changing Lives: The first mental health strategy for Canada

This strategy is a culmination of the hard work and advocacy of thousands of people all across the country. It offers recommendations to improve mental health and well-being throughout Canada. It represents a blueprint for change and provides six strategic directions to improve mental health care in Canada.

Canada - Lack of Sustainable Funding a Barrier to Physician Assistant Employment in Canada

Although largely an area of untapped potential in most provinces, physician assistants (PAs) can help address many service gaps and health system policy goals, including improved continuity care, access, equity, and sustainability. But a new Conference Board of Canada report finds that the absence of sustainable funding models is a significant barrier for the expansion of PA employment across Canada.

Canada - Reality Bites: How Canada’s Healthcare System Compares to its International Peers

Canadian provincial healthcare systems fare poorly compared to peer countries according to new research from the C.D. Howe Institute. In “Reality Bites: How Canada’s Healthcare System Compares to its International Peers,” authors Colin Busby, Ramya Muthukaran and Aaron Jacobs examine how the provinces, the major healthcare deliverers in Canada, fare compared to other nations in healthcare provision.

Canada - Better Home Care in Canada. A National Action Plan

Jointly created by the Canadian Home Care Association (CHCA), the College of Family Physicians of Canada (CFPC), and the Canadian Nurses Association (CNA), this action plan for home care in Canada sets out recommendations, measurable indicators, and policy considerations for federal, provincial, and territorial levels of government. It shows how home care can be made more accessible, how better health outcomes can be achieved through home care, and how the experience of individuals receiving care and support can be improved.

Canada — Telehealth use in Canada grew by more than 35 per cent annually over the past 5 years: national study

With more than 5,700 telehealth systems in at least 1,175 communities across the country, Canada is a global leader in improving access to care by connecting patients and care providers in different, and frequently, remote locations, according to a new national study released recently, announced Dr. Jennifer Zelmer, Senior Vice-President, Clinical Adoption and Innovation, Canada Health Infoway.

Canada - Number of doctors in Canada is rising, but average payments remain steady

On September 9, 2014, the Canadian Institute for Health Information released the latest statistics on doctors in Canada, showing an increase of 3.4% over 2012. The total amount paid to physicians grew at its slowest pace in 15 years. The report, entitled Physicians in Canada 2013, takes a comprehensive look at how the physician workforce is changing and how payments for services are shifting.

Canada - Reductions in federal health care spending worse than anticipated: New economic analysis

This report by the Canadian Federation of Nurses Unions (CFNU), released at the Council of the Federation on July 16, 2015, finds that reductions in federal health transfers may be greater than first feared, leading to a greater strain on provinces already struggling to sustain Canada’s public healthcare system. The cuts are the result of changes from the funding model agreed to in the 2004 Health Accord to a new formula based on the growth rate of Canada’s GDP. The report, The Canada Health Transfer Disconnect: An Aging Population, Rising Health Care Costs and a Shrinking Federal Role in Funding, written by Hugh Mackenzie, argues that these changes mean federal support for health care will drop from the current range of 22-23% to 19%.

Canada - The Case for Investing in Patient Safety in Canada

This analysis by the Canadian Patient Safety Institute (CPSI) determines that Canada experiences an average of 400,000 patient safety incidents each year that kill around 28,000 Canadians and generate $2.75 billion in extra healthcare costs. After describing Canada’s situation, the analysis discusses successful patient safety initiatives in the US, Scotland and Holland, and shows how increased investment would benefit patient safety in this country.

Canada - Canada's health care spending growth slows

Total health care spending in Canada is expected to reach $207 billion in 2012, averaging $5,948 per person. Figures in National Health Expenditure Trends, 1975 to 2012, released recently by the Canadian Institute for Health Information (CIHI), show that the pace of growth is slowing. Modest economic growth and budgetary deficits are having a moderating effect. For the third straight year, growth in health care spending will be less than that in the overall economy. The proportion of Canada’s gross domestic product (GDP) spent on health care will reach 11.6% this year - down from 11.7% in 2011 and the all-time high of 11.9% in 2010.

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…

Canada - Preschoolers most frequent visitors to Canada’s emergency departments

Young children were the most frequent visitors to Canada’s emergency departments (EDs) in 2012–2013, followed closely by young adults, according to new data from the Canadian Institute for Health Information (CIHI). Overall, children under age 5 accounted for 8.7% of total visits to EDs across Canada. Adults age 20 to 24 were the next most frequent visitors, accounting for 7.6% of total ED visits. In comparison, adults age 65 to 69 accounted for just 4.5% of ED visits.

Canada - Procurement Can Drive Innovation and Better Care in Canada's Health System

According to the Conference Board of Canada, procurement strategies used internationally in health systems could improve Canadians’ access to innovative technologies and better care without increasing costs. In this report, the Conference Board highlights procurement practices used outside Canada to introduce cost-effective, quality-conscious innovations into public health systems.

Canada - Learning From the Best: Benchmarking Canada’s Health System

Canada’s health system has mixed results in comparison with its peers in the Organisation for Economic Co-operation and Development (OECD), according to a new report released recently by the Canadian Institute for Health Information (CIHI). Learning From the Best: Benchmarking Canada’s Health System examines Canadians’ health status, non-medical determinants of health, quality of care and access to care. It is based on international results that appear in the OECD’s Health at a Glance 2011, also being released recently, which provides the latest statistics and indicators for comparing health systems across 34 member countries.

Canada - Improving Canada’s primary healthcare: benefits and opportunities

These three reports summarize the current state of primary healthcare in Canada, investigate best international practices and provide concrete recommendations on how Canada can redefine its priorities in order to strengthen the system. Commissioned by CHSRF and the Canadian Working Group for Primary Healthcare Improvement, the three reports will be used to guide activities in developing a pan-Canadian strategy for using evidence to improve the design and delivery of primary healthcare.

Canada - Quality of Healthcare in Canada: A Chartbook

The Canadian Health Services Research Foundation has released Canada’s first-ever chartbook on healthcare quality. Providing both domestic and international data, the chartbook reports on six key domains of quality: the effectiveness of the healthcare sector; access to healthcare services; the capacity of systems to deliver appropriate services; the safety of care delivered; the degree to which healthcare in Canada is patient-centred; and equity in healthcare outcomes and delivery.

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 — Physician assistants in Canada. Update on health policy initiatives

The objective of this article is to analyze the health policies related to physician assistants (PAs) and to understand the factors influencing this medical work force movement. The historical development of the role of PAs in Canada spans 2 decades. There are now more than 250 PAs, most working in family medicine and emergency medicine. Enabling legislation for PAs has been formalized in Manitoba, and 3 provinces have recognized PAs in various policy statements or initiatives. Three universities and 1 military training centre have enrolled more than 120 students in PA programs. Retired PAs of the Canadian Forces, returning ex-patriot Canadians who had trained as PAs in PA programs in the United States, and American immigrants are working as PAs in Canada. Demonstration projects are under way to better understand the usefulness of PAs in various medical settings.

Canada - Economic and Fiscal Implications of Canada's Aging Population

The Canadian Department of Finance published this report to examine the impact of changing demographics on Canada’s employment rate and standard of living. Two main messages emerge: it is imperative that Canada redouble efforts to boost productivity growth, and to ensure that an increasing number of Canadians have the necessary skills and incentives to fully participate in the workforce.

Canada - Canada should not allow two-tiered practicing for medically-necessary services

Comparing Canada with European nations that operate two-tiered health systems with both public and private care, this paper argues that Canada should not allow a two-tiered approach to medically necessary services. It says doing so will weaken healthcare outcomes in the public system as practitioners migrate to the private sector, leaving publicly-funded services with longer wait times and reduced quality.

Canada - Building on Canada's Strengths in Regenerative Medicine

This report summarizes a workshop convened by the Council of Canadian Academies in Toronto on October 13 and 14, 2016 to review current strengths and weaknesses in regenerative medicine in Canada. Overall, the workshop report confirms that Canadian regenerative medical research is both of high quality and highly cited. National networks are recognized as enabling Canada to maintain its status as an international leader in the field.

Canada - New report decries "patchwork" approach to seniors care in Canada

A new report launched recently by the Canadian Medical Association (CMA) shows that many seniors are falling through cracks in terms of accessing care and services due to a lack of a national approach and strategy. The report, The State of Seniors Health Care in Canada, demonstrates the need for a pan-Canadian strategy to address the health needs of Canada's growing senior population.

Canada - Canada's Largest Physician Survey Flags a Lack of Patient Care Resources and Workforce Planning - 2013 National Physician Survey reveals new data

New data released from the 2013 National Physician Survey (NPS) show that physicians are concerned over gaps in the health care system that may be adversely affecting patient care. Access to key health care resources, the impact of Canada’s aging population and workforce planning issues are posing significant challenges for Canada’s doctors. The survey found that the leading concerns among physicians include the insufficient availability of hospital beds, access to publicly-funded physiotherapists, and advanced diagnostic imaging tools.

Canada - Medical devices and healthcare costs in Canada and 65 other countries, 2006 to 2011

This study from Canadian Health Policy examines the impact of medical device expenditures on total healthcare costs in Canada and 65 other countries, and compares the affordability of medical device expenditures relative to GDP per capita. Canada ranks 9th in total health spending per capita, but only 56th in spending on medical devices as a percentage of total health expenditures.

Canada - The Challenge of Defining Medicare Coverage in Canada

In Canada’s healthcare system, coverage is determined by considerations of medical necessity, a term referring to physician or in-hospital services. Services outside these settings (such as stroke rehabilitation) are typically not covered. This University of Calgary study reviews coverage in Canada and argues that the current definition of medical necessity undermines health equity goals.

Canada - Measuring and improving quality in university hospitals in Canada: The Collaborative for Excellence in Healthcare Quality

Produced by the Ottawa Hospital Research Institute, this article describes a 2010-2015 initiative to achieve a higher quality of patient care in Canada’s university hospitals. The bottom-up initiative was successful in engaging healthcare leaders in developing a framework and set of performance measures for reporting and benchmarking.

Canada - Leaving Canada for Medical Care, 2016

Published by the Fraser Institute, this briefing estimates that 45,619 Canadians left the country to receive medical treatment in 2015. The largest number was from Ontario (22,352 patients). Almost 4,980 Canadians travelled abroad for urology procedures alone. One explanation for travelling abroad is long wait times in Canada’s healthcare system.

Canada - Antibiotics prescribed more often in Canada than in other OECD countries

According to new data from the Canadian Institute for Health Information (CIHI), antibiotics are prescribed more frequently in Canada than in other OECD countries. In 2015, more than 25 million courses of antibiotics were prescribed — almost one prescription for every Canadian aged 20 to 69.

Canada - Top performing hospitals and health regions across Canada identified on new website

On November 7, 2013, the Canadian Institute for Health Information (CIHI) launched a new website called It presents comparable, interactive and easily understood information about Canada’s health system, from the national level down to the local and facility levels. It shows which health regions have top results for indicators such as how many people have a regular family physician; life expectancy at birth; how many patients have repeat hospital stays for mental illness; and which hospitals had the top results for low readmission rates within 30 days of discharge.

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

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.

Canada - Report of the Advisory Panel on Resourcing Options for Sustainable Health Care in Canada to the Canadian Medical Association (CMA)

This report, released August 22, 2011, presents the recommendations of an advisory panel convened by the CMA in March 2011 to improve Canada’s health care system. The 10 recommendations focus particularly on problems with funding physician and hospital services at the expense of other supports more appropriate to the current needs of Canadians, such as long-term care, home care and pharmaceuticals.

Canada - Canadian Cancer Statistics 2016

The Canadian Cancer Society (CCS) has released Canadian Cancer Statistics 2016, which shows that rates of the country’s most predominate cancers, prostate, breast, and lung cancer, are continuing to increase as Canada’s population grows and ages. This year, an estimated 202,400 new cases of cancer will be diagnosed in Canada, with an estimated 78,800 deaths.

Canada - New data shows continued improvements in Canada’s health system performance

Canada’s health system performance is showing continued improvements according to new data from the Canadian Institute for Health Information (CIHI). The CIHI reports improvements in long-term care (lower usage of restraints and inappropriate antipsychotics); hospital deaths (a 3% improvement in 2015-2016); and wait times in emergency departments (down slightly from 2013-2014).

Canada - Canada's Quality Improvement Conundrum

The Health Council has published Proceedings of the National Symposium on Quality Improvement held last October. The symposium provided an opportunity for 200 senior leaders from across Canada to discuss health system performance measurement and reporting, as well as the need to build capacity and capability for quality improvement.

Canada - Difficulty accessing health care services in Canada

Based on a 2013 national survey, this Statistics Canada report explores Canadians’ experiences accessing healthcare services. A majority (71%) reported no difficulty with access. Delays obtaining appointments and long waits were the most common difficulties reported. People who reported poor health had the highest odds of difficulty accessing services such as specialist care, non-emergency surgery, and certain diagnostics tests.

Canada - Bilateral Health Agreements between the Federal and Provincial/Territorial Governments in Canada

According to this study, bilateral health transfer agreements between Ottawa and the provinces could increase innovation and enhance performance in Canada’s health system. Released by the Institute for Research on Public Policy (IRPP), the study notes that bilateral agreements can be tailored to provinces’ needs or used to promote innovation. The federal government is providing $3 billion through bilateral agreements over the next four years.

Canada - Canada’s health expenditure: Spending on prescribed drugs increases, total growth remains slow

The Canadian Institute for Health Information has released two reports on health spending in Canada. The first examines health expenditure trends from 1975 to 2016 and finds that the slow growth trend that started in 2011 continued in 2016, with an increase of 2.7%, which is below the pace of inflation and population growth combined. The second report looks specifically at drug spending. It finds that 42.6% of prescription drug spending was financed by the public sector and identifies drug categories with the highest impact on spending: topping the list were biologics used in rheumatoid arthritis and Crohn's disease, which accounted for 8.2% of total public spending; close behind were hepatitis C drugs. Both reports include provincial and national data.

Canada – Infoway invests $380 million to help physicians and nurse practitioners implement electronic medical record (EMR) systems

With its newest investment program, Canada Health Infoway (Infoway) is funding Electronic Medical Record (EMR) systems in community-based practices and outpatient settings throughout Canada. Infoway President and CEO, Richard Alvarez, recently provided details about the $380 million fund which is designed to focus investment at the points of care where the benefits of health information technology can deliver immediate value to patients and clinicians.

Health Care in Canada 2010: Evidence of progress, but care not always appropriate. Regional variations highlight potentially unnecessary surgical procedures

A new report released recently by the Canadian Institute for Health Information (CIHI) shows that in 2008–2009, more than 3,600 therapeutic knee arthroscopies, used for diagnosing and caring for a variety of knee problems, were performed in Canadian hospitals despite mounting evidence that the procedure fails to improve patient outcomes or reduce discomfort when used to treat osteoarthritis. CIHI’s report Health Care in Canada 2010 also found that about 1,050 vertebroplasty procedures were performed across Canada in 2008–2009, up from about 600 in 2006–2007. A significant number of these procedures were for patients suffering from vertebral fractures associated with osteoporosis. Recent evidence, however, suggests these patients are no better off than those who undergo placebo procedures.

Canada - Canadians want a national strategy on seniors care: report

The Canadian Medical Association (CMA) 2014 Health Report Card has found overwhelming support for the development of a national strategy to address the needs of Canada's rapidly aging population. The CMA survey found that 95% of respondents supported a national strategy to expand seniors' health care. The survey also showed that 61% of respondents lacked confidence in Canada's current ability to manage the needs of the elderly.

Canada - Where you live matters: Canadian views on health care quality Results from the 2013 Commonwealth Fund International Health Policy Survey of the General Public

This final bulletin in the Health Council of Canada's Canadian Health Care Matters series presents Canadians’ views on and experiences with health care, based on the 2013 Commonwealth Fund Survey. It focuses on differences between provinces, comparisons among the 11 OECD countries participating in the survey, and changes in Canada’s performance over the past decade. Large variations between provinces in patient experiences, not only around wait times and coordination of care, but also in other areas including out-of-pocket expenses, patient safety, and preventive care, were identified.

Canada — Physician payment mechanisms: An Overview of Policy Options for Canada

The following questions are addressed in this report: Can we influence the level of public spending and/or the efficiency of the system by moving from a FFS system to an alternative payment mechanism? What are the most promising payment mechanisms for Canada and what policy or regulatory elements are required or desirable for their implementation?

Canada — Hospital Payment Mechanisms: An Overview and Options for Canada

Through a review of international experiences with hospital funding, this paper aims to present a synthesis of evidence governing hospital funding. It discusses the relevance of other countries’ experiences to Canada’s federalist system, and it identifies key issues facing publicly funded hospitals from the funder’s perspective and policy options for decision-makers and Canadians.

Canada — Can We Get Better for Less: Value for Money in Canadian Health Care

Injecting tens of billions of dollars into Canadian hospitals with no value measures in place is an inefficient approach to health care spending, says a report from the Certified General Accountants Association of Canada (CGA-Canada). Before committing to investment in additional physician capacity, hospital beds or diagnostic technology, policy makers could establish consistent and transparent value-for-money measures that reflect access to and quality of care, patient health outcomes and costs, and are monitored and tracked regularly over time and compared across institutions. Uniformly computed and publicly reported value-for-money metrics for all hospitals could enable comparison and allow sharing of best practices.

Canada — Progress Report 2011: Health care renewal in Canada

This report on Canada's health care performance is a pan-Canadian look at five key commitments of the 2003 First Ministers' Accord on Health Care Renewal and the 2004 10- Year Plan to Strengthen Health Care, and it highlights the progress being achieved to date on wait times, pharmaceuticals management, electronic health records, teletriage, and health care innovation since 2003.

Canada — Manitoba will implement first-in-Canada cancer wait-time strategy

A $40-million, comprehensive, aggressive and first-in-Canada cancer strategy will streamline cancer services and dramatically reduce the wait time for patients between the time cancer is suspected and the start of effective treatment, Premier Greg Selinger announced recently.

Canada - Your Health System website reveals Canadian health care statistics by hospital, region, province and territory

The Canadian Institute for Health Information (CIHI) has launched a website that allows the Canadian public to find accessible and easy-to-understand information about Canada's healthcare system. Information is available on access to care, quality of care, spending, health outcomes and much more. Interactive graphics enable comparison between Canada and other countries, between provinces, regions and even individual hospitals on the different measures.

Canada — Accreditation Canada International Launches Global Health Care Services Standards

Accreditation Canada International is proud to announce the release of its Global Health Care Services Standards. The standards were developed to address the need for uniformity and standardization in the growing health tourism industry. Due to an increasing number of patients crossing borders to receive health care and concerns about the quality of care in these institutions, the need for international health services standards has never been greater.

Canada — Canada's Medicare Bubble: Is Government Health Spending Sustainable without User-based Funding?

The data presented in this study by the Fraser Institute suggest that the redistributive, tax based funding structure of Canada’s health system produces rates of growth in health spending that are not sustainable without at least a partial reliance on user-based, private financing.

Canada - Research Synthesis on Health Financing Models: The Potential for Social Insurance in Canada

Coverage by the various provincial plans for services not mandated by the Canada Health Act is uneven, raising equity concerns. The social insurance (SI) model has been suggested as a way to raise revenue to improve access to non-CHA services. This study begins with a description of how SI functions in four European countries and addresses a number of crucial questions about the SI model’s impact on risk sharing, delivery systems, jobs and income growth and cost control.

Canada — Health Indicators 2011

Health Indicators 2011 is the 12th in a series of annual reports containing the most recently available health indicators data from the Canadian Institute for Health Information and Statistics Canada. In addition to presenting the latest indicator data, this year's report features a focus section on mental health, including five new indicators that provide information about Canada's mental health system.

Canada - Better Value for Money in Healthcare: European Lessons for Canada

This commentary from the C.D. Howe Institute says Canadian health care would benefit from a serious look at European countries’ efforts to align incentives within their health systems to encourage better performance. Health systems in the U.K. and Netherlands have conducted reforms to attain greater value for money while continuing to adhere to equity principles similar to Canada’s.

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.

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.

Canada - The Inconvenient Truths about Canadian Health Care

This briefing from the Conference Board of Canada says Canada’s health system has slipped to 10th place internationally and is in urgent need of transformation. The briefing identifies key issues in Canadian healthcare and outlines priorities for reform, saying the country must abandon an obsolete model.

Canada - Feds can afford $3.3 billion for health, including seniors, CMA says

A new report by the Conference Board of Canada demonstrates that the federal government can deliver meaningful support for seniors care, starting in the next budget cycle, Dr. Cindy Forbes, president of the Canadian Medical Association (CMA) said recently. Commissioned by the CMA, the Conference Board report provides the economic costing for three proposed federal policy measures to support seniors care, beginning in the 2016-17 federal budget cycle. The three federal policy measures would total a $3.3 billion federal investment to support seniors care – $1.6 billion toward a demographic-based top-up to the Canada Health Transfer, $1.6 billion for catastrophic coverage for prescription drugs, and $90.8 million to make the caregiving tax credits refundable.

Canada - Lifetime Distributional Effects of Publicly Financed Health Care in Canada

Who pays for and who uses publicly financed health care in Canada? Does it affect income inequality? This report explores these questions and sheds light on the patterns that emerge when health care costs and associated tax payments are examined over the life course.

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 - Never Events for Hospital Care in Canada

This report published by Health Quality Ontario presents the collective work of the National Patient Safety Consortium to identify, for the first time, a list of 15 never events for hospital care in Canada. Never events are patient safety incidents that result in serious patient harm or death and that are preventable using organizational checks and balances.

Canada - Measuring Success: A Framework for Benchmarking Health Care System Performance

This report from the Conference Board of Canada discusses the benefits, process, and methods of benchmarking. The report proposes a detailed framework to guide the upcoming health performance benchmarking report by Canada’s provinces.

Canada – Measuring Outcomes in the Canadian Health Sector: Driving Better Value from Healthcare

While Canada has a well-established tradition of transparency and accountability for health-system performance comparisons, few measures of outcomes are reported, according to a new report from the C.D. Howe Institute. In “Measuring Outcomes in the Canadian Health Sector: Driving Better Value from Healthcare,” authors Jeremy Veillard, Omid Fekri, Irfan Dhalla, and Niek Klazinga examine the state of outcomes measurement in Canada, and offer recommendations so that the generation of better information on health system outcomes can help achieve greater value in the health sector.

Canada - Canada’s slow health spending growth continues

In 2015, health spending in Canada will continue a pattern of slow growth that began in 2011, according to data released recently by the Canadian Institute for Health Information(CIHI). Spending is projected to grow by $3.4 billion this year to reach $219.1 billion in 2015. This amounts to $6,105 per Canadian, about $35 more per person than last year.

Canada - Canadians Could Gain 70 Million Hours per Year with Health IT

In 2011, 47 million in-person medical appointments could have been avoided and millions of hours saved if Canadians had been able to consult with their health care providers, access test results (lab tests, MRIs, and X-rays) and request prescription renewals electronically. These findings are part of a Conference Board of Canada study commissioned by Canada Health Infoway, entitled: “Valuing Time Saved: Assessing the Impact of Patient Time Saved from the Adoption of Consumer Health Solutions.”

Canada - Measuring What Matters: The Cost vs. Values of Health Care

This white paper on Canada’s healthcare system from the Ivey International Centre for Health Innovation considers five key questions about stakeholder values and their alignment with funding, reimbursement, measures, and incentives. It also assesses whether Canada’s health care values and performance outcomes compare well over time to other OECD nations.

Canada - Unleashing Innovation: Excellent Healthcare for Canada Report of the Advisory Panel on Healthcare Innovation

This panel, chaired by Dr. David Naylor for Health Canada, undertook wide-ranging consultations and commissioned research in order to identify the five most promising areas for innovation in Canadian healthcare to be acted upon by the federal government. Top among them is patient engagement and empowerment, with system integration, technological transformation, better procurement and regulation also found to be key to breaking the gridlock. The report examines how federal institutions can be restructured to support the spread of innovative practices.

Canada - Wait times remain stable, while number of procedures grows

While the number of priority procedures performed in Canada has increased, wait times for these procedures—radiation therapy, joint replacement, hip fracture repair and cataract surgery—have remained stable. In fact, about 8 out of 10 patients have consistently had their priority surgery performed within the approved benchmark time frame every year since 2010. This information is included in Wait Times for Priority Procedures in Canada, 2015, released by the Canadian Institute for Health Information (CIHI).

Canada - Improving Value at Hospitals through Process Management

Using five case studies, this Conference Board of Canada report demonstrates how process management techniques, such as Six Sigma and Lean, which have been used successfully in other sectors, can improve health care outcomes and reduce costs in Canada.

Canada - Understanding Health and Social Services for Seniors in Canada

This report by The Conference Board of Canada establishes a clear snapshot of current seniors health care programs and services that can inform the design of future programs, plans, and strategies to better address seniors’, and their families’, needs.

Canada - Which way to quality? Key perspectives on quality improvement in Canadian health care systems

To learn what is happening across Canada, the Health Council interviewed senior health system leaders to hear more about their experiences with system-wide approaches to quality improvement. This report highlights the range of approaches to measuring and improving quality being used across Canada.

Canada - Canada’s doctor supply has grown faster than the population for the past decade

Outpacing population growth for the tenth year in a row, the number of physicians in Canada continued trending upward in 2016. There are now more than 84,000 physicians, or 230 per 100,000 people, the highest proportion ever. Growth in the number of doctors is now almost triple that of the Canadian population.

Canada - Renewing Canada’s Social Architecture: Modernizing Medicare

This paper argues that the ‘medically necessary services’ defined by the Canada Health Act need revising because hospital and physician services currently account for 40% of total Medicare spending, 20% less than when the Act became law in 1984. The paper says Medicare must address gaps in coverage left by the Act in a way that recognizes that health technologies change constantly.

Canada – Canada: Health system review. Health Systems in Transition, 2013

The new HiT (Health Systems in Transition) health system review for Canada has just been released by the European Observatory on Health Systems and Policies. HiT health system reviews are country or region-based reports providing a detailed description of local health system reforms and policy initiatives.

Canada - Supply of nurses in Canada declines for first time in 2 decades

For the first time in 2 decades, more regulated nurses left their profession than entered it, according to a recent report from the Canadian Institute for Health Information (CIHI). Fewer of these professionals — which include registered nurses (RNs), licensed practical nurses (LPNs) and registered psychiatric nurses (RPNs) — applied for registration, while more chose not to renew their registration due to factors such as retirement, a new career path or a move outside Canada.

Canada - Developing a rapid-response program for health system decision-makers in Canada: findings from an issue brief and stakeholder dialogue

The authors of this study say Canada’s health system needs a rapid response program to provide quick syntheses of research evidence for decision-makers on specific health system challenges. The authors developed a brief on the features of a rapid response program, which was then used in a stakeholder dialogue on implementation challenges.

Canada - Harper Government Responds to the Senate Review of the 2004 Health Accord

On September 25, 2012, the Government of Canada tabled its response to the Senate Review report “Time for Transformative Change.” The Government's response is grounded in the following core values: a steadfast commitment to Canada's universal, publicly funded health care system; the recognition that provincial and territorial governments hold primary responsibility for the delivery of care; and the firm belief that Canadians can and should play an active role in their own health.

Canada - From Innovation to Action: The First Report of the Health Care Innovation Working Group

In January 2012, Canada’s provincial premiers met to discuss shared healthcare concerns and established a Working Group to identify innovations in healthcare delivery across Canada. Published in August 2012, this initial report from the Working Group focuses on three priority areas: clinical practice guidelines, team-based health care delivery models, and health human resource management initiatives.

Canada - Canada’s nursing workforce continues to grow

The number of regulated nurses in Canada continues to increase, growing by 7% since 2008, according to the Canadian Institute for Health Information (CIHI). This growth outpaced that of both the Canadian labour force and the general population, resulting in 365,422 regulated nurses—or 1,048 per 100,000 people—in 2012.

Canada - Canada Health Consumer Index 2010

The annual Canada Health Consumer Index evaluates healthcare-system performance in the ten provinces from the perspective of the consumer. For the third straight year, Ontario and British Columbia finish with the top scores in the CHCI’s overall rankings.

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.

Canada - Debunking the Myths. A Broader Perspective of the Canada Health Act

This monograph published by the MacDonald-Laurier Institute points to the danger that misinterpreting the nature of the Canada Health Act leads legislators to fail to consider and implement essential changes.

Canada - Canada’s Health Spending Hits Slowest Growth Rate Since 1997

The Canadian Institute for Health Information (CIHI) projects that health spending will increase by just 2.1% in Canada in 2014. Drug expenditures will increase by just 0.8%, hospital spending will increase by 2.1%, and physician spending, the highest of the three main cost drivers, will increase by 4.5%.

Canada - Functional Federalism and the Future of Medicare in Canada

For Canada to rank among countries with the healthiest populations, we need a broadly shared vision of health and health care, sustained leadership by the federal government, as well as action and accountability on the parts of provincial and territorial governments, health care providers and the public. This is the main conclusion of the report on the role of the federal government in health and health care that was commissioned by the Health Action Lobby (HEAL) - a coalition representing 34 national health organizations.

Canada - The Naylor Report and Health Policy: Canada Needs a New Model

The federal government should recognize the limited success of past attempts to achieve healthcare reform with conditional transfers to the provinces and instead focus more on independent initiatives, according to a new C.D. Howe Institute report. In “The Naylor Report and Health Policy: Canada Needs a New Model,” authors Åke Blomqvist and Colin Busby suggest a variety of initiatives including the promotion of better information technology dissemination to providers and patients, and more systematic cost-effectiveness evaluations of new drugs and devices.

Canada - Improving Health System Efficiency in Canada: Perspectives of Decision-Makers

This report is Phase 3 of a multi-phased project undertaken by the Canadian Institute for Health Information (CIHI) that aims to understand health system efficiency in Canada. Phase 1 sought to define efficiency and Phase 2 applied this definition to existing data. Phase 3 presents a qualitative case study involving decision-makers from British Columbia and Nova Scotia that looks at actions they have taken and challenges they face in improving health system efficiency.

Canada - New report highlights urgent shortage of Emergency Physicians in Canada

This report from the College of Family Physicians of Canada estimates that there is now a shortage of 478 emergency physicians in the country and that without immediate action, this number will triple by 2025. The College calls for a significant expansion of emergency medicine residency slots.

Canada - Physician supply increasing twice as quickly as Canadian population. Physician payments also on the rise; fewer doctors migrating

The 2010 edition of CIHI’s annual report, Supply, Distribution and Migration of Canadian Physicians, shows that over the past five years, growth in the number of physicians in Canada has consistently outpaced population growth. It also shows a significant increase in the number of medical graduates, both from Canadian universities and abroad, and an 18% increase in the number of international medical graduates practising in Canada over the last five years.

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.

Canada - Learning from the Saskatchewan Surgical Initiative to Improve Wait Times in Canada

In 2010, the Saskatchewan government announced an initiative to tackle wait times for surgery. Today, the province’s wait times for elective surgery are among the shortest in Canada. This Fraser Institute study looks at Saskatchewan’s approach and lessons for other provinces. It credits the controversial use of private for-profit clinics to deliver day-surgery procedures as an important ingredient in Saskatchewan’s success.

Canada - Valuing health in Canada. Who, how, and how much?

Published by the Canada 2020 think tank, this paper examines Canadian healthcare treatments and services, identifies discrepancies and makes recommendations. It highlights the importance of cost-effectiveness in system sustainability, and emphasizes public input. The author explains how Quality Adjusted Life Years (QALYs) compare different spending options in a meaningful way.

Canada - Progress Report 2012: Health care renewal in Canada

This report from the Health Council of Canada looks at progress to date in home and community care, health human resources, telehealth, access to care in the North, and health indicators.

Canada - Setting the Record Straight on Health Care Funding in Canada

Contrary to what certain commentators declare, we are not witnessing the gradual privatization of health care funding in Canada. An Economic Note published by the Montreal Economic Institute demonstrates that this is a myth, at least when it comes to medically required care, which forms the core of our health care system.

Canada - Data indicators report on the Mental Health of Canadians

On January 22, 2015, the Mental Health Commission of Canada (MHCC) released the first phase of "Informing the Future: Mental Health Indicators for Canada." It is the first-ever national-level set of indicators that identifies and reports on the mental health of Canadians. The 13 indicators include measures of access and treatment, work-related and caregiving-related stress, immigrant sense of belonging, anxiety and mood disorders in children and seniors, suicide, and recovery among people with common mental health conditions.

Canada - Investments in seniors' care needed as Canada's aging population grows

The Canadian Medical Association (CMA) is concerned that Canada’s healthcare system isn’t keeping up with the health care needs of older Canadians. In a submission to Parliament, the organization recommended major new investments in senior care and called for a national seniors’ strategy that emphasizes primary care and the role of caregivers.

Canada - Integrated Health Care: The Importance of Measuring Patient Experience and Outcomes

This Conference Board of Canada report reviews the literature on evaluation and measurement efforts being undertaken in Canada and abroad, and focuses in on three Canadian examples of integrated health care systems for a more detailed exploration. The briefing concludes with four recommendations on actions health leaders can take to improve the measurement and evaluation of health system integration.

Canada - First-ever Training Program in Canada Successful at Retaining Physician Assistants

Nineteen of 23 graduates from Canada’s first Physician-Assistant Masters Program at the University of Manitoba have chosen careers within the province, according to this February 9, 2012 press release from the Manitoba government. The province invested $1.2 million in September 2008 to create the program. Physician assistants are now at work in Manitoba’s four largest communities in a variety of healthcare settings.

International Profiles of Health Care Systems

Brief analytical summaries or syntheses #32 International Profiles of Health Care Systems Summary This publication presents overviews of the health care systems of Australia, Canada, Denmark, England, France, Germany, Japan, Italy, the Netherlands, New Zealand, Norway, Sweden, Switzerland, and the U.S. Each overview covers health insurance, public and private financing, health system organization, quality of care, health disparities, efficiency and integration, use of health information technology, use of evidence-based practice, cost containment, and recent reforms and innovations. In addition, summary tables provide data on a number of key health system characteristics and performance indicators, including overall health care spending, hospital spending and utilization, health care access, patient safety, care coordination, chronic care management, disease prevention, capacity for quality improvement, and public views. Background The Commonwealth Fund is a private foundation that promotes a high performance health care system providing better access, improved quality, and greater efficiency. The Fund carries out…

Canada - Lung Disease Imposes Major Costs on Canada’s Economy

This cost-risk analysis by the Conference Board of Canada calculates the cost of three chronic lung diseases — lung cancer, asthma and chronic obstructive pulmonary disease — at $12 billion in 2012, a figure that is set to double by 2030. It also projects the potential for policy measures around smoking and air quality to attenuate the increase.

Canada - Measuring and reporting on health system performance in Canada: Opportunities for improvement

The paper highlights the need for governments to set clear policy goals with both measurable health outcomes and supporting health indicators in order to hold health system leaders accountable for performance. The paper provides recommendations to governments, at the same time highlighting innovative practices across Canada and in the United Kingdom and Australia that can provide a way forward.

Canada – Ed Clark, President and Chief Executive Officer, TD Bank Group discusses things that matter in a world of constrained resources

In a speech delivered Oct 19, 2011 at the Ivey Business Leader Award Dinner in Toronto, TD Bank President and CEO Ed Clark spoke of the role citizens can play in creating the future leadership Canada needs. Mr. Clark called for the delivery of sound long-term fiscal policy and a meaningful discussion of complex national issues, including changes to Canada’s public healthcare system.

Canada - Reducing Wait Times for Health Care: What Canada Can Learn from Theory and International Experience

From the Fraser Institute, this new book on Canadian healthcare wait times assesses wait list policy issues such as health effects, costs and labour market consequences. The authors argue that Canada’s current policies will not improve timely healthcare provision.

Canada – Exploring Accountable Care in Canada: Integrating Financial and Quality Incentives for Physicians and Hospitals

This report, commissioned by the Canadian Foundation for Healthcare Improvement and the Ontario Ministry of Health and Long-Term Care explores the relevance and feasibility of establishing Accountable Care Organizations (ACOs) in Canada using Ontario as a case study. In ACOs, physicians, hospitals and other provider organizations assume accountability for the cost and quality of care for a defined population.

Canada - Health Care Transformation in Canada: Change that Works. Care that Lasts

The Canadian Medical Association has recently unveiled an important new policy document aimed at driving change in Canada's health care system to better meet the needs of patients now and in the future. It also aims at framing future discussions among the Federal, Provincial and Territorial governments in preparation for the renewal of the Health Accord in 2014.

Canada - Challenge Ahead: Integrating robotics, artificial intelligence and 3D printing technologies into Canada’s healthcare systems

This parliamentary committee report looks at the integration of robotics, artificial intelligence (AI), and 3D printing technologies in Canada’s healthcare system. It lauds the potential for quicker diagnoses and reduced costs, but warns of radical changes to the current delivery of health care, along with ethical and privacy concerns. The report contains 14 recommendations focusing on healthcare delivery, workplace adjustments, and regulatory oversight.

Canada - Canada’s lagging healthcare productivity: Lost efficiencies and missed economic opportunities

Distributed by Canadian Health Policy (CHP), this paper discusses lost efficiencies and missed economic opportunities caused by lagging productivity in Canada’s healthcare sector. The paper discusses factors that affect productivity growth, such as organizational culture, incentives and technology.

Canada - Government of Canada, Canadian Partnership Against Cancer and The Heart and Stroke Foundation announce action to protect families from chronic diseases

Canada’s Health Minister Leona Aglukkaq, Dr. Simon Sutcliffe, Chair of the Canadian Partnership Against Cancer (CPAC) and Sally Brown, CEO, Heart and Stroke Foundation recently announced the launch of seven new and highly innovative cancer chronic disease prevention initiatives. The seven CLASP (Collaboration Linking Science and Action) programs bring together more than 30 groups and agencies to integrate cancer and other chronic disease prevention strategies.

Canada - Canada Could Save Over a Billion by Switching Some Medications from Prescriptions to Over-The-Counter

The Conference Board of Canada estimates that switching three prescription drug classes to over-the-counter medications could save consumers and the health system $1 billion annually. The report examines the economic impact of switching the status three specific drug categories: proton pump inhibitors to treat gastro-esophageal reflux disease, oral contraceptives, and erectile dysfunction drugs.

Canada - Mental Health Commission of Canada Launches Mental Health First Aid Program for Seniors and Their Caregivers and Service Providers

On September 6, 2017, the Mental Health Commission of Canada (MHCC) launched Mental Health First Aid (MHFA) Seniors, an Ontario training program to support the mental health needs of older people. MHFA Seniors trains senior citizens, caregivers, and service providers to respond to an emerging mental health problem until appropriate treatment is delivered.

Canada - Drug Information Systems to generate $436 million in benefits in 2010

Canada’s investments in drug information systems (DIS) will generate $436 million in cost savings and efficiencies in 2010, announced Richard Alvarez, Chairman of the board and CEO of Canada Health Infoway (Infoway). The findings are outlined in an independent study commissioned by Infoway and released recently.

Canada - Trends in out-of-pocket health care expenditures in Canada, by household income, 1997 to 2009

This report from Statistics Canada finds that between 1998 and 2009, out-of-pocket expenditures on healthcare services and products increased by 2.9% annually. The percentage of households spending more than 10% of their total after-tax income on health care rose by 56%, with the burden falling clearly on those in lower income quintiles.

Canada - Mental Health Report Focuses on Multicultural Groups

The Mental Health Commission of Canada has released a report addressing the needs of multicultural, immigrant and refugee groups. The study is part of its mandate to improve mental healthcare across all areas of Canadian society. The document, entitled ‘Improving Mental Health Services for Immigrant, Refugee, Ethno‐cultural and Racialized (IRER) Groups,’ outlines factors that policy makers and service providers may want to consider when working to improve mental health services for these groups. The 16 recommendations in the report are firmly rooted in the goals of the Mental Health Strategy for Canada. The recommendations fit into one of three main areas, including: better coordination of policy, knowledge and accountability, the involvement of communities, families, and people with lived experience, and more appropriate and improved services.

Canada - How Healthy are Canadians? A trend analysis of the health of Canadians from a healthy living and chronic disease perspective

Produced by Canada’s Public Health Agency, this trend analysis examines the last 15 years of data on key risk factors, major chronic diseases, mood and anxiety disorders, and overall life expectancy. In general Canada is a healthy nation, although major chronic diseases (cardiovascular and respiratory diseases, cancer and diabetes) cause 65% of all deaths.

Canada - Recommendations for Action: Getting the Most out of Interprofessional Primary Health Care Teams

This is the final report in a series on primary care by the Conference Board of Canada. It uses three research approaches to arrive at recommendations for improving interprofessional primary care in Canada. The nine recommendations are designed to help government decision-makers, primary care leaders, other care providers and patients get the most out of the interprofessional team experience.

Canada - Implementing E-Health through CHI: A Very Canadian Solution to a Very Canadian Problem

This paper suggests that the major influence behind the policy to establish Canada Health Infoway came from Canadian institutions and the fact that the federal government was hamstrung by the Canadian Constitution and Canada Health Act in efforts to support E-health. The paper addresses some of the criticisms Infoway has attracted, but suggests that Infoway represents a fair compromise solution for accelerating the implementation of e-Health in light of constitutional constraints.

Canada - Canadian Medical Association's 2010 report card points to emergence of health care generation gap

The number of elderly Canadians is growing, and concern about the future of Canada's health care system appears to be growing in lockstep. That is one of the main findings from the CMA's 2010 Report Card on Health Care in Canada, which reveals a clear generation gap developing in relation to health care issues. For instance, respondents under age 46 are much more likely to anticipate taking "financial steps" to meet future health care costs than those aged 46 and older. Those steps, such as buying health insurance to supplement the public system upon retirement, were much more popular within the younger cohort (37%) than the older one (17%).

Canada - Canadians have more than 1 million potentially unnecessary medical tests and treatments every year

A new report by the Canadian Institute for Health Information (CIHI) and Choosing Wisely Canada has found that up to 30% of selected medical tests, treatments and procedures in Canada are potentially unnecessary. The report measured the extent of unnecessary care associated with eight tests and procedures, including head scans in ERs for minor head injuries, use of benzodiazepines to treat insomnia or agitation in the elderly, and preoperative tests for low-risk surgeries.

Canada - 2010 Canadian Health Accreditation Report: Through the Lens of Qmentum - Exploring the Connection between Patient Safety and Quality of Worklife

Accreditation Canada's 2010 national report on health care in Canada explores the connection between quality of work life and patient safety in health organizations. The report also examines the relationship between health care staff perceptions of work climate and patient safety culture in their own organizations, and how those perceptions are useful in identifying patient safety issues.

Canada - Value for Money from Health Insurance Systems in Canada and the OECD

This paper compares the economic performance of Canada’s health insurance system against the health insurance systems of 27 other countries that are members of the Organisation for Economic Co-operation and Development (OECD). Economic performance is defined by the availability of medical resources and the output of medical services, as well as the associated level of national health spending as a percentage of GDP. The value for money produced by a country’s health insurance system is defined relative to the economic performance of the health insurance systems of its international peers.

Canada - Progress report 2003-2013: Highlights of health care reform

The Health Council of Canada recently released Progress timeline 2003-2013: Highlights of health care reform. With almost $2 trillion spent, from both public and private sources, on health care in Canada over this period, Canadians should demand accountability for their investments in the health care system. This report outlines key national, provincial and territorial policy reforms since 2003, in addition to the Health Council's contributions over this period.

Canada - Total health spending in Canada reaches $242 billion

New figures released by the Canadian Institute for Health Information (CIHI) show that the country’s health spending is forecast to grow by almost 4% in 2017, to $242 billion. This is a slight increase in the rate of health spending growth — since 2010, the average annual increase has been 3.2%. National Health Expenditure Trends, 1975 to 2017 finds that health costs are expected to represent 11.5% of Canada’s gross domestic product (GDP) in 2017, similar to last year.

Canada - The Rural Road Map for Action: Directions

The Canadian Collaborative Taskforce was formed by the College of Family Physicians of Canada and the Society of Rural Physicians of Canada in 2014, with the aim of producing and sustaining an increased number of family physicians practising comprehensive rural generalist medicine. This Roadmap for Action recommends 20 actions in four directions: increasing the social accountability of medical schools to address the needs of rural and Indigenous communities; policy interventions that align medical education with workforce planning; practice models that ensure timely access to quality care; and a rural research agenda.

Canada - A New Model for Sustainable Public Health Care Delivery in Canada Part two: The change thing and how to make it happen

This is a follow-up article to the one which appeared in September 2009 in which the authors proposed a new competition-based model for health care delivery. This article is an attempt to offer principles for implementing this model deriving from an examination of the history of Canada and a review of the success factors that can still be applied today.

Canada - More physicians than ever; greatest percentage increase in physicians in 20 years

Canada experienced the biggest annual percentage gain in the national supply of physicians since the late 1980s, according to a new report released recently by the Canadian Institute for Health Information (CIHI). In 2009, there were approximately 68,100 active physicians working in Canada, an increase of nearly 2,700 physicians over the previous year. This represents an increase of 4.1%—more than triple the rate of growth of the Canadian population as a whole (1.2%) and the largest annual increase of the past two decades.

Canada - Canada’s Aging Population and Implications for Government Finances

Canada’s aging population will put significant stress on government spending programs, which will result in large deficits and mounting debt in the future, finds a new study by the Fraser Institute. The study finds that from 2010 to 2063, the share of the Canadian population over the age of 65 will increase from just under 15 per cent to more than 25 per cent, which will necessitate increased government spending.

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 - Review of Family Medicine Within Rural and Remote Canada: Education, Practice, and Policy

The Advancing Rural Family Medicine Canadian Collaborative Taskforce released, on January 18, 2016, this document describing current challenges in recruitment and retention of rural physicians, and the lack of infrastructure and resources to support educational opportunities that might promote rural practice. Some 14% of family physicians currently practice in rural and remote areas.

Canada - Rates of avoidable deaths reduced, yet significant room for improvement remains

The rate of deaths that could potentially be avoided through timely and effective health care and disease prevention dropped from 373 per 100,000 Canadians in 1979 to 185 per 100,000 Canadians in 2008. Health Indicators 2012, the most recent edition of the report produced annually by the Canadian Institute for Health Information and Statistics Canada, includes updates on more than 40 measures for Canadian regions, including a suite of new avoidable mortality indicators.

Canada - Value of Physician Assistants: Recommandations for Action

Published by the Conference Board of Canada, this briefing is the last in a series of four reports on physician assistants (PAs) in Canadian healthcare settings. It provides five policy recommendations for optimizing PA roles, including developing appropriate funding models; addressing regulation and data tracking challenges; expanding supply and training; and enhancing evidence and understanding of the importance of PAs.

Canada - The Private Cost of Public Queues for Medically Necessary Care, 2016 edition

This Fraser Institute briefing calculates the private costs of waiting times for treatment in Canada (i.e. the value of time lost while waiting). Valuing only hours lost during the work week, the estimated cost of waiting for medically necessary care in 2015 was $1.2 billion. This works out to an average of about $1,304 for each of the 894,449 Canadians waiting for treatment that year.

Canada - Doctors' pay should be based on the right blend of incentives

This Conference Board of Canada report, Family Doctor Incentives: Getting Closer to the Sweet Spot, recommends that policymakers aim for the right blend of pay incentives, guided by principles that consider healthcare goals, global experience, and human motivation. The report raises strengths and weaknesses in each model and advocates combining them to achieve desired goals.

Canada - Mental health. Special Issue. Healthcare Quarterly

This special issue of Longwood’s Health Quarterly focuses on mental health in Canada. Topics of the 10 article include: psychiatrist health human resource planning, early intervention programs for psychoses and mood disorders, community recovery services, peer support, the social determinants of health (housing and income) and Ontario mental healthcare delivery.

Canada - Unhealthy Pressure: How Physician Pay Demands Put the Squeeze on Provincial Health-Care Budgets

In this paper published by the University of Calgary School of Public Policy, Hugh Grant and Jeremiah Hurley note that in the 11 years since the Romanow Commission warned that the income of physicians was threatening to become a significant driver of Canadian healthcare costs, doctors in Canada proceeded to chalk up some of their most rapid gains in earnings since the implementation of Medicare. The authors see an ongoing battle between provincial governments and physicians for public support as the guardians of health care — a battle in which governments recently seem to be gaining ground.

Canada - Select Cost Sharing in Universal Health Care Countries

A prominent feature of Canada’s public healthcare system is the absence of any charge at the point of consumption. This article by the Fraser Institute argues against this “first-dollar” coverage, citing international evidence that it encourages the consumption of services whose costs exceed associated benefits. The article also cites evidence that cost sharing does not result in adverse health outcomes.

Canada - The Canadian Health Care Debate: A Survey and Assessment of Key Studies

In this report, the Conference Board of Canada reviews 18 major Canadian studies on how to reform health care and identifies 432 recommendations that fall into seven broad themes — with more than half dealing with system management processes and financing.

Canada - Approach to economic evaluation in primary care. Review of a useful tool for primary care reform

In several provinces across Canada, primary care physicians are playing a larger role overseeing resource planning and the allocation of primary care services. This study published in Canadian Family Physician summarizes methods of economic evaluation in health care, and presents primary care cost-effectiveness estimates from the literature. Authors argue that economic evaluation provides a framework within which the costs and benefits can be assessed objectively.

Germany - Health Care Lessons from Germany

Published by Canada’s Fraser Institute, this study compares the German and Canadian healthcare systems. The study concludes that the German system performs at a level similar to Canada, with a stronger performance in patient safety. Germany’s health expenditures, as an age-adjusted share of GDP, were 22% lower than Canada’s. Germany also has higher ratios of physicians and hospital beds per population and shorter wait times for all types of care.

Canada - Canadian governments must rethink healthcare on five areas of national priority, according to a new report from the C.D. Howe Institute

In “Challenging Vested Interests: National Priorities for Healthcare,” authors Åke Blomqvist and Colin Busby find that compared to the healthcare systems of a large group of peers, Canadian systems do not produce enough high-quality care for the money spent. The authors outline five healthcare policy priorities for 2016: 1. Policies to Improve Value for Money, 2. Gaps in Public and Private Coverage, 3. The Canada Health Transfer – Hold the Line and Tweak, 4. A New Health Accord, and 5. Direct Federal Health Programs

Canada - Electronic medical records outperform paper in primary care “Practice Challenge”

Primary care practices with electronic medical records (EMRs) identified patients who need preventative or follow-up care approximately 30 times more quickly than paper-based clinics, according to this study commissioned by Canada Health Infoway. Clinics were challenged to identify patients who would benefit from six different types of evidence-based interventions.

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.

Canada - Sustainability of the Canadian Health Care System and Impact of the 2014 Revision to the Canada Health Transfer

The Canadian Institute of Actuaries finds that, without significant government intervention, the Canadian healthcare system in its current form is not sustainable. Assuming no governmental steps to curb healthcare expenditures, it estimates that provincial/territorial spending on health care will increase at 5.1% real growth per year, from 44% today to 103% of total provincial/territorial revenues by 2037. Proposed changes to the Canadian Health Transfer will see the federal government's portion of expenditures drop from the current 21% to 14.3% by 2037.

Canada - Canada's Doctors Urge Health Impact Assessment for all Federal Policies

The Canadian Medical Association (CMA) is calling on the federal government to conduct a health impact assessment as part of its policy development process to ensure that the health of Canadians is a key factor in every policy decision it makes.

Canada - Grey Zones: Emerging Issues at the Boundaries of the Canada Health Act (CHA)

This Commentary published by the CD Howe Institute examines four current issues relating to the CHA: annual fees charged by integrative health clinics; provincial healthcare deductibles; provincial funding of health services purchased or insured out-of-country; and provincial funding of out-of-province health services facilitated by private medical concierge services. In each case, the Commentary examines how the practice might be subject to penalties under the CHA, and highlights the federal role to date in debates on these issues.

Canada - The Value of Electronic Health Records Extends Far Beyond Patient Care

A paper released March 2, 2012, by the Toronto Board of Trade describes the benefits of incorporating the principles of Privacy by Design into the electronic health record (EHR) environment. The paper, entitled Embedding Privacy Into the Design of Electronic Health Records to Enable Multiple Functionalities – Win/Win is co-authored by Dr. Ann Cavoukian, Information and Privacy Commissioner of Ontario, and Richard C. Alvarez, President & CEO, Canada Health Infoway, argues that privacy considerations are essential to using health information for a broad range of purposes.

Canada - Managing the cost of healthcare for an aging population: 2014 provincial perspectives

Canada’s provinces face a common challenge in managing the rising cost of health care for aging populations. Published by the C.D. Howe Institute, this series of ten reports looks at population aging and its projected effects on government revenues and programs.

Canada - Time for Transformative Change: A Review of the 2004 Health Accord

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.

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.

Canada - Lean in British Columbia’s Health Sector.
Annual Report 2010–11

Brief analytical summaries or syntheses #38 Canada - Lean in British Columbia’s Health Sector. Annual Report 2010–11 Summary Published in September 2011 by the British Columbia Ministry of Health, this annual report presents seven case studies of Lean process redesign work carried out by B.C. health authorities in 2010-11. In the health sector, Lean is a patient-focused approach that systematically eliminates waste in health care organizational processes in order to improve quality, productivity, and efficiency. Background Lean is an approach to systematically eliminate waste in organizational processes in order to improve quality and productivity, and reduce costs. At the heart of Lean in health care is the mapping of a patient’s journey through the system in order to identify steps that are of value to the patient, and those that add no value (i.e., are waste). Lean may be used to redesign a discrete process, as a strategy for improving…

Canada - Canadian Federal Health Transfers to the Provinces 2012 edition

The continued commitment to growing federal cash transfers to Canadian provinces raises the important question of whether or not marked increases in such transfers have previously been effective at improving Canada’s health care system. To answer this question, this study from the Fraser Institute examines the evidence. The first section outlines federal transfers to the provinces for health. The second examines a series of health care performance indicators in 1997 and 2004, and compares them with current performance to determine if any changes have occurred. The final section provides recommendations.

Canada - Reforming Canadian Primary Care – Don't Stop Half-Way

Strong primary care is a fundamental underpinning of high-performing health systems. Sadly, primary care infrastructure and performance in Canada lag behind many of our international peers. Although substantial reforms have been implemented over the past decade, progress has been uneven, and no province has all the essential system elements in place. Continued investment is both needed and affordable, according to this paper.

Canada - Canada Needs Federal Leadership to Accelerate Health Innovation and Improve System Performance

On December 2, 2014, 39 national healthcare organizations that comprise the Health Action Lobby (HEAL) issued a consensus statement calling for the federal government to embrace the Canadian Way of addressing national health issues through compassion, consensus, and collaboration. The statement is intended to prompt federal parties to articulate their positions on health care in advance of elections in 2015.

Canada – Resource allocation to health and social service organizations: Ways and means of implementing activity-based funding

Allocation des ressources aux établissements de santé et services sociaux : Pistes et balises pour implanter le financement à l'activité The Association québécoise d’établissements de santé et de services sociaux (AQESSS) published this document to describe its position on activity-based financing. It follows lengthy examination and debate within the association. The document analyses current mechanisms for allocating resources to health and social service organizations, noting their limitations and suggesting ways to gradually put activity-based funding in place. It includes an analysis of experiences in different parts of Canada and elsewhere in the world. The AQESSS intends to pursue discussions with the Québec government based on this document.

Canada - Waiting Your Turn: Wait Times for Health Care in Canada 2010 Report

The Fraser Institute’s twentieth annual waiting list survey finds that province-wide wait times for surgical and other therapeutic treatments have increased in 2010. The total waiting time between referral from a general practitioner and delivery of elective treatment by a specialist, averaged across all 12 specialties and 10 provinces surveyed, has risen from 16.1 weeks in 2009 to 18.2 weeks in 2010.

Canada - Hospital deaths dropping in Canada

The Canadian Institute for Health Information (CIHI) released 2013-14 data showing that 57% of Canadian hospitals outside Québec have shown a decrease in hospital deaths over the last 5 years. The six leading causes of death in hospital are stroke, heart failure, chronic obstructive pulmonary disease, sepsis and heart attack. The CIHI considers that public reporting on hospital deaths plays an important role in improving care.

Canada - Additional Funds for the Healthcare System in Canada: The Distributional and Economic Impact of Alternative Revenue-raising Schemes

Canadian governments are concerned about the sustainability of the publicly funded healthcare systems. Public healthcare expenditures are increasing at a rate that exceeds gross domestic product (GDP) growth and the recent global economic downturn has put pressure on available resources. Total current health expenditure is estimated to have reached $192 billion in 2010, with the public sector covering about 70% of the total and the private sector the balance. This report focuses on potential actions governments can take to increase revenues for the healthcare system and examines their economic and distributional consequences.

Canada - Comparative Review of the Policy Landscape of Team-based Primary Health Care Service Delivery in Western Canada

Conducted for Alberta Health Services (AHS), this review gives a snapshot of the policy landscape of team-based primary healthcare in British Columbia, Alberta and Saskatchewan. The review finds that policies in all three provinces reflect poor planning in primary care, and notes that guidance, metrics, resources and appropriate pay scales are often not available for team-based models.

Canada - Release of 2014 Report Card on Wait Times in Canada - Time to Close the Gap

The Wait Time Alliance (WTA) released its 2014 Report Card on June 3. It finds that medical wait times have improved since the signing of the 2004 Health Accord, but progress has been uneven. While Newfoundland and Labrador, Ontario and Saskatchewan have made or are beginning to make substantive and sustained progress, other provinces continue to struggle and there remain significant variations within provinces and communities.

Canada - Growth in drug spending lowest in 15 years

While drug spending continues to increase in Canada, overall annual growth has slowed to its lowest rate in 15 years, according to a new report released recently by the Canadian Institute for Health Information (CIHI). Total drug expenditure is estimated to have reached $32.0 billion in 2011, an increase of 4.0% over 2010; this was equal to $929 per Canadian in 2011. The share of total health dollars spent on drugs is forecast to have been 16% in 2011—the same percentage that was spent on drugs 10 years ago.

Canada - Funding Canadian Health Care in 2035: Strategic Foresight Scenarios

In October 2015, the Conference Board invited a broad range of Canadian health care stakeholders to participate in a full-day workshop entitled “How will health care in Canada be funded in 2035?” The goal was to develop a number of plausible scenarios outlining how the funding of health care could evolve. This report presents four very different, plausible worlds that Canadians could face in the future when it comes to healthcare funding and the implications that need to be considered.

Canada - Policy Innovation is Needed to Match Health Care Delivery Reform: The Story of the Champlain BASE eConsult Service

This commentary says Canada needs to reform health services delivery and finds that the current lack of policy responsiveness hinders the expansion of innovations to improve patient care. To illustrate these challenges and how they might be overcome, the authors explore an innovative electronic specialist consultation start-up that is growing into an Ontario-wide service.

Canada - The Scope of Medicare: What makes sense today? Report from the MUHC-ISAI’s fourth annual conference

The McGill University Health Centre’s Institute for Strategic Analysis and Innovation (MUHC-ISAI) enables the MUHC to contribute to the ongoing development of health care policy. This report presents highlights from the conference it held on October 26 and 27, 2011 to evaluate Canada’s performance against increasing costs and expectations and explore the scope of Medicare with a view to encouraging and supporting an effective framework for change. It includes presentations on health system changes in the U.K. and The Netherlands and talks by Jeffrey Simpson, Pierre-Gerlier Forest, Claude Castonguay, Philippe Couillard, André Picard and others.

Canada - A Snapshot of Health Care in Canada as Demonstrated by Top 10 Lists, 2011

The purpose of this publication published by the Canadian Institute for Health Information (CIHI) is to provide an overview of health care use and resource demands. It provides a snapshot of the most common reasons for hospitalization, emergency care and primary care along with the most important costs.

Canada - How to Effectively Engage Patients in Patient Safety: New Guide available

Written by patients and providers for patients and providers, the Guide was developed in collaboration with patients and patient engagement experts from across Canada. It is designed for use in all healthcare settings. Published by the Canadian Patient Safety Institute, the guide includes four sections: evidence, challenges and enablers that support patients as partners; patient engagement at the point of care; patient engagement at organization and system levels; and evaluating patient engagement.

Canada - Health care in Canada. What Makes us sick?

Throughout the winter and spring of 2013, the Canadian Medical Association (CMA) conducted consultations to gather input on Canadians’ views on the social determinants of health. Four main social determinants of health were identified by participants: income, housing, nutrition and food security and early childhood development. Twelve recommendations emerged, including piloting a guaranteed annual income, expanding the “Housing First” approach for people with chronic conditions causing homelessness, and ensuring that all Canadians have access to medically necessary drug therapies.

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.

Canada - 2017 CMA Workforce Survey highlights doctors' concern over patient access to care

A survey by the Canadian Medical Association (CMA) shows physicians are concerned about patients' ability to access care. Sampling 7,000 physicians across Canada, the CMA Workforce Survey found that only 48.6% rated Canadians' access to hospital elective procedures as satisfactory. A large majority (80.9%) rated access to long-term care beds as unsatisfactory.

Canada - How do Canadian primary care physicians rate the health system? Survey results from the 2012 Commonwealth Fund International Health Policy Survey of Primary Care Doctors

In this issue of Canadian Health Care Matters, the Health Council of Canada examines survey results that shed light on the potential for improvement in several key areas: access to primary health care, coordination among health care providers, the uptake of information technology in primary care, and initiatives to drive practice improvement.

Canada - Canadian Public Administration - Special issue on performance measurement, performance management, and accountability

This special issue Includes an editorial and eight original articles (five in English and three in French) on performance measurement, management, and accountability in Canada. It looks at cities (municipal management indicators); provinces (Quebec's health and welfare commissioner); and the national scene (health system performance reporting). Other articles look at performance measurement in public sector management, service delivery and research.

Canada - Paying for Hospital Services: A Hard Look at the Options

Hospitals are the most costly form of care, adding up to over $58 billion per year across Canada. This study from the C.D. Howe Institute examines what it says is an ineffective use of hospital resources nationwide and makes recommendations for activity-based funding and budgeting at the hospital level.

Canada - Electronic Medical Records Deliver Efficiencies, Patient Safety, Improved Communication

Canada Health Infoway commissioned this study from PriceWaterhousCooper to calculate the benefits achieved since 2006 with a doubling in the adoption of electronic medical records (EMRs) in community-based practices. The study reveals that adoption of EMRs has brought efficiency and patient care benefits valued at $1.3 billion, most of which comes from administrative efficiencies.

Canada - Developing a New First Nations Health Governance System: Creation of an Independent, First Nations Run Organization

In 2011 a tripartite agreement between the province of British Columbia (BC), Health Canada, and First Nations leaders created the First Nations Health Authority (FNHA), with the goal of addressing health disparities between First Nations and other residents of BC, as well as increase the voice of First Nations people in the health system. This article considers that the FNHA has good potential and may be emulated by other provinces. However there remain administrative weaknesses and issues of recruitment and retention.

Canada - Harper government offers student loan forgiveness to family doctors and nurses working in 4 200 rural communities

Family doctors and nurses can work in more than 4,200 designated rural and remote communities to be eligible for Canada Student Loan forgiveness. Designated communities refer to those with a population of less than 50 000, including communities that provide health services to First Nations, Inuit and Métis populations. Nurses and nurse practitioners will be eligible to receive up to $4,000 per year in loan forgiveness, while family doctors and residents in family medicine could receive up to $8,000 per year, for a maximum of five years. The Program will begin accepting applications for student loan forgiveness on April 1, 2013.

Canada - The Concentration of Hospital-based Medical Spending: Evidence from Canada

Using longitudinal administrative data, this paper documents how hospital spending is concentrated cross-sectionally over time. Starting around age 50, expenditures in Québec rise rapidly. The top 1% of users account for 55.5% of total spending. Spending in the last year of life accounts for 11% of total hospital spending, with most occurring in the last month of life.

Canada - Ontario ranks among the best in Canada and internationally when it comes to certain measures of the coordination of care and communication between older patients and their health care providers

Ontario patients aged 55 and older often experience top-rated coordination of their health care, as well as communication with their health care providers, compared to people in other provinces and in other countries, according to Experiencing Integrated Care, the latest report from Health Quality Ontario (HQO), the provincial advisor on health care quality.

Canada - Many more young Canadians using health services for mental disorders

The Canadian Institute for Health Information reports that the rate of hospitalizations and emergency department (ED) visits by children and youth in Canada for mental disorders has increased substantially since 2006–2007. The increase is largest in youth age 10 to 17, with ED visit rates up 53% and inpatient rates up 74%. One theory is that reduced stigma has prompted more people to seek help.

Canada - Experimental Measures of Output and Productivity in the Canadian Hospital Sector, 2002 to 2010

This paper published by Statistics Canada constructed an experimental volume index of hospital sector output by aggregating inpatient and outpatient cases using their cost share as weights. This cost-weighted activity index was corrected for substitution bias and aggregation bias.

Canada - Spending on drugs continues to rise but at a much slower annual growth rate—3.3%, the lowest in 16 years—reveals the Canadian Institute for Health Information (CIHI)

According to CIHI’s Drug Expenditure in Canada, 1985 to 2012, drugs continued to account for the second-highest share (15.9%) of health spending, behind hospitals and ahead of physicians. However, drug spending has grown more slowly than those two categories over the past decade. The slowed growth in prescribed drug spending is due to patent expirations of several blockbuster pharmaceuticals and generic pricing policies.

Canada - Advancing team-based primary health care: a comparative analysis of policies in western Canada

This study compares primary health care (PHC) policies in British Columbia, Alberta and Saskatchewan to see how they inform the design and implementation of team-based PHC service delivery. The concept of team-based PHC varies widely across and within the three provinces. The study noted policy gaps related to team configuration, leadership, scope of practice, role clarity and financing of team-based care.

Canada - Drug Coverage for Low-Income Families: The Canadian reality and lessons from Switzerland and the Netherlands

As the Canadian government looks at drug insurance policy in Canada, the Fraser Institute has published two studies that seek to inform policy debate. A first explains the drug insurance coverage already available to low-income Canadians. A second presents the universal drug coverage programs available in Switzerland and the Netherlands, which are provided through regulated, competing private insurance companies.

Canada - Toward Health and Equity for All: Canada's Doctors Release Blueprint for Action

On March 18, 2013, the Canadian Medical Association announced the release of a paper outlining ways front-line physicians can help level the playing field and ensure that more of their patients can achieve good health. Physicians and Health Equity: Opportunities in Practice outlines seven steps physicians can take to help their patients counter social or economic factors that are barriers to good health.

Canada - Reviewing the Potential Roles of Financial Incentives for Funding Healthcare in Canada

This report from the Canadian Foundation for Healthcare Improvement (CFHI) describes the methods and results of different approaches to funding healthcare, including global budgets, activity-based funding (ABF), and pay-for-performance (P4P). These are described in detail and contextualized to the Canadian healthcare setting. The report looks at recent provincial initiatives for funding healthcare services.

Canada - Health Care Reform from the Cradle of Medicare

According to this report from the Macdonald-Laurier Institute, fundamental changes to Canada’s healthcare system and funding will be required in the near future to address a looming fiscal crisis caused by aging baby boomers. The report recommends serial changes that can be made to offset demographic impacts while maintaining the current single payer healthcare system.

Canada - Canadians lagging well behind similar countries on access to new medicines: report

This report prepared by IMS Brogan for Rx&D says Canadians’ access to new medicines ranks 17th among 18 OECD countries. Canadians face wait times of over 460 days to gain access to new medicines, and only 23% of Health Canada-approved new medicines in 2014 are included within public drug plans.

Canada - The Experience of GP Surgeons in Western Canada: The Influence of Interprofessional Relationships in Training and Practice

This article from the Journal of Research in Interprofessional Practice and Education surveys the barriers faced today by GP surgeons in British Columbia and Alberta, and highlights the need for new training programs. Barriers include lack of interprofessional support and a culture of specialist care. The authors maintain that the goal of treating patients close to home cannot be achieved until enhanced-skill generalist physicians are equipped and trusted to provide quality care.

Canada - Canadians continue to wait for care

While progress has been made in some areas - most notably priority surgeries - people continue to wait at nearly all points of their journey through the health care system, concludes two new reports from the Canadian Institute for Health Information (CIHI). Health Care in Canada, 2012: A Focus on Wait Times looks at people’s experiences in accessing care across the health system. Seniors and Alternate Level of Care provides further insight into hospitalized patients waiting for long-term care or home care services.

Canada - Disparities in Care Point to Need for Complex Cancer Surgical Centres

A new report from the Canadian Partnership Against Cancer finds that there are tremendous variations in in-hospital mortality, resection rates and length of stay outcomes in cancer surgery across Canada. Surgical mortality rates were three to four times higher in some provinces than in others. As well, people in provinces with high resection rates are twice as likely to receive potentially curative surgeries than people in provinces with low rates. The report proposes regional centres of excellence to improve access to and outcomes of cancer surgeries.

Canada - Better Healthcare for Albertans

Produced by Alberta's Auditor General, this analysis of Alberta Health Service (AHS) primary care networks and chronic disease management notes barriers to better care resulting from: the health system's fragmented structure, the poor integration of physician services, inadequate sharing and use of clinical information. The analysis calls for further service integration and provides examples of integrated care from Canada's other provinces.

Canada - Future Care for Canadian Seniors: A Status Quo Forecast

The Conference Board of Canada estimates, in this report, that spending on continuing care for seniors will increase from $29.3 billion in 2011 to $184.2 billion in 2046. Labour demand in the sector will far exceed supply and reliance on unpaid caregivers and volunteers will grow dramatically. The Conference Board considers that responding to these needs in an efficient and sustainable manner will require collaboration among the diverse mix of public and private stakeholders that make up the continuing care sector.

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.

Canada - A Better Prescription: Advice for a National Strategy on Pharmaceutical Policy in Canada

Building on published research and international frameworks, this article proposes that the pharmaceutical policies of federal, provincial, and territorial governments be coordinated around a core health-focused goal. It strongly suggests policy action on four core objectives: universal access to necessary medicines; appropriate prescribing and use of medicines; value for money spent on medicines; and patient safety.

Canada - Trends in Income-Related Health Inequalities in Canada

This project undertaken by the Canadian Institute for Health Information, examines whether the health gaps between lower- and higher-income individuals have changed over the past decade. The Health Inequalities Interactive Tool provides a series of visualizations to explore inequalities for 9 health indicators over time, by sex and by province. The technical report provides additional analysis.

Canada - Comparing Performance of Universal Health Care Countries, 2017

The comparable data assembled in this study suggests that although Canada has one of the most expensive healthcare systems in the OECD, its performance is modest to poor. The study compares the cost and performance of universal healthcare systems in 29 high-income countries. Levels of expenditure are measured by two indicators, while system performance is measured using 42.

Canada – CHSRF: Three new reports on healthcare improvement commissioned with the Canadian Nurses Association

The three reports released by the CHSRF in June 2012 are 1) Better Health: An analysis of public policy and programming focusing on the determinants of health and health outcomes that are effective in achieving the healthiest populations, 2) Better Value: An analysis of the impact of current healthcare system funding and financing models and the value of health and healthcare in Canada and 3) Better Care: An Analysis of Nursing and Healthcare System Outcomes.

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.

Canada - Nine out of 10 emergency visits take 7.5 hours or less

This report from the Canadian Institute for Health Information (CIHI) is based on data covering more than half of all visits to the emergency department (ED) in Canada. The analysis reveals that complex patients can expect to spend more than twice as long in the ED as minor/uncomplicated patients. Nine out of 10 complex patients spent 10.5 hours or less in the ED in 2011–2012. In comparison, nine out of 10 of the minor/uncomplicated patients spent 4.2 hours or less in the ED. Data tables are available on the CIHI website.

Canada - Maximizing Community Health Nursing Capacity in Canada: A Research Summary for Decision Makers

This research summary is a valuable resource for health administrators, planners and policy-makers who – in the face of rising demand for improved home care, public health, primary healthcare and other community care services – are tasked with developing HR policies for community health.

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.

Canada - The Price of Public Health Care Insurance: 2012 Edition

Published by the Fraser Institute, this report itemizes the current expenditures and costs of the Canadian public healthcare system. Between 2002 and 2012, healthcare insurance costs increased twice as fast as average income in Canada.

Canada - More than 60,000 Canadians left the country for medical treatment in 2016

A Fraser Institute study has found that 63,459 Canadians travelled abroad for medical care in 2016, departing for general surgeries (9,454 patients), urology treatment (6,426), internal medicine procedures (5,095) and ophthalmology treatment (3,990). British Columbia reported the highest proportion (2.4%), while Ontario had the greater number (26,513) of patients leaving Canada for care.

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.

Canada - Primary care teams are not as effective as they could be because of three sets of barriers

Interprofessional primary care teams are not working as well as they should says the Conference Board of Canada in a report released at the Summit on Sustainable Health and Health Care in Toronto on Oct 31, 2012. Barriers in the system, among team-mates and in practices prevent teams from serving patients effectively.

Canada - A Third Option for the Heath Care debate: Think community and courage

In “A Third Option for the Health Care Debate”, authors Dianne Kelderman and Dr. David Zitner unveil a third option, health care co-operatives.There are over a hundred health care co-ops operating in Canada today, especially in Québec and Saskatchewan. They are incontestable evidence of the determination and ability of ordinary people – people without medical training – to have a say in the design, delivery, and evaluation of health services that they and their neighbours receive.

Canada - Ground-Breaking Research Shows that ‘Housing First’ Approach Working to End Homelessness

The Mental Health Commission of Canada released research findings from the At Home/Chez soi program it has pioneered in several Canadian cities since 2008. The program demonstrated housing stability over a two-year period for participants; it was effective for people from diverse backgrounds, and every $10 invested resulted in cost savings of up to $21.72.

Canada - Measuring performance is essential to patient-centred care

A paradigm shift is needed in Canada toward a patient-centred health system according to this editorial by Paul C. Hébert, Editor-in-Chief, CMAJ. Change will only occur if patients have access to the necessary information to make their health care decisions. Without comparative measurements, decisions focused on the interests of institutions and health practitioners will continue to be made by administrators and bureaucrats because of limited public engagement.

Canada - The implementation evaluation of primary care groups of practice: a focus on organizational identity

Since 2002 the Health Ministry of Quebec (Canada) has been implementing a primary care organizational innovation called 'family medicine groups'. This is occurring in a political context in which the reorganization of primary care is considered necessary to improve health care system performance. More specifically, the purpose of this reform has been to overcome systemic deficiencies in terms of accessibility and continuity of care. This paper examines the first years of implementation of the family medicine group program, with a focus on the emergence of the organizational identity of one of the pilot groups located in the urban area of Montreal.

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 - 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.

Canada - Measuring Up. A yearly report on how Ontario’s health system is performing

Measuring Up uses the Common Quality Agenda, a set of indicators developed with experts across the province, to see how the quality of care is changing in Ontario — how each local health integration network (LHIN) region is performing, and how the province compares with the rest of Canada and other countries. The report shows that over the past four to 10 years, 13 key performance indicators demonstrate improvement, 20 indicators show no change and two have deteriorated.

Canada - Healthcare in Quebec: more money in, fewer services out

A new publication from the Centre for Productivity and Prosperity compares best practices in healthcare management in Quebec and six European countries. It finds that while Quebec spends more on healthcare than the rest of Canada and these other countries, the province not only provides fewer services than elsewhere, but has fewer doctors and less equipment.

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 - Waiting Your Turn: Wait Times for Health Care in Canada, 2015 Report

Produced annually by the Fraser Institute, this report indicates that Canadian wait times for medically necessary treatment did not improve in 2015. Provincially, Saskatchewan reported the shortest total waits (13.6 weeks), while Prince Edward Island reported the longest (43.1 weeks). In 2015, roughly 2.5% of Canadians were waiting for treatment; the longest waits are for orthopedic surgery (35.7 weeks).

Canada — New healthcare financing series by the CHSRF: What If?

This series puts forward tangible policy options for addressing the sustainability of Canada’s healthcare. It presents possibilities and opportunities for improving efficiency and providing additional revenue.

Canada - Comparing Performance of Universal Health Care Countries, 2016

Canada spends more on health care than almost every other comparable country with universal care finds a new study released by the Fraser Institute. The study compares 28 universal health-care systems in developed countries, spotlighting several key areas including cost, use of resources, access to care and treatment, clinical performance and quality, and the health status of patients.

Canada - New health information technology strategy: put money where the patient is

The Canadian Medical Association (CMA) has released a new health information technology (HIT) investment strategy that aims to reboot Canada’s HIT agenda to better focus on supporting front line patient care. Transforming the health care system hinges on building better tools and supports to help health care professionals interact and provide care for patients. To that end, the HIT strategy prioritizes the key clinical and system priorities for investment over the next 3-5 years as follows: chronic disease management; prevention and health promotion; medication management; continuity of care (information flow, access and wait times); patient involvement; and public health reporting.

Canada - Canadians ready to talk about death and dying

The Canadian Medical Association (CMA) held a number of town hall meetings across Canada to find out what people had to say about death and dying. The CMA recommends, based on what it heard, that all Canadians have access to palliative care services and that people communicate more about their end-of-life wishes.

Canada - Economic arguments for shifting health dollars upstream

Researchers have offered evidence that Canada’s health sector could serve citizens better at less cost if more attention was paid to improving living and working conditions across society. This paper analyzes drivers of Canadian health funding and spending while making an economic argument explicitly linking healthcare outcomes and costs with social determinants, structural social power relations, and current government socioeconomic policies.

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 - e-Booking Initiative

Canada Health Infoway's e-Booking Initiative offers financial support to help offset costs associated with e-booking implementation and participation in the Initiative. To qualify for the Initiative, eligible clinicians must acquire and implement a qualifying e-booking solution of their choice, which enables their patients to choose a date and time for an appointment electronically and book the appointment without interacting with another person.

Canada — Did changing primary care delivery models change performance? A population based study using health administrative data

Primary care reform in Ontario, Canada started with the introduction of new enrolment models, the two largest of which are Family Health Networks (FHNs), a capitation-based model, and Family Health Groups (FHGs), a blended fee-for-service model. The purpose of this study was to evaluate differences in performance between FHNs and FHGs and to compare performance before and after physicians joined these new primary care groups.

Canada — Canada’s Health Care System – Time for an Intervention

This report concludes that Canadians are not getting full value for their health care dollars and that much of the problem stems from an over-emphasis on acute care rather than on prevention. A change in priorities could do much to improve the system. The recommendations highlighted in this report focus on the following six issues: the level of health spending, user-based funding, health credits, evidence-based medicine, outsourcing, and wellness.

Canada — Registered nurses launch Expert Commission on health system renewal

The Canadian Nurses Association recently launched its National Expert Commission on health system improvement, entitled The Health of Our Nation — The Future of Our Health System. The Commission’s mandate is to generate policy solutions that contribute to a transformed health system — one that is better equipped to meet the changing health needs of Canada’s population.

Canada - Triple Aim in Canada: developing capacity to lead to better health, care and cost

Many health systems strive for Triple Aim — better population health, improved patient care, and lower costs. This paper describes the participation of nine Canadian teams in an international Triple Aim improvement community offering support for design, implementation, assessment and sustainability through a program of webinars and activities. An evaluation of the Canadian cohort examines their progress in building Triple Aim infrastructure across healthcare settings.

Canada - Pharmacist care for patients with hypertension would save Canada's health care system more than $15.7 billion

A study published in the May/June issue of the Canadian Pharmacists Journal shows that long-term pharmacist care for Canadians with hypertension, including patient education and prescribing, improves health outcomes and reduces costs in the health system. Projected cost savings would be more than $15.7 billion if pharmacists provided care to their full scope of practice.

Canada - Less Ottawa, More Province: How Decentralization is Key to Health Care Reform

Based on Canada’s experience with welfare reform, this paper by the Fraser Institute recommends the devolution of healthcare decision-making powers to the provinces, with the federal government permitting each province maximum flexibility (within a portable and universal system) to provide and regulate healthcare provision as they see fit.

Canada - Effect of provincial spending on social services and health care on health outcomes in Canada: an observational longitudinal study

This study used retrospective data from provincial expenditure reports (1981-2011) to model the effects of social and health spending on life expectancy and potentially avoidable mortality. Findings showed that a one-cent increase in social spending per dollar spent on health was associated with increased life expectancy and decreased mortality. The authors conclude that health outcomes benefit from reallocating government dollars from health to social spending.

Canada - Healthcare Organizations Across Canada Launch Improvement Projects

In April 2017, the Canadian Foundation for Healthcare Improvement (CFHI) announced nine healthcare improvement projects it will support through its flagship fellowship program. Selected healthcare organizations in Quebec, Ontario, British Columbia and Nova Scotia will implement and evaluate projects focusing on innovative ways of providing patient care in the home and communities.

Canada - Canada curbs health spending as expenditures reach $211B

The Canadian Institute for Health Information published National Health Expenditure Trends that show slower spending growth in each year since 2011. Spending is expected to rise by 2.6% in 2013, less than half the average growth of 7% per year between 2000 and 2010.

Canada - Hold the Applause: Why Provincial Restraint on Healthcare Spending Might Not Last

According to this report by the CD Howe Institute, the recent downward bending of provincial healthcare cost curves across Canada (an average 0.6% drop in 2015) will likely be temporary due to rising drug cost pressures and an inability to maintain large decreases in capital spending. The authors recommend that the federal government ensure provincial health transfers never fall below 3% annually.

Canada - Current State of Lean in Canadian Health Care

Published by the Conference Board of Canada, this review of Lean management in Canadian health care shows that although Lean effectively addresses clinical, operational, and experiential value, its application has been limited by modest investment from health regions. The review says large differences in the approaches used across the country suggest different philosophical views of Lean techniques.

Canada - The Path to Health Care Reform: Policy and Politics

In this monograph journalist and CIBC Scholar at the Conference Board of Canada, André Picard, takes a non-ideological look at the genesis of the modern health care system to understand what was constructed in previous generations and why. He explores the intersection between health policy and health politics and concludes with an optimistic view that universality - within practical limits - can continue.

Canada - More doctors, but average payments to physicians virtually unchanged

According to the Canadian Institute for Health Information (CIHI), the number of physicians in Canada increased to more than 82,000 in 2015 (228 doctors per 100,000 population). Annual average gross clinical pay remained virtually unchanged at $339,000. The province of Alberta recorded the highest payments, and Nova Scotia the lowest.

Canada - Harper Government committed to increasing palliative care training across the country

The federal Minister of Health committed to increasing funding to the Pallium Foundation of Canada for an initiative called Building the Future of Palliative Care Together, which aims to equip more front-line healthcare providers with the skills and knowledge they need to care for people with life-threatening conditions.

Canada - Generic drugs slow spending growth

The Canadian Institute for Health Information (CIHI) published its report on drug spending, entitled Prescribed Drug Spending in Canada, 2012: A Focus on Public Drug Programs. Prescription drugs accounted for 85% of the $34.5 billion that was spent on all drugs in 2013, at a cost of $29.3 billion. The annual growth rate was the second-lowest in more than 20 years, at 2.3%, due primarily to greater use of generics.

Canada - Learning from Kaiser Permanente: Integrated systems and healthcare improvement in Canada

Written by a UK academic for the Canadian Foundation for Healthcare Improvement, this paper compares two distinctive approaches to health service provision: a US non-profit insurance and managed care system, and two provincial tax-funded, single insurer systems in Ontario and Saskatchewan. The report finds that the US system, Kaiser Permanente, invested heavily in an integrated clinical system that holds many lessons for Canadian systems.

Canada - Unmet Mental Health Care Needs Costing Canadian Economy Billions

According to the Conference Board of Canada, anxiety and depression cost the Canadian economy almost $50 billion every year because of lost productivity. According to this report, a quarter of Canadians with mental illness are unable to work and workplace programs, supports and benefits are rarely offered.

Canada - Exploring alternative level of care (ALC) and the role of funding policies: An evolving evidence base for Canada

This report commissioned by the Canadian Health Services Research Foundation (CHSRF) synthesizes the evidence regarding funding policies designed to improve patient care in the transition period between acute and post-acute settings. Those in this transition period are referred to as alternate level of care (ALC) patients. Provinces and regions are adopting a number of strategies to prevent the use of expensive hospital beds for ALC patients. This report provides a number of recommendations for improving policies and practices in this area.

Canada - Scan of Mental Health Strategies across Canada

The scan produced by the National Collaborating Centre for Healthy Public Policy is presented in the form of a table that is divided into 6 sections. It presents provincial and territorial strategies in mental health whose objectives target different dimensions of mental well being and mental illness; foundational documents in the field of population mental health; social policies that target the determinants of mental health; strategies and reports related to suicide prevention; public health-related strategies; and federal mental health-related strategies.

Canada - Integrated Funding: Connecting the Silos for the Healthcare We Need

According to this article from the C.D. Howe Institute, healthcare delivery silos are impeding Canada’s ability to adapt to changing demands. The article points to experiences in the US and Europe with integrated payment models that distribute funding envelopes across providers. The authors consider this the best way to reduce healthcare costs and increase efficiency and effectiveness.

Canada - Evidence-informed options for hospital funding. Are hospital funding mechanisms in Canada designed to provide efficient care?

Based on a paper commissioned by the Canadian Health Services Research Foundation, this brief provides a summary of the available evidence on promising hospital funding options and their impact on the following goals: timely and equitable access, optimal volume of care, quality, efficiency and constraining future cost increases.

Canada - The At Home/ Chez Soi Project: Sustainability of Housing & Support Programs Implemented at the Montreal Site

Published by the Mental Health Commission of Canada, this study tells the sustainability story of the Housing First (HF) services that were established during the At Home/Chez Soi (AHCS) project in Montreal, after its official closure in March 2013. The research program was designed to measure the effects and benefits of HF on adults experiencing homelessness and a severe mental illness. In Montreal, 469 people participated. The study, based on interviews with a wide range of system actors, identifies factors that influenced the sustainability of the HF program.

Canada - Smart Public Spending in Mental Health Spells Long-term Savings, Says New MHCC Report

This report from the Mental Health Commission of Canada (MHCC) outlines investments in mental health that have the greatest impact and produce a return on investment to government. It proposes three areas for action: prevention and promotion, community-based services for common mental illnesses, and specialized services for people with severe mental illness.

Canada — Research synthesis on cost drivers in the health sectors and proposed policy options

This synthesis and the concluding policy options represent a starting place for more in-depth exploration by CHSRF, and will inform policy dialogues on how best to ensure accessible, high-quality and sustainable healthcare for Canadians. This report synthesizes the current body of knowledge on cost drivers in Canadian healthcare. Cost drivers are factors that bring about increased spending on healthcare. Thus, a comprehensive understanding of cost drivers is essential to a productive debate on the sustainability of Canada’s publicly funded healthcare systems.

Canada - Dramatic results show shifting chronic disease care closer to home reduces hospital use

The Canadian Foundation for Healthcare Improvement (CFHI) is releasing results from an initiative that moves care for chronic obstructive pulmonary disease (COPD) from hospital to home. Conducted in six health regions across Canada, the initiative has dramatically reduced emergency department visits and hospital readmissions while improving quality of life for patients and caregivers.

Canada - Accepting our responsibility. A blueprint for physician leadership in transforming Canada’s health care system

This white paper from the Canadian Society of Physician Leaders recognizes the central role physician play in health system improvement and calls on governments, administrators and physicians themselves to formally recognize the role of physicians as leaders. The paper includes recommended actions for each of these groups and is intended to stimulate discussion at all levels on ways to generate greater physician leadership in healthcare reform.

Canada - New Study Compares Healthcare System Costs among OECD Countries

On January 30, 2014, the Canadian Institute of Actuaries (CIA) and the Society of Actuaries (SOA) released a research report, Funding Public Health Insurance Plans, Canada and Globally. It analyzes potential healthcare metrics that would allow different countries to compare their results and identify relative inefficiencies in their healthcare systems. A Lifestyle Index adjusts expected costs to the health of the population.

Canada - The Conference Board of Canada is launching a new research initiative, called The Canadian Alliance for Sustainable Health Care, or CASHC

CASHC is intended to provide Canadian leaders and policy-makers with insightful, forward-looking, quantitative research and analysis of the sustainability of the Canadian health care system and all of its facets. CASHC is being launched with the ambition of using research and dialogue to help improve the operation of the Canadian health system as a whole, and the health care practices within firms and organizations.

Canada - Canadians continue to report longer wait times for care

A new international survey shows that Canadians continue to report some of the longest wait times for doctors, specialists and emergency department visits compared with citizens in peer countries. However, once they do get medical care, Canadians generally report experiences with their regular providers that are better than the international average. These and more insights come from How Canada Compares: Results From The Commonwealth Fund’s 2016 International Health Policy Survey of Adults in 11 Countries, released by the Canadian Institute for Health Information (CIHI) in partnership with the Canadian Institutes of Health Research.

Canada - CHT Conundrum. Ontario Case Study

Ontario has yet to agree to decreases in the Canada Health Transfer (CHT) proposed by the federal government. As Ontario’s healthcare costs are expected to rise at a pace well above the previously agreed CHT, the health transfer will fall as a share of provincial expenditures even if it is not cut as anticipated. This paper urges a quick return to the negotiating table to resolve the issue.

The Netherlands - Health Care Lessons from the Netherlands

This instalment in the Fraser Institute series "Lessons from Abroad" looks at what Canada can learn from the Dutch system of funding and providing health care. The author highlights features he feels contribute to lower wait times in The Netherlands, such as cost-sharing for non-primary medical services, private provision of acute care hospital and surgical services, activity-based funding for hospitals, direct purchasing and independent insurers. He recommends adopting these measures in Canada, acknowledging that some would contravene the Canada Health Act.

Canada - Health Care Sustainability More Than a Fiscal Matter

A new Conference Board of Canada report,Defining Health and Health Care Sustainability, stresses that sustaining health and health care requires a multi-faceted approach that goes far beyond decisions about how much money to spend. According to the report, four principles should guide sustainability strategies: accountability for results, value for money, fair and timely access, and appropriateness.

Canada - Canada Needs a National Pharmacare Program

A Roadmap to a Rational Pharmacare Policy, published by the Canadian Federation of Nurses' Unions, calls for governments, insurers, policy makers, and pharmaceutical companies to recognize that the present hybrid system to fund prescription drug purchases is unfair, inequitable and wastes money. The Roadmap states that universal pharmacare program will help build the institutional capacity to improve access, diminish costs, improve practices and ensure the continued sustainability of the healthcare system.

Canada - Three Canadian Cities Receive Top Marks in Conference Board’s First City Health Ranking

Saskatoon, Calgary and Winnipeg have earned the top grades in the Conference Board of Canada’s first City Health Monitor benchmarking the health performances of 10 Canadian cities. Each city received a grade on 24 indicators regarding life satisfaction, population health, lifestyle and access to health care. The city of Montreal had the worst scores.

Canada - The Role of the Federal Government in Health Care Report Card 2016

Produced by the College of Family Physicians of Canada, this report card for 2016 uses 23 indicators to evaluate the federal government’s success in upholding national standards of care. It gives the government consistently mediocre grades on ensuring health care access, equity and funding, although there is strong support for research. Federal government support for primary care is minimal.

Canada — Canadian Alliance for Sustainable Health Care Launched To Tackle the Full Spectrum of Canadian Health

The Conference Board of Canada recently launched the Canadian Alliance for Sustainable Health Care (CASHC), a five-year, multi-million dollar initiative that seeks to improve the Canadian health system as a whole – as well as health-care practices within firms and organizations. The work of CASHC will help Canadians to better understand the conditions for a sustainable health-care system, which includes dimensions of financial sustainability, firm-level performance, and institutional factors.

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 - Understanding and Implementing Best Practices in Accountability

Relying on document analysis and informant interviews, this study assesses whether findings on best practices in accountability from a previous Ontario-based study (Approaches to Accountability, 2014) apply across Canada. Results reinforce earlier findings, showing that goals, resources, stable leadership and a focus on transitions points within the system are essential to good practice, as is the availability of good measurement.

Canada - National Health Expenditure Trends, 1975 to 2010

Total spending on health care in Canada is expected to reach $191.6 billion this year, growing an estimated $9.5 billion, or 5.2%, since 2009, according to new figures released recently by the Canadian Institute for Health Information (CIHI). This represents an increase of $216 per Canadian, bringing total health expenditure per capita to an estimated $5,614. After removing the effects of inflation and population growth, health care spending per person is expected to increase by 1.4% in 2010, the lowest annual growth rate seen in 13 years.

Canada - The Sustainability of Health Care Spending in Canada 2017

Health-care spending by provincial governments has increased by 116 per cent since 2001, and even though increases have slowed recently, health care is projected to consume an even larger portion of program spending over the next 15 years, according to a new study released by the Fraser Institute.

Canada — New National Mental Health Standards Focus on Community Services

Accreditation Canada has released new national health care standards for community-based mental health services. The Community-Based Mental Health Services and Supports Standards cover a wide variety of services including mental health promotion and education, early intervention services, crisis intervention, counselling and therapy, peer and self-help programs, diversion and court support, and social rehabilitation and recreation.

Canada - Is the Budget Balance Fragile or Robust? Quebec Faces Health Funding Challenges

The Institut du Quebec produced this paper looking at whether the province's newly balanced budget can withstand health spending increases. It finds Quebec now has enough financial leeway to increase health spending by 4.2% a year. If the economy slows substantially, a balanced budget could be preserved if the federal government reverted to 6% annual growth in the Canada Health Transfer.

Canada - Family Physicians Challenge the Federal Government to Play a Greater Role in Health Care

On November 6, 2013, the College of Family Physicians of Canada (CFPC) released a report card on the federal government’s involvement across five areas, including supporting care for the most vulnerable, setting a national health strategy, and developing and implementing national programs such as home care and immunization. It highlights specific areas in which the CFPC believes the federal government should assume a larger leadership role.

Canada - The Fiscal Sustainability of Canadian Publicly Funded Healthcare Systems and the Policy Response to the Fiscal Gap

This fifth paper in the Canadian Health Services Research Foundation (CHSRF) series on health care financing models presents five expenditure scenarios for Canada as a whole, each of the 10 provinces and the territories for the period 2010 to 2035. It finds that real per capita public health care spending can be expected to grow anywhere from 78% to 115% and reach dollar levels of between $6,552 and $8,798 per capita by 2035. Potential policy solutions to make health care more sustainable are presented.

Canada - A Road Map to Health System Sustainability

The Canadian Alliance for Sustainable Health Care (CASHC) was created to address the widening sustainability gap between government budgets and Canada’s healthcare spending through informed dialogue and consensus for reform and action. This report summarizes the activities and contributions of CASHC in its first mandate, and outlines the framework within which CASHC will function in the coming years.

Canada - With Health Accord debate heating up, CMA publishes special section in Globe

This six-page section of the December 1, 2011, edition of the Globe and Mail reports on the Canadian Medical Association’s recent debates regarding the future of Canada’s national Health Accord. The report includes in-depth polling conducted by the CMA and points to the changes Canadians want to see.

Canada - New Brunswick Health Council (NBHC)’s Population Health Snapshot shows more work needed to address the four health priorities

The NBHC's latest Population Health Snapshot, updated with the most current indicators for the province, show little progress on the four areas identified as priorities in 2011. High blood pressure is increasing, obesity rates have not changed, self-rated mental health remains among the lowest in Canada and rates of hospitalized injuries remain higher than the Canadian average despite a decrease since 2011.

Canada - Health Care Reform: Lessons from the Edge

Most Canadians would acknowledge that health care in Canada requires reform. But substantive changes will likely be difficult to effect, given current demand and expectations around health care. This commentary argues that solid policy options are an essential first step. Equally important, given the political challenges associated with health care, is the process for reform. There are instructive lessons from the recent New Brunswick strategy on poverty reduction and income security renewal that successfully involved government, business and voluntary organizations in a comprehensive, collaborative initiative.

Canada - Prelude to a Systematic Review of Activity-Based Funding of Hospitals: Effects on Health Care System Cost, Quality, Access, Efficiency, and Equity

While decision-makers in Canada contemplate introducing activity-based funding (ABF) models for hospitals, the authors of this study published in Open Medicine point out that there are presently no systematic reviews of evidence on the potential effects of this model. This commentary is intended to alert decision-makers to the upcoming release of a series of papers based on the authors' systematic review of ABF, in the hope that there will be an appetite for this knowledge at a time when they are being asked to make decisions in its absence.

Canada - The Sustainability of Health Care Spending in Canada

Released by the Fraser Institute, this paper assesses expected trends in Canadian health care spending to determine if current spending is sustainable into the future. The paper projects spending to grow by 4.6% to 6.3% per annum between 2015 and 2030, and concludes this rate of increase is not sustainable and will require reductions in other government services or higher taxation and debt.

Canada - Financial Models and Fiscal Incentives: Proceedings From the Healthy Canada Conference, June 2016

The conference, held at the end of 2015, provided delegates with practical insights and evidence-based solutions on how financial models and tax incentives can be leveraged to improve population health and the sustainability of the health care system while delivering value for money. Presentations dealt with funding models and with financial incentives in health innovation and to promote healthy behaviours.

Canada - Improving Access to Canadian Health Care: The Role of Tax Policies

Produced by the Conference Board of Canada, this paper assesses Canadian fiscal and tax policies related to health care. It examines their role in providing access to uninsured or underinsured health care services, and their costs in terms of foregone federal revenues. The research concludes it is unclear whether health-related fiscal policies can be leveraged to improve access to health care.

Canada - Healthier Lifestyles by Quebecers Would Ease the Economic Burden of Chronic Diseases

The report from the Conference Board of Canada, Improving Lifestyle Habits: Substantial Benefits for Quebec’s Economy and the Health of Its Citizens, says that adopting healthy lifestyles and reducing the prevalence of major risk factors for six chronic diseases could bring significant savings for Québec by 2030. The key risk factors include smoking, low daily fruit and vegetable consumption, physical inactivity, overweight and obesity, diabetes and hypertension.

Canada - Substance Abuse Costs Canadian Hospitals Hundreds of Millions of Dollars per Year - Alcohol Abuse the Prime Culprit

A new report from the Canadian Centre on Substance Abuse (CCSA) highlights that substance abuse is a serious and increasingly costly health concern in Canada. Analysing the latest data provided by the Canadian Institute for Health Information, CCSA’s report, The Impact of Substance Use Disorders on Hospital Use, found the cost of hospitalizing people with substance use disorders is significant, increasing 22% over five years to $267 million in 2011 from $219 million in 2006.

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 - Slowing economic growth and rising health care pressures squeeze Ontario's finances

A new report from the Conference Board of Canada sheds light on Ontario’s fiscal challenges in three ways. It estimates potential economic growth over the longer term. It models health and education spending to account for demographic and other changes, and it projects when the government is likely to rebalance its books based on revised revenue projections that account for sluggish growth. The report concludes that to achieve a balanced budget by 2022, the Ontario government needs to hold increases in health care costs well below the growth rates of the past decade.

Canada - Therapy or Surgery? A Prescription for Canada’s Health System

Published by the C. D. Howe Institute, this lecture by pre-eminent economist Don Drummond offers a diagnosis of Canadian health care. Mr. Drummond believes Canadians would be best served by aligning the interests of providers and patients.

Canada - Premiers Announce Health Care Innovation Working Group

On January 17, 2012, Canada’s 13 provincial and territorial Premiers announced the creation of a Health Care Innovation Working Group composed of all provincial and territorial health ministers. The purpose of the initiative is to enhance capacity to meet new challenges in health care systems, including the needs of seniors, patients with chronic diseases, and Northern populations.

Canada - Health spending to reach $200 billion in 2011

A report by the Canadian Institute for Health Information (CIHI) says spending on health in Canada will grow by more than $7 billion through 2011 to reach a forecast $200.5 billion. However, health spending was expected to increase by only 4% over 2010, the lowest annual growth rate seen in the last 15 years.

Canada - Federal and Provincial Governments Launch MyHealthNS to Improve Health Care in Nova Scotia

Doctors and patients in Nova Scotia can now get routine test results and share information through MyHealthNS, a new secure online tool. Patients of participating physicians receiving results from the QEII Health Sciences Centre, the IWK Health Centre or other facilities in the Halifax, Eastern Shore and West Hants areas will now be able to access this information on their smartphone or other web-enabled devices. The system will be expanded to all other parts of the province by early 2017, making Nova Scotia the first province in Canada to offer a digital health service option provincewide.

Canada - Economic arguments for shifting health dollars upstream

Economists have long provided evidence that Canada’s health sector would work better at lower cost if more funds were spent on improvements to Canadians’ living and working conditions. This paper advocates a re-invigoration of this approach and reviews health system spending and arguments for moving dollars upstream, especially in the areas of early child development and food security.

Canada - Managing health reform through an economic downturn

This study looks at today’s fiscally motivated reform of the U.K. National Health Service (NHS) through the eyes of Canada’s experience in the 1990s, when painful health reform took place during an economic downtown. Published in October 2011 by Nuffield trust, draws lessons from the Canadian reforms and applies them to the current situation in the U.K.

Canada - Wait Times Holding Steady Across Canada. Demand for priority procedures continues to rise

Last year, 8 out of 10 patients received priority surgical procedures within medically acceptable wait times, a figure that has not improved over the past three years, according to the Canadian Institute for Health Information (CIHI). CIHI’s new report, Wait Times for Priority Procedures, 2014, focuses on wait times for five key priority procedures: knee and hip replacement, hip fracture repair, cataract surgery and radiation therapy. The report focuses on the degree to which patients received these procedures within benchmarks established by the federal government and provinces in 2005.

Canada - The impact of primary care reform on health system performance in Canada: a systematic review

Using 15 years of records (2000-2015) from Embase, PubMed, and Web of Science databases, this study aimed to draw inferences about whether primary care reforms have improved health system performance based on measures of utilization, processes of care, and physician productivity. It found some evidence that team-based models of care led to reductions in emergency department use and improved care processes.

Canada - Alignment of Canadian Primary Care With the Patient Medical Home Model: A QUALICO-PC Study

The patient-centred medical home (PCMH) approach emphasizes integrated care, relationships with a regular physician, holistic self-care and a focus on quality, safety, and access. This paper compares current primary care across Canada with the goals of the PMH model. After surveying 1,172 patients and 772 primary care practices in 10 provinces, the paper found little evidence of consistent implementation of PCMH goals.

Canada - More regulated nurses entering the profession than leaving it

New data shows that more regulated nurses in Canada are entering the profession than leaving it. In 2015, there was an inflow of 30,897 regulated nurses and an outflow of 22,534, culminating a 10-year period in which Canadian nursing supply grew by 18%. Regulated nurses are Registered nurses (RNs), including nurse practitioners (NPs); Licensed practical nurses (LPNs), also called registered practical nurses in Ontario; and Registered psychiatric nurses (RPNs).

Canada - Manitoba Liberal Senator Sharon Carstairs Calls on Governments to Provide Palliative Care

Manitoba Liberal Senator Sharon Carstairs recently called on federal, provincial and territorial governments and community organizations and professional associations to improve palliative care services for Canadians. In a report tabled in the Senate, titled Raising the Bar: A Roadmap for the Future of Palliative Care in Canada, Carstairs sets out vision and goals for improved palliative care services, and makes 17 recommendations to serve as a roadmap to governments and the community for the implementation of that vision.

Canada - The Private Cost of Public Queues for Medically Necessary Care, 2017

This study by the Fraser Institute calculates the privately borne costs of waiting times for medically necessary treatments, defined as the value of time lost while waiting for treatment. Valuing hours lost during the workweek, the estimated cost of waiting for care in Canada in 2016 was more than $1.7 billion — an average $1,759 for each of the 973,505 Canadians waiting for treatment that year.

Canada - New Brunswick Health System Report Card: Access Challenges Remains despite Increase in Number of Providers

The New Brunswick Health Council (NBHC) released its second Health System Report Card in January 2012. An important tool measuring the quality of health services delivered in the province, the Report Card also indicates how New Brunswick compares with Canada’s other provinces. The 2012 Report Card gives New Brunswick a “C” as an overall performance grade, unchanged from 2011.

Canada – Fiscal Sustainability and the Transformation of Canada's Healthcare System: A Shifting Gears Report

This report from Toronto’s Mowat Centre is intended to help facilitate long-term decision-making in Canadian health care. It calls for a shift in perspective through the application of four concepts: treating health care as a high-tech industry; utilizing disruptive innovation; focusing on quality improvement; recognizing that ”Moore’s Law” (of declining costs over time) applies to health care.

Canada - Analysis of a centralized registry to improve access to family doctors

This project report published by CIRANO analyses results of Quebec's GACOs (guichets d’accès pour la clientèle orpheline), seeking in particular to evaluate whether these registries designed to help orphan patients find a GP actually improved access to GPs for people living with chronic diseases. The authors find that wait times to access a GP actually increased since the GACO registry was created in 2008. The percentage of patients registered with the GACOs to be referred to a GP ranges between 65% and 80% according to region.

Canada - CIHI releases top 10 reasons for hospitalization and surgery

The Canadian Institute for Health Information (CIHI) has released its annual report, "Inpatient Hospitalizations, Surgeries and Childbirth Indicators," detailing national figures and provincial variations. Giving birth, respiratory disease and pneumonia were among the top 10 reasons for hospitalization in all provinces. Cesarean section was the most common surgical hospitalisation. Two of the 10 most common reasons for hospitalization in acute care facilities across the country were mental health issues.

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.

Canada - The governance of the health system in Quebec should be based on ten user-focused Service Regions responsible for coordinating and supervising the health-care establishments within their region

The reforms carried out in recent years failed to yield the expected results. The coordination and availability of services to patients will be achieved through a decentralized system made up of autonomous organizations operating with a tight and effective governance. The overall supervision of the network remains the responsibility of the Ministère de la Santé et des services sociaux (MSSS), which sets policies, budgets and structures of the system. However, the Ministère must not manage the network; it must govern it effectively. This proposal comes from a Working Group set up by the Institute for Governance (IGOPP), which publishes recently a report proposing a simplified, more effective governance for the health network in Quebec.

Canada - Measuring Up. A yearly report on how Ontario’s health system is performing

This report marks the first time Health Quality Ontario (HQO) has used the Common Quality Agenda – a set of about 40 indicators created by HQO in consultation with health partners and system leaders — to monitor the quality of health care. Comparisons with other provinces and countries are included for some indicators.

Canada - Optimizing Scopes of Practice: New Models of Care for a New Health Care System

The Canadian Academy of Health Sciences initiated, in 2012, an expert panel assessment on optimizing scopes of practice to help shift the healthcare system towards collaboration and patient-focused care. This report highlights the barriers and enablers related to optimal scopes of practice using the macro (structural), meso (institutional/organizational) and micro (practice) framework. Report recommendations largely address macro level structural barriers as they were seen as having the greatest impact on change.

Canada - Health Quality Ontario Publishes New Report on Cross-Sectoral Quality Improvement

A Quality Improvement Plan (QIP) is a formal commitment to quality improvement, aligned with system and provincial priorities. This most recent analysis of the QIPs submitted by Ontario’s healthcare organizations explores how organizations across the province are partnering with their peers in other sectors in order to deliver more collaborative care for their patients and ensure appropriate transitions between care providers.

Canada - Expanding the Scope of Practice for Pharmacists in Ontario

In 2009, legislation enlarged Ontario pharmacists’ scope of practice to allow them to administer vaccinations, alter and renew prescriptions, and prescribe a small number of drugs. This paper argues that the reforms have increased vaccinations but failed to shift physicians’ burden of care for minor illnesses. It finds no evidence of improved health system efficiency.

Canada - The Montreal model: the challenges of a partnership relationship between patients and healthcare professionals

The Montreal model is a patient engagement strategy that partners the complementary knowledge bases of patients and healthcare professionals in the organization of care. This article by the model’s originators at the Université de Montréal describes its theoretical basis and implementation at clinical, organizational, and systemic levels. Facilitators and barriers are described.

International - International Survey Of Older Adults Finds Shortcomings In Access, Coordination, And Patient-Centered Care

The journal Health Affairs conducted a survey of the healthcare experiences of 15,617 older adults in 11 Western countries, including Canada. This report presents the survey findings, which show that the US lags behind in care access, quality, and affordability. Accessing primary care and avoiding the emergency department was more difficult in Canada than in other countries.

Canada - Weekend Admissions and In-Hospital Mortality

The Canadian Institute for Health Information undertook this study to see whether mortality was higher for patients admitted to hospital on weekends, as appears to be the case in some other countries. The risk of dying was 7% higher for emergency surgical patients and 3% higher for emergency medical patients seeking care on weekends. The difference in mortality between weekday and weekend admissions is lower than in the US and UK.

Canada - Improvements in patient and public safety highlighted in 2014 Quality Index on Ontario's Cancer System

The Cancer Quality Council of Ontario (CQCO) released its 10th annual Cancer System Quality Index on June 24, 2014. It shows that the Ontario cancer system is successful in ensuring Ontarians are receiving care based on the best available evidence. Notable improvements were made in automated drug ordering systems in hospitals. Areas for improvement include reducing unplanned hospital visits during chemotherapy and radiation.

Canada - Health Quality Council launches first Saskatchewan Change Day

People working in Saskatchewan’s healthcare system, and those who access care, are being encouraged to pledge to do one small thing to improve the lives of patients, family members and healthcare workers as part of a new campaign called Saskatchewan Change Day. The day will be held on November 6, 2014. The belief that underlies the initiative is that small actions, when combined together, can make a big difference.

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 - Patient engagement: Why does it matter and how is it done?

Published by the McGill University Health Centre's Institute for Strategic Analysis and Innovation (MUHC-ISAI) and the Health Innovation Forum, this eighth issue of Health innovation Report is completely devoted to the patient as partner. It includes papers on patient experience, patient engagement in system transformation, medical education, health system design and disease self-management, as well as a look at care coordination from the patient's perspective. Three in-depth case studies look at patient partnership initiatives underway at the MUHC.

Canada - Ontario Investing $44 Million in Home and Community Care

The Minister of Health and Long-Term Care in Ontario is increasing funding to programs that can help seniors who have experienced a loss of strength or mobility, often associated with a hospitalization, recover from illness or injury so they can continue to live more independently. Among the programs that will receive additional funding are short-stay rehabilitation programs, community supports and comprehensive risk assessment programs in the community.

Canada - Bringing Care Home

This report from the Expert Group on Home and Community Care, commissioned by the Ministry of Health and Long-Term Care in Ontario, aims to improve services available to the province's population. Its recommendations will help advance the transformation from a home and community care system based on the needs and preferences of providers to one based on the needs and preferences of the client and family—bringing care home rather than providing homecare.

Canada - Government of Alberta to create rural health care action plan

Alberta has created a panel of experts and stakeholders to develop a healthcare action plan for the province’s rural communities. The panel will review access to healthcare services’, quality, organization and coordination. The final report is expected in January 2015.

Canada - Study finds significant overlap in the drugs covered by Canadian public drug plans

The Patented Medicine Prices Review Board (PMPRB) has published the first of three reports that compare drug coverage across provincial and federal public drug plans. The report found that plans listed a high percentage of the same drugs, especially essential medicines and generic drugs. Variation was greatest for high-cost drugs.

Canada - Ontario Launches Updated Plan for Health Care

On February 2, 2015, the Ontario Ministry of Health and Long-Term Care launched "Patients First: Action Plan for Health Care to Improve the Health Care Experience." It represents the next phase of transformation to the province's healthcare system to improve results for patients and meet the needs of an aging population. The plan focuses on access, connecting people with services they need close to home, information and education, and protecting the universal public health care system for generations to come.

Canada - Approaches to Accountability

This special issue of Healthcare Policy is dedicated to approaches to accountability in Canadian healthcare policy. The issue includes 15 research articles covering accountability in the context of internal hospital functioning, the primary care system, cancer care, long-term care, medical laboratories, funders and regulatory bodies.

Canada - Patients admitted to hospital spend almost 5 times longer in ED than non-admitted

1 in 10 emergency department (ED) patients required admission to hospital in 2013–2014, and they spent 4.7 times longer in the ED than those who were not admitted, reveals new data from the Canadian Institute for Health Information (CIHI). Of the 1 million patients admitted, 1 in 10 spent more than 28.4 hours in the ED first. When looking at all ED visits, however, 9 out of 10 were completed in 7.5 hours or less.

Canada - Accelerating Health System Transformation in Saskatchewan: Lessons Learned from the Saskatchewan Surgical Initiative

In 2010, the Saskatchewan government set out to transform the surgical patient experience through an ambitious multi-year, system-wide strategy. While the Saskatchewan Surgical Initiative (SkSI) placed strong emphasis on wait time reduction for elective surgery, the breadth of the initiative also gave priority to quality, safety, patient experience, and sustainability. Through the systematic exploration of a single policy case study—the SkSI—this research published by the Foundation for Healthcare Improvement identifies the critical factors that facilitate and inhibit major health system change.

Canada - Nearly 1 in 5 Patient Visits to Emergency Could Potentially Be Treated Elsewhere

A new study by the Canadian Institute for Health Information (CIHI) identified that about 1 in 5 patients visited the emergency department (ED) for conditions that could be treated in a family practice setting or that are potentially preventable. The study, Sources of Potentially Avoidable Emergency Department Visits, focused on 2 groups of patients: those who use the ED for minor conditions not requiring hospitalization; and seniors who live in long-term care (LTC) residences. With approximately 17 million visits to EDs across the country in 2013–2014, Canadians are among the most frequent users of EDs in the world, compared with countries such as Australia, the United States and the United Kingdom.

Canada - Bending the Medicare Cost Curve in 12 Months or Less: How Preventative Health Care can Yield Significant Near-Term Savings for Acute Care in Alberta

The potential of disease prevention to bend the cost curve in health care has long been evident. This study examined a preventative healthcare program in Alberta and found that its 5,689 participants made 45% fewer hospital visits per year than the general population, a significant cost saving. Extrapolated to a province-wide level, this would be equivalent to freeing up 1,632 hospital beds.

Canada - Québec's health care commissioner releases its 2014 report on the performance of the health and social services system

Published on May 13, this report is based on analysis of a wide range of data from multiple sources at provincial, national, and international levels. Quebec performs very well with regard to wait times to see a specialist, obtain specialized testing, as well as for hospital readmissions, but performs less well on continuity and coordination between specialists and family physicians. Quebec comes dead last in the use of information technology by physicians, access to a regular doctor, and follow-up care.

Canada - Patient experience survey

The Primary Care Patient Experience Survey is an evidence-based tool that will help providers develop an understanding of their patients’ experiences of care, identify what is working well and where there may be room for improvement. The survey is the result of a collaboration between Health Quality Ontario, the Association of Ontario Health Centres, the Ontario College of Family Physicians, the Ontario Medical Association, and the Association of Family Health Teams of Ontario. It is currently being field tested in primary care practices across the province. A draft version is available to download.

Canada - Role Clarification Processes for Better Integration of Nurse Practitioners into Primary Healthcare Teams: A Multiple-Case Study

Poorly defined roles can reduce the effectiveness of clinical teams. This paper outlines effective processes for introducing the role of primary healthcare nurse practitioners (PHCNPs) to clinical teams. Data collection included 34 interviews with informants involved in PHCNP implementation. The paper concludes that role clarification is both an organizational process and a key primary care team member competency.

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 - New Study Shows Canadians Want Physician Assistants to Play a Greater Role in Their Health Care

A new survey for the Canadian Association of Physician Assistants (CAPA) suggests Canadians have a favourable impression of Physician Assistants (PAs) and that the impression increases the more they learn about their role and training. Even though only 10% of Canadians have been cared for by a PA, 65% have a favourable opinion and 56% support a greater PA role.

Canada - Program to Keep New Doctors in Nova Scotia

A tuition relief program in Nova Scotia is helping to keep new doctors in communities that need them. The province will repay $120,000 of medical school tuition in exchange for a commitment to practice for five years in an underserved community. Open to 25 medical graduates or out-of-province doctors annually, the program will run to 2019.

Canada - Health Quality Council of Alberta releases two reports that address continuing care in Alberta

On June 5, 2014, the Health Quality Council of Alberta (HQCA) released findings and recommendations from two separate reviews that focused on the quality of continuing care in Alberta. The first report examined the quality and patient safety implications of Alberta Health Services’ (AHS) policy on continuing care wait lists. The second report looked at the structures and processes that support quality assurance of publicly funded continuing care services in Alberta, including home care, supportive living, and long-term care. A need to provide more fairness, some degree of choice and improve demand modeling are among the recommendations.

Canada - Alberta Health Services announces cost-containment measures

Alberta Health Services (AHS) has announced it is implementing cost-containment measures to deal with a budgetary shortfall due to falling oil revenues. The measures will affect three areas: payroll and staffing costs, procurement of goods and services and discretionary spending. Similar measures are being adopted across Alberta’s provincial government.

Canada - It's all about synergies: Understanding the role of the RPN in Ontario's health care system

The Registered Practical Nurses Association of Ontario (RPNAO) presents, in this document, key learnings and practical strategies for enhancing registered practical nurse (RPN) role clarity and nursing team collaboration. The RPNAO invited nurses and other healthcare experts from around Ontario to share insights about critical factors that support or hinder the appropriate utilization of RPNs.

Canada - Changes to Long-Term Care Policies will Improve Access to Care in Nova Scotia

Nova Scotia has introduced changes to its long-term care policies to ensure more timely access for those with the greatest needs. Starting March 2, 2015, new criteria will ensure that efforts have been made to support people in their homes or communities before seeking long-term care placement.

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 - Expanding Pharmacist Services in Québec: A Health Reform Analysis of Bill 41 and its Implications for Equity in Financing Care

In December, 2011, Québec’s Health Minister introduced Bill 41 to amend the province's Pharmacy Act and enable pharmacists to modify the form and dosage of a medication prescribed by a physician. Discussion is underway about pharmacist remuneration for the service and whether it will be publicly covered. It would appear as though only those with public drug insurance will be covered for the expanded services, and not those who have employer-sponsored private drug insurance.

Canada - Timely access to care for all Canadians: The role of the federal government

The Wait Time Alliance’s (WTA) 2014 annual report card identifies progress on reducing wait times in several provinces. However, Canadians still wait longer for primary, specialist, and emergency department care than citizens in other developed countries. The report card highlights differences in wait times across the country, reviews successful federal initiatives in reducing wait times, and calls for increased involvement of the federal government in setting and revising wait time benchmarks.

Canada - National Survey of Nurses' Perspectives on Safe Home Care

The Canadian Federation of Nurses’ Unions (CFNU) has released a nation-wide survey of nurses’ perspectives on home care. The survey of 1,116 home care and long-term care nurses provides insight into the home care client population and service quality. Most of the surveyed nurses agreed that there are safety concerns in home care at present.

Canada - Quebec: Health accounts 2012-2013, 2013-2014, 2014-2015

This annual publication provides a financial review of health and social service system accounts, looks at changes in expenditures and funding sources as well as various performance indicators. New this year, Section 2 details the expenditures of health and social services institutions according to service programs and support programs.

Canada - Measuring Up 2017. A yearly report on how Ontario’s health system is performing

Using 50 indicators to assess the annual performance of Ontario’s health system, this year’s report by Health Quality Ontario (HQO) finds improvements in premature mortality, care continuity, screening, surgical wait times and long-term care. It gives black marks to access, equity, caregiver support and transitional and palliative care.

Canada - Impact of Quebec's healthcare reforms on the organization of primary healthcare (PHC): a 2003-2010 follow-up

Québec’s healthcare reforms in the early 2000s involved new modes of primary healthcare (PHC) delivery and the creation of supportive Health and Social Services Centres (HSSCs or CSSS in French). This article assesses PHC organizational changes following the reforms and determines that a mix of top-down and bottom-up strategies produced most changes in local organization.

Canada - Delivering a Patient-Centred, High Performing and Sustainable Health System in B.C.: A Call to Build Consensus and Take Action

British Columbia’s Ministry of Health produced this report calling for provincial action in three areas: the delivery of patient-centred services and care; the enhancement of outcomes and services; and the prioritization of cross-sector actions to improve quality and sustainability. The report includes over 50 recommendations.

Canada - Ontario Health Innovation Council Delivers Report to Ontario

The Council makes five main recommendations for creating conditions to favour the adoption of new technologies in health care. Entitled The Catalyst, the report calls for the creation of a dedicated office to lead and coordinate innovation efforts, investment in made-in-Ontario technologies, the elimination of barriers to innovation across the health system and closer relationships between industry, research and health sector stakeholders to accelerate commercialization.

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.

Canada - The Case of the Vanishing Quebec Physicians: How to Improve Access to Care

In this report published by the CD Howe Institute, Claude Forget looks at why, despite having more physicians per capita than other provinces, Quebec has poor access to primary care. He finds that Quebec family physicians work fewer hours per week and take on fewer patients. Mr. Forget examines why reforms have failed to improve the situation and considers that new financial incentives and a willingness to provide more primary care in the community as opposed to hospitals are key ingredients of a successful transition.

Canada - Are health expenditures out of control?

This socio-economic brief from the Institut de recherche et d'information socio-économique (IRIS) decries the use of increasing healthcare costs to justify the impossibility of maintaining public health services in Quebec. The authors demonstrate how this catastrophic view is not only simplistic but also generates counterproductive solutions such as increasing the role of the private sector.

Canada - Doctors without Hospitals: What to do about Specialists Who Can’t Find Work

Canadian healthcare is facing a new challenge as recently graduated specialist physicians struggle to find work, even while there are long waits for their services. This paper from the C. D. Howe Institute examines how separate budgets for hospitals and specialists add to this problem, and proposes dismantling the two-silo approach to paying doctors and funding hospitals.

Canada - Barriers, facilitators and views about next steps to implementing supports for evidence-informed decision-making in health systems: a qualitative study

In this study, conducted in hospitals and primary care practices in Ontario and Quebec, authors interviewed 57 managers to identify barriers and facilitators to evidence-informed decision-making (EIDM). Limited resources were the most frequently identified barriers, while advocacy by decision-makers was the main facilitator. Most interviewees said documentation and reporting tools were needed to support EIDM.

Canada - Canadian healthcare system must brace for a technological revolution

This report on integrating robotics, artificial intelligence (AI) and 3D printing technologies into health care expects these technologies to bring great benefits to patients, physicians, and the healthcare workforce. Prepared by the Senate committee on social affairs, science and technology, it cautions that everyone working in the healthcare sector must prepare for inevitable and radical change.

Canada - Who gets a family physician through centralized waiting lists?

In 2011, Quebec introduced financial incentives for family physicians to enrol patients through centralized waiting lists, with higher payments awarded for vulnerable patients. This study examines enrolments and finds they have quadrupled since the introduction of incentives, although most of the increase involves non-vulnerable patients, who represent 70% of those currently enrolled through centralized lists.

Canada - Gainsharing and shared savings strategies in the healthcare setting: Evidence for effectiveness

Alberta Health Services (AHS) is exploring ways to leverage resources with the aim of improving outcomes and value for money. One way to achieve this is to incentivize and reward innovation and quality improvement using gainsharing or shared savings strategies. This internal report investigates evidence for the effectiveness of these strategies. It summarizes 25 facilitators of gainsharing within the AHS, along with 12 barriers to its implementation.

Canada - Improvements in health system quality still in the future says New Brunswick Health Council

The New Brunswick Health Council (NBHC) has released its 2016 report card for the province’s health system, giving it a C grade that signifies adherence to national standards but no improvements in system performance and quality of care. Primary care and long-term care continue to push New Brunswick’s grade downwards.

Canada - Circle of care modelling: an approach to assist in reasoning about healthcare change using a patient-centric system

Circle of care modelling (CCM) is a patient-centric approach to analyzing health system change that uses four steps (finding out, conceptualizing, discussion, and establishing improvements). This paper presents three case studies where CCM was applied to help stakeholders’ think about care gaps around data fragmentation, coordinated medication management, and support for a community health centre for unattached patients.

Canada - Getting the Foundations Right: Alberta's Approach to Healthcare Reform

In 2008, Alberta abolished its health regions and integrated providers into the new Alberta Health Services (AHS). This article responds to past critiques of the reforms by describing long-term benefits that include lower administrative costs, greater equity of access, improved intra-provincial learning, and economies of scale. Some benefits have already appeared, but performance should be judged over a multi-year time frame.

Canada - Ontario: Wait times down in emergency, but still long for some patients

A new report by Health Quality Ontario (HQO), the provincial advisor on health care quality, shows a 10% drop in the maximum amount of time patients spent waiting in Ontario’s emergency departments (EDs). Urban residents wait longest, especially ED patients requiring hospital admission.

Canada - Breadth vs. depth: How to start deploying the daily management system for your lean transformation

The Lean Daily Management System (LDMS) addresses the management of daily operations during continuous improvement at the process level. This paper proposes a framework for healthcare organizations deploying an LDMS model. It examines whether to deploy LDMS in one area at a time or introduce a simplified version across the organization. Field research was conducted at three hospitals to test different deployment strategies.

Canada - Canadian Nurses Association leads the development of a national nursing framework on medical assistance in dying

The Canadian Nurses Association (CNA) has released a national nursing framework on medical assistance in dying (MAID) that outlines the role of nurses and nurse practitioners (NPs) caring for patients who are considering end-of-life decisions. The framework also highlights changes to federal laws arising from the MAID legislation.

Canada - Ontario’s Health System: Key Insights for Engaged Citizens, Professionals and Policymakers

Edited by the McMaster Health Forum’s director, John Lavis, this book aims to help make the Ontario healthcare system more understandable to the citizens who pay for it and are served by it, the professionals who work in it, and the policymakers who govern it. The book begins by providing historical context and ends by examining current goals and improvement strategies. Each of the 11 chapters begins with key messages for each of these groups.

Canada - Nurse Practitioners Propose New Primary Health Care Model for B.C.

The BC Nurse Practitioner Association (BCNPA) has released a comprehensive plan to more fully integrate nurse practitioners (NPs) into the provincial healthcare system. The plan proposes two distinct funding paradigms, illustrated by case studies, to guide the integration of NPs within a new primary care model for British Columbia.

Canada - Ontario Introduces Legislation on Medical Assistance in Dying

Ontario has introduced legislation to support medical assistance in dying by providing more protection and greater clarity for patients, their families, and healthcare providers. The proposed Medical Assistance in Dying Statute Law Amendment Act aligns with new federal laws concerning medical assistance in dying.

Canada - Ontario Establishing Patient and Family Advisory Council

Ontario is creating a Patient and Family Advisory Council to advise the province on health policy priorities impacting patient care. The council will involve patients, families and caregivers throughout the policy development process. Council members will be chosen by a public process to nominate suitable candidates taking place in 2017.

Canada - Health Quality Council of Alberta Releases Follow up Report to 2013 Continuity of Patient Care Study

Released in July 2016, this follow-up report to a 2013 study on continuity of care finds that considerable effort has been made by Alberta stakeholders towards implementing the study's recommendations. The newly released report identifies measures that stand to have the greatest impact on continuity of care for the greatest number of patients.

Canada - Paying For Primary Care: The Relationship between Payment for Primary Care Physicians and Selection of Patients Based on Case-Mix

Using administrative data to compare primary care physicians across payment models in Ontario, this study analyzes whether physicians respond to financial incentives by selecting patients based on their risk profile. After controlling for physician self-selection, the study found no evidence of risk-selection behaviour.

Canada - CFHI Shows Care Closer to Home Can Cut Hospitalizations and Improve Outcomes

This report from the Canadian Foundation for Healthcare Improvement (CFHI) says hospitalizations for chronic disease rarely meet patients’ needs. The report finds that hospitalizations due to COPD can be decreased by up to 80 percent when healthcare is provided to patients and their families at home. This transformational approach not only improves quality of care, but would also avoid 68,500 emergency department visits, 44,100 hospitalizations and 400,000 bed days - saving $688 million in hospital costs over the next five years.

Canada - Catalyzers and brakes on health system innovation in Québec

This project report prepared by Pôle Santé HEC and CIRANO describes results of the first phase of a study aiming to formulate recommendations to the government of Québec to promote the development of a culture of innovation in the health system. It includes a document review and consultation with system stakeholders, and identifies 26 factors that impact innovation.

Canada – New report outlines actions needed to reduce chronic disease in Aboriginal communities

On June 15, 2016, Cancer Care Ontario released the report Path to Prevention - Recommendations for Reducing Chronic Disease in First Nations, Inuit and Métis. Rates of cancer, diabetes, heart disease and respiratory diseases are increasing, and the report provides the Government of Ontario with evidence-based policy recommendations to reduce exposure to four key risk factors: commercial tobacco use, alcohol consumption, physical inactivity and unhealthy eating.

Canada - WANTED: Leadership for Healthcare

The C.D. Howe Institute presents this verbatim report of a talk given by Don Drummond and Duncan Sinclair in June 2016. They discuss leadership and the need for transformative changes to integrate care and improve access. They set out a detailed plan to expand Medicare into the Phase 2 that Tommy Douglas originally anticipated, broadening the range of insured services. They also propose ending the prohibition on providing medical services outside Medicare, and allowing some flexibility to charge user fees for certain types of service.

Canada - Variations in Quality Indicators across Ontario Physician Networks

This chartbook from the Institute for Clinical Evaluative Sciences (ICES) in Ontario reports performance levels for a set of quality indicators that reflect health care delivery across settings of primary and specialty care, acute hospital care and long-term care, as well as shared care and transitions from one setting to another. The quality indicators include screening and prevention, evidence-based medications, drug safety, hospital to community transitions, adverse outcomes, imaging and cancer end-of-life care.

Canada - New survey shows majority of Canadians support the federal government “topping up” health care funding of provinces and territories with older populations

Nearly 74% of Canadians responding to a July 2016 poll for the Canadian Medical Association (CMA) agreed that the federal government should provide extra funding to provinces and territories for the health care of elderly citizens. Respondents felt additional funding should be based on the proportion of older people in a province or territory.

Canada - A population-based analysis of incentive payments to primary care physicians for the care of patients with complex disease

In 2007, British Columbia implemented incentive payments to primary care physicians for the care of patients with chronic conditions. This study examines the program’s impact on access to primary care, hospital admissions, and costs. It finds that the $240-million dollar program increased physician compensation but did not improve access or continuity; neither did it reduce resource use in the healthcare system.

Canada - Quality Reporting in German Hospitals: A Model for Quebec

Québec’s government is planning to fund hospitals using an activity-based formula rather than historically defined global budgets. This article says this measure should be paired with the kind of mandatory quality reporting that exists in Germany in order to harmonize and publicize Québec’s hospital quality data. Published regularly on the Internet, German quality reports provide comprehensive information on the treatments provided in hospitals.

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.

Canada - Province Increasing Access to Primary Care for Ontario Families

Ontario is improving access to primary care by providing $22 million in additional funding for 445 primary care organizations, including community health centres, nurse practitioner-led clinics, family health teams and nursing stations that together serve nearly six million Ontarians. The funding will allow the organizations to better attract and retain healthcare professionals.

Canada - CMA releases platform for new Canadian Health Accord

In October 2016, the Canadian Medical Association (CMA) released its platform for a new national health accord. The platform makes six recommendations: extra funding for seniors; added coverage for expensive medicine; tax credits for family caregivers; a national strategy for end-of-life care; a coordinated home care plan; and investments in long-term care.

Canada - Performance of an integrated network model. Evaluation of the first 4 years

Conducted by Université de Montréal researchers, this study evaluated changes in accessibility, care experiences, and quality-of-care indicators after a Québec clinic moved to a fully integrated network model. Increases in accessibility were seen after the transition, while improvements in biologic data suggested better quality of care. Patient satisfaction remained high throughout the four-year study.

Canada - Healthcare Spending Decelerating? Not so Fast!

Published by the CD Howe Institute, this article objects to the 2015 National Health Expenditures (NHEX) report of the Canadian Institute for Health Information (CIHI), which showed a sharp deceleration in increases in provincial health budgets. The article says NHEX figures are based on budget estimates and that later revisions based on actual numbers have shown materially larger increases.

Canada - Health Transformation: An Action Plan for Ontario

Produced by the Ontario Chamber of Commerce, this report makes three main strategic recommendations for the province’s healthcare system and health sector. It calls for shifting Ontario towards a value-based system with a focus on patient outcomes for money spent. It also recommends a modernization of procurement chain processes and further integrating the health sciences sector within the public system.

Canada - Safer cancer care for Ontarians

The 2017 Cancer System Quality Index (CSQI), released May 17, 2017 by the Cancer Quality Council of Ontario, identifies several improvements to safety this year within the cancer system. There were fewer perforations during colonoscopies, better drug ordering for chemotherapy, and increasing use of peer review among radiation oncologists across Ontario, increasing quality assurance and safety within the system.

Canada - Ideas on health care for Québec

This report describes the results of a project that included constructive discussions about the future of the health and social services system in Quebec. Focus groups, expert consultations and the public highlighted areas of consensus. Among the most important, both citizens and network actors want to reverse current dynamics and put citizens and local actors in charge of their health choices.

Canada - New Brunswick: New model for family medicine aims to improve physician access

New Brunswick's government and Medical Society have established a new team-based model for family medicine that will provide patients enhanced access to family physicians. Participating doctors will have individual patient rosters but will also be available to patients of team members. The new model will begin operating in the fall of 2017.

Canada - Nearly 1 in 2 Canadians expected to get cancer

Nearly one in two Canadians can expect to be diagnosed with cancer in their lifetime according to Canadian Cancer Statistics 2017. This latest Canadian Cancer Society report finds a 49% lifetime cancer risk for men and 45% risk for women. One in four Canadians is now expected to die of cancer.

Canada - Canadians seeking more federal innovation to improve health care system

A survey on health innovation conducted for the Canadian Medical Association (CMA) shows that provincial governments are viewed as more effective drivers of innovation than the federal government. While 68% of Canadians feel the provinces are doing the most to support innovative health care, a majority of respondents also wanted more federal action.

Canada - New Wait Times Data Now Available for Surgeries and Procedures Across Ontario

Ontario has launched an online tool to help people find wait times information for surgeries and procedures at the province’s hospitals. Available at, the easy-to-use tool includes the length of time between referrals and specialist appointments, as well as providing the date a procedure is due to be performed.

Canada - Costs of health care across primary care models in Ontario

This study examines the relationship between new primary care models in Ontario and the costs of primary care and total health care. It focuses on payment mechanisms for primary care physicians (fee-for-service [FFS] and blended capitation), and finds that new primary care models are associated with lower total healthcare costs compared to the traditional FFS model, despite higher primary care costs in some models.

Canada - How the private insurance market operates in the regulatory framework governing prescription drug insurance in Québec

This report presents the results of a unique survey of Québec employers with 50 or more employees to better analyze issues that arise in this market. The first part examines the views of company directors on issues surrounding group insurance. The second provides a detailed look at the characteristics of insurance contracts. On the basis of these data, the authors propose an analysis of the general functioning of group and private insurance and the profitability of the products offered.

Canada - An economic analysis of a system wide Lean approach: cost estimations for the implementation of Lean in the Saskatchewan healthcare system for 2012–2014

Published in BMC Health Services Research, this study estimates cost involved in the first two years of the province’s implementation of Lean, including poorly documented costs such as health leader training, along with more transparent costs for consultancy services. The authors examine the types of event involved in implementation and the costs associated with them. Cost estimates show that the annual cost of Lean in Saskatchewan during the 2012–2014 period was about $23.4 million.

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.

Canada - Evidence highlights danger of cutting RNs in Ontario

The Registered Nurses' Association of Ontario (RNAO) has launched an online database collecting 70 years of research into nurse effectiveness. Over 95% of the 626 studies in the new database show that registered nurses (RNs) have a positive impact on health outcomes.

Canada - Nurse practitioners improve community care

A $10-million, three-year health project in Alberta is placing nurse practitioners alongside registered nurses on community teams that deliver ‘first-stop’ health services where needs are high. Project grants have been given to The Alex Community Health Centre in Calgary, the Calgary Urban Project Society (CUPS), and Edmonton’s Boyle McCauley Health Centre.

Canada - Adopting eHealth Solutions: Implementation Strategies

Published by the Registered Nurses’ Association of Ontario, this guideline provides evidence-based recommendations to enhance the capacity of all individuals involved in the implementation of an eHealth solution. Organizations are encouraged to establish suitable infrastructures to support eHealth education needs and facilitate technology-enabled health system transformation.

Canada - Most Canadians receive priority procedures within medically acceptable wait times

The Canadian Institute for Health Information’s new report, Wait Times for Priority Procedures in Canada, 2017, shows that 3 out of 4 Canadians received their procedure within the medically recommended wait time. This edition includes regional-level data for hip and knee replacements, as well as provincial data in 5 priority areas: cancer treatment, cardiac care, diagnostic imaging, joint replacement and sight restoration. It also features updated interactive graphics on wait times across the country.

Canada - Implementation of Integrated Service Networks under the Quebec Mental Health Reform: Facilitators and Barriers associated with Different Territorial Profiles

Using interview data obtained from 208 psychiatrists, managers and network stakeholders, this study evaluates the implementation of the Quebec Mental Health Reform (2005–2015), which saw the development of 11 integrated local service networks organized into four territorial groups. Organizational factors were the strongest barriers to implementation in most networks.

Canada - $140 million to improve access, target key mental-health initiatives

British Columbia has launched a new Web-based system to help people find services and support for mental health and substance use problems. The province's 2017 budget includes new investments to improve prevention, early intervention, treatment and better access to services. The digital hub brings together more than 6000 services from over 450 providers throughout the province. BC health authorities are introducing specialized mental health community care programs to facilitate access and coordinate services.

Canada - New funding to help create team-based primary care services throughout B.C.

The provincial government of British Columbia has announced $90 million in new funding over three years to bring integrated team-based primary care services to more communities. Operating within doctors' offices, new positions for nurses and nurse practitioners will allow physicians to care for more patients, as well as provide better supports. Other health professionals in the community will also be better connected with doctors' offices.

Canada - Major $1.3 Billion Investment for Quicker Access to Specialized Care and Services in Ontario

Ontario is improving access to health care by investing $1.3 billion over three years to reduce wait times, with more than $285 million designated for the year 2017-2018. Patients will see improved local access through the introduction of innovative interprofessional models of care, including new ways to assess patients with lower back, hip, and knee pain.

Canada - Release of New Brunswick Family Plan report on improving access to primary and acute care

New Brunswick’s government has released a report on improving access to primary and acute care that is part of the province’s Family Plan focusing action on priority healthcare areas. The report highlights initiatives to shift hospital-based care to a community integrated treatment framework and outlines actions to achieve better health outcomes.

Canada - Team-based innovations in primary care delivery in Quebec and timely physician follow-up after hospital discharge: a population-based cohort study

Outpatient follow-up is key to addressing gaps in care after hospital discharge. This Québec study estimated the association between enrolment in new team-based primary care practices and 30-day post-discharge physician follow-up. The study found lower rates of follow-up with a medical specialist among patients enrolled in team-based primary care practices compared with those in traditional primary care practices.

Canada - Health Equity in Northern Ontario

The life expectancy rates for those living in northern Ontario continue to be lower and mortality rates higher than the rates in the province overall, according to a new report by Health Quality Ontario, the provincial advisor on the quality of health care.

Canada - Learning from the best: a comparative study of Québec emergency departments

Apprendre des meilleurs : étude comparative des urgences du Québec The report from the Commissaire à la Santé et au Bien-être documents the performance of Quebec emergency departments and links this performance to practices and processes implemented in emergency departments in order to learn from the best performing hospitals. The report includes an analysis of emergency department data, a review of their practices and processes, and incorporates the results of a consultation session with the Commissioner's Forum.

Canada - Drug Costs Up in 2013/14 for Canadian Public Drug Plans Due to Increased Spending on High-Cost Drugs; Reduced Savings from Generics

A report from the Patented Medicine Prices Review Board (PMPRB) indicates that spending by Canadian public drug plans increased by 2% in 2014, reversing a multi-year trend of negative growth. The report attributes the increases to a surge in the use of higher-cost drugs and reduced savings from generic versions of brand-name drugs.

Canada - Competing demands and opportunities in primary care

In primary care, competing demands present a substantial barrier to the provision of specific services to patients. This study estimates the feasibility of meeting all current demands in primary care and considers the relative benefits of interventions such as screening and preventive health care, chronic disease management, and caring for patients with acute medical conditions.

Canada - Ontario Funds Bundled Care Teams to Improve Patient Experience

Patients in six communities across the province will now benefit from an approach called bundled care, which is helping people transition more smoothly out of hospital and into their homes. The bundled care model provides a single payment to a team of health care providers to cover care for patients both in the hospital and at home. As a patient moves throughout the system and back to their home, the majority of their health care team remains the same. Services are coordinated around the patient's needs, resulting in fewer emergency department visits and less risk of being readmitted to hospital.

Canada - The Price of Public Health Care Insurance: 2015 Edition

This Fraser Institute report sets out to calculate the actual costs of public healthcare insurance in 2015. The report estimates that average payments range from $3,789 to $12,055 a year for Canadian families divided into 6 family types at various income levels.

Canada - What can organizations do to improve family physicians’ interprofessional collaboration? Results of a survey of primary care in Quebec

This Quebec survey of 375 primary healthcare organizations assessed collaboration between family physicians (FPs) and other healthcare professionals. It found that 47.1% of organizations reported a high degree of collaboration between FPs and specialists. Collaboration was less common between FPs and non-physician professionals (16.5%). Clinical relationships with a hospital, and patients with chronic disease were associated with higher FP collaboration with other professionals.

Canada - Quality in Primary Care Setting a Foundation for Monitoring and Reporting in Ontario

Ontarians are less likely to receive optimal primary care if they are immigrants, live in a low-income neighbourhood, or live in a rural, remote or northern area of the province, according to this new report published by Health Quality Ontario.

Canada - Understanding Multilevel Governance Processes: The Case of the Québec Healthcare System

In 2004, Québec’s healthcare system created 95 Health and Social Service Centres (HSSCs) that were given decision-making power over service organization. Family physicians were also incentivized to work in family medicine groups (FMGs) that emphasize multidisciplinary teams. This paper examines the multilevel processes of governance implemented in the development of collaborative practices between these levels of care. Case studies are included.

Canada - New framework for primary health care reform in Newfoundland Labrador

The provincial government of Newfoundland and Labrador has released a new framework for primary healthcare reform in the province. The framework outlines short and long-term enhancements to the way primary healthcare services such as family practice, pharmacy, social support, nursing occupational therapy and counselling will be delivered.

Canada - Adding it all up: A value-based allocation process for child and youth mental health services

Focused on Ontario, this report examines ways to efficiently allocate provincial resources for child and youth mental health services. It recommends a process whereby the Ontario Ministry of Children and Youth Services (MCYS) and its agencies clarify the value and cost of services when determining allocations. The process would involve data collection, determination of service value, and collaborative planning.

Canada - Quality Matters: Realizing Excellent Care for All

The Quality Matters initiative is part of Health Quality Ontario’s ongoing effort to unite everyone in the health system through a common language of quality and to reach a shared commitment to take action on common goals. This report articulates the vision guiding the initiative. It offers six domains of quality, a set of principles to guide us, and key factors we need to consider in order to instill quality at the core of our health system. A one-page visual and a patient video accompany the report.

Canada - Aligning Health System Performance Frameworks

This new framework provides a system-level overview that allows stakeholders to assess the collective contribution of all parts of the health system and enables people to see how each of the system’s distinct components (such as hospitals or long-term care facilities) connects to overall system performance. This report shows how frameworks can help to build a common language across and within sectors to articulate how they each contribute to, and are influenced by, the performance of the wider health system.

Canada - Improving Access to Care by Expanding the Role of Pharmacists

This economic note from the Montreal Economic Institute considers that expanding the role of pharmacists in offering front-line services is a good way to improve patient access to care and reduce costs. However, it states that the recently adopted Bill 28 does not go far enough, offering remuneration for just 3 of the 7 new pharmaceutical consultations that government has authorized, in theory, since 2011. Pharmacists are not allowed to charge a fee for the other services.

Canada - Project Management and Practitioners in the Health Sector: From the Quebec Healthcare System Perspective to PM Literature Review

Authored by Quebec researchers, this article reviews 40 years of literature (1979-2017) on project management (PM) in both the health sector internationally and Quebec’s provincial healthcare system. The article describes the importance ascribed to health sector project management but finds a lack of emphasis on PM as a lever for healthcare service improvement. Most health sector PM research is not published by mainstream PM journals.

Canada - Evaluating the Collaborative Emergency Centre Experience in Nova Scotia

Nova Scotia’s eight Collaborative Emergency Centres (CECs) link together primary care teams, urgent care capacity, and Emergency Health Services (EHS). This provincial government report evaluates CECs to understand the model’s strengths and weaknesses, its impact on patient access to primary and emergency care, and the impact on providers working within CECs.

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.

Canada - Ontario Launches Home Care Plan to Improve Access and Expand Service

The new plan outlines how the government will transform how care is delivered at home and in the community. In addition to increasing nursing hours, key initiatives will include: Expanding supports for family caregivers; Giving clients and caregivers greater say in choosing a provider, and how and when that provider delivers services; Clear and consistent levels of home and community care services no matter where in the province a patient lives; Enhancing support for personal support workers; Providing greater choice for palliative and end-of-life care.

Canada - Consolidating mental health services in Québec: the 2005-2010 Mental Health Action Plan

The study published by the Health Reform Observer examines results of Québec's 2005-2010 Mental Health Action Plan, which aimed to consolidate medical services and community group services under a local needs-based approach. The author concludes that the plan did not achieve the desired results and required multiple adjustments.

Canada - Alberta Health Services continues to put patients first with new strategy

A new Alberta Health Services (AHS) strategy paper says patients and families must be welcomed as partners within their healthcare teams. The Patient First Strategy identifies priority actions needed to further embed the principles of patient and family-centred care within AHS in a consistent, standardized manner.

Canada - Canadians spent $28.8 billion on prescription drugs in 2014

This report from the Canadian Institute for Health Information reveals that while Canadians continued to save money on generic drugs last year, those savings were offset by increased spending on newer classes of biologic drugs. Decreased spending due to patent expiration was seen in five drug classes, including statins, PPIs, ACE inhibitors, SSRIs and drugs used in bipolar disorder and schizophrenia.

Canada - New study suggests that a family physician's decision to investigate symptoms suggestive of cancer could help explain international differences in cancer survival

This study by the International Cancer Benchmarking Partnership examined beliefs, behaviours and systems in primary care across six countries with similar healthcare systems, analysing responses from family physicians (FPs) on how they would manage patients presenting with symptoms suggestive of lung, colorectal or ovarian cancer. These responses were then correlated to one-year mortality rates from these cancers. Cancer Care Ontario researchers who participated in the study report that early investigation by FPs is reflected in mortality and that access to diagnostic tests by FPs may play a role in their decision to investigate symptoms.

Canada - Navigating the Evidence: Communicating Canadian Health Policy in the Media

Published by the University of Manitoba, this e-book is a compilation of newspaper commentaries published in 2014 by Canadian health policy experts. The Op-Eds highlight recent evidence on a wide range of topics, including population aging, healthcare sustainability, pharmaceutical policy, mental health, obesity, and the social determinants of health.

Canada - Patient partnership in quality improvement of healthcare services: Patients’ inputs and challenges faced

Researchers at the Université de Montréal’s teaching hospitals co-authored this patient engagement study looking at patient participation as members of clinical teams in hospital Continuous Quality Improvement Committees (CICs). The study highlights the contribution of patient CIC members to quality of care improvement and includes interviews with patient participants.

Canada - Policy Capacity for Health System Reform

This review analyzes dimensions of policy capacity that support effective policy making in health care. Examining the skills, competencies, and conditions required for productive policy results, the review notes that policy making is a social exchange process that requires organizational support for successful development.

Canada - New Wait Time Alliance Report Card reveals important lessons for next Health Accord

The Wait Time Alliance's (WTA) tenth national report card shows that, despite encouraging signs that wait times for the initial five areas identified in the 2004 Health Accord are being reduced, progress to reduce waits for care other medical procedures and treatments is spotty across the country.

Canada - A $4.9 Billion Decrease in Health Care Expenditure: The Ten-Year Impact of Improving Smoking, Alcohol, Diet and Physical Activity in Ontario

This report describes the proportion of Ontario adults at risk for four health behaviours: smoking, unhealthy alcohol consumption, poor diet and physical inactivity. It then estimates the impact of these behaviours and socioeconomic position on total healthcare costs, and, separately, costs for hospital care, community care and prescription drugs.

Canada - Impacts of Québec primary healthcare reforms on patients' experience of care, unmet needs, and use of services

Québec’s healthcare reforms in the early 2000s involved primary care reorganization. Based on surveys conducted in two regions of the province in 2005 and 2010, this study examines how the new organization impacted patients’ care experience, use of services, and unmet needs. Results showed slight improvements in care accessibility but no impact on continuity, care outcomes, service use and unmet needs.

Canada - New report reveals inequities in people’s health risks, care and outcomes based on their income

Health Quality Ontario has issued a health equity report showing that the province’s poorest people are more likely to have shorter lifespans and suffer from chronic conditions. Ontarians below the poverty line are twice as likely to have multiple chronic conditions and die up to five years earlier than richer residents.

Canada - Transformation through Value and Innovation: Revitalizing Health Care in Ontario

Produced by the Ontario Chamber of Commerce (OCC), this report calls for healthcare reform in the province that preserves the publically funded single-payer model but increasingly incorporates the private sector as a productive partner. The report includes three case studies of collaborations by Ontario’s public and private sector to improve healthcare value and innovation.

Canada – The Ontario Government Reports First Year Progress on Patients First Action Plan

On March 23, 2016, the Ontario Minister of Health and Long-Term Care released a report detailing results of efforts to give patients better and faster access to high-quality health services. Measures to improve access have included making hospital parking more affordable, supporting in vitro fertilization, funding nurse practitioners and selecting Ontario's first ever Patient Ombudsman.

Canada - Potential effects of rational prescribing on national health care spending More than half a billion dollars in annual savings

The objective of this study is to estimate the cost savings that could result from implementation of a rational prescribing model for drug classes that are equivalent in terms of efficacy, toxicity, and convenience. This study has found that, while looking at merely 4 classes of medications, the estimated annual savings is estimated at $521 million.

Canada - Policy Approaches to Reducing Health Inequalities

The National Collaborating Centre for Healthy Public Policy produced this briefing note to help actors more easily distinguish between broad approaches to reducing health inequalities. It illustrates the difference between social determinants of health and social determinants of health inequalities and helps to see what impact might be had with different strategies.

Canada - Increasing accessibility and quality of primary care through family medicine groups

Despite the support of stakeholders, the implementation of family medicine groups (FMGs) in Quebec has been slow. The number of registered patients has barely increased, and patients who are registered report better continuity of care, but not access to care. This report finds that the rushed nature of reform and slow computerization to enable electronic medical records that facilitate multidisciplinary care are, in part, responsible for poor implementation.

Canada - Ontario Launches $222 Million First Nations Health Action Plan

Ontario is launching a $222 Million First Nations Health Action Plan over the next three years to ensure that the province’s indigenous peoples have access to improved health outcomes and culturally appropriate care. The Action Plan includes additional funding of $104.5 million annually to address health inequities among Ontario First Nations.

Canada - Reducing Surgical Wait Times. The Case for Public Innovation and Provincial Leadership

British Columbia’s provincial government recently released a policy paper recommending the use of private for-profit facilities to reduce elective surgery wait times. This study provides a review of research on for-profit surgical delivery within public healthcare systems. It presents recommendations that build on best practices from the province of Saskatchewan, along with Scotland, which is recognized as a global leader in public sector wait-time solutions.

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.

Canada - Greater efficiencies realized in Ontario's cancer system

The Cancer Quality Council of Ontario has released findings from the 2016 Cancer System Quality Index (CSQI) that measures the performance of the province’s cancer system. The findings indicate that efficiencies, such as new cancer treatment centres, have begun improving patient outcomes and safety by enabling greater capacity in the system.

Canada - Taking seniors off antipsychotics shows dramatic improvement in care

A Canadian Foundation for Healthcare Improvement (CFHI) initiative to reduce antipsychotic use by seniors in long-term care (LTC) has shown dramatic results — far fewer falls, less aggression, and improved quality of life. Contrary to expectations, inappropriate behaviours decreased by over 50% in the sample of 416 LTC residents whose antipsychotic use was discontinued.

Canada - Potential of physician assistants to support primary care. Evaluating their introduction at 6 primary care and family medicine sites

This Manitoba study looks at strategies for introducing physician assistants (PAs) into primary care settings. The authors evaluated the roles of PAs at six sites and conducted focus groups with participating PAs and professional colleagues. Collaborative planning was found to help integrate PAs effectively into most primary care settings over a short period of time, with high acceptance from stakeholders.

Canada - Rolling-out Lean in the Saskatchewan Health Care System: Politics Derailing Policy

This paper examines the recent Lean management reform of Saskatchewan’s provincial healthcare system. Lean focuses on continuous improvement, employee engagement, and the elimination of waste. The paper says Saskatchewan’s reforms appear to have been derailed as key actors, and the public have challenged the goals and process of Lean methodology, as well as its costs.

Canada - Portrait of rural emergency departments in Québec and utilization of the provincial emergency department management Guide: cross sectional survey

Rural emergency departments (EDs) constitute crucial safety nets for the 20 % of Canadians who live in rural areas. Pilot data suggests that the province of Québec appears to provide more comprehensive access to services than do other provinces. A difference that may be attributable to provincial policy/guidelines “the provincial ED management Guide”. The aim of this study was to provide a detailed description of rural EDs in Québec and utilization of the provincial ED management Guide.

Canada - A 3-year study of high-cost users of health care

This study presents a 2009-2011 retrospective analysis of Ontario residents. It identifies the clinical diagnoses, demographic characteristics and costs of high-cost users of healthcare (users with the highest 5% of costs). Diagnoses included chronic diseases, infections, and palliative care. Most spending among high-cost users was for institutional care; costs were far more concentrated among children than older adults.

Canada - Depression now equal to high blood pressure as a top reason Canadians see physicians

In this news release, Morneau Shepell presents results of a recent survey on the prevalence and impact of depression in the workplace. Among the findings: half of managers believe they have employees with mental health issues; workplace engagement levels are strongly correlated with mental health issues; and the stigma around mental health issues remains apparent. The survey also finds that 63 per cent of physicians report the fastest increase in the number of their recent cases is from depression, anxiety disorders and stress-related issues.

Canada - Patients First: A Proposal to Strengthen Patient-Centred Health Care in Ontario

This discussion paper, published on December 17, 2015, by the Ontario Ministry of Health and Long-term Care, presents recommendations for addressing structural issues that create inequities and for truly integrating the healthcare system so that it provides the care patients need no matter where they live. The Ministry is inviting input on the proposal from patients and providers across the province. Feedback should be provided by February 29, 2016.

Canada - Comparison of Family Health Teams to Other Primary Care Models, 2004/05 to 2011/12

Produced by the Institute for Clinical Evaluative Sciences (ICES), this longitudinal analysis fills a longstanding knowledge gap by comparing outcomes of Family Health Team patients in relation to other Ontario primary care models over time. The report has been released in tandem with a paper addressing population variability in Ontario Community Health Centre (CHC) data.

Canada - Mapping the Journey—Success and Failure with Lean

Lean is an organizational management approach that supports the concept of continuous improvement. This briefing on the use of Lean in Canadian health care describes the tools, systems and principles involved, and outlines the challenges and rewards these brings to healthcare organizations. Examples from the recent Lean reorganization of the British Columbia Provincial Health Services Authority (PHSA) are highlighted.

Canada - A better basket of services. Brief submitted as part of a public consultation on public coverage of health and social services

This brief was produced as part of the public consultation launched in August 2015 by the Commissioner for health and well-being of Quebec (CEBS) regarding public coverage of health and social services. This consultation covers the basket of services covered by public health insurance to reflect changing needs of the population, changing technology and limited financial resources.

Canada - Integrating Long-Term Care into a Community-Based Continuum. Shifting from “Beds” to “Places”

The authors of this IRPP study argue that if more community support were available, the tipping point at which patients with greater care needs require residential long-term care would be higher, and people would be able to stay at home longer. Drawing on research in Ontario and overseas, the authors examine some promising community--based rural and urban initiatives. Through the lens of neo-institutional political theory, they analyze the hurdles encountered in attempting to scale up or replicate such initiatives.

Canada - Positive trends in antipsychotic use in LTC emerging: Initiatives to address inappropriate use showing success

Despite the known health risks of antipsychotics, 39% of residents in long-term care (LTC) facilities were prescribed an antipsychotic at least once in 2014. This is the finding of a new report released by the Canadian Institute for Health Information (CIHI) — Use of Antipsychotics Among Seniors Living in Long-Term Care Facilities, 2014 — that looks at the overall use of these drugs (including cases where use may be appropriate). Antipsychotics are often prescribed to seniors to treat symptoms of dementia, such as aggression and agitation, as well as schizophrenia and other psychoses, but they can have harmful side effects.

Canada - McMaster Health Forum launches revamped Health Systems Evidence

Health Systems Evidence (HSE) has recently improved its ability to support policymakers, stakeholders and researchers who want access the best available research evidence in a timely manner. The site now features a number of enhancements, including: responsive design to optimize the interface on both desktop and mobile; a more powerful open search function; a guided search option to help inexperienced users quickly find what they need; and the ability to save preferred searches, save retrieved documents and exports results.

Canada - New Brunswickers’ Experiences with Home Care

The New Brunswick Health Council (NBHC) is publishing the results of its most recent survey regarding home care services in New Brunswick. For the first time, comparisons can be made between survey results (2015 and 2012) to see if any improvements have been made. This year again, satisfaction remains high. In terms of the services received, 95.1% of respondents were satisfied with the Extra-Mural Program, and 88.7% indicated they were satisfied with services received from home care agencies or home support workers, results similar to those of 2012. However, unmet needs are a growing concern, as 14.5% of respondents have reported in 2015 that more could be done to help them stay at home (compared to 11.4% in 2012), such as more hours of service on weeknights or on weekends.

Canada - New Pilot Program Allows Saskatchewan Residents to View their Personal Health Care Information Online

eHealth Saskatchewan is piloting a program that allows residents to view their personal health information online through a secure website. The six-month trial Citizen Health Information Portal (CHIP) Pilot will allow 1,000 participants to view lab results and immunization, pharmacy and hospital visit history from anywhere in the world.

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.

Canada - A coherent basket of services

Une offre de services cohérente The INSPQ submitted this brief to the Québec Health and Welfare Commissioner consultation on the basket of publicly insured health and social services. Among its recommendations, the INSPQ considers that the discussion must promote the participation of professionals from different disciplines, aim to reduce health inequalities, and allow each intervention level to make decisions that reflect its needs.

Canada - Levels of care, quality norms and standards

Les niveaux de soins. Normes et standards de qualité The guide is now available on the Web site of the Institut national d’excellence en santé et en services sociaux (INESSS). This guide aims at supporting establishments and healthcare professionals in the adoption and the application of policies concerning levels of care which answer the proposed norms and standards. It is designed to promote the good use of the levels of care so that they always remain a shared clinical decision-making tool in varied contexts.

Canada - Ontario Needs New Conversation On Health

Ontario’s Chief Medical Officer of Health, Dr. Arlene King, stated on December 1, 2011, that Ontario needs a new conversation about health, and that very little of that conversation is about health care. She calls for a comprehensive plan that is geared towards health promotion and chronic disease and injury prevention.

Canada - Enhancing the Continuum of Care - Report of the Avoidable Hospitalization Advisory Panel

In September 2010, the Ontario Ministry of Health and Long-term Care convened an Avoidable Hospitalization (AH) Advisory Panel, with Dr. Ross Baker as the chair. Its mandate was to identify system-wide AH best practice guidance, inventory AH improvement practices and measures and produce an evaluation framework for AH initiatives. The full report is now available.

Canada - Primary Care Reform: Can Quebec’s Family Medicine Group Model Benefit from the Experience of Ontario’s Family Health Teams?

This paper published in Healthcare Policy analyzes the family medicine group (FMG) model's potential as a lever for improving health care system performance and discusses how it could be improved. It reviews the history of primary care in Quebec, presents the FMG model and discusses ways of advancing primary care services in Quebec using the family health team (FHT) model developed in Ontario.

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.

Canada - Doctors say lengthy surgical wait times driven by lack of operating room time and changes in patient case load

A lack of operating room time and changes in patient case loads are two of the most commonly reported factors behind increased wait times for medical care and surgical procedures, concludes a new report released recently by the Fraser Institute. The report, Why We Wait: Physician Opinions on Factors Affecting Health Care Wait Times, analyzes physicians’ responses to the Institute’s annual Waiting Your Turn survey on health care wait times and the reasons they gave for changes in their waiting lists.

Canada – British Columbia: Amendments allow nurse practitioners to fulfil expanded role

In October 2011, B.C.’s government introduced new rules allowing nurse practitioners to fully work within their scope of practice and act as primary care providers. These roles were not previously allowed under provincial law. The changes will provide British Columbians more options in medical care and improve access to a variety of health programs.

Canada - Recommendations to the New Brunswick Minister of Health. Moving towards a planned and citizen-centered publicly-funded provincial health care system

In 2010, the New Brunswick Health Council (NBHC) solicited New Brunswickers’ views on their health care system. After measuring health care performance and input from citizens and stakeholders, the NHBC has now released a report that calls for an integrated citizen-centered health care system for the province. The report calls on all stakeholders to assume their full responsibilities.

Canada - Impact of remuneration and organizational factors on completing preventive manoeuvres in primary care practices

This study, published in the Canadian Medical Association Journal compares the delivery of preventive services by practices in four primary care funding models and identifies organizational factors associated with superior preventive care.

Canada - Beyond the Hospital Walls. Activity Based Funding Versus Integrated Health Care Reform

Released in January 2012 by the Canadian Centre for Policy Alternatives, this study raises concerns about Activity-Based Funding (ABF), a health care funding model introduced in British Columbia that pays hospitals based on the number of surgeries performed. The study argues that ABF’s narrow focus does not address the need to control overall hospital costs while improving patient care.

Canada - Charting the course. Designing British Columbia’s health care system for the next 25 years

This report is the British Columbia Medical Association (BCMA)’s submission to the Select Standing Committee on Health of BC. The report presents data that will help the Committee identify new strategies to respond to the needs of an aging population. It includes statistics, survey results and recommendations.

Canada - Ontario is launching an Action Plan to transform the health care system and deal with the demographic challenges as well as the province's deficit

The Action Plan for Health Care in Ontario will ensure families get the best health care where and when they need it, while ensuring all Ontarians get better value for their health dollars. The Plan will : make the necessary and responsible decisions regarding funding priorities and ensure funding is shifted to where we get the best value; provide new measures to prevent illness in the first place and to help Ontarians stay healthy; give Ontarians better access to family doctors and nurse practitioners — through after hours care and same-day and next-day appointments — that will save Ontarians time, keep them healthier, and help them avoid trips to hospital; support Ontario’s seniors who want to live independently at home, in their communities, by providing more home care supports.

Canada – Baskets of services: comparative analysis of the management mechanisms

Management of the basket of services promises efficiency gains by rationalizing decisions around coverage and care. This literature review by Joanne Castonguay at CIRANO examines how the basket of services is managed in a sample of OECD countries. The exercise allowed the author to make a number of observations, to see how management of the basket of services in Quebec compares to other countries and to suggest ways that management could be improved.

Canada - Provincial and Territorial Health System Priorities: An Environmental Scan

With the approaching expiry of the 10-Year Plan to Strengthen Health Care (2004), the Canadian Health Services Research Foundation (CHSRF) undertook an environmental scan to explore the shared values and principles, goals and key health policy issues across provinces and territories. The authors examined strategic planning documents and consulted with senior policy-makers across provinces and territories in ministries of health, intergovernmental affairs and finance. This summary presents key findings from the framework analysis and face-to-face meetings.

Canada — Family medicine group implemented in Québec: potential and limits to improve healthcare performance

L’implantation du modèle des groupes de médecine de famille au Québec : potentiel et limites pour l’accroissement de la performance des soins de santé primaires The aim of this article is to analyze the potential of the FMG model to be a lever for improving the health system performance as well as to discuss potential improvement for this model.

Canada — Canadians See "Moral Imperative" to Fix Health Care System

The Canadian Medical Association (CMA) has recently released the report on the National Dialogue on Health Care Transformation with Canadians. The report shows clearly that, while the public recognizes that the system does not work as well as it should, there remains a strong national commitment to transform the system so that it can deliver timely, compassionate and efficient care in the appropriate setting.

Canada – Ontario : 2011 Quality Monitor Released

Health Quality Ontario’s sixth annual report on Ontario’s health system, and first as HQO, identifies significant achievements and challenges in areas such as access to healthcare, chronic disease management and keeping the population healthy. Overall, despite progress across a wide range of indicators, there is room for further improvement.

Canada — Royal College to examine Quebec duty hour decision in national context

As Quebec hospitals begin adapting schedules to abide by an arbitration decision quashing 24-hour shifts, the Royal College is undertaking a new study to help set pan-Canadian duty hours standards. The project, which is already underway, will now also examine the broader implications of the arbitrator’s decision. In a landmark ruling issued June 8, 2011, an arbitrator ruled that 24-hour shifts violated resident rights under the Canadian Charter of Rights and Freedoms.

Canada - Return on Investment: Mental Health Promotion and Mental Illness Prevention

The Canadian Population Health Initiative (CPHI) of the Canadian Institute for Health Information (CIHI) commissioned the Canadian Policy Network at the University of Western Ontario to complete a scoping study that examines the return on investment and cost effectiveness of mental health promotion. It found that there is research showing a return on investment for some mental health promotion/illness prevention interventions, especially those targeting children and youth.

Canada - National health spending crunch the result of public insurance programs, not drug costs according to The Fraser Institute

This report released September 26, 2011, measures how all types of drug spending affect total government health care costs. It finds that prescription drugs consumed only 9.0 per cent of total government health spending in 2010, a percentage that has remained virtually unchanged since 2003. Patented prescription drugs accounted for only 5.2 per cent of total government health spending. Co-author Mark Rovere concludes that even if governments spent nothing on drugs, the cost of all other medical goods and services would still be unsustainable.

Did changing primary care delivery models change performance? A population based study using health administrative data

Brief analytical summaries or syntheses #24 Did changing primary care delivery models change performance? A population based study using health administrative data Summary Primary care reform in Ontario started with the introduction of new enrolment models, the two largest of which are Family Health Networks (FHNs), a capitation-based model, and Family Health Groups (FHGs), a blended fee-for-service model. The purpose of this study was to evaluate differences in performance between FHNs and FHGs and to compare performance before and after physicians joined these new primary care groups. Background It has been increasingly recognized that health care systems with a strong primary care component are more efficient and better able to handle current and future health care pressures. This has led to several primary care reform strategies in the U.K., Australia, the U.S. and Canada. Common to all of these reform strategies is a movement away from providing service based on…

Canada - McGuinty Government Releases e-Health Progress Report

The 2011 eHealth Progress Report, released August 19, showed that more than 7,000 doctors, who care for 6.5 million Ontarians, now manage their patients' health information with an electronic medical record — more than any other province. The report points to significant cost and wait-time savings as well as better safety resulting from the use of electronic health records.

Canada - Health care should include patient charter, complaint mechanism: CMA report card

The Canadian Medical Association (CMA) released its 11th Annual National Report Card on Health Care at its annual meeting on August 22, 2011. Based on a national survey of over 2,000 Canadian adults, its main message was that patients want accountability to become the watchword for the health care system. Guarantees, redress and better federal/provincial/territorial cooperation were important to a great majority of respondents.

Canada - Performance-Based Healthcare: How Hospitals Can Leverage Business Intelligence and Information Management to Meet Ontario's Healthcare Reforms

This paper by three consultants with IBM Global Business Services in Volume 10, Number 2 of Electronic Healthcare recognizes that hospitals are at different stages of readiness in information management to align their practice with Excellent Care for All Act quality legislation. It identifies eight key business intelligence dimensions that can help hospitals advance their information management and quality improvement agendas.

Canada - Will Paying the Piper Change the Tune?

This article, published in Volume 6 Number 4 of Healthcare Policy, questions the rapid push to adopt activity-based funding (ABF) models in Canadian hospitals. Co-authored by Jason Sutherland, Morris Barer, Robert Evans and Trafford Crump, the paper examines the objectives, the mechanisms of action, experiences elsewhere and implementation challenges with ABF.

Canada - More surgeries, more beds improve access to health care in Alberta. First 5-Year Health Action Plan update shows steady progress

A progress update on Alberta’s 5-Year Health Action Plan was released. The update reports the successful completion of 18 actions by June 2011 and outlines strategies to further improve the province’s health system. Achievements include cutting wait times, increasing numbers of surgeries and hospital beds, establishing coordinated cancer care, and expanding the eHealth platform

Canada- Social Systems Evidence provides policymakers and stakeholders with better access to research evidence

Funded by McMaster University, Social Systems Evidence (SSE) is a new website that provides a repository of research syntheses concerning government programs, services and products in the areas of community and social services, culture, gender, economic development, education, and transportation.

Canada - Office of Health System Renewal being established in New Brunswick

On April 26, 2012, the Minister of Health announced the creation of a new Office of Health System Renewal to provide focused leadership and accelerate efforts to build a sustainable healthcare system in New Brunswick. Initial priorities include an organizational review leading to management efficiencies, a review of shared services and the identification and implementation of health innovations and best practices.

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.

Canada - Little change in wait times for Canadians

A new analysis from the Canadian Institute for Health Information (CIHI) reveals that about 8 out of 10 Canadians receive priority-area procedures within the medically recommended time frames. Nationally, 97% of patients receive radiation therapy within the recommended four weeks, 82% of patients receive hip replacement surgery within recommended time frames, as do 75% of patients receiving knee replacement surgery. The wait times are generally similar to last year’s, though some provinces are seeing longer waits for certain procedures.

Canada - A new report from the Parkland Institute says that supporting private health facilities with public health dollars costs more, damages the public system, and puts tax dollars and patient care at risk

The Parkland Institute is a non-partisan public policy research institute in the Faculty of Arts at the University of Alberta. It prepared this case study of Calgary’s failed Health Resources Centre, a private surgery facility, to assess the actual costs and benefits of contracting private clinics to perform surgeries at public expense.

Canada - B.C. celebrates innovation in health care

On April 4, 2012, the government British Columbia announced the launch of the B.C. Innovation and Change Agenda. It includes the introduction of innovative healthcare delivery strategies in four categories: innovation and efficiency, health promotion and disease prevention, primary and community care, and acute hospital care.

Canada – Nova Scotia Releases Physician Resource Plan

On May 9, 2012, Nova Scotia released its plan to improve planning and management of the province's physician and healthcare workforce. The plan is part of a commitment to provide timely care by improving access to health care, especially in smaller communities.

Canada - How Many Patients Should a Family Physician Have? Factors to Consider in Answering a Deceptively Simple Question

The authors of this study, published in Healthcare Policy, argue that before practice size can be used as an accountability measure for individual physicians in primary care, its relationship to quality and outcomes at individual and population levels, as well as the contextual factors that affect it, must be better understood.

Canada - The Economic Impact of Improvements in Primary Healthcare Performance

This report from the Canadian Health Services Research Foundation presents the results of four different approaches to evaluate the economic impact of enhancements to primary health care (PHC). These include a synthesis of the literature on the macro- and micro-economic effects of good health; a systematic review of the economic impact of incorporating a pharmacist into a PHC practice; a simulation exercise that evaluates the economic impact of improvements to influenza immunization rates for older adults; and a literature review of reductions in burden of illness associated with four specific enhancements to chronic disease management.

Canada – Evaluating the Potential Socio-Economic Impact of Personalized Medicine

This study by researchers at CIRANO for Genome Québec seeks to provide a methodology with which to evaluate the potential socio-economic impact of personalized medicines. The methodology is demonstrated on two applications of genomic technology.

Canada - Activity-Based Hospital Funding: We've Waited Long Enough

In Quebec, expressed interest in implementing activity-based funding is receiving consideration by the Ministère de la Santé et des Services sociaux. This economic note from the Montreal Economic Institute looks at the history of activity-based funding and its application and results in different countries. It also highlights particular aspects of Quebec’s healthcare system that may render implementation more difficult.

Canada - Manitoba’s Plan to Protect Universal Health Care

This report from the Government of Manitoba, entitled Focused on What Matters Most, looks at the province’s achievements over the past few decades on assuring quality cost-effective health care, and plots the path ahead. It is summed up by the following equation: healthier Manitobans + better health services + better value = sustainable health care.

Canada - Patient Centred Community Designed Team Delivered. A framework for achieving a high performing primary health care system in Saskatchewan

This Government of Saskatchewan document synthesizes the healthcare perspectives of over 400 community leaders, patients, providers, policy-makers and managers. It outlines shared visions for a sustainable primary healthcare system providing a superior patient experience and improved outcomes.

Canada - Contexts and Models in Primary Healthcare and their Impact on Interprofessional Relationships

This report, published by the Canadian Health Services Research Foundation (CHSRF), examines Alberta’s experience in the development of Primary Care Networks (PCNs) over the period 2007 to 2011. Researchers used a comparative case study approach to describe how contextual influences act together with the different characteristics of the primary health care models in Alberta to influence outcomes, with a particular emphasis on the role of inter-professional relationships.

Canada - New CIHI online resource shows hospital performance improving

New resource at that looks at clinical and financial performance in acute care hospitals shows that hospitals saw fewer deaths after major surgery, heart attack and stroke; fewer readmissions after heart attack, stroke, and hip and knee surgery; and fewer cases of in-hospital hip fracture in 2010 than in 2007. This resource, a part of the Canadian Hospital Reporting Project at the Canadian Institute for Health Information (CIHI), provides a series of 21 clinical indicators (with risk-adjusted rates) and 9 financial indicators that allows hospitals to compare their performance against those of their peers and to learn from leading practices.

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.

Canada - Public Services For Ontarians: A Path To Sustainability And Excellence

This publication from the Ontario Minister of Finance provides a detailed proposal for reducing Ontario’s budget deficit. The authors assessed the 2011 Budget Scenario for the next seven years. It then developed a Status Quo Scenario on how the province’s finances would unfold if no changes were made now and projected that the deficit would more than double in 2017–18. The authors then drew up a Preferred Scenario to see the budget balanced by 2017-18, relying on spending cuts as no new taxes were permitted in the exercise. Health care reforms figure prominently in the cuts needed for the Preferred Scenario.

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 - Moving To Patient-Based Funding Will Improve Care in Ontario

On March 19, 2012, the Ontario government announced a new funding model that will see hospitals funded based on how many patients they see, the services they deliver and the quality of those services. Anticipated results include shorter wait times and better access, more services and better quality care with less variation between hospitals.

Canada - Productivity of healthcare logistics activities

La productivité des activités de logistique hospitalière Logistical activities such as purchasing, inventory management and replenishment of goods and services required for the delivery of medical services can represent up to 46% of hospital spending. This report published (in French only) by the Centre for Productivity and Prosperity takes stock of current best practices and offers solutions to improve performance in Quebec.

Canada - Roadblocks to Reform: Beyond the Usual Suspects

This paper from the Centre for Health Economics and Policy Analysis (CHEPA) looks at the failure of healthcare system reform in 20 countries. Three main explanations have been offered for why such reforms are so difficult: institutional gridlock, path dependency, and societal preferences. This paper focuses on the role of societal preferences as a plausible cause for opposition to reform.

Canada – Medical tourism. What Role for the State?

Tourisme médical : quel rôle pour l’État? A root canal in Argentina, a knee operation in Thailand and plastic surgery in Morocco: these options are attracting more and more people from developed countries. This report by an anthropologist at Laboratoire d’étude sur les politiques publiques et la mondialisation (LEPPM at ENAP) discusses the phenomenon of medical tourism and the issues and challenges it raises. It discusses the effects of medical tourism on patients, on the patient’s country of origin and on the care provider’s health system.

Canada - Comparison of Primary Care Models in Ontario by Demographics, Case Mix and Emergency Department Use, 2008/09 to 2009/10

This study by the Institute for Clinical Evaluative Sciences (ICES) compares primary care models and concludes that Ontario’s Community Health Centres (CHCs) are the most effective way to keep Ontarians out of hospital ERs. The study finds that CHC clients visited ERs 21% less often than patients in other primary care models, and that CHCs connect services to poorer populations who face barriers to accessing primary care.

Canada – Presentation from the International Health Observatory’s seminar now available on line

Since its creation in 2009, the International observatory on health and social services (OISSS) has hosted three international seminars, and has just made the presentations available on line. Also available are videos from the most recent seminar, held in December 2011, entitled How do health organizations succeed in increasing their performance? The OISSS’s mission is to analyze health and social service systems in various countries, provinces or regions, tracking developments, changes and trends in order to promote knowledge and align research and decision-making.

Canada - Lean in British Columbia’s Health Sector. Annual Report 2010–11

Published in September 2011 by the British Columbia Ministry of Health, this annual report presents seven case studies of Lean process redesign work carried out by B.C. health authorities in 2010-11. In the health sector, Lean is a patient-focused approach that systematically eliminates waste in health care organizational processes in order to improve quality, productivity, and efficiency.

Canada - Perinatal and early childhood health. More appropriate care and services in a timely manner

Périnatalité et petite enfance : Pour des soins et services mieux adaptés en temps opportun This report presents the Commissioner for health and well-being of Québec’s long-term vision of perinatal and early childhood health in Quebec. This view of the health and social services system’s performance follows on two prior efforts by the Commissioner, in 2009 and 2010, to deal with primary care and then chronic diseases. The Commissioner’s analysis of different indicators, review of the literature and consultations revealed a need to better support parents and stakeholders in the societal project that is raising children. The Commissioner recommends the creation of a dedicated website, supported by the Ministère de la Santé et des Services sociaux, that would assemble validated information on the perinatal and early childhood period, and make it easily accessible.

Canada - Population Health and Health System Reform: Needs-Based Funding for Health Services in Five Provinces

This essay explores the introduction of population-needs-based funding (PNBF) formulae for the provision of health care services in five provinces (Newfoundland and Labrador, Quebec, Ontario, Saskatchewan and Alberta) as part of a larger project examining a range of health reform decisions in those provinces.

Canada - B.C. commits to a family doctor for everyone by 2015

The Province’s ongoing overhaul of its primary health-care system is reinforced by a $137-million investment to improve service delivery, ensure patients are full participants in their care and provide every British Columbian who wants a family doctor with one by 2015.

Canada - Wait Time Hot Spots Highlight Work to be Done

A Wait Time Alliance (WTA) report card released recently reveals troubling wait time hot spots in the five clinical areas deemed priorities by governments and more problems across a broader range of medical care. The WTA’s fifth annual report card — entitled No Time for Complacency highlights the fact that much more work remains to be done to cut down waiting times — grades provinces on wait times in the initial five priority areas set by governments in 2004 and across additional areas of specialty care.

Canada – Quality Monitor. Ontario Health Quality Council. 2010 report on Ontario’s health System

The report shows that although there have been some modest improvements in quality across Ontario’s health system, there is room for more improvement. There are examples of higher performance that could be applied more broadly. The top-line findings underscore areas of concern that are of critical importance: wait times; the accuracy and completeness of medical information; chronic disease management; access to primary care; and patient safety.

Canada - Charting a Path to Sustainable Health Care in Ontario. Tenproposals to restrain cost growth without compromising quality of care

Urgent action is required to place Ontario’s health care system on more sustainable ground according to a new report by TD Economics. The report’s ten recommendations, which were submitted to Ontario’s Ministry of Health, represent significant change from the current system. Combined, they should help keep healthcare spending in line with the projected provincial growth rate of four percent.

Canada - Ontario is lowering emergency room waiting time by expanding the Pay for Results program that has already helped hospitals across the province make significant wait time improvements

Since 2008, the province's Pay for Results program has helped participating hospitals lower overall waiting time by 4.7 hours (28%) for patients who require complex medical care or admission to hospital, and by 1.4 hours (22%) for patients with minor conditions. The program helps hospitals implement initiatives like patient flow tracking systems, which improve discharge and admission processes, or hiring nurse practitioners to treat patients with less complex conditions. This year, through a $100 million investment, the government is expanding the Pay for Results program to an additional 25 hospitals across the province, bringing the total number of participating hospitals to 71.

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.

Canada – Fatal Flaws: Assessing Quebec’s Failed Health Deductible Proposal

Quebec’s government recently withdrew its proposal to impose a form of user fees for health care. In a new C.D. Howe Institute Working Paper, “Fatal Flaws: Assessing Quebec’s Failed Health Deductible Proposal,” health policy experts Mark Stabile, C.D. Howe Fellow-in-Residence and Associate Professor at the Rotman School of Management, and Sevil N-Marandi, a graduate of the School of Public Policy at the University of Toronto, assess Quebec’s failed proposal. Their recommendations lay out how future reforms in other provinces or in Quebec might be made more likely to succeed.

Canada - Manitoba Provincial Health Ethics Network Launches Website

The new Manitoba Provincial Health Ethics Network (MB-PHEN) recently launched its Website, a portal for health care providers to link to health ethics resources and strategies in Manitoba and beyond. MB-PHEN was created in 2009 as a collaboration of Manitoba RHAs.

Canada – New Brunswick: First team begins work under province’s new Family Medicine model

A group of four doctors in Oromocto, New Brunswick has become the first team organized under the province’s new family medicine model. The new model aims to improve patient access and increase electronic collaboration between physicians. Participating doctors will work in teams in order to improve service to their patients, including after hours.

Canada – The health-care system achieves a reasonable balance of treatment quality, cost and health outcomes, but reforms are needed to contain expenditures pressures according to the OECD

The growth of public health spending must be reduced from an annual rate of about 8% seen over the last decade toward the trend rate of growth of nominal income in coming years (estimated to be less than 4% per year), the only alternative being to squeeze other public spending or to raise taxes or user charges. Regulation currently prohibiting private insurance for core services and mixed public-private contracts for doctors should be removed to spur more efficient service delivery and expanded capacity by way of private entry. Pharmaceuticals, home and therapeutic care should be integrated into the core public package. Revenues could be raised and excess demand curbed by carrying out some sort of capped patient co-payments and deductibles.

Canada - National pharmacare plan could save up to $10.7 billion a year: study

A universal public pharmacare plan could generate savings of up to $10.7 billion on prescription drugs, says a new study released recently by the Canadian Centre for Policy Alternatives (CCPA) and Institut de recherche et d’informations socio-economiques (IRIS). The study finds Canadians could save between 10% and 42%—up to $10.7 billion—of total drug expenditures, depending on the choice of industrial policies related to drug costs.

Canada - Your Alberta Health Act. Putting People First. Consultation report available

On September 15, government received the final report prepared by MLA Fred Horne and an eight-member advisory committee on the four-month long consultation on the Alberta Health Act. The report is now available. The report is in two parts: Part One, Putting People First – Recommendations for an Alberta Health Act – contains 15 recommendations intended to provide input on developing a new Alberta Health Act; and, Part Two, Putting People First – A Summary of Views – a comprehensive summary of the input provided by Albertans through the consultation process. The report and recommendations are now being reviewed and a formal government response is expected in October.

Canada - Effective Governance for Quality and Safety

Commissioned by the Canadian Health Services Research Foundation in partnership with the Canadian Patient Safety Institute, this report, prepared by a team of researchers led by Ross Baker, explores the structures, processes and tools used by effective governing boards of healthcare organizations, and the strategies and tactics that can be employed by boards in their efforts to improve governance for quality and patient safety. The report also offers recommendations for board members and executives of healthcare organizations and for policy makers.

Canada - Alberta: Quality and Patient Safety Dashboard Indicators

Alberta Health Services announced a new “dashboard” of measurements designed to gauge its performance and drive improvement throughout the health system. The Quality and Patient Safety Dashboard will measure 26 quality- and safety-related indicators and identify potential areas for improvement. The Alberta Health Services Board, through its Quality and Safety Committee, will monitor the dashboard on a regular basis. About half of the dashboard indicators will be reported in 2010, with the remainder reported by 2013, as some indicators require the implementation of a program or data collection processes.

Canada - A Foundation for Alberta’s Health System. Report of the Minister’s Advisory Committee on Health. A New Legislative Framework For Health

This report by the Minister’s Advisory Committee on Health presents a new focus and architecture for health care legislation in Alberta that will reframe the way Albertans, health policy makers and the health system view health and health care in the years ahead. The report defines a new context for Alberta’s health system. It will shape the system in ways that ensure the health needs of Albertans are served by using best available evidence and removing barriers to putting people and families at the centre of their health care.

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.

Canada - Health Care Funding: Needs and Reality

There is no shortage of flashing red lights on health care funding by Ottawa and the provinces, as Antonia Maioni notes in this overview of the health issue. First, the 0-year, $41-billion federal transfer to the provinces is up for renewal in 2014, with no indication of where the money will come from. Then, an aging population will make increasing demands on a system that already consumes more than 10 percent of GDP. In the provinces, British Columbia and Ontario have introduced health care premiums, while Quebec, in its 2010 budget, brings on a health care head tax that will rise to $200 per taxpayer in 2012, as well as a $25 user fee for doctors’ visits, which, she writes: “is contrary to the spirit of the Canada Health Act.”

Canada - Consultation begins on Alberta Health Act

Consultation on new Alberta health legislation is underway and Albertans are urged to provide their ideas on recommendations for the forthcoming Alberta Health Act.

Canada - Improving Access to Health Care by Enhancing Pharmacists' Prescribing Authority in Saskatchewan

Health Minister Don McMorris recently announced the intent to expand prescribing authority for Saskatchewan pharmacists. Expected to take effect by summer, the amendments will authorize pharmacists to provide services such as extending refills during a physician's absence and providing emergency supplies of prescribed medications.

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 - Best Advice Guide: Social Determinants of Health

Many general practitioners (GPs) recognize it is difficult to treat health concerns without addressing underlying social conditions that can lead to poor health. This practical guide for family physicians provides concrete steps on how to consider and improve patients’ social determinants of health (SDoH). The guide provides suggested clinical, community, and population-level interventions.

Canada - Investing in Prevention Leads to Better Health

A strengthened provincial strategy and investment in prevention can improve the health of British Columbians and potentially avoid up to $2 billion in yearly health-care costs, according to a report released recently by provincial health officer Dr. Perry Kendall. The report, Investing in Prevention, found that focused prevention activities and a provincial, population-based, healthy-living strategy could: reduce the burden of disease on families and communities, delay the need for health-care services and reduce the impact of disease, disability and premature death on the economy.

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 — To relieve the congestion of the health system - The Ordre des pharmaciens du Québec calls for legislative changes by the end of 2011

The Ordre des pharmaciens du Québec has submitted a proposal to the Ministère de la Santé et des Services sociaux to enable pharmacists to contribute more effectively to the health system. The proposed changes will require legislative amendments, however, so the Order is calling for a bill to be passed. The proposed changes would enable pharmacists to : 1. Extend some prescriptions in accordance with precise criteria, in stable clinical situations; 2. Adapt a prescription when necessary, for example, based on the patient's weight or allergies; 3. Help resolve simple health problems like cold sores and seasonal allergies; 4. Order certain laboratory tests, for example, to monitor the safety of a course of treatment (e.g., kidney function); 5. Administer certain medications for the purpose of teaching patients how to do it (e.g., asthma inhalers) or meeting public health objectives.

Canada — Primary health-care consultation begins in New Brunswick

New Brunswickers are being asked by the provincial government for their opinions about how to improve primary health care in New Brunswick. Health Minister Madeleine Dubé released recently a discussion paper, Improving Access and Delivery of Primary Health Care Services in New Brunswick, which makes 12 recommendations to improve primary health-care services.

Canada - Accepting new patients: What does the public think about Ontario’s policy?

The aim of this study is to gauge the public’s opinion of the College of Physicians and Surgeons of Ontario’s (CPSO’s) policy on how primary care physicians should accept new patients.

Canada — Neat, Plausible, and Wrong: The Myth of Health Care Unsustainability

A new report on health care financing demonstrates that the widely repeated concern about the sustainability of public health care is unsubstantiated. Despite comments by Prime Ministers, Premiers, bank presidents and newspaper reporters suggesting that we are in a public health care financing crisis, the facts show that Medicare and public sector health care spending in general has grown little over the last 30 years and shows no signs of rapid future growth. The report, “Neat, Plausible and Wrong”, was released recently by Canadian Doctors for Medicare (CDM) and draws on the full range of health care statistics to put the myth to rest.

Canada — Province Launches eChart Manitoba

Manitoba’s electronic health-record system, known as eChart Manitoba, was launched recently by Health Minister Theresa Oswald at Kildonan Medical Centre, the first site to implement the new system. EChart Manitoba is a tool for authorized health-care providers to view key information about a patient such as dispensed medications, immunization and laboratory test results.

Canada - Fostering development of nursing practices to support integrated care when implementing integrated care pathways: what levers to use?

The role of nurses in care integration is a particular focus of health system reform. In this study at a Québec health and social services centre (HSSC), researchers interviewed 37 nurses and managers to identify strategies that support nursing practices aligned with care integration requirements. Findings suggest that clinical and organizational processes should be reconceived along with organizational resources and structures.

Canada — New mental health action plan for New Brunswick

The provincial government’s new action plan for mental health puts patients at the centre of treatment; includes new targets; and incorporates a plan to increase access to specialized services across New Brunswick. The action plan follows the 2009 report of the New Brunswick Mental Health Task Force, Together into the future: a transformed mental-health-system for New Brunswick.

Canada — Ontario is consolidating the former Ontario Health Quality Council and five other health care organizations into Health Quality Ontario

Under the Excellent Care for All Act, the Ontario Health Quality Council is now Health Quality Ontario which has an expanded mandate to: recommend and help health care providers adopt evidence-based standards of care and best practices; and monitor and report on quality improvement efforts across health care sectors.

Canada - Lessons learned from the deployment of Lean management in Québec’s health and social service establishments

Leçons apprises d’un déploiement de l’approche Lean dans des établissements de santé et de services sociaux au Québec Between 2012 and 2016, the Québec Ministry of Health and Social Services carried out a program aimed at supporting an accelerated deployment of the Lean management approach adapted to health and social services. Nineteen institutions with various vocations took part in this process. This article describes lessons learned from this experiment.

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 — The Response of Ontario Primary Care Physicians to Pay-for-Performance Incentives

Beginning in 1999, Ontario introduced pay-for-performance incentives for selected preventive primary care services and defined sets of other services provided by family physicians, with the goal of improving the quality of patient care. These performance incentives were considerably expanded in 2004. At the request of the Ministry and as part of the collaborative research program between the Ontario Ministry of Health and Long-Term Care (MOHLTC) and the Centre for Health Economics and Policy Analysis (CHEPA), CHEPA researchers undertook an evaluation of the effect of performance incentives on service provision in Ontario. This report presents the results of that evaluation.

Canada - B.C. plan focuses on healthy minds, healthy people

The Province of British Columbia recently released a ten-year plan to address mental health and substance use with a focus on prevention of problems, early intervention, treatment and sustainability. Entitled Healthy Minds, Healthy People, the cross-ministry plan reflects both extensive public and stakeholder consultation and evidence-based research and practice.

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.

Canada - A Provincial Cancer Control Policy Framework for Newfoundland and Labrador

Following a significant investment of over $125 million in cancer prevention and treatment over the last seven years, the Williams Government recently released a provincial cancer control strategy entitled Gaining Ground: A Provincial Cancer Control Policy Framework for Newfoundland and Labrador. The goal of the strategy is to reduce the incidence and impact of cancer and to improve the quality of life of those living with cancer in Newfoundland and Labrador.

Canada - Primary Care Economics

The authors of this paper provide an analysis of the economic landscape of primary care in Alberta and a discussion of the proposed reforms in terms of ends and means.

Canada – Leveraging Information Technologies to Transform and Sustain British Columbia’s Health Care Sector

This paper provides a forward-thinking perspective on the role information technology could play in British Columbia’s (BC) health care system by 2020. It also covers the impact it could have on BC’s economic development in relation to Outlook 2020, an initiative of The Business Council of British Columbia.

Canada — Government accepts "Putting People First" recommendations: Alberta Health Act to be introduced during fall session

On behalf of the Government of Alberta, Health and Wellness Minister Gene Zwozdesky accepted all 15 recommendations contained in the Alberta Health Act consultation report, with which was presented in September. He also confirmed that he will introduce a proposed Alberta Health Act during the fall legislative session as the first phase in implementing all of the report’s recommendations.

Canada – ER Advisor Recommends Improvements to Emergency Health Care in Nova Scotia

Dr. Ross's report includes 26 recommendations to : create same-or next-day access to primary care by creating collaborative health care teams, explore more innovative ways to pay physicians, make hospital funding models outcome and performance-based, enhance the role and scope of work for all health care professionals, adopt and implement emergency care standards, enhance the roles of paramedics and HealthLink 811, change the way hospitals provide services to seniors, and enhance access to mental health services.

Canada - First steps toward a family doctor for every Manitoban by 2015

Manitoba will introduce nurse-practitioner-led quick-care clinics and mobile clinics while expanding the successful Advanced Access care model as the first steps toward ensuring every Manitoban who wants a family doctor has one by 2015, Premier Greg Selinger announced recently. Manitoba’s plan will not only focus on introducing more doctors and nurses into the system but also on innovations to help front-line providers see more patients faster.

Canada - Bold new approaches needed to prevent Ontarians overwhelming the hospital system by 2020

A new report released recently by the Ontario College of Family Physicians (OCFP) urgently calls for more emphasis to be put on family medicine and the primary care sector in order to provide Ontarians with what they need and want when it comes to their healthcare, and to prevent them from overwhelming Ontario's hospitals and emergency departments by 2020. The report, called "Vision 2020: Raising the Bar in Family Medicine and Ontario's Primary Care Sector" is supported by a survey conducted by Harris-Decima for the Ontario College of Family Physicians.

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…

Nurses in advanced roles: a description and evaluation of experiences in 12 developed countries

Brief analytical summaries or syntheses #1 Nurses in advanced roles a description and evaluation of experiences in 12 developed countries Summary This health working paper from the OECD Directorate for Employment, Labour and Social Affairs looks at the development of advanced practice nurses in 12 countries Australia, Belgium, Canada, Cyprus, Czech Republic, Finland, France, Ireland, Japan, Poland, United Kingdom and United States. Many countries are seeking to improve healthcare delivery by reviewing the roles of health professionals, including nurses. Developing new and more advanced roles for nurses could improve access to care in situations of limited or diminishing supply of doctors. The redefinition of roles might also contain costs by delegating some of the tasks currently accomplished by expensive doctors to nurses, especially in primary care. The paper also assesses how the reorganization of work impacts the quality of patient care. Background Advanced nursing roles vary significantly between countries. The…

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 - Improving Rural And Northern Health Care. The Ontario Government Seeking Input To Address Unique Health Care Challenges

Ontarians are being asked for their feedback on how to provide the best access to quality health care services in rural and northern areas of the province. Specifically, Ontarians are invited to respond to recommendations made by the Rural and Northern Health Care Panel. There are a number of ways that the public can make its views known - including online, by phone and in-person at roundtable discussions in rural communities across the province.

Canada - Supporting primary health care nurse practitioners’ transition to practice

The aim of this article is to examine role transition and support requirements for nurse practitioner (NP) graduates in their first year of practice from the perspectives of the NPs and co participants familiar with the NPs’ practices; and to make recommendations for practice, education, and policy.

Canada – Nova Scotia’s Personal Health Information Legislation Introduced

Nova Scotians' personal health information will be better protected with a Personal Health Information Act introduced recently, Nov. 9. The act will provide consistent rules for the management of personal health information. Nova Scotia joins eight other provinces that have comprehensive legislation to manage personal health information. The legislation sets out rules on how information is collected, used, disclosed, retained, and destroyed by the health-care sector in Nova Scotia.